Abstract:
BACKGROUND:Extracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes, and the second leading cause of stroke in patients younger than 45 years of age. Antithrombotic agents (heparin, oral anticoagulants or antiplatelet drugs) may prevent arterial thrombosis in eICAD, but these benefits may be offset by increased bleeding. OBJECTIVES:To determine whether antithrombotic drugs (antiplatelet drugs, anticoagulation) are effective and safe in treatment of patients with extracranial internal carotid artery dissection, and which is the better treatment. SEARCH STRATEGY:We searched the Cochrane Stroke Group specialised Trials Register for relevant randomised trials and controlled clinical trials. In addition, we performed comprehensive searches of MEDLINE and EMBASE and checked reference lists of all relevant papers for additional eligible studies. SELECTION CRITERIA:Randomised controlled trials, controlled clinical trials assessing the efficacy of antiplatelet drugs or anticoagulants in the treatment of extracranial carotid artery dissection. For non-randomised trials, case series (studies), that reported on antithrombotic treatment with at least 4 patients, were eligible. All trials and studies were assessed for eligibility. Data from all eligible studies were extracted independently by two reviewers. Disagreements were resolved by discussion. DATA COLLECTION AND ANALYSIS:Data on the primary outcome measures were extracted systematically. These were: all deaths, vascular deaths, and disability. Secondary outcomes were: first stroke occurrence, stroke recurrence, any stroke during reported follow-up, extracranial haemorrhage, and intracranial haemorrhage. The first choice treatment was taken for analyses. MAIN RESULTS:No randomised trials and 49 case series (including 683 treated patients) were identified. No reliable comparisons of antiplatelet drugs or anticoagulants with control were available. 24 eligible studies including 286 patients (who either received antiplatelet drugs or anticoagulants) were included in the analysis. There was no significant difference in odds of death comparing antiplatelet drugs with anticoagulants, odds ratio (OR) 2.41, 95% CI 0.27-21.80). There was also no significant difference in the odds of being alive but disabled (OR 1.65, 95% CI 0.50-5.42). Few major haemorrhages were reported. REVIEWER'S CONCLUSIONS:There were no randomised trials comparing either anticoagulants or antiplatelet drugs with control. There is, therefore, no evidence to support their routine use for the treatment of extracranial internal carotid artery dissection. There were also no randomised trials, that directly compared anticoagulants with antiplatelet drugs, and the reported non-randomised studies did not show any evidence of a significant difference between the two. We suggest that a randomised trial including at least 1000 patients in each treatment arm with this condition is clearly needed.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Lyrer P,Engelter Sdoi
10.1002/14651858.CD000255keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
CD000255issue
4issn
1469-493Xpii
CD000255pub_type
杂志文章,评审abstract:BACKGROUND:Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009514.pub2
更新日期:2018-03-28 00:00:00
abstract:BACKGROUND:The method of delivering a diagnosis of breast cancer to women has the potential to impact on their level of interpretation, patient recall and satisfaction. OBJECTIVES:To assess the effectiveness of different methods when used to communicate a primary diagnosis of breast cancer to women. SEARCH STRATEGY:W...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD006011.pub2
更新日期:2007-07-18 00:00:00
abstract:BACKGROUND:Anticoagulation may improve survival in patients with cancer through an antitumor effect in addition to the perceived antithrombotic effect. OBJECTIVES:To evaluate the efficacy and safety of parenteral anticoagulants in patients with cancer with no therapeutic or prophylactic indication for anticoagulation....
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006652.pub2
更新日期:2011-01-19 00:00:00
abstract:BACKGROUND:Autopsy studies suggest that Wernicke-Korsakoff syndrome (WKS) is not a rare disorder, particularly in individuals who abuse alcohol. Thiamine has been established as the treatment of choice for over 50 years, but uncertainty remains about appropriate dosage and duration. Current practice guidelines are base...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004033.pub3
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Retrospective survival data have suggested poor effectiveness of oxygen therapy in patients with interstitial lung disease (ILD). OBJECTIVES:To determine the effect of domiciliary oxygen therapy on survival and quality of life in patients with a diagnosis of ILD and hypoxaemia. SEARCH STRATEGY:Randomized C...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002883
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incen...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006058.pub2
更新日期:2009-07-08 00:00:00
abstract:BACKGROUND:The in vitro fertilization (IVF) technique is commonly used and is the only treatment option for a proportion of infertile couples. To obtain better outcomes of IVF, it is important to enhance embryo quality by optimizing IVF techniques. In IVF procedures, oocytes and sperm are routinely co-incubated overnig...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009391.pub2
更新日期:2013-04-30 00:00:00
abstract:BACKGROUND:In osteogenesis imperfecta (OI) a genetic defect in type I collagen results in multiple fractures with little or no trauma. Bisphosphonates are used to attempt to reduce these fractures. OBJECTIVES:To assess the effectiveness and safety of bisphosphonates in increasing bone mineral density (BMD), reducing f...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005088.pub2
更新日期:2008-10-08 00:00:00
abstract:BACKGROUND:Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may l...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD009901.pub3
更新日期:2018-11-15 00:00:00
abstract:BACKGROUND:Cognitive behavioural therapy (CBT) is a psychosocial treatment that aims to help individuals re-evaluate their appraisals of their experiences that can affect their level of distress and problematic behaviour. CBT is now recommended by the National Institute for Health and Care Excellence (NICE) as an add-o...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD008712.pub3
更新日期:2018-11-15 00:00:00
abstract:BACKGROUND:Medications used to treat inflammatory bowel disease (IBD) have significantly improved patient outcomes and delayed time to surgery. However, some of these therapies are recognized to increase the general risk of infection and have an unclear impact on postoperative infection risk. OBJECTIVES:To assess the ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD013256.pub2
更新日期:2020-10-24 00:00:00
abstract:BACKGROUND:Problems attributed to the accumulation of wax (cerumen) are among the most common reasons for people to present to their general practitioners with ear trouble. Treatment for this condition often involves use of a wax softening agent (cerumenolytic) to disperse the cerumen, reduce the need for, or facilitat...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004326.pub3
更新日期:2018-07-24 00:00:00
abstract:BACKGROUND:Heel lance has been the conventional method of blood sampling in neonates for screening tests. Neonates undergoing this procedure experience pain. Despite various studies evaluating the role of pharmacological and non-pharmacological interventions to date, there are no effective and practical methods to alle...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001452
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Many small, sick and premature infants are unable to coordinate sucking, swallowing and breathing, and therefore, require gavage feeding. In gavage feeding, milk feeds are delivered through a tube passed via the nose or mouth into the stomach. Intermittent bolus milk feeds may be administered using a syringe...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005249.pub2
更新日期:2012-11-14 00:00:00
abstract:BACKGROUND:Spinal anaesthesia has been in use since the turn of the late nineteenth century. During the last decade there has been an increase in the number of reports implicating lidocaine as a possible cause of temporary and permanent neurologic complications after spinal anaesthesia. Follow-up of patients who receiv...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003006.pub2
更新日期:2005-10-19 00:00:00
abstract:BACKGROUND:Central venous catheters (CVC) continue to play a prominent role in haemodialysis vascular access with 46% to 70% of patients commencing haemodialysis via a CVC. CVC access is associated with catheter-related infections, increased patient hospitalisations and death due to infection. A variety of intervention...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006894.pub2
更新日期:2010-01-20 00:00:00
abstract:BACKGROUND:Pain following brain surgery can compromise recovery. Several pharmacological interventions have been used to prevent pain after craniotomy; however, there is currently a lack of evidence regarding which interventions are most effective. OBJECTIVES:The objectives are to assess the effectiveness of pharmacol...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD011931.pub2
更新日期:2019-11-21 00:00:00
abstract:BACKGROUND:Haloperidol was developed in the late 1950s for use in the field of analgesia. Research subsequently demonstrated effects on hallucinations, delusions, aggressiveness, impulsiveness and states of excitement and led to the introduction of haloperidol as an antipsychotic. OBJECTIVES:To evaluate the clinical e...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003082
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Acute respiratory infections (ARIs) comprise a large and heterogeneous group of infections including bacterial, viral and other aetiologies. In recent years, procalcitonin - the prohormone of calcitonin - has emerged as a promising marker for the diagnosis of bacterial infections and for improving decisions ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007498.pub2
更新日期:2012-09-12 00:00:00
abstract:BACKGROUND:Alzheimer's disease is the most common cause of dementia in older people. One of the aims of therapy is to inhibit the breakdown of a chemical neurotransmitter, acetylcholine, by blocking the relevant enzyme. This can be done by a group of chemicals known as cholinesterase inhibitors. However, some (like tac...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001190
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provis...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000564.pub2
更新日期:2016-10-11 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is a common adverse effect of anaesthesia and surgery. Up to 80% of patients may be affected. These outcomes are a major cause of patient dissatisfaction and may lead to prolonged hospital stay and higher costs of care along with more severe complications. Many antiem...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD012859.pub2
更新日期:2020-10-19 00:00:00
abstract:BACKGROUND:Acquired haemophilia A is a rare bleeding disorder caused by the development of specific autoantibodies against coagulation factor VIII. Rituximab may be an alternative approach to the treatment of acquired haemophilia by eradicating FVIII autoantibodies. OBJECTIVES:To assess and summarise the efficacy and ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD011907.pub2
更新日期:2016-07-08 00:00:00
abstract:BACKGROUND:It is believed that ivermectin (a microfilaricide) could prevent blindness due to onchocerciasis. However, when given to everyone in communities where onchocerciasis is common, the effects of ivermectin on lesions affecting the eye are uncertain and data on whether the drug prevents visual loss is unclear. ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD002219
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Social phobia (SP), or social anxiety disorder, is a prevalent and disabling disorder. There is growing evidence that SP is mediated by specific neurobiological factors, and increased interest in the use of medication in its treatment. OBJECTIVES:To assess the effects of pharmacotherapy for Social Phobia, a...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001206.pub2
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Chinese herbal medicines are commonly used to treat sore throat in China and are used worldwide by practitioners of traditional Chinese medicine (TCM). Their efficacy in treating sore throat has not previously been systematically reviewed. OBJECTIVES:To assess the efficacy and safety of Chinese herbal medic...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004877.pub3
更新日期:2012-03-14 00:00:00
abstract:BACKGROUND:Elective caesarean delivery for women in labour with a small or immature baby might reduce the chances of fetal or neonatal death, but it might also increase the risk of maternal morbidity. OBJECTIVES:To assess the effects of a policy of elective caesarean delivery versus expectant management for small babi...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000078
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Electroconvulsive therapy (ECT) involves the induction of a seizure (fit) for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp. The effects of its use in people with schizophrenia are unclear. OBJECTIVES:To determine whether ele...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000076
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009957.pub2
更新日期:2017-01-21 00:00:00
abstract:BACKGROUND:Postnatal depression, with a prevalence of at least 10%, is probably the most common complication of the puerperium. A deficiency or imbalance of sex hormones has repeatedly been suggested as a cause. OBJECTIVES:The objective of this review was to evaluate the role of oestrogens and progestogens in the prev...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001690
更新日期:2000-01-01 00:00:00