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Strategies to improve recruitment to randomised trials.
CONCLUSIONS: The literature on interventions to improve recruitment to trials has plenty of variety but little depth. Only 3 of 72 comparisons are supported by high-certainty evidence according to GRADE: having an open trial and using telephone reminders to non-responders to postal interventions both increase recruitment; a specialised way of developing participant information leaflets had little or no effect. The methodology research community should improve the evidence base by replicating evaluations of existing strategies, rather than developing and testing new ones. PMID: 29468635 [PubMed - as supplied by publish...
Source: Cochrane Database of Systematic Reviews - February 22, 2018 Category: General Medicine Authors: Treweek S, Pitkethly M, Cook J, Fraser C, Mitchell E, Sullivan F, Jackson C, Taskila TK, Gardner H Tags: Cochrane Database Syst Rev Source Type: research

Mini-Cog for the diagnosis of Alzheimer's disease dementia and other dementias within a primary care setting.
CONCLUSIONS: There is a limited number of studies evaluating the accuracy of the Mini-Cog for the diagnosis of dementia in primary care settings. Given the small number of studies, the wide range in estimates of the accuracy of the Mini-Cog, and methodological limitations identified in most of the studies, at the present time there is insufficient evidence to recommend that the Mini-Cog be used as a screening test for dementia in primary care. Further studies are required to determine the accuracy of Mini-Cog in primary care and whether this tool has sufficient diagnostic test accuracy to be useful as a screening test in t...
Source: Cochrane Database of Systematic Reviews - February 22, 2018 Category: General Medicine Authors: Seitz DP, Chan CC, Newton HT, Gill SS, Herrmann N, Smailagic N, Nikolaou V, Fage BA Tags: Cochrane Database Syst Rev Source Type: research

BIS monitoring versus clinical assessment for sedation in mechanically ventilated adults in the intensive care unit and its impact on clinical outcomes and resource utilization.
CONCLUSIONS: We found insufficient evidence about the effects of BIS monitoring for sedation in critically ill mechanically ventilated adults on clinical outcomes or resource utilization. The findings are uncertain due to the low- and very low-quality evidence derived from a limited number of studies. PMID: 29464690 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 21, 2018 Category: General Medicine Authors: Shetty RM, Bellini A, Wijayatilake DS, Hamilton MA, Jain R, Karanth S, Namachivayam A Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for treating gonorrhoea in pregnancy.
CONCLUSIONS: This Cochrane Review found high levels of cure of gonococcal infections in pregnancy with the given antibiotic regimens. However, the evidence in this review is inconclusive as it does not support one particular regimen over another. This conclusion was based on very low-quality evidence (downgraded for poor trial design, imprecision) from two trials (involving 514 women), which we assessed to be at a high risk of bias for a number of domains. The harm profiles of the antibiotic regimes featured in this review remain unknown.High-quality RCTs are needed, with sufficient power to assess the clinical effectivene...
Source: Cochrane Database of Systematic Reviews - February 21, 2018 Category: General Medicine Authors: Comunián-Carrasco G, Peña-Martí GE, Martí-Carvajal AJ Tags: Cochrane Database Syst Rev Source Type: research

Community screening for visual impairment in older people.
CONCLUSIONS: The evidence from RCTs undertaken to date does not support vision screening for older people living independently in a community setting, whether in isolation or as part of a multi-component screening package. This is true for screening programmes involving questions about visual problems, or direct measurements of visual acuity.The most likely reason for this negative review is that the populations within the trials often did not take up the offered intervention as a result of the vision screening and large proportions of those who did not have vision screening appeared to seek their own intervention. Also, t...
Source: Cochrane Database of Systematic Reviews - February 20, 2018 Category: General Medicine Authors: Clarke EL, Evans JR, Smeeth L Tags: Cochrane Database Syst Rev Source Type: research

Surgery for trigger finger.
CONCLUSIONS: Low-quality evidence indicates that, compared with steroid injection, open surgical treatment in people with trigger finger, may result in a less recurrence rate from six up to 12 months following the treatment, although it increases the incidence of pain during the first follow-up week. We are uncertain about the effect of open surgery with regard to the resolution rate in follow-up at six to 12 months, compared with steroid injections, due high heterogeneity and few events occurred in the trials; we are uncertain too about the risk of adverse events and neurovascular injury because of a few events occurred i...
Source: Cochrane Database of Systematic Reviews - February 20, 2018 Category: General Medicine Authors: Fiorini HJ, Tamaoki MJ, Lenza M, Gomes Dos Santos JB, Faloppa F, Belloti JC Tags: Cochrane Database Syst Rev Source Type: research

Antifibrinolytic drugs for treating primary postpartum haemorrhage.
CONCLUSIONS: TXA when administered intravenously reduces mortality due to bleeding in women with primary PPH, irrespective of mode of birth, and without increasing the risk of thromboembolic events. Taken together with the reliable evidence of the effect of TXA in trauma patients, the evidence suggests that TXA is effective if given as early as possible.Facilities for IV administration may not be available in non-hospital settings therefore, alternative routes to IV administration need to be investigated. PMID: 29462500 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 20, 2018 Category: General Medicine Authors: Shakur H, Beaumont D, Pavord S, Gayet-Ageron A, Ker K, Mousa HA Tags: Cochrane Database Syst Rev Source Type: research

Combination pharmacotherapy for the treatment of fibromyalgia in adults.
CONCLUSIONS: There are few, large, high-quality trials comparing combination pharmacotherapy with monotherapy for fibromyalgia, consequently limiting evidence to support or refute the use of combination pharmacotherapy for fibromyalgia. PMID: 29457627 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 19, 2018 Category: General Medicine Authors: Thorpe J, Shum B, Moore RA, Wiffen PJ, Gilron I Tags: Cochrane Database Syst Rev Source Type: research

Effects of total fat intake on bodyweight in children.
CONCLUSIONS: We were unable to reach firm conclusions. Limited evidence from three trials that randomised children to a lower total fat intake (30% or less TE) versus usual or modified fat intake, but with no intention to reduce weight, showed small reductions in body mass index, total- and LDL-cholesterol at some time points with lower fat intake compared to controls, and no consistent differences in effects on weight, high-density lipoprotein (HDL) cholesterol or height. Associations in cohort studies that related total fat intake to later measures of body fatness in children were inconsistent and the quality of this evi...
Source: Cochrane Database of Systematic Reviews - February 15, 2018 Category: General Medicine Authors: Naude CE, Visser ME, Nguyen KA, Durao S, Schoonees A Tags: Cochrane Database Syst Rev Source Type: research

Vision screening for correctable visual acuity deficits in school-age children and adolescents.
CONCLUSIONS: Vision screening plus provision of free spectacles improves the number of children who have and wear the spectacles they need compared with providing a prescription only. This may lead to better educational outcomes. Health education interventions, as currently devised and tested, do not appear to improve spectacle wearing in children. In lower-income settings, ready-made spectacles may provide a useful alternative to expensive custom-made spectacles. PMID: 29446439 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 15, 2018 Category: General Medicine Authors: Evans JR, Morjaria P, Powell C Tags: Cochrane Database Syst Rev Source Type: research

Phytomedicines (medicines derived from plants) for sickle cell disease.
CONCLUSIONS: While Niprisan® appeared to be safe and effective in reducing severe painful crises over a six-month follow-up period, further trials are required to assess its role in the management of people with sickle cell disease and the results of its multicentre trials are awaited. Currently no conclusions can be made regarding the efficacy of Ciklavit®. Based on the published results for Niprisan® and in view of the limitations in data collection and analysis of both trials, phytomedicines may have a potential beneficial effect in reducing painful crises in sickle cell disease. This needs to be further val...
Source: Cochrane Database of Systematic Reviews - February 15, 2018 Category: General Medicine Authors: Oniyangi O, Cohall DH Tags: Cochrane Database Syst Rev Source Type: research

Primary care professionals providing non-urgent care in hospital emergency departments.
CONCLUSIONS: We assessed the evidence from the four included studies as of very low-certainty overall, as the results are inconsistent and safety has not been examined. The evidence is insufficient to draw conclusions for practice or policy regarding the effectiveness and safety of care provided to non-urgent patients by GPs and NPs versus EPs in the ED to mitigate problems of overcrowding, wait times, and patient flow. PMID: 29438575 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 13, 2018 Category: General Medicine Authors: Gonçalves-Bradley D, Khangura JK, Flodgren G, Perera R, Rowe BH, Shepperd S Tags: Cochrane Database Syst Rev Source Type: research

Personally tailored activities for improving psychosocial outcomes for people with dementia in long-term care.
CONCLUSIONS: Offering personally tailored activities to people with dementia in long-term care may slightly improve challenging behaviour. Evidence from one study suggested that it was probably associated with a slight reduction in the quality of life rated by proxies, but may have little or no effect on self-rated quality of life. We acknowledge concerns about the validity of proxy ratings of quality of life in severe dementia. Personally tailored activities may have little or no effect on negative affect and we are uncertain whether they improve positive affect or mood. There was no evidence that interventions were more ...
Source: Cochrane Database of Systematic Reviews - February 13, 2018 Category: General Medicine Authors: Möhler R, Renom A, Renom H, Meyer G Tags: Cochrane Database Syst Rev Source Type: research

Non-steroidal anti-inflammatory agents to induce regression and prevent the progression of cervical intraepithelial neoplasia.
CONCLUSIONS: There are currently no convincing data to support a benefit for NSAIDs in the treatment of CIN. With the addition of this new, larger randomised trial we would rate this as overall moderate-certainty evidence by the GRADE criteria. PMID: 29431861 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 12, 2018 Category: General Medicine Authors: Grabosch SM, Shariff OM, Helm CW Tags: Cochrane Database Syst Rev Source Type: research

Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants.
Abstract BACKGROUND: Newborn admission temperature is a strong predictor of outcomes across all gestations. Hypothermia immediately after birth remains a worldwide issue and, if prolonged, is associated with harm. Keeping preterm infants warm is difficult even when recommended routine thermal care guidelines are followed in the delivery room. OBJECTIVES: To assess the efficacy and safety of interventions designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room, compared with routine thermal care or any other single/combination...
Source: Cochrane Database of Systematic Reviews - February 12, 2018 Category: General Medicine Authors: McCall EM, Alderdice F, Halliday HL, Vohra S, Johnston L Tags: Cochrane Database Syst Rev Source Type: research

Graft type for femoro-popliteal bypass surgery.
CONCLUSIONS: There was moderate-quality evidence of improved long-term (60 months) primary patency for autologous vein grafts when compared to prosthetic materials for above-knee bypasses. In the long term (two to five years) there was low-quality evidence that Dacron confers a small secondary patency benefit over PTFE for above-knee bypass. Only very low-quality data exist on below-knee bypasses, so we are uncertain which graft type is best. Further randomised data are needed to ascertain whether this information translates into an improvement in limb survival. PMID: 29429146 [PubMed - as supplied by publisher] (Sour...
Source: Cochrane Database of Systematic Reviews - February 11, 2018 Category: General Medicine Authors: Ambler GK, Twine CP Tags: Cochrane Database Syst Rev Source Type: research

Planned birth at or near term for improving health outcomes for pregnant women with pre-existing diabetes and their infants.
CONCLUSIONS: In the absence of evidence, we are unable to reach any conclusions about the health outcomes associated with planned birth, at or near term, compared with an expectant approach for pregnant women with pre-existing diabetes.This review demonstrates the urgent need for high-quality trials evaluating the effectiveness of planned birth at or near term gestation for pregnant women with pre-existing (Type 1 or Type 2) diabetes compared with an expectant approach. PMID: 29423911 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 9, 2018 Category: General Medicine Authors: Biesty LM, Egan AM, Dunne F, Smith V, Meskell P, Dempsey E, Ni Bhuinneain GM, Devane D Tags: Cochrane Database Syst Rev Source Type: research

Inhaled mannitol for cystic fibrosis.
CONCLUSIONS: There is moderate-quality evidence to show that treatment with mannitol over a six-month period is associated with an improvement in some measures of lung function in people with cystic fibrosis compared to control. There is low to very low-quality evidence suggesting no difference in quality of life for participants taking mannitol compared to control. This review provides very low-quality evidence suggesting no difference in lung function or quality of life comparing mannitol to dornase alfa alone and to mannitol plus dornase alfa.The clinical implications from this review suggest that mannitol could be cons...
Source: Cochrane Database of Systematic Reviews - February 9, 2018 Category: General Medicine Authors: Nevitt SJ, Thornton J, Murray CS, Dwyer T Tags: Cochrane Database Syst Rev Source Type: research

Pulmonary artery perfusion versus no perfusion during cardiopulmonary bypass for open heart surgery in adults.
CONCLUSIONS: The effects of pulmonary artery perfusion with blood during cardiopulmonary bypass (CPB) are uncertain owing to the small numbers of participants included in meta-analyses. Risks of death and serious adverse events may be higher with pulmonary artery perfusion with blood during CPB, and robust evidence for any beneficial effects is lacking. Future randomized controlled trials (RCTs) should provide long-term follow-up and patient stratification by preoperative lung function and other documented risk factors for mortality. One study that is awaiting classification (epub abstract with preliminary results) may cha...
Source: Cochrane Database of Systematic Reviews - February 8, 2018 Category: General Medicine Authors: Buggeskov KB, Grønlykke L, Risom EC, Wei ML, Wetterslev J Tags: Cochrane Database Syst Rev Source Type: research

Self-management for bronchiectasis.
CONCLUSIONS: There is insufficient evidence to determine whether self-management interventions benefit people with bronchiectasis. In the absence of high-quality evidence it is advisable that practitioners adhere to current international guidelines that advocate self-management for people with bronchiectasis.Future studies should aim to clearly define and justify the specific nature of self-management, measure clinically important outcomes and include children as well as adults. PMID: 29411860 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 7, 2018 Category: General Medicine Authors: Kelly C, Grundy S, Lynes D, Evans DJ, Gudur S, Milan SJ, Spencer S Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Systemic treatments for metastatic cutaneous melanoma.
CONCLUSIONS: There is no evidence from randomised controlled clinical trials to show superiority of systemic therapy over best supportive care / placebo in the treatment of malignant cutaneous melanoma.Given that patients with metastatic melanoma frequently receive systemic therapy, it is our pragmatic view that a future systematic review could compare any systemic treatment, or combination of treatments, to single agent dacarbazine. PMID: 29411867 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 7, 2018 Category: General Medicine Authors: Crosby T, Fish R, Coles B, Mason M Tags: Cochrane Database Syst Rev Source Type: research

Osmotic therapies added to antibiotics for acute bacterial meningitis.
CONCLUSIONS: Glycerol was the only osmotic therapy evaluated, and data from trials to date have not demonstrated an effect on death. Glycerol may reduce neurological deficiency and deafness. PMID: 29405037 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Wall EC, Ajdukiewicz KM, Bergman H, Heyderman RS, Garner P Tags: Cochrane Database Syst Rev Source Type: research

Systemic treatments for metastatic cutaneous melanoma.
Abstract BACKGROUND: The prognosis of people with metastatic cutaneous melanoma, a skin cancer, is generally poor. Recently, new classes of drugs (e.g. immune checkpoint inhibitors and small-molecule targeted drugs) have significantly improved patient prognosis, which has drastically changed the landscape of melanoma therapeutic management. This is an update of a Cochrane Review published in 2000. OBJECTIVES: To assess the beneficial and harmful effects of systemic treatments for metastatic cutaneous melanoma. SEARCH METHODS: We searched the following databases up to October 2017: the Cochrane Skin Group...
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Pasquali S, Hadjinicolaou AV, Chiarion Sileni V, Rossi CR, Mocellin S Tags: Cochrane Database Syst Rev Source Type: research

Mosquito repellents for malaria prevention.
CONCLUSIONS: There is insufficient evidence to conclude topical or spatial repellents can prevent malaria. There is a need for better designed trials to generate higher certainty of evidence before well-informed recommendations can be made. Adherence to daily compliance remains a major limitation. Insecticide-treated clothing may reduce risk of malaria infection in the absence of insecticide-treated nets; further studies on insecticide-treated clothing in the general population should be done to broaden the applicability of the results. PMID: 29405263 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Maia MF, Kliner M, Richardson M, Lengeler C, Moore SJ Tags: Cochrane Database Syst Rev Source Type: research

Intraoperative interventions for preventing surgical site infection: an overview of Cochrane Reviews.
CONCLUSIONS: This overview provides the most up-to-date evidence on use of intraoperative treatments for the prevention of SSIs from all currently published Cochrane Reviews. There is evidence that some interventions are useful in reducing SSI risk for people undergoing surgery, such as antibiotic prophylaxis for caesarean section and hernia repair, and also the timing of prophylactic intravenous antibiotics administered before caesarean incision. Also, there is evidence that adhesive drapes increase SSI risk. Evidence for the many other treatment choices is largely of low or very low certainty and no quality-of-life or co...
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Liu Z, Dumville JC, Norman G, Westby MJ, Blazeby J, McFarlane E, Welton NJ, O'Connor L, Cawthorne J, George RP, Crosbie EJ, Rithalia AD, Cheng HY Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Cranial irradiation for preventing brain metastases of small cell lung cancer in patients in complete remission.
This study aims to test whether prophylactic cranial irradiation prolongs survival of patients with small cell lung cancer in complete remission. SEARCH METHODS: Published and unpublished trials were eligible. Electronic databases (Medline, Cancerlit, Excerpta Medica, Biosis from 1965 to 1998), reference lists of trial publications, review articles and relevant books were used to identify potentially eligible trials. The search was also guided by discussions with investigators and experts, and the examination of meeting proceedings and of the Physician Data Query clinical trial registry. SELECTION CRITERIA: Rando...
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Prophylactic Cranial Irradiation Overview Collaborative Group Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Chemoimmunotherapy versus chemotherapy for metastatic malignant melanoma.
CONCLUSIONS: We failed to find any clear evidence that the addition of immunotherapy to chemotherapy increases survival of people with metastatic melanoma. Further use of combined immunotherapy and chemotherapy should only be done in the context of clinical trials. PMID: 29409139 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Sasse AD, Sasse EC, Clark LG, Clark OAC Tags: Cochrane Database Syst Rev Source Type: research

Antipsychotic reduction and/or cessation and antipsychotics as specific treatments for tardive dyskinesia.
CONCLUSIONS: Limited data from small studies using antipsychotic reduction or specific antipsychotic drugs as treatments for TD did not provide any convincing evidence of the value of these approaches. There is a need for larger trials of a longer duration to fully investigate this area. PMID: 29409162 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 6, 2018 Category: General Medicine Authors: Bergman H, Rathbone J, Agarwal V, Soares-Weiser K Tags: Cochrane Database Syst Rev Source Type: research

Interventions to prevent injuries in construction workers.
CONCLUSIONS: The vast majority of interventions to adopt safety measures recommended by standard texts on safety, consultants and safety courses have not been adequately evaluated. There is very low-quality evidence that introducing regulations as such may or may not result in a decrease in fatal and non-fatal injuries. There is also very low-quality evidence that regionally oriented safety campaigns, training, inspections or the introduction of occupational health services may not reduce non-fatal injuries in construction companies. There is very low-quality evidence that company-oriented safety interventions such as a mu...
Source: Cochrane Database of Systematic Reviews - February 5, 2018 Category: General Medicine Authors: van der Molen HF, Basnet P, Hoonakker PL, Lehtola MM, Lappalainen J, Frings-Dresen MH, Haslam R, Verbeek JH Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic vitamin K for the prevention of vitamin K deficiency bleeding in preterm neonates.
CONCLUSIONS: Preterm infants have low levels of vitamin K and develop detectable PIVKA proteins during the first week of life. Despite being at risk for VKDB, there are no studies comparing vitamin K versus non-treatment and few studies that address potential dosing strategies for effective treatment. Dosage studies suggest that we are currently giving doses of vitamin K to preterm infants that lead to supraphysiologic levels. Because of current uncertainty, clinicians will have to extrapolate data from term infants to preterm infants. Since there is no available evidence that vitamin K is harmful or ineffective and since ...
Source: Cochrane Database of Systematic Reviews - February 5, 2018 Category: General Medicine Authors: Ardell S, Offringa M, Ovelman C, Soll R Tags: Cochrane Database Syst Rev Source Type: research

Primaquine or other 8-aminoquinolines for reducing Plasmodium falciparum transmission.
CONCLUSIONS: A single low dose of PQ (0.25 mg/kg) added to artemisinin-based combination therapy for malaria reduces infectiousness of people to mosquitoes at day 3-4 and day 8, and appears as effective as higher doses. The absolute effect is greater at day 3 or 4, and smaller at day 8, in part because of the lower infectiousness in the control group. There was no evidence of increased haemolysis at 0.25 mg/kg, but few G6PD-deficient individuals were included in the trials. The effect on infectiousness precedes the effect of PQ on gametocyte prevalence. We do not know whether single dose PQ could reduce malaria transmissio...
Source: Cochrane Database of Systematic Reviews - February 2, 2018 Category: General Medicine Authors: Graves PM, Choi L, Gelband H, Garner P Tags: Cochrane Database Syst Rev Source Type: research

Exercise-based cardiac rehabilitation for adults with stable angina.
CONCLUSIONS: Due to the small number of trials and their small size, potential risk of bias and concerns about imprecision and lack of applicability, we are uncertain of the effects of exercise-based CR compared to control on mortality, morbidity, cardiovascular hospital admissions, adverse events, return to work and health-related quality of life in people with stable angina. Low-quality evidence indicates that exercise-based CR may result in a small increase in exercise capacity compared to usual care. High-quality, well-reported randomised trials are needed to assess the benefits and harms of exercise-based CR for adult...
Source: Cochrane Database of Systematic Reviews - February 2, 2018 Category: General Medicine Authors: Long L, Anderson L, Dewhirst AM, He J, Bridges C, Gandhi M, Taylor RS Tags: Cochrane Database Syst Rev Source Type: research

Vaccines for preventing influenza in healthy children.
CONCLUSIONS: In children aged between 3 and 16 years, live influenza vaccines probably reduce influenza (moderate-certainty evidence) and may reduce ILI (low-certainty evidence) over a single influenza season. In this population inactivated vaccines also reduce influenza (high-certainty evidence) and may reduce ILI (low-certainty evidence). For both vaccine types, the absolute reduction in influenza and ILI varied considerably across the study populations, making it difficult to predict how these findings translate to different settings. We found very few randomised controlled trials in children under two years of age. Adv...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V Tags: Cochrane Database Syst Rev Source Type: research

Vaccines for preventing influenza in healthy adults.
CONCLUSIONS: Healthy adults who receive inactivated parenteral influenza vaccine rather than no vaccine probably experience less influenza, from just over 2% to just under 1% (moderate-certainty evidence). They also probably experience less ILI following vaccination, but the degree of benefit when expressed in absolute terms varied across different settings. Variation in protection against ILI may be due in part to inconsistent symptom classification. Certainty of evidence for the small reductions in hospitalisations and time off work is low. Protection against influenza and ILI in mothers and newborns was smaller than the...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Demicheli V, Jefferson T, Ferroni E, Rivetti A, Di Pietrantonj C Tags: Cochrane Database Syst Rev Source Type: research

Vaccines for preventing influenza in the elderly.
CONCLUSIONS: Older adults receiving the influenza vaccine may have a lower risk of influenza (from 6% to 2.4%), and probably have a lower risk of ILI compared with those who do not receive a vaccination over the course of a single influenza season (from 6% to 3.5%). We are uncertain how big a difference these vaccines will make across different seasons. Very few deaths occurred, and no data on hospitalisation were reported. No cases of pneumonia occurred in one study that reported this outcome. We do not have enough information to assess harms relating to fever and nausea in this population.The evidence for a lower risk of...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Demicheli V, Jefferson T, Di Pietrantonj C, Ferroni E, Thorning S, Thomas RE, Rivetti A Tags: Cochrane Database Syst Rev Source Type: research

Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI).
CONCLUSIONS: We did not find that tailoring the FSH dose in any particular ORT population (low, normal, high ORT), influenced rates of live birth/ongoing pregnancy but we could not rule out differences, due to sample size limitations. In predicted high responders, lower doses of FSH seemed to reduce the overall incidence of moderate and severe OHSS. Moderate-quality evidence suggests that ORT-based individualisation produces similar live birth/ongoing pregnancy rates to a policy of giving all women 150 IU. However, in all cases the confidence intervals are consistent with an increase or decrease in the rate of around five ...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Lensen SF, Wilkinson J, Leijdekkers JA, La Marca A, Mol BWJ, Marjoribanks J, Torrance H, Broekmans FJ Tags: Cochrane Database Syst Rev Source Type: research

Influenza vaccines in immunosuppressed adults with cancer.
CONCLUSIONS: Observational data suggest lower mortality and infection-related outcomes with influenza vaccination. The strength of evidence is limited by the small number of studies and low grade of evidence. It seems that the evidence, although weak, shows that the benefits overweigh the potential risks when vaccinating adults with cancer against influenza. However, additional placebo or no-treatment controlled RCTs of influenza vaccination among adults with cancer is ethically questionable.There is no conclusive evidence regarding the use of adjuvanted versus non-adjuvanted influenza vaccine in this population. PMID...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Bitterman R, Eliakim-Raz N, Vinograd I, Zalmanovici Trestioreanu A, Leibovici L, Paul M Tags: Cochrane Database Syst Rev Source Type: research

Interventions for weight reduction in obesity to improve survival in women with endometrial cancer.
CONCLUSIONS: There is currently insufficient high-quality evidence to determine the effect of combined lifestyle and behavioural interventions on survival, quality of life, or significant weight loss in women with a history of endometrial cancer compared to those receiving usual care. The limited evidence suggests that there is little or no serious or life-threatening adverse effects due to these interventions, although musculoskeletal problems were increased, presumably due to increased activity levels. Our conclusion is based on low- and very low-quality evidence from a small number of trials and very few patients. We th...
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Kitson S, Ryan N, MacKintosh ML, Edmondson R, Duffy JM, Crosbie EJ Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for asymptomatic bacteriuria in kidney transplant recipients.
CONCLUSIONS: Currently, there is insufficient evidence to support routinely treating kidney transplant recipients with antibiotics in case of asymptomatic bacteriuria after transplantation, but data are scarce. Further studies assessing routine antibiotic treatment would inform practice and we await the results of three ongoing randomised studies, which may help resolve existing uncertainties. PMID: 29390169 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Coussement J, Scemla A, Abramowicz D, Nagler EV, Webster AC Tags: Cochrane Database Syst Rev Source Type: research

Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery.
CONCLUSIONS: It is uncertain whether absorbable sutures confer better, worse or equivalent outcomes compared to non-absorbable sutures following carpal tunnel decompression, because the quality of evidence is very low. Use of absorbable suture eliminates the need for suture removal, which could confer considerable savings to patients and healthcare providers alike. We need rigorously-performed, non-inferiority randomised trials with economic analyses to inform choice of suture. PMID: 29390170 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Wade RG, Wormald JC, Figus A Tags: Cochrane Database Syst Rev Source Type: research

Orthodontic treatment for deep bite and retroclined upper front teeth in children.
CONCLUSIONS: There is no evidence from clinical trials to recommend or discourage any type of orthodontic treatment to correct Class II division 2 malocclusion in children. This situation seems unlikely to change as trials to evaluate the best management of Class II division 2 malocclusion are challenging to design and conduct due to low prevalence, difficulties with recruitment and ethical issues with randomisation. PMID: 29390172 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 1, 2018 Category: General Medicine Authors: Millett DT, Cunningham SJ, O'Brien KD, Benson PE, de Oliveira CM Tags: Cochrane Database Syst Rev Source Type: research

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.
CONCLUSIONS: A minority of interventions have been shown to reduce children's exposure to environmental tobacco smoke and improve children's health, but the features that differentiate the effective interventions from those without clear evidence of effectiveness remain unclear. The evidence was judged to be of low or very low quality, as many of the trials are at a high risk of bias, are small and inadequately powered, with heterogeneous interventions and populations. PMID: 29383710 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 31, 2018 Category: General Medicine Authors: Behbod B, Sharma M, Baxi R, Roseby R, Webster P Tags: Cochrane Database Syst Rev Source Type: research

Comprehensive geriatric assessment for older people admitted to a surgical service.
CONCLUSIONS: There is evidence that CGA can improve outcomes in people with hip fracture. There are not enough studies to determine when CGA is most effective in relation to surgical intervention or if CGA is effective in surgical patients presenting with conditions other than hip fracture. PMID: 29385235 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 31, 2018 Category: General Medicine Authors: Eamer G, Taheri A, Chen SS, Daviduck Q, Chambers T, Shi X, Khadaroo RG Tags: Cochrane Database Syst Rev Source Type: research

Early versus late ureteric stent removal after kidney transplantation.
Abstract BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage kidney disease. In a previous review we concluded that the routine use of ureteric stents in kidney transplantation reduces the incidence of major urological complications (MUC). Unfortunately, this reduction appears to lead to a concomitant rise in urinary tract infections (UTI). For kidney recipients UTI is now the commonest post-transplant complication. This represents a considerable risk to the immunosuppressed transplant recipient, particularly in the era of increased immunologically challenging transplants. The...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Thompson ER, Hosgood SA, Nicholson ML, Wilson CH Tags: Cochrane Database Syst Rev Source Type: research

Selenium for preventing cancer.
CONCLUSIONS: Well-designed and well-conducted RCTs have shown no beneficial effect of selenium supplements in reducing cancer risk (high certainty of evidence). Some RCTs have raised concerns by reporting a higher incidence of high-grade prostate cancer and type 2 diabetes in participants with selenium supplementation. No clear evidence of an influence of baseline participant selenium status on outcomes has emerged in these studies.Observational longitudinal studies have shown an inverse association between selenium exposure and risk of some cancer types, but null and direct relations have also been reported, and no system...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Vinceti M, Filippini T, Del Giovane C, Dennert G, Zwahlen M, Brinkman M, Zeegers MP, Horneber M, D'Amico R, Crespi CM Tags: Cochrane Database Syst Rev Source Type: research

Physical activity for women with breast cancer after adjuvant therapy.
CONCLUSIONS: No conclusions regarding breast cancer-related and all-cause mortality or breast cancer recurrence were possible. However, physical activity interventions may have small-to-moderate beneficial effects on HRQoL, and on emotional or perceived physical and social function, anxiety, cardiorespiratory fitness, and self-reported and objectively measured physical activity. The positive results reported in the current review must be interpreted cautiously owing to very low-to-moderate quality of evidence, heterogeneity of interventions and outcome measures, imprecision of some estimates, and risk of bias in many trial...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Lahart IM, Metsios GS, Nevill AM, Carmichael AR Tags: Cochrane Database Syst Rev Source Type: research

Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome.
CONCLUSIONS: Apart from low quality of evidence data suggesting a short-term mortality benefit of levosimendan compared with dobutamine, at present there are no robust and convincing data to support a distinct inotropic or vasodilator drug-based therapy as a superior solution to reduce mortality in haemodynamically unstable people with cardiogenic shock or LCOS.Considering the limited evidence derived from the present data due to a generally high risk of bias and imprecision, it should be emphasised that there remains a great need for large, well-designed randomised trials on this topic to close the gap between daily pract...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Schumann J, Henrich EC, Strobl H, Prondzinsky R, Weiche S, Thiele H, Werdan K, Frantz S, Unverzagt S Tags: Cochrane Database Syst Rev Source Type: research

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.
CONCLUSIONS: Despite the large number of childhood and adolescent obesity treatment trials, we were only able to partially assess the impact of obesity treatment interventions on school achievement and cognitive abilities. School and community-based physical activity interventions as part of an obesity prevention or treatment programme can benefit executive functions of children with obesity or overweight specifically. Similarly, school-based dietary interventions may benefit general school achievement in children with obesity. These findings might assist health and education practitioners to make decisions related to prom...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH Tags: Cochrane Database Syst Rev Source Type: research

Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome.
CONCLUSIONS: Some of the interventions can decrease prostatitis symptoms in an appreciable number without a greater incidence of adverse events. The QoE was mostly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes. PMID: 29372565 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 26, 2018 Category: General Medicine Authors: Franco JV, Turk T, Jung JH, Xiao YT, Iakhno S, Garrote V, Vietto V Tags: Cochrane Database Syst Rev Source Type: research

Intrauterine insemination versus intracervical insemination in donor sperm treatment.
CONCLUSIONS: There was insufficient evidence to determine whether there was a clear difference in live birth rates between IUI and ICI in natural or gonadotrophin-stimulated cycles in women who started with donor sperm treatment. There was insufficient evidence available for the effect of timing of IUI or ICI on live birth rates. Very low-quality data suggested that in gonadotrophin-stimulated cycles, ICI may be associated with a higher clinical pregnancy rate than IUI, but also with a higher risk of multiple pregnancy rate. We concluded that the current evidence was too limited to choose between IUI or ICI, in natural cyc...
Source: Cochrane Database of Systematic Reviews - January 25, 2018 Category: General Medicine Authors: Kop PA, Mochtar MH, O'Brien PA, Van der Veen F, van Wely M Tags: Cochrane Database Syst Rev Source Type: research