Cannabis for the treatment of ulcerative colitis.
CONCLUSIONS: The effects of cannabis and cannabidiol on UC are uncertain, thus no firm conclusions regarding the efficacy and safety of cannabis or cannabidiol in adults with active UC can be drawn.There is no evidence for cannabis or cannabinoid use for maintenance of remission in UC. Further studies with a larger number of patients are required to assess the effects of cannabis in UC patients with active and quiescent disease. Different doses of cannabis and routes of administration should be investigated. Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use. PMID: 30406638 [P...
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Kafil TS, Nguyen TM, MacDonald JK, Chande N Tags: Cochrane Database Syst Rev Source Type: research

Rutosides for prevention of post-thrombotic syndrome.
CONCLUSIONS: As there were no studies identified in this review there is currently insufficient evidence to determine the effectiveness and safety of rutosides for prevention of PTS in patients with DVT. Some studies suggest that rutosides may provide short-term relief of PTS symptoms. However, there is nothing published on their use as a preventative therapy for PTS. High quality randomised controlled trials of rutoside versus any alternative are required to build the evidence base in this area. PMID: 30406639 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Morling JR, Yeoh SE, Kolbach DN Tags: Cochrane Database Syst Rev Source Type: research

Rutosides for treatment of post-thrombotic syndrome.
CONCLUSIONS: There was no evidence that rutosides were superior to the use of placebo or ECS. Overall, there is currently limited low-quality evidence that 'venoactive' or 'phlebotonic' remedies such as rutosides reduce symptoms of PTS. Mild side effects were noted in one study. The three studies included in this review provide no evidence to support the use of rutosides in the treatment of PTS. PMID: 30406640 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Morling JR, Broderick C, Yeoh SE, Kolbach DN Tags: Cochrane Database Syst Rev Source Type: research

Cannabis for the treatment of Crohn's disease.
CONCLUSIONS: The effects of cannabis and cannabis oil on Crohn's disease are uncertain. Thus no firm conclusions regarding the efficacy and safety of cannabis and cannabis oil in adults with active Crohn's disease can be drawn. The effects of cannabis or cannabis oil in quiescent Crohn's disease have not been investigated. Further studies with larger numbers of participants are required to assess the potential benefits and harms of cannabis in Crohn's disease. Future studies should assess the effects of cannabis in people with active and quiescent Crohn's disease. Different doses of cannabis and delivery modalities should ...
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Kafil TS, Nguyen TM, MacDonald JK, Chande N Tags: Cochrane Database Syst Rev Source Type: research

Effect of testing for cancer on cancer- or venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE.
CONCLUSIONS: Specific testing for cancer in people with unprovoked VTE may lead to earlier diagnosis of cancer at an earlier stage of the disease. However, there is currently insufficient evidence to draw definitive conclusions concerning the effectiveness of testing for undiagnosed cancer in people with a first episode of unprovoked VTE (DVT or PE) in reducing cancer- or VTE-related morbidity and mortality. The results could be consistent with either benefit or no benefit. Further good-quality large-scale randomised controlled trials are required before firm conclusions can be made. PMID: 30407621 [PubMed - as suppli...
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Robertson L, Yeoh SE, Broderick C, Stansby G, Agarwal R Tags: Cochrane Database Syst Rev Source Type: research

Sinonasal debridement versus no debridement for the postoperative care of patients undergoing endoscopic sinus surgery.
CONCLUSIONS: We are uncertain about the effects of postoperative sinonasal debridement due to high risk of bias in the included studies and the low quality of the evidence. Sinonasal debridement may make little or no difference to disease-specific health-related quality of life or disease severity. Low-quality evidence suggests that postoperative debridement is associated with a significantly lower risk of adhesions at three months follow-up. Whether this has any impact on longer-term outcomes is unknown. PMID: 30407624 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Tzelnick S, Alkan U, Leshno M, Hwang P, Soudry E Tags: Cochrane Database Syst Rev Source Type: research

Perioperative alcohol cessation intervention for postoperative complications.
CONCLUSIONS: This systematic review assessed the efficacy of perioperative alcohol cessation interventions for postoperative complications and alcohol consumption. All three studies showed a significant reduction in the number of participants who quit drinking alcohol during the intervention period. Intensive alcohol cessation interventions offered for four to eight weeks to participants undergoing all types of surgical procedures to achieve complete alcohol cessation before surgery probably reduced the number of postoperative complications. Data were insufficient for review authors to assess their effects on postoperative...
Source: Cochrane Database of Systematic Reviews - November 8, 2018 Category: General Medicine Authors: Egholm JW, Pedersen B, Møller AM, Adami J, Juhl CB, Tønnesen H Tags: Cochrane Database Syst Rev Source Type: research

Ketogenic diets for drug-resistant epilepsy.
CONCLUSIONS: The RCTs discussed in this review show promising results for the use of KDs in epilepsy. However, the limited number of studies, small sample sizes and the limited studies in adults, resulted in a low to very low overall quality of evidence.There were adverse effects within all of the studies and for all KD variations, such as short-term gastrointestinal-related disturbances and increased cholesterol. However, study periods were short, therefore the long-term risks associated with these adverse effects is unknown. Attrition rates remained a problem with all KDs and across all studies; reasons for this being la...
Source: Cochrane Database of Systematic Reviews - November 7, 2018 Category: General Medicine Authors: Martin-McGill KJ, Jackson CF, Bresnahan R, Levy RG, Cooper PN Tags: Cochrane Database Syst Rev Source Type: research

Insecticide-treated nets for preventing malaria.
CONCLUSIONS: Although there is some evidence that insecticide resistance frequency has some effects on mosquito mortality, it is unclear how quantitatively important this is. It appeared insufficient to downgrade the strong evidence of benefit on mortality and malaria illness from the trials conducted earlier. PMID: 30398672 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 6, 2018 Category: General Medicine Authors: Pryce J, Richardson M, Lengeler C Tags: Cochrane Database Syst Rev Source Type: research

Percutaneous vertebroplasty for osteoporotic vertebral compression fracture.
CONCLUSIONS: We found high- to moderate-quality evidence that vertebroplasty has little clinical benefit in terms of pain for treating acute or subacute osteoporotic vertebral fractures in routine practice when compared with a sham procedure. Results were consistent across the studies irrespective of the average duration of pain.Sensitivity analyses confirmed that open trials comparing vertebroplasty with usual care are likely to have overestimated any benefit of vertebroplasty. Correcting for these biases would likely drive any benefits observed with vertebroplasty towards the null, in keeping with findings from the place...
Source: Cochrane Database of Systematic Reviews - November 6, 2018 Category: General Medicine Authors: Buchbinder R, Johnston RV, Rischin KJ, Homik J, Jones CA, Golmohammadi K, Kallmes DF Tags: Cochrane Database Syst Rev Source Type: research

Communication interventions for autism spectrum disorder in minimally verbal children.
CONCLUSIONS: There is limited evidence that verbally based and ACC interventions improve spoken and non-verbal communication in minimally verbal children with ASD. A substantial number of studies have investigated communication interventions for minimally verbal children with ASD, yet only two studies met inclusion criteria for this review, and we considered the overall quality of the evidence to be very low. In the study that used an AAC intervention, there were significant gains in frequency of PECS use and verbal and non-verbal initiations, but not in expressive vocabulary or social communication immediately postinterve...
Source: Cochrane Database of Systematic Reviews - November 5, 2018 Category: General Medicine Authors: Brignell A, Chenausky KV, Song H, Zhu J, Suo C, Morgan AT Tags: Cochrane Database Syst Rev Source Type: research

Graduated compression stockings for prevention of deep vein thrombosis.
Abstract BACKGROUND: Hospitalised patients are at increased risk of developing deep vein thrombosis (DVT) in the lower limb and pelvic veins, on a background of prolonged immobilisation associated with their medical or surgical illness. Patients with DVT are at increased risk of developing a pulmonary embolism (PE). The use of graduated compression stockings (GCS) in hospitalised patients has been proposed to decrease the risk of DVT. This is an update of a Cochrane Review first published in 2000, and last updated in 2014. OBJECTIVES: To evaluate the effectiveness and safety of graduated compression stockings...
Source: Cochrane Database of Systematic Reviews - November 3, 2018 Category: General Medicine Authors: Sachdeva A, Dalton M, Lees T Tags: Cochrane Database Syst Rev Source Type: research

Caseworker-assigned discharge plans to prevent hospital readmission for acute exacerbations in children with chronic respiratory illness.
CONCLUSIONS: Current evidence suggests that individual caseworker-assigned discharge plans, as compared to non-caseworker-assigned plans, may be beneficial in preventing hospital readmissions for acute exacerbations in children with asthma. There was no clear indication that the intervention reduces emergency department and general practitioner attendances for asthma, and there is an absence of data for children with other chronic respiratory conditions. Given the potential benefit and cost savings to the healthcare sector and families if hospitalisations and outpatient attendances can be reduced, there is a need for furth...
Source: Cochrane Database of Systematic Reviews - November 2, 2018 Category: General Medicine Authors: Hall KK, Petsky HL, Chang AB, O'Grady KF Tags: Cochrane Database Syst Rev Source Type: research

Follow-up services for improving long-term outcomes in intensive care unit (ICU) survivors.
CONCLUSIONS: We found insufficient evidence, from a limited number of studies, to determine whether ICU follow-up services are effective in identifying and addressing the unmet health needs of ICU survivors. We found five ongoing studies which are not included in this review; these ongoing studies may increase our certainty in the effect in future updates. Because of limited data, we were unable to explore whether one design of follow-up service is preferable to another, or whether a service is more effective for some people than others, and we anticipate that future studies may also vary in design. We propose that future ...
Source: Cochrane Database of Systematic Reviews - November 2, 2018 Category: General Medicine Authors: Schofield-Robinson OJ, Lewis SR, Smith AF, McPeake J, Alderson P Tags: Cochrane Database Syst Rev Source Type: research

Insecticide space spraying for preventing malaria transmission.
CONCLUSIONS: Evidence from one state in India conducted over 30 years ago suggests an effect of space spraying on the incidence of malaria, but the certainty of the evidence is very low. Reliable research in a variety of settings will help establish whether and when this intervention may be worthwhile. PMID: 30388303 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 2, 2018 Category: General Medicine Authors: Pryce J, Choi L, Richardson M, Malone D Tags: Cochrane Database Syst Rev Source Type: research

Subpial transection surgery for epilepsy.
CONCLUSIONS: We found no evidence to support or refute the use of subpial transection surgery for patients with medically refractory epilepsy. Well-designed randomised controlled trials are needed to guide clinical practice. PMID: 30383287 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 1, 2018 Category: General Medicine Authors: Krishnaiah B, Ramaratnam S, Ranganathan LN Tags: Cochrane Database Syst Rev Source Type: research

Vitamin and mineral supplementation for preventing dementia or delaying cognitive decline in people with mild cognitive impairment.
CONCLUSIONS: The evidence on vitamin and mineral supplements as treatments for MCI is very limited. Three years of treatment with high-dose vitamin E probably does not reduce the risk of progression to dementia, but we have no data on this outcome for other supplements. Only B vitamins have been assessed in more than one RCT. There is no evidence for beneficial effects on cognition of supplementation with B vitamins for six to 24 months. Evidence from a single study of a reduced rate of brain atrophy in participants taking vitamin B and a beneficial effect of vitamin B on episodic memory in those with higher tHcy at baseli...
Source: Cochrane Database of Systematic Reviews - November 1, 2018 Category: General Medicine Authors: McCleery J, Abraham RP, Denton DA, Rutjes AW, Chong LY, Al-Assaf AS, Griffith DJ, Rafeeq S, Yaman H, Malik MA, Di Nisio M, Martínez G, Vernooij RW, Tabet N Tags: Cochrane Database Syst Rev Source Type: research

Surgical portosystemic shunts versus transjugular intrahepatic portosystemic shunt for variceal haemorrhage in people with cirrhosis.
CONCLUSIONS: We found evidence suggesting that surgical portosystemic shunts may have benefit over TIPS for treatment of refractory or recurrent variceal haemorrhage in people with cirrhotic portal hypertension. Given the very low-certainty of the available evidence and risks of random errors in our analyses, we have very little confidence in our review findings. PMID: 30378107 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Brand M, Prodehl L, Ede CJ Tags: Cochrane Database Syst Rev Source Type: research

Chlorpromazine versus piperacetazine for schizophrenia.
CONCLUSIONS: The results of this review show chlorpromazine and piperacetazine may have similar clinical efficacy, but data are based on very small numbers of participants and the evidence is very low quality. We can not make firm conclusions based on such data. Currently, should clinicians and people with schizophrenia need to choose between chlorpromazine and piperacetazine they should be aware there is no good quality evidence to base decisions. More high quality research is needed. PMID: 30378678 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Eslami Shahrbabaki M, Dehnavieh R, Vali L, Sharafkhani R Tags: Cochrane Database Syst Rev Source Type: research

Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease).
CONCLUSIONS: Very low-quality evidence suggests there may be an effect of the use of bone marrow-derived stem cells in the healing of ulcers and improvement in the pain-free walking distance in patients with Buerger's disease. High-quality trials assessing the effectiveness of stem cell therapy for treatment of patients with thromboangiitis obliterans (Buerger's disease) are needed. PMID: 30378681 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Cacione DG, do Carmo Novaes F, Moreno DH Tags: Cochrane Database Syst Rev Source Type: research

Laparoscopy versus laparotomy for the management of early stage endometrial cancer.
CONCLUSIONS: This review found low to moderate-certainty evidence to support the role of laparoscopy for the management of early endometrial cancer. For presumed early stage primary endometrioid adenocarcinoma of the endometrium, laparoscopy is associated with similar OS and DFS. Furthermore, laparoscopy is associated with reduced operative morbidity and hospital stay. There is no significant difference in severe postoperative morbidity between the two modalities.The certainty of evidence for OS and RFS was moderate and was downgraded for unclear risk of bias profiles and imprecision in effect estimates. However, most stud...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Galaal K, Donkers H, Bryant A, Lopes AD Tags: Cochrane Database Syst Rev Source Type: research

Gene therapy for peripheral arterial disease.
CONCLUSIONS: Moderate-quality evidence shows no clear differences in amputation-free survival, major amputation, and all-cause mortality between those treated with gene therapy and those not receiving gene therapy. Some evidence suggests that gene therapy may lead to improved complete ulcer healing, but this outcome needs to be explored with improved reporting of the measure, such as decreased ulcer area in cm², and better description of ulcer types and healing. Further standardised data that are amenable to meta-analysis are needed to evaluate other outcomes such as quality of life, ankle brachial index, symptom scor...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Forster R, Liew A, Bhattacharya V, Shaw J, Stansby G Tags: Cochrane Database Syst Rev Source Type: research

One-to-one oral hygiene advice provided in a dental setting for oral health.
CONCLUSIONS: There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review. PMID: 30380139 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Soldani FA, Lamont T, Jones K, Young L, Walsh T, Lala R, Clarkson JE Tags: Cochrane Database Syst Rev Source Type: research

Action observation for upper limb rehabilitation after stroke.
CONCLUSIONS: We found evidence that AO is beneficial in improving upper limb motor function and dependence in activities of daily living (ADL) in people with stroke, when compared with any control group; however, we considered the quality of the evidence to be low. We considered the effect of AO on hand function to be large, but it does not appear to be clinically relevant, although we considered the quality of the evidence as moderate. As such, our confidence in the effect estimate is limited because it will likely change with future research. PMID: 30380586 [PubMed - as supplied by publisher] (Source: Cochrane Datab...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Borges LR, Fernandes AB, Melo LP, Guerra RO, Campos TF Tags: Cochrane Database Syst Rev Source Type: research

Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis.
CONCLUSIONS: There is little useful high-level evidence to judge the effectiveness of inhaled antibiotics for the treatment of pulmonary exacerbations in people with cystic fibrosis. The included trials were not sufficiently powered to achieve their goals. Hence, we are unable to demonstrate whether one treatment was superior to the other or not. Further research is needed to establish whether inhaled tobramycin may be used as an alternative to intravenous tobramycin for some pulmonary exacerbations. PMID: 30376155 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Smith S, Rowbotham NJ, Charbek E Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).
Abstract BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS: We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018. SELECTION CRITERIA: Randomised...
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Herath SC, Normansell R, Maisey S, Poole P Tags: Cochrane Database Syst Rev Source Type: research

Gamma aminobutyric acid (GABA) receptor agonists for acute stroke.
CONCLUSIONS: This review provides moderate-quality evidence that fails to support the use of GABA receptor agonists (chlormethiazole or diazepam) for the treatment of people with acute stroke. More well-designed RCTs with large samples of participants with total anterior circulation syndrome are required to determine if there are benefits for this subgroup. Somnolence and rhinitis are frequent adverse events related to chlormethiazole. PMID: 30376593 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Liu J, Zhang J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Swallowing therapy for dysphagia in acute and subacute stroke.
CONCLUSIONS: Moderate- and low-quality evidence suggests that swallowing therapy did not have a significant effect on the outcomes of death or dependency/disability, case fatality at the end of the trial, or penetration aspiration score. However, swallowing therapy may have reduced length of hospital stay, dysphagia, and chest infections, and may have improved swallowing ability. However, these results are based on evidence of variable quality, involving a variety of interventions. Further high-quality trials are needed to test whether specific interventions are effective. PMID: 30376602 [PubMed - as supplied by publi...
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Bath PM, Lee HS, Everton LF Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for exacerbations of chronic obstructive pulmonary disease.
CONCLUSIONS: Researchers have found that antibiotics have some effect on inpatients and outpatients, but these effects are small, and they are inconsistent for some outcomes (treatment failure) and absent for other outcomes (mortality, length of hospital stay). Analyses show a strong beneficial effect of antibiotics among ICU patients. Few data are available on the effects of antibiotics on health-related quality of life or on other patient-reported symptoms, and data show no statistically significant increase in the risk of adverse events with antibiotics compared to placebo. These inconsistent effects call for research i...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Vollenweider DJ, Frei A, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA Tags: Cochrane Database Syst Rev Source Type: research

Heliox for croup in children.
CONCLUSIONS: Due to very limited evidence, uncertainty remains about the effectiveness and safety of heliox. Heliox may not be more effective than 30% humidified oxygen for children with mild croup, but may be beneficial in the short term for children with moderate to severe croup treated with dexamethasone. The effect may be similar to 100% oxygen given with one or two doses of adrenaline. Adverse events were not reported, and it is unclear if these were monitored in the included studies. Adequately powered RCTs comparing heliox with standard treatments are needed to further assess the role of heliox in the treatment of c...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Moraa I, Sturman N, McGuire TM, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia.
CONCLUSIONS: Overall prognosis of people with IH worsened over time. T2DM cumulative incidence generally increased over the course of follow-up but varied with IH definition. Regression from IH to normoglycaemia decreased over time but was observed even after 11 years of follow-up. The risk of developing T2DM when comparing IH with normoglycaemia at baseline varied by IH definition. Taking into consideration the uncertainty of the available evidence, as well as the fluctuating stages of normoglycaemia, IH and T2DM, which may transition from one stage to another in both directions even after years of follow-up, practitioner...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Richter B, Hemmingsen B, Metzendorf MI, Takwoingi Y Tags: Cochrane Database Syst Rev Source Type: research

Carvedilol versus traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices.
CONCLUSIONS: We found no clear beneficial or harmful effects of carvedilol versus traditional, non-selective beta-blockers on mortality, upper gastrointestinal bleeding, serious or non-serious adverse events despite the fact that carvedilol was more effective at reducing the hepatic venous pressure gradient. However, the evidence was of low or very low quality, and hence the findings are uncertain. Additional evidence is required from adequately powered, long-term, double-blind, randomised clinical trials, which evaluate both clinical and haemodynamic outcomes. PMID: 30372514 [PubMed - as supplied by publisher] (Sourc...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Zacharias AP, Jeyaraj R, Hobolth L, Bendtsen F, Gluud LL, Morgan MY Tags: Cochrane Database Syst Rev Source Type: research

Biocompatible dialysis fluids for peritoneal dialysis.
CONCLUSIONS: This updated review strengthens evidence that neutral pH, low GDP PD solution improves RRF and urine volume preservation with high certainty. These effects may be related to increased peritoneal solute transport and reduced peritoneal ultrafiltration, although the evidence for these outcomes is of low certainty due to significant heterogeneity and suboptimal methodological quality. Icodextrin prescription increased peritoneal ultrafiltration and mitigated uncontrolled fluid overload with moderate certainty. The effects of either neutral pH, low GDP solution or icodextrin on peritonitis, technique survival and ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Htay H, Johnson DW, Wiggins KJ, Badve SV, Craig JC, Strippoli GF, Cho Y Tags: Cochrane Database Syst Rev Source Type: research

Extended-field radiotherapy for locally advanced cervical cancer.
CONCLUSIONS: Moderate-certainty evidence shows that, compared with pelvic RT alone, extended-field RT probably improves overall survival and reduces risk of para-aortic lymph node recurrence. However, pelvic RT alone would now be considered substandard treatment, so this result cannot be extrapolated to modern standards of care. Low- to moderate-certainty evidence suggests that pelvic CRT may increase overall and progression-free survival compared to extended-field RT, although there may or may not be a higher rate of para-aortic recurrence and acute adverse events. Extended-field CRT versus pelvic CRT may improve overall ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Thamronganantasakul K, Supakalin N, Kietpeerakool C, Pattanittum P, Lumbiganon P Tags: Cochrane Database Syst Rev Source Type: research

Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke.
CONCLUSIONS: The present review directly compared intravenous thrombolytic treatment with percutaneous vascular interventions for ischaemic stroke. We found no evidence from RCTs that percutaneous vascular interventions are superior to intravenous thrombolytic treatment with respect to functional outcome. Quality of evidence was low (outcome assessment was blinded, but not the treating physician or participants). New trials with adequate sample sizes are warranted because of the rapid development of new techniques and devices for such interventions. PMID: 30365156 [PubMed - as supplied by publisher] (Source: Cochrane ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Lindekleiv H, Berge E, Bruins Slot KM, Wardlaw JM Tags: Cochrane Database Syst Rev Source Type: research

Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications.
Abstract BACKGROUND: This is an update of the review last published in 2011. It focuses on early postoperative enteral nutrition after lower gastrointestinal surgery. Traditional management consisted of 'nil by mouth', where patients receive fluids followed by solids after bowel function has returned. Although several trials have reported lower incidence of infectious complications and faster wound healing upon early feeding, other trials have shown no effect. The immediate advantage of energy intake (carbohydrates, protein or fat) could enhance recovery with fewer complications, and this warrants a systematic eva...
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Herbert G, Perry R, Andersen HK, Atkinson C, Penfold C, Lewis SJ, Ness AR, Thomas S Tags: Cochrane Database Syst Rev Source Type: research

Carbamazepine versus phenobarbitone monotherapy for epilepsy: an individual participant data review.
CONCLUSIONS: Moderate-quality evidence from this review suggests that carbamazepine is likely to be a more effective drug than phenobarbitone in terms of treatment retention (treatment failures due to lack of efficacy or adverse events or both). Moderate- to low-quality evidence from this review also suggests an association between treatment efficacy and seizure type in terms of seizure recurrence and seizure remission, with an advantage for phenobarbitone for focal onset seizures and an advantage for carbamazepine for generalised onset seizures.However, some of the trials contributing to the analyses had methodological in...
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Nevitt SJ, Marson AG, Tudur Smith C Tags: Cochrane Database Syst Rev Source Type: research

Gabapentin add-on treatment for drug-resistant focal epilepsy.
CONCLUSIONS: Gabapentin has efficacy as an add-on treatment in people with drug-resistant focal epilepsy. However, the trials reviewed were of relatively short duration and provide no evidence for the long-term efficacy of gabapentin beyond a three-month period. The results cannot be extrapolated to monotherapy or to people with other epilepsy types. PMID: 30357813 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Panebianco M, Al-Bachari S, Weston J, Hutton JL, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Oxcarbazepine versus phenytoin monotherapy for epilepsy: an individual participant data review.
CONCLUSIONS: High-quality evidence provided by this review indicates that treatment failure due to adverse events occurs significantly later with oxcarbazepine than phenytoin. For individuals with focal onset seizures, moderate-quality evidence suggests that oxcarbazepine may be superior to phenytoin in terms of treatment failure for any reason, seizure recurrence and seizure remission. Therefore, oxcarbazepine may be a preferable alternative treatment than phenytoin, particularly for individuals with focal onset seizures. The evidence in this review which relates to individuals with generalised onset seizures is of low qu...
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Nevitt SJ, Tudur Smith C, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral amputation.
CONCLUSIONS: The limited evidence presented in this review is of very low quality and is insufficient to inform the choice of prosthetic rehabilitation, including the optimum weight of the prosthesis, after unilateral transfemoral amputation in older dysvascular people. A programme of research that includes randomised controlled trials to examine key interventions is urgently required in this area. PMID: 30350430 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Barr S, Howe TE Tags: Cochrane Database Syst Rev Source Type: research

Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers.
CONCLUSIONS: We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs. For other physical ergonomic interventions there is no evidence of an effect. For organisational interventions, in the form of supplementary breaks, there is very low-quality evidence of an effect on upper limb discomfort. For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort. Further high-quality studies are needed to determine the effectiveness of these interventions among office workers. PMID: 3035085...
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR Tags: Cochrane Database Syst Rev Source Type: research

Penile rehabilitation for postprostatectomy erectile dysfunction.
CONCLUSIONS: Based on mostly very-low and some low-quality evidence, penile rehabilitation strategies consisting of scheduled PDE5I use following radical prostatectomy may not promote self-reported potency and erectile function any more than on demand use. PMID: 30352488 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Philippou YA, Jung JH, Steggall MJ, O'Driscoll ST, Bakker CJ, Bodie JA, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Skin preparation for preventing infection following caesarean section.
CONCLUSIONS: There was insufficient evidence available from the included RCTs to fully evaluate different agents and methods of skin preparation for preventing infection following caesarean section. Therefore, it is not yet clear what sort of skin preparation may be most effective for preventing postcaesarean surgical site infection, or for reducing other undesirable outcomes for mother and baby.Most of the evidence in this review was deemed to be very low or low quality. This means that for most findings, our confidence in any evidence of an intervention effect is limited, and indicates the need for more high-quality rese...
Source: Cochrane Database of Systematic Reviews - October 22, 2018 Category: General Medicine Authors: Hadiati DR, Hakimi M, Nurdiati DS, da Silva Lopes K, Ota E Tags: Cochrane Database Syst Rev Source Type: research

Leukotriene receptor antagonists for eczema.
CONCLUSIONS: The findings of this review are limited to montelukast. There was a lack of evidence addressing the review question, and the quality of the available evidence for most of the measured outcomes was low. Some primary and secondary outcomes were not addressed at all, including long-term control.We found no evidence of a difference between montelukast (10 mg) and placebo on disease severity, pruritus improvement, and topical corticosteroid use. Very low-quality evidence means we are uncertain of the effect of montelukast (10 mg) compared with conventional treatment on disease severity. Participants in only one stu...
Source: Cochrane Database of Systematic Reviews - October 21, 2018 Category: General Medicine Authors: Ferguson L, Futamura M, Vakirlis E, Kojima R, Sasaki H, Roberts A, Mori R Tags: Cochrane Database Syst Rev Source Type: research

Intrauterine administration of human chorionic gonadotropin (hCG) for subfertile women undergoing assisted reproduction.
Abstract BACKGROUND: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone that is synthesised and released by the syncytiotrophoblast and has a fundamental role in embryo implantation and the early stages of pregnancy. Intrauterine administration of hCG via ET catheter during a mock procedure around the time of ET is a novel approach that has been suggested to improve the outcomes of assisted reproduction. ...
Source: Cochrane Database of Systematic Reviews - October 20, 2018 Category: General Medicine Authors: Craciunas L, Tsampras N, Raine-Fenning N, Coomarasamy A Tags: Cochrane Database Syst Rev Source Type: research

Interventions for reducing inflammation in familial Mediterranean fever.
CONCLUSIONS: There were limited RCTs assessing interventions for people with familial Mediterranean fever. Based on the evidence, three times daily colchicine appears to reduce the number of people experiencing attacks, colchicine single dose and divided dose might not be different for children with familial Mediterranean fever and anakinra might reduce C-reactive protein in colchicine-resistant participants; however, only a few RCTs contributed data for analysis. Further RCTs examining active interventions, not only colchicine, are necessary before a comprehensive conclusion regarding the efficacy and safety of interventi...
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Wu B, Xu T, Li Y, Yin X Tags: Cochrane Database Syst Rev Source Type: research

Drugs for preventing red blood cell dehydration in people with sickle cell disease.
CONCLUSIONS: While the results of zinc for reducing sickle-related crises are encouraging, larger and longer-term multicenter studies are needed to evaluate the effectiveness of this therapy for people with sickle cell disease.While the Phase II and the prematurely terminated phase III studies of senicapoc showed that the drug improved red blood cell survival (depending on dose), this did not lead to fewer painful crises.Given this is no longer an active area of research, this review will no longer be regularly updated. PMID: 30338520 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Nagalla S, Ballas SK Tags: Cochrane Database Syst Rev Source Type: research

Infant formulas containing hydrolysed protein for prevention of allergic disease.
CONCLUSIONS: We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergic disease. Very low-quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA. Further trials are recommended before implementation of this practice.We found no evidence to support prolonged feeding with a hydrolysed formula compared with a CMF for prevention of allergic disease in infants unable to be exclusively breast fed. PMID: 30338526 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Osborn DA, Sinn JK, Jones LJ Tags: Cochrane Database Syst Rev Source Type: research

Zonisamide add-on therapy for focal epilepsy.
CONCLUSIONS: When used as an add-on treatment in people with focal epilepsy uncontrolled by one or more concomitant antiepileptic drugs, moderate-quality evidence found that zonisamide was more successful than placebo at reducing the frequency of seizures by at least 50%. We were unable to identify minimum effective and maximum tolerated doses. The included trials evaluated a maximum stable-dose phase of 18 weeks, so results cannot be used to confirm longer periods of efficacy in seizure control. The results cannot be extrapolated to monotherapy or to people with other seizure types or epilepsy syndromes. PMID: 303352...
Source: Cochrane Database of Systematic Reviews - October 18, 2018 Category: General Medicine Authors: Brigo F, Lattanzi S, Igwe SC, Behzadifar M, Bragazzi NL Tags: Cochrane Database Syst Rev Source Type: research

Prokinetics for functional dyspepsia.
Abstract BACKGROUND: Dyspepsia is a common condition associated with gastrointestinal (GI) disease. Prokinetics are the treatment of choice for functional dyspepsia (FD). However, the role of prokinetics in FD treatment is still controversial. OBJECTIVES: We conducted a systematic review and meta-analysis of randomised control trials (RCTs) examining the efficacy of prokinetics in the treatment of FD. The primary outcome was overall absence of or improvement of symptoms and symptom scores at the end of treatment. We also evaluated quality of life (QoL) and adverse events as secondary outcomes. SEARCH MET...
Source: Cochrane Database of Systematic Reviews - October 18, 2018 Category: General Medicine Authors: Pittayanon R, Yuan Y, Bollegala NP, Khanna R, Leontiadis GI, Moayyedi P Tags: Cochrane Database Syst Rev Source Type: research