Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation.
CONCLUSIONS: Burkholderia cepacia complex infections present a significant challenge for people with cystic fibrosis and their clinicians. The incidence is likely to increase as the cystic fibrosis population ages; and managing and treating these infections will become more important. There is a lack of trial evidence to guide decision making and no conclusions can be drawn from this review about the optimal antibiotic regimens for people with cystic fibrosis who have chronic Burkholderia cepacia complex infections. Clinicians must continue to assess each person individually, taking into account in vitro antibiotic suscept...
Source: Cochrane Database of Systematic Reviews - April 2, 2020 Category: General Medicine Authors: Lord R, Jones AM, Horsley A Tags: Cochrane Database Syst Rev Source Type: research

Treatments for the prevention of Sudden Unexpected Death in Epilepsy (SUDEP).
Abstract BACKGROUND: This is an updated version of the original Cochrane Review, published in 2016, Issue 7. Sudden Unexpected Death in Epilepsy (SUDEP) is defined as sudden, unexpected, witnessed or unwitnessed, non-traumatic or non-drowning death of people with epilepsy, with or without evidence of a seizure, excluding documented status epilepticus and in whom postmortem examination does not reveal a structural or toxicological cause for death. SUDEP has a reported incidence of 1 to 2 per 1000 patient-years and represents the most common epilepsy-related cause of death. The presence and frequency of generalised ...
Source: Cochrane Database of Systematic Reviews - April 2, 2020 Category: General Medicine Authors: Maguire MJ, Jackson CF, Marson AG, Nevitt SJ Tags: Cochrane Database Syst Rev Source Type: research

Spectacle correction versus no spectacles for prevention of strabismus in hyperopic children.
CONCLUSIONS: The effect of spectacle correction for prevention of strabismus is still unclear. In addition, the use of spectacle on the risk of visual acuity worse than 20/30, amblyopia, and inadequate emmetropization is also unclear. There may be a benefit on prevention of inadequate stereoacuity. However, these effects may have been chance findings or due to bias. PMID: 32240551 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - April 2, 2020 Category: General Medicine Authors: Jones-Jordan L, Wang X, Scherer RW, Mutti DO Tags: Cochrane Database Syst Rev Source Type: research

Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants.
CONCLUSIONS: We found low-certainty evidence from studies of good methodological quality that lactoferrin supplementation of enteral feeds decreases late-onset sepsis but not NEC ≥ stage II or 'all cause mortality' or neurodevelopmental outcomes at 24 months of age in preterm infants without adverse effects. Low- to very low-certainty evidence suggests that lactoferrin supplementation of enteral feeds in combination with probiotics decreases late-onset sepsis and NEC ≥ stage II in preterm infants without adverse effects, however, there were few included studies of poor methodological quality. The presence of publicat...
Source: Cochrane Database of Systematic Reviews - March 31, 2020 Category: General Medicine Authors: Pammi M, Suresh G Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing and managing advanced liver disease in cystic fibrosis.
CONCLUSIONS: In order to develop the best source of evidence, there is a need to undertake randomised controlled trials of interventions for preventing and managing advanced liver disease in adults and children with cystic fibrosis. PMID: 32227478 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 30, 2020 Category: General Medicine Authors: Palaniappan SK, Than NN, Thein AW, van Mourik I Tags: Cochrane Database Syst Rev Source Type: research

Physical therapies for postural abnormalities in people with cystic fibrosis.
CONCLUSIONS: Due to methodological limitations in the included trials, and in addition to the very low to low quality of the current evidence, there is limited evidence about the benefits of physical therapies on postural abnormalities in people with CF. Therefore, further well-conducted trials with robust methodologies are required considering a prior inclusion criterion to identify the participants who have postural abnormalities. PMID: 32227599 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 30, 2020 Category: General Medicine Authors: Oliveira VH, Mendonça KM, Monteiro KS, Silva IS, Santino TA, Nogueira PAM Tags: Cochrane Database Syst Rev Source Type: research

Antibiotic prophylaxis for operative vaginal delivery.
CONCLUSIONS: Prophylactic intravenous antibiotics are effective in reducing infectious puerperal morbidities in terms of superficial and deep perineal wound infection or serious infectious complications in women undergoing operative vaginal deliveries without clinical indications for antibiotic administration after delivery. Prophylactic antibiotics slightly improve perineal pain and health consequences of perineal pain, probably reduce the costs, and may slightly reduce the maternal hospital re-admission and health-related quality of life. However, the effect on reduction of endometritis, organ or space perineal wound inf...
Source: Cochrane Database of Systematic Reviews - March 26, 2020 Category: General Medicine Authors: Liabsuetrakul T, Choobun T, Peeyananjarassri K, Islam QM Tags: Cochrane Database Syst Rev Source Type: research

Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis.
CONCLUSIONS: Our findings propose a nuanced view about mHealth programmes. The complexities of healthcare delivery and human interactions defy simplistic conclusions on how health workers will perceive and experience their use of mHealth. Perceptions reflect the interplay between the technology, contexts, and human attributes. Detailed descriptions of the programme, implementation processes and contexts, alongside effectiveness studies, will help to unravel this interplay to formulate hypotheses regarding the effectiveness of mHealth. PMID: 32216074 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 26, 2020 Category: General Medicine Authors: Odendaal WA, Anstey Watkins J, Leon N, Goudge J, Griffiths F, Tomlinson M, Daniels K Tags: Cochrane Database Syst Rev Source Type: research

Nasogastric versus nasojejunal tube feeding for severe acute pancreatitis.
CONCLUSIONS: There is insufficient evidence to conclude that there is superiority, inferiority, or equivalence between the nasogastric and nasojejunal mode of enteral tube feeding in people with severe acute pancreatitis. PMID: 32216139 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 26, 2020 Category: General Medicine Authors: Dutta AK, Goel A, Kirubakaran R, Chacko A, Tharyan P Tags: Cochrane Database Syst Rev Source Type: research

Convective radiofrequency water vapour thermal therapy for lower urinary tract symptoms in men with benign prostatic hyperplasia.
CONCLUSIONS: Compared to a sham procedure, urologic symptom scores and quality of life appear to improve with convective radiofrequency water vapour thermal therapy, but we are very uncertain about major adverse events. The certainty of evidence ranged from moderate to very low, with study limitations and imprecision being the most common reasons for rating down. These findings are based on a single industry-sponsored study, with three-month short-term follow-up. We did not find any studies comparing convective radiofrequency water vapour thermal therapy to any other active treatment form, such as TURP. PMID: 32212174...
Source: Cochrane Database of Systematic Reviews - March 25, 2020 Category: General Medicine Authors: Kang TW, Jung JH, Hwang EC, Borofsky M, Kim MH, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Death audits and reviews for reducing maternal, perinatal and child mortality.
CONCLUSIONS: A complex intervention including maternal death audit and review, as well as development of local leadership and training, probably reduces inpatient maternal mortality in low-income country district hospitals, and probably slightly improves quality of care. Perinatal death audit and review, as part of a complex intervention with training, probably improves quality of care, as measured by perinatal morbidity related to suboptimal care, in a high-income setting where mortality was already very low. The WHO recommends that maternal and perinatal death reviews should be conducted in all hospitals globally. Howeve...
Source: Cochrane Database of Systematic Reviews - March 25, 2020 Category: General Medicine Authors: Willcox ML, Price J, Scott S, Nicholson BD, Stuart B, Roberts NW, Allott H, Mubangizi V, Dumont A, Harnden A Tags: Cochrane Database Syst Rev Source Type: research

Daikenchuto for reducing postoperative ileus in patients undergoing elective abdominal surgery.
Abstract Reason for withdrawal: Serious breach of Cochrane's conflict of interest policy. A ruling by Cochrane's Funding Arbiters that a Cochrane Review has seriously breached Cochrane's conflict of interest policy. PMID: 32212387 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 25, 2020 Category: General Medicine Authors: Hoshino N, Takada T, Hida K, Hasegawa S, Furukawa TA, Sakai Y Tags: Cochrane Database Syst Rev Source Type: research

Breathing exercises for adults with asthma.
CONCLUSIONS: Breathing exercises may have some positive effects on quality of life, hyperventilation symptoms, and lung function. Due to some methodological differences among included studies and studies with poor methodology, the quality of evidence for the measured outcomes ranged from moderate to very low certainty according to GRADE criteria. In addition, further studies including full descriptions of treatment methods and outcome measurements are required. PMID: 32212422 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 25, 2020 Category: General Medicine Authors: Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM Tags: Cochrane Database Syst Rev Source Type: research

Treatment of newly diagnosed glioblastoma in the elderly: a network meta-analysis.
CONCLUSIONS: For elderly people with glioblastoma who are self-caring, evidence suggests that CRT prolongs survival compared with RT and may prolong overall survival compared with TMZ alone. For those undergoing RT or TMZ therapy, there is probably little difference in QoL overall. Systemic anti-cancer treatments TMZ and BEV carry a higher risk of severe haematological and thromboembolic events and CRT is probably associated with a higher risk of these events. Current evidence provides little justification for using BEV in elderly patients outside a clinical trial setting. Whilst the novel TTF device appears prom...
Source: Cochrane Database of Systematic Reviews - March 23, 2020 Category: General Medicine Authors: Hanna C, Lawrie TA, Rogozińska E, Kernohan A, Jefferies S, Bulbeck H, Ali UM, Robinson T, Grant R Tags: Cochrane Database Syst Rev Source Type: research

Occlusion for stimulus deprivation amblyopia.
CONCLUSIONS: We found no evidence from RCTs or quasi-randomized trials on the effectiveness of any treatment for SDA. RCTs are needed in order to evaluate the safety and effectiveness of occlusion, duration of treatment, level of vision that can be realistically achieved, effects of age at onset and magnitude of visual defect, optimum occlusion regimen, and factors associated with satisfactory and unsatisfactory outcomes with the use of various interventions for SDA. PMID: 32203629 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 23, 2020 Category: General Medicine Authors: Antonio-Santos A, Vedula SS, Hatt SR, Powell C Tags: Cochrane Database Syst Rev Source Type: research

Barrier agents for adhesion prevention after gynaecological surgery.
CONCLUSIONS: We found no evidence on the effects of barrier agents used during pelvic surgery on pelvic pain or live birth rate in women of reproductive age because no trial reported these outcomes. It is difficult to draw credible conclusions due to lack of evidence and the low quality of included studies. Given this caveat, low-quality evidence suggests that collagen membrane with polyethylene glycol plus glycerol may be more effective than no treatment in reducing the incidence of adhesion formation following pelvic surgery. Low-quality evidence also shows that oxidised regenerated cellulose may reduce the incidence of ...
Source: Cochrane Database of Systematic Reviews - March 22, 2020 Category: General Medicine Authors: Ahmad G, Kim K, Thompson M, Agarwal P, O'Flynn H, Hindocha A, Watson A Tags: Cochrane Database Syst Rev Source Type: research

Physical fitness training for stroke patients.
CONCLUSIONS: Few deaths overall suggest exercise is a safe intervention but means we cannot determine whether exercise reduces mortality or the chance of death or dependency. Cardiorespiratory training and, to a lesser extent mixed training, reduce disability during or after usual stroke care; this could be mediated by improved mobility and balance. There is sufficient evidence to incorporate cardiorespiratory and mixed training, involving walking, within post-stroke rehabilitation programmes to improve fitness, balance and the speed and capacity of walking. The magnitude of VO2 peak increase after cardiorespiratory traini...
Source: Cochrane Database of Systematic Reviews - March 20, 2020 Category: General Medicine Authors: Saunders DH, Sanderson M, Hayes S, Johnson L, Kramer S, Carter DD, Jarvis H, Brazzelli M, Mead GE Tags: Cochrane Database Syst Rev Source Type: research

Lamotrigine add-on therapy for drug-resistant focal epilepsy.
CONCLUSIONS: Lamotrigine as an add-on treatment for drug-resistant focal seizures appears to be effective in reducing seizure frequency, and seems to be fairly well-tolerated. However, the trials were of relatively short duration and provided no evidence for the long term. Further trials are needed to assess the long-term effects of lamotrigine, and to compare lamotrigine with other add-on drugs. PMID: 32196639 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 20, 2020 Category: General Medicine Authors: Panebianco M, Bresnahan R, Ramaratnam S, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Glucocorticoid replacement regimens for treating congenital adrenal hyperplasia.
CONCLUSIONS: There are currently limited trials comparing the efficacy and safety of different glucocorticoid replacement regimens for treating 21-hydroxylase deficiency CAH in children and adults and we were unable to draw any firm conclusions based on the evidence that was presented in the included trials. No trials included long-term outcomes such as quality of life, prevention of adrenal crisis, presence of osteopenia, presence of testicular or ovarian adrenal rest tumours, subfertility and final adult height. There were no trials examining a modified-release formulation of HC or use of 24-hour circadian continuous sub...
Source: Cochrane Database of Systematic Reviews - March 19, 2020 Category: General Medicine Authors: Ng SM, Stepien KM, Krishan A Tags: Cochrane Database Syst Rev Source Type: research

Antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis.
CONCLUSIONS: This review did not identify any evidence regarding the effectiveness of antibiotic treatment for Stenotrophomonas maltophilia in people with cystic fibrosis. Until such evidence becomes available, clinicians need to use their clinical judgement as to whether or not to treat Stenotrophomonas maltophilia infection in people with cystic fibrosis. Randomized clinical trials are needed to address these unanswered clinical questions. PMID: 32189337 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 18, 2020 Category: General Medicine Authors: Amin R, Jahnke N, Waters V Tags: Cochrane Database Syst Rev Source Type: research

Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes.
CONCLUSIONS: Our meta-analysis of nine studies shows that sustained lung inflation without chest compression was not better than intermittent ventilation for reducing mortality in the delivery room (low-quality evidence ‒ GRADE) or during hospitalisation (moderate-quality evidence ‒ GRADE), which were the primary outcomes of this review. However, the single largest study, which was well conducted and had the greatest number of enrolled infants, was stopped early for higher mortality rate in the sustained inflation group. When considering secondary outcomes, such as rate of intubation, rate or duration of respiratory su...
Source: Cochrane Database of Systematic Reviews - March 18, 2020 Category: General Medicine Authors: Bruschettini M, O'Donnell CP, Davis PG, Morley CJ, Moja L, Calevo MG Tags: Cochrane Database Syst Rev Source Type: research

Psychological interventions for people with hemophilia.
CONCLUSIONS: Not all of the seven included trials analysed the effects of the interventions on our primary outcomes (mood and personal well-being, coping strategies and QoL). Three trials were conducted in the 1970s and 1980s using techniques of auto-hypnosis or relaxation and, in accordance with the needs and therapeutic possibilities of the time, they focused on secondary outcomes, e.g. frequency of bleeding (physical health) and adherence to the intervention. The four newer trials assessed psycho-educational interventions all mediated by the use of technologies (DVD or computer) and often created according to age needs ...
Source: Cochrane Database of Systematic Reviews - March 18, 2020 Category: General Medicine Authors: Palareti L, Melotti G, Cassis F, Nevitt SJ, Iorio A Tags: Cochrane Database Syst Rev Source Type: research

Intense pulsed light (IPL) therapy for the treatment of meibomian gland dysfunction.
CONCLUSIONS: This systematic review finds a scarcity of RCT evidence relating to the effectiveness and safety of IPL as a treatment for MGD. Whether IPL is of value for modifying the symptoms or signs of evaporative dry eye disease is currently uncertain. Due to a lack of comprehensive reporting of adverse events, the safety profile of IPL in this patient population is also unclear. The current limitations in the evidence base should be considered by clinicians using this intervention to treat MGD, and outlined to individuals potentially undergoing this procedure with the intent of treating dry eye disease. The results of ...
Source: Cochrane Database of Systematic Reviews - March 18, 2020 Category: General Medicine Authors: Cote S, Zhang AC, Ahmadzai V, Maleken A, Li C, Oppedisano J, Nair K, Busija L, Downie LE Tags: Cochrane Database Syst Rev Source Type: research

Diaphragm-triggered non-invasive respiratory support in preterm infants.
Abstract BACKGROUND: Diaphragm-triggered non-invasive respiratory support, commonly referred to as NIV-NAVA (non-invasive neurally adjusted ventilatory assist), uses the electrical activity of the crural diaphragm to trigger the start and end of a breath. It provides variable inspiratory pressure that is proportional to an infant's changing inspiratory effort. NIV-NAVA has the potential to provide effective, non-invasive, synchronised, multilevel support and may reduce the need for invasive ventilation; however, its effects on short- and long-term outcomes, especially in the preterm infant, are unclear. OBJEC...
Source: Cochrane Database of Systematic Reviews - March 17, 2020 Category: General Medicine Authors: Goel D, Oei JL, Smyth J, Schindler T Tags: Cochrane Database Syst Rev Source Type: research

Postnatal corticosteroids for transient tachypnoea of the newborn.
CONCLUSIONS: Given the paucity and very low quality of the available evidence, we are unable to determine the benefits and harms of postnatal administration of either inhaled or systemic corticosteroids for the management of TTN. PMID: 32180216 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 17, 2020 Category: General Medicine Authors: Bruschettini M, Moresco L, Calevo MG, Romantsik O Tags: Cochrane Database Syst Rev Source Type: research

Topical benzoyl peroxide for acne.
CONCLUSIONS: Current evidence suggests that BPO as monotherapy or add-on treatment may be more effective than placebo or no treatment for improving acne, and there may be little to no difference between BPO and either adapalene or clindamycin. Our key efficacy evidence is based on participant self-assessment; trials of BPO versus erythromycin or salicylic acid did not report this outcome. For adverse effects, the evidence is very uncertain regarding BPO compared with adapalene, erythromycin, or salicylic acid. However, risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment. Withdrawa...
Source: Cochrane Database of Systematic Reviews - March 16, 2020 Category: General Medicine Authors: Yang Z, Zhang Y, Lazic Mosler E, Hu J, Li H, Zhang Y, Liu J, Zhang Q Tags: Cochrane Database Syst Rev Source Type: research

Calcitonin testing for detection of medullary thyroid cancer in people with thyroid nodules.
CONCLUSIONS: Both basal and combined basal and stimulated calcitonin testing have a high sensitivity and specificity. However, this may be an overestimation due to high risk of bias in the use and choice of reference standard The value of routine testing in patients with thyroid nodules remains questionable, due to the low prevalence, which results in a low PPV of basal calcitonin testing. Whether routine calcitonin testing improves prognosis in MTC patients remains unclear. PMID: 32176812 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 16, 2020 Category: General Medicine Authors: Verbeek HH, de Groot JWB, Sluiter WJ, Muller Kobold AC, van den Heuvel ER, Plukker JT, Links TP Tags: Cochrane Database Syst Rev Source Type: research

Health education interventions to promote early presentation and referral for women with symptoms of endometrial cancer.
CONCLUSIONS: There is currently an absence of evidence to indicate the effectiveness of health education interventions involving healthcare providers or individuals or both to promote early presentation and referral for women with endometrial cancer symptoms. High-quality RCTs are needed to assess whether health education interventions enhance early presentation and referral. If health education interventions can be shown to reduce treatment delays in endometrial cancer, further studies would be required to determine which interventions are most effective. PMID: 32168393 [PubMed - as supplied by publisher] (Source: Co...
Source: Cochrane Database of Systematic Reviews - March 13, 2020 Category: General Medicine Authors: Cheewakriangkrai C, Kietpeerakool C, Charoenkwan K, Pattanittum P, John D, Aue-Aungkul A, Lumbiganon P Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.
CONCLUSIONS: Currently, available evidence does not support the overall superiority of any anticoagulant to another. Compared to UFH, citrate probably reduces major bleeding and probably has little or no effect on preventing clotting or death at 28 days. For other pharmacological anticoagulation methods, there is no available data showing overall superiority to citrate or no pharmacological anticoagulation. Further studies are needed to identify patient populations in which CRRT should commence with no pharmacological anticoagulation or with citrate. PMID: 32164041 [PubMed - in process] (Source: Cochrane Database...
Source: Cochrane Database of Systematic Reviews - March 13, 2020 Category: General Medicine Authors: Tsujimoto H, Tsujimoto Y, Nakata Y, Fujii T, Takahashi S, Akazawa M, Kataoka Y Tags: Cochrane Database Syst Rev Source Type: research

Immunosuppressive agents for treating IgA nephropathy.
CONCLUSIONS: In moderate certainty evidence, corticosteroid therapy probably prevents decline in GFR or doubling of SCr in adults and children with IgA nephropathy and proteinuria. Evidence for treatment effects of immunosuppressive agents on death, infection, and malignancy is generally sparse or low-quality. Steroid therapy has uncertain adverse effects due to a paucity of studies. Available studies are few, small, have high risk of bias and generally do not systematically identify treatment-related harms. Subgroup analyses to identify specific patient characteristics that might predict better response to therapy were no...
Source: Cochrane Database of Systematic Reviews - March 12, 2020 Category: General Medicine Authors: Natale P, Palmer SC, Ruospo M, Saglimbene VM, Craig JC, Vecchio M, Samuels JA, Molony DA, Schena FP, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Transarterial (chemo)embolisation versus no intervention or placebo for liver metastases.
CONCLUSIONS: Based on one, small randomised trial at high risk of bias, the evidence is very uncertain about the effect of TAE or TACE versus no active therapeutic intervention on mortality for people with liver metastases as the true effect may be substantially different. The trial did not measure failure to clear liver metastases, time to progression of liver metastases, tumour response measures, or health-related quality of life. Short-term, minor adverse events were recorded in the intervention groups only. Large trials, following current standards of conduct and reporting, are required to explore the benefits and harm...
Source: Cochrane Database of Systematic Reviews - March 12, 2020 Category: General Medicine Authors: Swierz MJ, Storman D, Riemsma RP, Wolff R, Mitus JW, Pedziwiatr M, Kleijnen J, Bala MM Tags: Cochrane Database Syst Rev Source Type: research

Fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery.
CONCLUSIONS: Based on the current available evidence, fibrin sealants may have little or no effect on postoperative pancreatic fistula in people undergoing distal pancreatectomy. The effects of fibrin sealants on the prevention of postoperative pancreatic fistula are uncertain in people undergoing pancreaticoduodenectomy. PMID: 32157697 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 11, 2020 Category: General Medicine Authors: Deng Y, He S, Cheng Y, Cheng N, Gong J, Gong J, Zeng Z, Zhao L Tags: Cochrane Database Syst Rev Source Type: research

Alcoholics Anonymous and other 12-step programs for alcohol use disorder.
Abstract BACKGROUND: Alcohol use disorder (AUD) confers a prodigious burden of disease, disability, premature mortality, and high economic costs from lost productivity, accidents, violence, incarceration, and increased healthcare utilization. For over 80 years, Alcoholics Anonymous (AA) has been a widespread AUD recovery organization, with millions of members and treatment free at the point of access, but it is only recently that rigorous research on its effectiveness has been conducted. OBJECTIVES: To evaluate whether peer-led AA and professionally-delivered treatments that facilitate AA involvement (Twelve-...
Source: Cochrane Database of Systematic Reviews - March 11, 2020 Category: General Medicine Authors: Kelly JF, Humphreys K, Ferri M Tags: Cochrane Database Syst Rev Source Type: research

Ab interno trabecular bypass surgery with Schlemm ´s canal microstent (Hydrus) for open angle glaucoma.
Ab interno trabecular bypass surgery with Schlemm´s canal microstent (Hydrus) for open angle glaucoma. Cochrane Database Syst Rev. 2020 Mar 09;3:CD012740 Authors: Otarola F, Virgili G, Shah A, Hu K, Bunce C, Gazzard G Abstract BACKGROUND: Glaucoma is a leading cause of irreversible blindness. A number of minimally-invasive surgical techniques have been introduced as a treatment to prevent glaucoma from progressing; ab interno trabecular bypass surgery with the Schlemm's canal Hydrus microstent is one of them. OBJECTIVES: To evaluate the efficacy and safety of ab interno trabecular bypass su...
Source: Cochrane Database of Systematic Reviews - March 9, 2020 Category: General Medicine Authors: Otarola F, Virgili G, Shah A, Hu K, Bunce C, Gazzard G Tags: Cochrane Database Syst Rev Source Type: research

Self-administered versus provider-administered medical abortion.
Abstract BACKGROUND: The advent of medical abortion has improved access to safe abortion procedures. Medical abortion procedures involve either administering mifepristone followed by misoprostol or a misoprostol-only regimen. The drugs are commonly administered in the presence of clinicians, which is known as provider-administered medical abortion. In self-administered medical abortion, drugs are administered by the woman herself without the supervision of a healthcare provider during at least one stage of the drug protocol. Self-administration of medical abortion has the potential to provide women with control ov...
Source: Cochrane Database of Systematic Reviews - March 9, 2020 Category: General Medicine Authors: Gambir K, Kim C, Necastro KA, Ganatra B, Ngo TD Tags: Cochrane Database Syst Rev Source Type: research

Ovarian suppression for adjuvant treatment of hormone receptor-positive early breast cancer.
Abstract BACKGROUND: Approximately 80% of breast cancers amongst premenopausal women are hormone receptor-positive. Adjuvant endocrine therapy is an integral component of care for hormone receptor-positive breast cancer and in premenopausal women includes oestrogen receptor blockade with tamoxifen, temporary suppression of ovarian oestrogen synthesis by luteinising hormone releasing hormone (LHRH) agonists, and permanent interruption of ovarian oestrogen synthesis with oophorectomy or radiotherapy. Recent international consensus statements recommend single-agent tamoxifen or aromatase inhibitors with ovarian funct...
Source: Cochrane Database of Systematic Reviews - March 6, 2020 Category: General Medicine Authors: Bui KT, Willson ML, Goel S, Beith J, Goodwin A Tags: Cochrane Database Syst Rev Source Type: research

Sclerotherapy versus sham or no intervention for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis.
CONCLUSIONS: The evidence, obtained from one randomised clinical trial at high risk of bias, is very uncertain on whether sclerotherapy has an influence on mortality and if it may decrease first upper gastrointestinal or oesophageal variceal bleeding in children. The evidence is very uncertain on whether sclerotherapy has an influence on congestive hypertensive gastropathy, incidence on gastric varices, and incidence of bleeding from gastric varices. Health-related quality of life was not measured. There were no serious events caused by sclerotherapy, and analysis of non-serious adverse events could not be performed due to...
Source: Cochrane Database of Systematic Reviews - March 5, 2020 Category: General Medicine Authors: Gattini D, Cifuentes LI, Torres-Robles R, Gana JC Tags: Cochrane Database Syst Rev Source Type: research

Shock wave therapy for rotator cuff disease with or without calcification.
CONCLUSIONS: Based upon the currently available low- to moderate-certainty evidence, there were very few clinically important benefits of shock wave therapy, and uncertainty regarding its safety. Wide clinical diversity and varying treatment protocols means that we do not know whether or not some trials tested subtherapeutic doses, possibly underestimating any potential benefits. Further trials of extracorporeal shock wave therapy for rotator cuff disease should be based upon a strong rationale and consideration of whether or not they would alter the conclusions of this review. A standard dose and treatment protocol should...
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Surace SJ, Deitch J, Johnston RV, Buchbinder R Tags: Cochrane Database Syst Rev Source Type: research

Probiotics for maintenance of remission in ulcerative colitis.
CONCLUSIONS: The effectiveness of probiotics for the maintenance of remission in ulcerative colitis remains unclear. This is due to low- to very low-certainty evidence from poorly conducted studies, which contribute limited amounts of data from a small number of participants. Future trials comparing probiotics with 5-ASA rather than placebo will better reflect conventional care given to people with ulcerative colitis. Appropriately powered studies with a minimum length of 12 months are needed. PMID: 32128794 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Iheozor-Ejiofor Z, Kaur L, Gordon M, Baines PA, Sinopoulou V, Akobeng AK Tags: Cochrane Database Syst Rev Source Type: research

Probiotics for induction of remission in ulcerative colitis.
CONCLUSIONS: Low-certainty evidence suggests that probiotics may induce clinical remission in active ulcerative colitis when compared to placebo. There may be little or no difference in clinical remission with probiotics alone compared to 5-ASA. There is limited evidence from a single study which failed to provide a definition of remission, that probiotics may slightly improve the induction of remission when used in combination with 5-ASA. There was no evidence to assess whether probiotics are effective in people with severe and more extensive disease, or if specific preparations are superior to others. Further targeted an...
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Kaur L, Gordon M, Baines PA, Iheozor-Ejiofor Z, Sinopoulou V, Akobeng AK Tags: Cochrane Database Syst Rev Source Type: research

Oxcarbazepine add-on for drug-resistant focal epilepsy.
CONCLUSIONS: Oxcarbazepine might be effective at reducing seizure frequency when used as an add-on for drug-resistant focal epilepsy. The efficacy outcomes - 50% or greater seizure reduction and seizure freedom - were derived from low-certainty evidence. We are, therefore, uncertain whether the estimated effect size is representative of the true effect. In contrast, the evidence for median percentage seizure reduction and treatment withdrawal were of moderate certainty: thus, we are fairly certain of the effect estimates' reliability. Overall, we are unsure of the true efficacy of oxcarbazepine, but have concerns about its...
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Bresnahan R, Atim-Oluk M, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological interventions for promoting smoking cessation during pregnancy.
CONCLUSIONS: NRT used for smoking cessation in pregnancy may increase smoking cessation rates in late pregnancy. However, this evidence is of low certainty, as the effect was not evident when potentially biased, non-placebo-controlled RCTs were excluded from the analysis. Future studies may therefore change this conclusion. We found no evidence that NRT has either positive or negative impacts on birth outcomes; however, the evidence for some of these outcomes was also judged to be of low certainty due to imprecision and inconsistency. We found no evidence that bupropion may be an effective aid for smoking cessation during ...
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Claire R, Chamberlain C, Davey MA, Cooper SE, Berlin I, Leonardi-Bee J, Coleman T Tags: Cochrane Database Syst Rev Source Type: research

Drugs for preventing lung cancer in healthy people.
CONCLUSIONS: Well-designed RCTs have shown no beneficial effect of supplements for the prevention of lung cancer and lung cancer mortality in healthy people. Vitamin A supplements increase lung cancer incidence and mortality in smokers or persons exposed to asbestos. Vitamin C increases lung cancer incidence in women. Vitamin E increases the risk of haemorrhagic strokes. PMID: 32130738 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 4, 2020 Category: General Medicine Authors: Cortés-Jofré M, Rueda JR, Asenjo-Lobos C, Madrid E, Bonfill Cosp X Tags: Cochrane Database Syst Rev Source Type: research

Severe fatigue after treatment for childhood cancer.
CONCLUSIONS: It is unclear how many childhood cancer survivors suffer from severe fatigue. This review encountered several difficulties. We found statistical and clinical heterogeneity and great variation in the reporting of possible risk and associated factors. The evidence in this review is therefore weak, and the exact prevalence of severe fatigue after treatment for childhood cancer remains to be determined. This is also the case for the course of severe fatigue following treatment and the strength of the relationship between fatigue and associated and risk factors. Despite these limitations, our review does provide a ...
Source: Cochrane Database of Systematic Reviews - March 3, 2020 Category: General Medicine Authors: van Deuren S, Boonstra A, van Dulmen-den Broeder E, Blijlevens N, Knoop H, Loonen J Tags: Cochrane Database Syst Rev Source Type: research

Transcutaneous electrical nerve stimulation (TENS) for pain management in sickle cell disease.
CONCLUSIONS: Since we have only included one small and very low-quality trial, with a high risk of bias across several domains, we are unable to conclude whether TENS is harmful or beneficial for managing pain in people with SCD. There is a need for a well-designed, adequately-powered, RCT to evaluate the role of TENS in managing pain in people with SCD. PMID: 32124977 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 3, 2020 Category: General Medicine Authors: Pal S, Dixit R, Moe S, Godinho MA, Abas AB, Ballas SK, Ram S, Yousuf UAM Tags: Cochrane Database Syst Rev Source Type: research

Intra-uterine insemination for unexplained subfertility.
CONCLUSIONS: Due to insufficient data, it is uncertain whether treatment with IUI with or without OH compared to timed intercourse or expectant management with or without OH improves cumulative live birth rates with acceptable multiple pregnancy rates in couples with unexplained subfertility. However, treatment with IUI with OH probably results in a higher cumulative live birth rate compared to expectant management without OH in couples with a low prediction score of natural conception. Similarly, treatment with IUI in a natural cycle probably results in a higher cumulative live birth rate compared to treatment with timed ...
Source: Cochrane Database of Systematic Reviews - March 3, 2020 Category: General Medicine Authors: Ayeleke RO, Asseler JD, Cohlen BJ, Veltman-Verhulst SM Tags: Cochrane Database Syst Rev Source Type: research

Green tea (Camellia sinensis) for the prevention of cancer.
CONCLUSIONS: Overall, findings from experimental and nonexperimental epidemiological studies yielded inconsistent results, thus providing limited evidence for the beneficial effect of green tea consumption on the overall risk of cancer or on specific cancer sites. Some evidence of a beneficial effect of green tea at some cancer sites emerged from the RCTs and from case-control studies, but their methodological limitations, such as the low number and size of the studies, and the inconsistencies with the results of cohort studies, limit the interpretability of the RR estimates. The studies also indicated the occurrence of se...
Source: Cochrane Database of Systematic Reviews - March 2, 2020 Category: General Medicine Authors: Filippini T, Malavolti M, Borrelli F, Izzo AA, Fairweather-Tait SJ, Horneber M, Vinceti M Tags: Cochrane Database Syst Rev Source Type: research

Structural magnetic resonance imaging for the early diagnosis of dementia due to Alzheimer's disease in people with mild cognitive impairment.
CONCLUSIONS: The volume of hippocampus or medial temporal lobe, the most studied brain regions, showed low sensitivity and specificity and did not qualify structural MRI as a stand-alone add-on test for an early diagnosis of dementia due to Alzheimer's disease in people with MCI. This is consistent with international guidelines, which recommend imaging to exclude non-degenerative or surgical causes of cognitive impairment and not to diagnose dementia due to Alzheimer's disease. In view of the low quality of most of the included studies, the findings of this review should be interpreted with caution. Future research should ...
Source: Cochrane Database of Systematic Reviews - March 2, 2020 Category: General Medicine Authors: Lombardi G, Crescioli G, Cavedo E, Lucenteforte E, Casazza G, Bellatorre AG, Lista C, Costantino G, Frisoni G, Virgili G, Filippini G Tags: Cochrane Database Syst Rev Source Type: research

Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.
CONCLUSIONS: This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and low-certainty evidence suggests that increasing LCn3 slightly reduces risk of coronary heart disease mortality and events, and reduces serum triglycerides (evidence mainly from supplement trials). Increasing ALA slightly reduces risk of cardiovascular events and arrhythmia. PMID: 32114706 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 29, 2020 Category: General Medicine Authors: Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, Summerbell CD, Worthington HV, Song F, Hooper L Tags: Cochrane Database Syst Rev Source Type: research

Timing of hypertonic saline inhalation for cystic fibrosis.
CONCLUSIONS: Timing of hypertonic saline inhalation makes little or no difference to lung function (low-certainty evidence). However, inhaling hypertonic saline before or during airway clearance techniques may maximise perceived efficacy and satisfaction. The long-term efficacy of hypertonic saline has only been established for twice-daily inhalations; however, if only one dose per day is tolerated, the time of day at which it is inhaled could be based on convenience or tolerability until evidence comparing these regimens is available. The identified trials were all of very short intervention periods, so longer-term resear...
Source: Cochrane Database of Systematic Reviews - February 28, 2020 Category: General Medicine Authors: Elkins M, Dentice R Tags: Cochrane Database Syst Rev Source Type: research