Physical therapy interventions, other than general physical exercise interventions, in children and adolescents before, during and following treatment for cancer
CONCLUSIONS: Results demonstrate that the evidence to date is inadequate to inform clinical practice. Recommendations for future research include the need for large-scale, high-quality designs that examine: (1) paediatric populations with same cancer types; (2) similar intervention protocols; (3) long-term outcomes; (4) physical therapy interventions (e.g. electrophysical modalities and sensory interventions); and (5) outcomes commonly impaired in children with cancer (e.g. peripheral neuropathy and gait deficits).PMID:34343340 | DOI:10.1002/14651858.CD012924.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 3, 2021 Category: General Medicine Authors: Paula A Ospina Alyssa McComb Lesley E Pritchard-Wiart David D Eisenstat Margaret L McNeely Source Type: research

Timing of pancreatic enzyme replacement therapy (PERT) in cystic fibrosis
CONCLUSIONS: We were unable to determine whether one dosing schedule for PERT is better than another since we identified no eligible RCTs. While the introduction of PERT to people with CF can improve their nutritional status, there are a limited number of studies which address this review question, and none met our eligibility criteria. Since malnutrition and adverse gastrointestinal symptoms remain a common feature in CF, the assessment of the relative performance of dosing schedules may provide evidence to improve outcomes in people with CF who are pancreatic insufficient. Further research is needed to fully evaluate the...
Source: Cochrane Database of Systematic Reviews - August 2, 2021 Category: General Medicine Authors: Christabella Ng Giles Major Alan R Smyth Source Type: research

Timing of pancreatic enzyme replacement therapy (PERT) in cystic fibrosis
CONCLUSIONS: We were unable to determine whether one dosing schedule for PERT is better than another since we identified no eligible RCTs. While the introduction of PERT to people with CF can improve their nutritional status, there are a limited number of studies which address this review question, and none met our eligibility criteria. Since malnutrition and adverse gastrointestinal symptoms remain a common feature in CF, the assessment of the relative performance of dosing schedules may provide evidence to improve outcomes in people with CF who are pancreatic insufficient. Further research is needed to fully evaluate the...
Source: Cochrane Database of Systematic Reviews - August 2, 2021 Category: General Medicine Authors: Christabella Ng Giles Major Alan R Smyth Source Type: research

Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer
CONCLUSIONS: The available high to moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT probably reduces the risk of serious adverse events, especially those around the time of surgery, and reduces the risk of postoperative mortality and the need for stoma formation. These data will inform women and clinicians (involving specialist gynaecological multidisciplinary teams) and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing ...
Source: Cochrane Database of Systematic Reviews - July 30, 2021 Category: General Medicine Authors: Sarah L Coleridge Andrew Bryant Sean Kehoe Jo Morrison Source Type: research

Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer
CONCLUSIONS: The available high to moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT probably reduces the risk of serious adverse events, especially those around the time of surgery, and reduces the risk of postoperative mortality and the need for stoma formation. These data will inform women and clinicians (involving specialist gynaecological multidisciplinary teams) and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing ...
Source: Cochrane Database of Systematic Reviews - July 30, 2021 Category: General Medicine Authors: Sarah L Coleridge Andrew Bryant Sean Kehoe Jo Morrison Source Type: research

Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer
CONCLUSIONS: The available high to moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT probably reduces the risk of serious adverse events, especially those around the time of surgery, and reduces the risk of postoperative mortality and the need for stoma formation. These data will inform women and clinicians (involving specialist gynaecological multidisciplinary teams) and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing ...
Source: Cochrane Database of Systematic Reviews - July 30, 2021 Category: General Medicine Authors: Sarah L Coleridge Andrew Bryant Sean Kehoe Jo Morrison Source Type: research

Ivermectin for preventing and treating COVID-19
CONCLUSIONS: Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID-19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.PMID:34318930 | DOI:10.1002/14651858.CD015017.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 28, 2021 Category: General Medicine Authors: Maria Popp Miriam Stegemann Maria-Inti Metzendorf Susan Gould Peter Kranke Patrick Meybohm Nicole Skoetz Stephanie Weibel Source Type: research

Ivermectin for preventing and treating COVID-19
CONCLUSIONS: Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID-19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.PMID:34318930 | DOI:10.1002/14651858.CD015017.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 28, 2021 Category: General Medicine Authors: Maria Popp Miriam Stegemann Maria-Inti Metzendorf Susan Gould Peter Kranke Patrick Meybohm Nicole Skoetz Stephanie Weibel Source Type: research

Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)
CONCLUSIONS: Our review did not find evidence supporting a substantial role of MMSE as a stand-alone single-administration test in the identification of MCI patients who could develop dementia. Clinicians could prefer to request additional and extensive tests to be sure about the management of these patients. An important aspect to assess in future updates is if conversion to dementia from MCI stages could be predicted better by MMSE changes over time instead of single measurements. It is also important to assess if a set of tests, rather than an isolated one, may be more successful in predicting conversion from MCI to dem...
Source: Cochrane Database of Systematic Reviews - July 27, 2021 Category: General Medicine Authors: Ingrid Arevalo-Rodriguez Nadja Smailagic Marta Roqu é-Figuls Agust ín Ciapponi Erick Sanchez-Perez Antri Giannakou Olga L Pedraza Xavier Bonfill Cosp Sarah Cullum Source Type: research

Decision-support tools via mobile devices to improve quality of care in primary healthcare settings
CONCLUSIONS: We are uncertain about the effectiveness of mobile phone-based decision-support tools on several outcomes, including adherence to recommended practice. None of the studies had a quality of care framework and focused only on specific health areas. We need well-designed research that takes a systems lens to assess these issues.PMID:34314020 | DOI:10.1002/14651858.CD012944.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 27, 2021 Category: General Medicine Authors: Smisha Agarwal Claire Glenton Tigest Tamrat Nicholas Henschke Nicola Maayan Marita S F ønhus Garrett L Mehl Simon Lewin Source Type: research

Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)
CONCLUSIONS: Our review did not find evidence supporting a substantial role of MMSE as a stand-alone single-administration test in the identification of MCI patients who could develop dementia. Clinicians could prefer to request additional and extensive tests to be sure about the management of these patients. An important aspect to assess in future updates is if conversion to dementia from MCI stages could be predicted better by MMSE changes over time instead of single measurements. It is also important to assess if a set of tests, rather than an isolated one, may be more successful in predicting conversion from MCI to dem...
Source: Cochrane Database of Systematic Reviews - July 27, 2021 Category: General Medicine Authors: Ingrid Arevalo-Rodriguez Nadja Smailagic Marta Roqu é-Figuls Agust ín Ciapponi Erick Sanchez-Perez Antri Giannakou Olga L Pedraza Xavier Bonfill Cosp Sarah Cullum Source Type: research

Decision-support tools via mobile devices to improve quality of care in primary healthcare settings
CONCLUSIONS: We are uncertain about the effectiveness of mobile phone-based decision-support tools on several outcomes, including adherence to recommended practice. None of the studies had a quality of care framework and focused only on specific health areas. We need well-designed research that takes a systems lens to assess these issues.PMID:34314020 | DOI:10.1002/14651858.CD012944.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 27, 2021 Category: General Medicine Authors: Smisha Agarwal Claire Glenton Tigest Tamrat Nicholas Henschke Nicola Maayan Marita S F ønhus Garrett L Mehl Simon Lewin Source Type: research

Compression bandages or stockings versus no compression for treating venous leg ulcers
CONCLUSIONS: If using compression bandages or stockings, people with venous leg ulcers probably experience complete wound healing more quickly, and more people have wounds completely healed. The use of compression bandages or stockings probably reduces pain and may improve disease-specific quality of life. There is uncertainty about adverse effects, and cost effectiveness. Future research should focus on comparing alternative bandages and stockings with the primary endpoint of time to complete wound healing alongside adverse events including pain score, and health-related quality of life, and should incorporate cost-effect...
Source: Cochrane Database of Systematic Reviews - July 26, 2021 Category: General Medicine Authors: Chunhu Shi Jo C Dumville Nicky Cullum Emma Connaughton Gill Norman Source Type: research

Tailored or adapted interventions for adults with chronic obstructive pulmonary disease and at least one other long-term condition: a mixed methods review
CONCLUSIONS: Owing to a paucity of eligible trials, as well as diversity in the intervention type, comorbidities and the outcome measures reported, we were unable to provide a robust synthesis of data. Pulmonary rehabilitation or multicomponent interventions may improve quality of life and functional status (6MWD), but the evidence is too limited to draw a robust conclusion. The key take-home message from this review is the lack of data from RCTs on treatments for people living with COPD and comorbidities. Given the variation in number and type of comorbidity(s) an individual may have, and severity of COPD, larger studies ...
Source: Cochrane Database of Systematic Reviews - July 26, 2021 Category: General Medicine Authors: Emma J Dennett Sadia Janjua Elizabeth Stovold Samantha L Harrison Melissa J McDonnell Anne E Holland Source Type: research

Compression bandages or stockings versus no compression for treating venous leg ulcers
CONCLUSIONS: If using compression bandages or stockings, people with venous leg ulcers probably experience complete wound healing more quickly, and more people have wounds completely healed. The use of compression bandages or stockings probably reduces pain and may improve disease-specific quality of life. There is uncertainty about adverse effects, and cost effectiveness. Future research should focus on comparing alternative bandages and stockings with the primary endpoint of time to complete wound healing alongside adverse events including pain score, and health-related quality of life, and should incorporate cost-effect...
Source: Cochrane Database of Systematic Reviews - July 26, 2021 Category: General Medicine Authors: Chunhu Shi Jo C Dumville Nicky Cullum Emma Connaughton Gill Norman Source Type: research

Tailored or adapted interventions for adults with chronic obstructive pulmonary disease and at least one other long-term condition: a mixed methods review
CONCLUSIONS: Owing to a paucity of eligible trials, as well as diversity in the intervention type, comorbidities and the outcome measures reported, we were unable to provide a robust synthesis of data. Pulmonary rehabilitation or multicomponent interventions may improve quality of life and functional status (6MWD), but the evidence is too limited to draw a robust conclusion. The key take-home message from this review is the lack of data from RCTs on treatments for people living with COPD and comorbidities. Given the variation in number and type of comorbidity(s) an individual may have, and severity of COPD, larger studies ...
Source: Cochrane Database of Systematic Reviews - July 26, 2021 Category: General Medicine Authors: Emma J Dennett Sadia Janjua Elizabeth Stovold Samantha L Harrison Melissa J McDonnell Anne E Holland Source Type: research

Hybrid repair versus conventional open repair for aortic arch dissection
CONCLUSIONS: This review revealed one ongoing RCT and two unpublished RCTs evaluating hybrid versus conventional open repair for aortic arch surgery. Observational data suggest that hybrid repair for aortic arch dissection could potentially be favourable, but conclusions can not be drawn from these studies, which are highly selective, and are based on the clinical status of the patient, the presence of comorbidities and the skills of the operators. However, a conclusion about its definitive benefit over conventional open surgical repair cannot be made from this review without published RCTs or CCTs. Future RCTs or CCTs nee...
Source: Cochrane Database of Systematic Reviews - July 25, 2021 Category: General Medicine Authors: Edel P Kavanagh Sherif Sultan Fionnuala Jordan Ala Elhelali Declan Devane Dave Veerasingam Niamh Hynes Source Type: research

Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts
CONCLUSIONS: The meta-analyses of three studies for ticlopidine (an antiplatelet treatment), which all used the same dose of treatment but with a short follow-up of only one month, suggest ticlopidine may have a beneficial effect as an adjuvant treatment to increase the patency of AVFs and AVGs in the short term. There was insufficient evidence to determine if there was a difference in graft patency between placebo and other treatments such as aspirin, fish oil, clopidogrel, dipyridamole, dipyridamole plus aspirin, warfarin, sulphinpyrazone and GTN patch. The certainty of the evidence was low to moderate due to short follo...
Source: Cochrane Database of Systematic Reviews - July 23, 2021 Category: General Medicine Authors: Imran Mohamed Mohamad Fathul Aizat Kamarizan Antonio Da Silva Source Type: research

Medical adjuvant treatment to increase patency of arteriovenous fistulae and grafts
CONCLUSIONS: The meta-analyses of three studies for ticlopidine (an antiplatelet treatment), which all used the same dose of treatment but with a short follow-up of only one month, suggest ticlopidine may have a beneficial effect as an adjuvant treatment to increase the patency of AVFs and AVGs in the short term. There was insufficient evidence to determine if there was a difference in graft patency between placebo and other treatments such as aspirin, fish oil, clopidogrel, dipyridamole, dipyridamole plus aspirin, warfarin, sulphinpyrazone and GTN patch. The certainty of the evidence was low to moderate due to short follo...
Source: Cochrane Database of Systematic Reviews - July 23, 2021 Category: General Medicine Authors: Imran Mohamed Mohamad Fathul Aizat Kamarizan Antonio Da Silva Source Type: research

Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence regarding the efficacy of different interventions at preventing persistent olfactory dysfunction following COVID-19 infection. However, we have identified a small number of additional ongoing studies in this area. As this is a living systematic review, the evidence will be updated regularly to incorporate new data from these, and other relevant studies, as they become available. For this (first) version of the living review, we identified a single study of intranasal corticosteroids to include in this review, which provided data for only two of our prespecified outcomes. The evid...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Katie E Webster Lisa O'Byrne Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified other ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available. For this (first) version of the living review we identified only one study with a small sample size, which assessed systemic steroids and nasal irrigation (intranasal steroid/mucolytic/decongestant). However, the evidence regarding the benefits and harms from this intervention to treat persistent po...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Lisa O'Byrne Katie E Webster Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the management of abdominal pain in ulcerative colitis
CONCLUSIONS: We found very low-certainty evidence on the efficacy and safety of interventions for the management of abdominal pain in ulcerative colitis. Pervasive issues with very serious imprecision from small samples size and high risk of bias have led to very low-certainty outcomes, precluding conclusions. While few adverse events and no serious adverse events were reported, the certainty of these findings was again very low for all comparisons, so no conclusions can be drawn. There is a need for further research. We have identified eight ongoing studies in this review, so an update will be warranted. It is key that fu...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Vassiliki Sinopoulou Morris Gordon Terence M Dovey Anthony K Akobeng Source Type: research

Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence regarding the efficacy of different interventions at preventing persistent olfactory dysfunction following COVID-19 infection. However, we have identified a small number of additional ongoing studies in this area. As this is a living systematic review, the evidence will be updated regularly to incorporate new data from these, and other relevant studies, as they become available. For this (first) version of the living review, we identified a single study of intranasal corticosteroids to include in this review, which provided data for only two of our prespecified outcomes. The evid...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Katie E Webster Lisa O'Byrne Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified other ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available. For this (first) version of the living review we identified only one study with a small sample size, which assessed systemic steroids and nasal irrigation (intranasal steroid/mucolytic/decongestant). However, the evidence regarding the benefits and harms from this intervention to treat persistent po...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Lisa O'Byrne Katie E Webster Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the management of abdominal pain in ulcerative colitis
CONCLUSIONS: We found very low-certainty evidence on the efficacy and safety of interventions for the management of abdominal pain in ulcerative colitis. Pervasive issues with very serious imprecision from small samples size and high risk of bias have led to very low-certainty outcomes, precluding conclusions. While few adverse events and no serious adverse events were reported, the certainty of these findings was again very low for all comparisons, so no conclusions can be drawn. There is a need for further research. We have identified eight ongoing studies in this review, so an update will be warranted. It is key that fu...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Vassiliki Sinopoulou Morris Gordon Terence M Dovey Anthony K Akobeng Source Type: research

Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence regarding the efficacy of different interventions at preventing persistent olfactory dysfunction following COVID-19 infection. However, we have identified a small number of additional ongoing studies in this area. As this is a living systematic review, the evidence will be updated regularly to incorporate new data from these, and other relevant studies, as they become available. For this (first) version of the living review, we identified a single study of intranasal corticosteroids to include in this review, which provided data for only two of our prespecified outcomes. The evid...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Katie E Webster Lisa O'Byrne Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction
CONCLUSIONS: There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified other ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available. For this (first) version of the living review we identified only one study with a small sample size, which assessed systemic steroids and nasal irrigation (intranasal steroid/mucolytic/decongestant). However, the evidence regarding the benefits and harms from this intervention to treat persistent po...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Lisa O'Byrne Katie E Webster Samuel MacKeith Carl Philpott Claire Hopkins Martin J Burton Source Type: research

Interventions for the management of abdominal pain in ulcerative colitis
CONCLUSIONS: We found very low-certainty evidence on the efficacy and safety of interventions for the management of abdominal pain in ulcerative colitis. Pervasive issues with very serious imprecision from small samples size and high risk of bias have led to very low-certainty outcomes, precluding conclusions. While few adverse events and no serious adverse events were reported, the certainty of these findings was again very low for all comparisons, so no conclusions can be drawn. There is a need for further research. We have identified eight ongoing studies in this review, so an update will be warranted. It is key that fu...
Source: Cochrane Database of Systematic Reviews - July 22, 2021 Category: General Medicine Authors: Vassiliki Sinopoulou Morris Gordon Terence M Dovey Anthony K Akobeng Source Type: research

Stem cell therapy for dilated cardiomyopathy
CONCLUSIONS: We are uncertain whether SCT in people with DCM reduces the risk of all-cause mortality and procedural complications, improves HRQoL, and performance status (exercise capacity). SCT may improve functional class (NYHA), compared to usual care (no cells). Similarly, when compared to G-CSF, we are also uncertain whether SCT in people with DCM reduces the risk of all-cause mortality although some studies within this comparison observed a favourable effect that should be interpreted with caution. SCT may not improve HRQoL but may improve to some extent performance status (exercise capacity). Very low-quality eviden...
Source: Cochrane Database of Systematic Reviews - July 21, 2021 Category: General Medicine Authors: Rienzi Diaz-Navarro Gerard Urr útia John Gf Cleland Daniel Poloni Francisco Villagran Roberto Acosta-Dighero Shrikant I Bangdiwala Gabriel Rada Eva Madrid Source Type: research

Schedules for home visits in the early postpartum period
CONCLUSIONS: The evidence is very uncertain about the effect of home visits on maternal and neonatal mortality. Individualised care as part of a package of home visits probably improves depression scores at four months and increasing the frequency of home visits may improve exclusive breastfeeding rates and infant healthcare utilisation. Maternal satisfaction may also be better with home visits compared to hospital check-ups. Overall, the certainty of evidence was found to be low and findings were not consistent among studies and comparisons. Further well designed RCTs evaluating this complex intervention will be required ...
Source: Cochrane Database of Systematic Reviews - July 21, 2021 Category: General Medicine Authors: Naohiro Yonemoto Shuko Nagai Rintaro Mori Source Type: research

Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis
CONCLUSIONS: There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers ...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Claire Glenton Benedicte Carlsen Simon Lewin Manuela Dominique Wennekes Brita Askeland Winje Renske Eilers VITAL consortium Source Type: research

Diagnostic test accuracy of telehealth assessment for dementia and mild cognitive impairment
CONCLUSIONS: We found only very few eligible studies with a small number of participants. An important difference between the studies providing data for the analyses was whether the target condition was dementia only (two studies) or dementia and MCI (one study). The data suggest that telehealth assessment may be highly sensitive and specific for the diagnosis of all-cause dementia when assessed against a reference standard of conventional face-to-face assessment, but the estimates are imprecise due to small sample sizes and between-study heterogeneity, and may apply mainly to telehealth models which incorporate a consider...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Jenny McCleery Julian Laverty Terry J Quinn Source Type: research

Exercise training for adult lung transplant recipients
Cochrane Database Syst Rev. 2021 Jul 20;7:CD012307. doi: 10.1002/14651858.CD012307.pub2.ABSTRACTBACKGROUND: Pulmonary transplantation is the final treatment option for people with end-stage respiratory diseases. Evidence suggests that exercise training may contribute to speeding up physical recovery in adults undergoing lung transplantation, helping to minimize or resolve impairments due to physical inactivity in both the pre- and post-transplant stages. However, there is a lack of detailed guidelines on how exercise training should be carried out in this specific sub-population.OBJECTIVES: To determine the benefits and sa...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Ruvistay Gutierrez-Arias Maria Jos é Martinez-Zapata Monica C Gaete-Mahn Dimelza Osorio Luis Bustos Joel Melo Tanner Ricardo Hidalgo Pamela Seron Source Type: research

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions
CONCLUSIONS: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Tanya Walsh Richard Macey Alexander R Kerr Mark W Lingen Graham R Ogden Saman Warnakulasuriya Source Type: research

Healthcare workers' perceptions and experiences of communicating with people over 50 years of age about vaccination: a qualitative evidence synthesis
CONCLUSIONS: There is little research focusing specifically on healthcare workers' perceptions and experiences of communication with older adults about vaccination. The studies we identified suggest that healthcare workers differed among themselves in their perceptions about the aim of this communication and about the role of older adults in vaccine decisions. Based on these findings and the other findings in our review, we have developed a set of questions or prompts that may help health system planners or programme managers when planning or implementing strategies for vaccination communication between healthcare workers ...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Claire Glenton Benedicte Carlsen Simon Lewin Manuela Dominique Wennekes Brita Askeland Winje Renske Eilers VITAL consortium Source Type: research

Diagnostic test accuracy of telehealth assessment for dementia and mild cognitive impairment
CONCLUSIONS: We found only very few eligible studies with a small number of participants. An important difference between the studies providing data for the analyses was whether the target condition was dementia only (two studies) or dementia and MCI (one study). The data suggest that telehealth assessment may be highly sensitive and specific for the diagnosis of all-cause dementia when assessed against a reference standard of conventional face-to-face assessment, but the estimates are imprecise due to small sample sizes and between-study heterogeneity, and may apply mainly to telehealth models which incorporate a consider...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Jenny McCleery Julian Laverty Terry J Quinn Source Type: research

Exercise training for adult lung transplant recipients
Cochrane Database Syst Rev. 2021 Jul 20;7:CD012307. doi: 10.1002/14651858.CD012307.pub2.ABSTRACTBACKGROUND: Pulmonary transplantation is the final treatment option for people with end-stage respiratory diseases. Evidence suggests that exercise training may contribute to speeding up physical recovery in adults undergoing lung transplantation, helping to minimize or resolve impairments due to physical inactivity in both the pre- and post-transplant stages. However, there is a lack of detailed guidelines on how exercise training should be carried out in this specific sub-population.OBJECTIVES: To determine the benefits and sa...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Ruvistay Gutierrez-Arias Maria Jos é Martinez-Zapata Monica C Gaete-Mahn Dimelza Osorio Luis Bustos Joel Melo Tanner Ricardo Hidalgo Pamela Seron Source Type: research

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions
CONCLUSIONS: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this...
Source: Cochrane Database of Systematic Reviews - July 20, 2021 Category: General Medicine Authors: Tanya Walsh Richard Macey Alexander R Kerr Mark W Lingen Graham R Ogden Saman Warnakulasuriya Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a secondary care setting
CONCLUSIONS: The IQCODE can be used to identify older adults in the general hospital setting who are at risk of dementia and require specialist assessment; it is useful specifically for ruling out those without evidence of cognitive decline. The language of administration did not affect test accuracy, which supports the cross-cultural use of the tool. These findings are qualified by the significant heterogeneity, the potential for bias and suboptimal reporting found in the included studies.PMID:34278561 | DOI:10.1002/14651858.CD010772.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Jennifer K Burton Patricia Fearon Anna H Noel-Storr Rupert McShane David J Stott Terry J Quinn Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within community dwelling populations
CONCLUSIONS: Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality.PMID:34278562 | DOI:10.1002/14651858.CD010079.pub3 (Sou...
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Terry J Quinn Patricia Fearon Anna H Noel-Storr Camilla Young Rupert McShane David J Stott Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a general practice (primary care) setting
CONCLUSIONS: It is not possible to give definitive guidance on the test accuracy of IQCODE for the diagnosis of dementia in a primary care setting based on the single study identified. We are surprised by the lack of research using the IQCODE in primary care as this is, arguably, the most appropriate setting for targeted case finding of those with undiagnosed dementia in order to maximise opportunities to intervene and provide support for the individual and their carers.PMID:34278564 | DOI:10.1002/14651858.CD010771.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Jennifer K Burton Patricia Fearon Anna H Noel-Storr Rupert McShane David J Stott Terry J Quinn Source Type: research

Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients
CONCLUSIONS: There is moderate-certainty evidence regarding the benefit of multicomponent non-pharmacological interventions for the prevention of delirium in hospitalised adults, estimated to reduce incidence by 43% compared to usual care. We found no evidence of an effect on mortality. There is emerging evidence that these interventions may reduce hospital length of stay, with a trend towards reduced delirium duration, although the effect on delirium severity remains uncertain. Further research should focus on implementation and detailed analysis of the components of the interventions to support more effective, tailored p...
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Jennifer K Burton Louise E Craig Shun Qi Yong Najma Siddiqi Elizabeth A Teale Rebecca Woodhouse Amanda J Barugh Alison M Shepherd Alan Brunton Suzanne C Freeman Alex J Sutton Terry J Quinn Source Type: research

Nutritional supplementation for nonalcohol-related fatty liver disease: a network meta-analysis
CONCLUSIONS: The evidence indicates considerable uncertainty about effects of nutritional supplementation compared to no additional intervention on all clinical outcomes for people with non-alcohol-related fatty liver disease. Accordingly, high-quality randomised comparative clinical trials with adequate follow-up are needed. We propose registry-based randomised clinical trials or cohort multiple randomised clinical trials (study design in which multiple interventions are trialed within large longitudinal cohorts of patients to gain efficiencies and align trials more closely to standard clinical practice) comparing interve...
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Oluyemi Komolafe Elena Buzzetti Audrey Linden Lawrence Mj Best Angela M Madden Danielle Roberts Thomas Jg Chase Dominic Fritche Suzanne C Freeman Nicola J Cooper Alex J Sutton Elisabeth Jane Milne Kathy Wright Chavdar S Pavlov Brian R Davidson Emmanuel Ts Source Type: research

Interventions for treating cavitated or dentine carious lesions
CONCLUSIONS: Compared with CR, there were lower numbers of failures with HT and SE in the primary dentition, and with SE and SW in the permanent dentition. Most studies showed high risk of bias and limited precision of estimates due to small sample size and typically limited numbers of failures, resulting in assessments of low or very low certainty of evidence for most comparisons.PMID:34280957 | DOI:10.1002/14651858.CD013039.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Falk Schwendicke Tanya Walsh Thomas Lamont Waraf Al-Yaseen Lars Bj ørndal Janet E Clarkson Margherita Fontana Jesus Gomez Rossi Gerd G östemeyer Colin Levey Anne M üller David Ricketts Mark Robertson Ruth M Santamaria Nicola Pt Innes Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a secondary care setting
CONCLUSIONS: The IQCODE can be used to identify older adults in the general hospital setting who are at risk of dementia and require specialist assessment; it is useful specifically for ruling out those without evidence of cognitive decline. The language of administration did not affect test accuracy, which supports the cross-cultural use of the tool. These findings are qualified by the significant heterogeneity, the potential for bias and suboptimal reporting found in the included studies.PMID:34278561 | DOI:10.1002/14651858.CD010772.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Jennifer K Burton Patricia Fearon Anna H Noel-Storr Rupert McShane David J Stott Terry J Quinn Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within community dwelling populations
CONCLUSIONS: Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality.PMID:34278562 | DOI:10.1002/14651858.CD010079.pub3 (Sou...
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Terry J Quinn Patricia Fearon Anna H Noel-Storr Camilla Young Rupert McShane David J Stott Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the detection of dementia within a general practice (primary care) setting
CONCLUSIONS: It is not possible to give definitive guidance on the test accuracy of IQCODE for the diagnosis of dementia in a primary care setting based on the single study identified. We are surprised by the lack of research using the IQCODE in primary care as this is, arguably, the most appropriate setting for targeted case finding of those with undiagnosed dementia in order to maximise opportunities to intervene and provide support for the individual and their carers.PMID:34278564 | DOI:10.1002/14651858.CD010771.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2021 Category: General Medicine Authors: Jennifer K Burton Patricia Fearon Anna H Noel-Storr Rupert McShane David J Stott Terry J Quinn Source Type: research

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the early detection of dementia across a variety of healthcare settings
CONCLUSIONS: Included studies were heterogenous, recruited from specialist settings, and had potential biases. The studies identified did not allow us to make specific recommendations on the use of the IQCODE for the future detection of dementia in clinical practice. The included studies highlighted the challenges of delayed verification dementia research, with issues around prevalent dementia assessment, loss to follow-up over time, and test non-completion potentially limiting the studies. Future research should recognise these issues and have explicit protocols for dealing with them.PMID:34275145 | DOI:10.1002/14651858.C...
Source: Cochrane Database of Systematic Reviews - July 18, 2021 Category: General Medicine Authors: Jennifer K Burton David J Stott Rupert McShane Anna H Noel-Storr Rhiannon S Swann-Price Terry J Quinn Source Type: research

Intermittent preventive treatment for malaria in infants
CONCLUSIONS: In areas of sub-Saharan Africa, giving antimalarial drugs known to be effective against the malaria parasite at the time to infants as IPT probably reduces the risk of clinical malaria, anaemia, and hospital admission. Evidence from SP studies over a 19-year period shows declining efficacy, which may be due to increasing drug resistance. Combinations with ACTs appear promising as suitable alternatives for IPTi.PMID:34273901 | DOI:10.1002/14651858.CD011525.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 17, 2021 Category: General Medicine Authors: Ekpereonne B Esu Chioma Oringanje Martin M Meremikwu Source Type: research

Intermittent preventive treatment for malaria in infants
CONCLUSIONS: In areas of sub-Saharan Africa, giving antimalarial drugs known to be effective against the malaria parasite at the time to infants as IPT probably reduces the risk of clinical malaria, anaemia, and hospital admission. Evidence from SP studies over a 19-year period shows declining efficacy, which may be due to increasing drug resistance. Combinations with ACTs appear promising as suitable alternatives for IPTi.PMID:34273901 | DOI:10.1002/14651858.CD011525.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 17, 2021 Category: General Medicine Authors: Ekpereonne B Esu Chioma Oringanje Martin M Meremikwu Source Type: research