Reducing medication errors for adults in hospital settings
CONCLUSIONS: Low- to moderate-certainty evidence suggests that, compared to usual care, medication reconciliation, CPOE/CDSS, barcoding, feedback and dispensing systems in surgical wards may reduce medication errors and ADEs. However, the results are imprecise for some outcomes related to medication reconciliation and CPOE/CDSS. The evidence for other interventions is very uncertain. Powered and methodologically sound studies are needed to address the identified evidence gaps. Innovative, synergistic strategies -including those that involve patients- should also be evaluated.PMID:34822165 | DOI:10.1002/14651858.CD009985.pu...
Source: Cochrane Database of Systematic Reviews - November 25, 2021 Category: General Medicine Authors: Agust ín Ciapponi Simon E Fernandez Nievas Mariana Seijo Mar ía Belén Rodríguez Valeria Vietto Herney A Garc ía-Perdomo Sacha Virgilio Ana V Fajreldines Josep Tost Christopher J Rose Ezequiel Garcia-Elorrio Source Type: research

Treatment for gastrointestinal and pancreatic neuroendocrine tumours: a network meta-analysis
CONCLUSIONS: The findings from this study suggest that a range of efficient therapies with different safety profiles is available for people with NETs.PMID:34822169 | DOI:10.1002/14651858.CD013700.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 25, 2021 Category: General Medicine Authors: Martin A Walter C édric Nesti Marko Spanjol Attila Koll ár Lukas B ütikofer Viktoria L Gloy Rebecca A Dumont Christian A Seiler Emanuel R Christ Piotr Radojewski Matthias Briel Reto M Kaderli Source Type: research

Omega-3 fatty acids for depression in adults
CONCLUSIONS: At present, we do not have sufficient high-certainty evidence to determine the effects of n-3PUFAs as a treatment for MDD. Our primary analyses may suggest a small-to-modest, non-clinically beneficial effect of n-3PUFAs on depressive symptomology compared to placebo; however the estimate is imprecise, and we judged the certainty of the evidence on which this result is based to be low to very low. Our data may also suggest similar rates of adverse events and trial non-completion in n-3PUFA and placebo groups, but again our estimates are very imprecise. Effects of n-3PUFAs compared to antidepressants are very im...
Source: Cochrane Database of Systematic Reviews - November 24, 2021 Category: General Medicine Authors: Katherine M Appleton Philip D Voyias Hannah M Sallis Sarah Dawson Andrew R Ness Rachel Churchill Rachel Perry Source Type: research

Topiramate for juvenile myoclonic epilepsy
CONCLUSIONS: We have found no new studies since the last version of this review was published in 2019. This review does not provide sufficient evidence to support topiramate for the treatment of people with JME. Based on the current limited available data, topiramate seems to be better tolerated than valproate, but has no clear benefits over valproate in terms of efficacy. Well-designed, double-blind RCTs with large samples are required to test the efficacy and tolerability of topiramate in people with JME.PMID:34817852 | DOI:10.1002/14651858.CD010008.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 24, 2021 Category: General Medicine Authors: Jia Liu Yao-Jun Tai Lu-Ning Wang Source Type: research

Omega-3 fatty acids for depression in adults
CONCLUSIONS: At present, we do not have sufficient high-certainty evidence to determine the effects of n-3PUFAs as a treatment for MDD. Our primary analyses may suggest a small-to-modest, non-clinically beneficial effect of n-3PUFAs on depressive symptomology compared to placebo; however the estimate is imprecise, and we judged the certainty of the evidence on which this result is based to be low to very low. Our data may also suggest similar rates of adverse events and trial non-completion in n-3PUFA and placebo groups, but again our estimates are very imprecise. Effects of n-3PUFAs compared to antidepressants are very im...
Source: Cochrane Database of Systematic Reviews - November 24, 2021 Category: General Medicine Authors: Katherine M Appleton Philip D Voyias Hannah M Sallis Sarah Dawson Andrew R Ness Rachel Churchill Rachel Perry Source Type: research

Topiramate for juvenile myoclonic epilepsy
CONCLUSIONS: We have found no new studies since the last version of this review was published in 2019. This review does not provide sufficient evidence to support topiramate for the treatment of people with JME. Based on the current limited available data, topiramate seems to be better tolerated than valproate, but has no clear benefits over valproate in terms of efficacy. Well-designed, double-blind RCTs with large samples are required to test the efficacy and tolerability of topiramate in people with JME.PMID:34817852 | DOI:10.1002/14651858.CD010008.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 24, 2021 Category: General Medicine Authors: Jia Liu Yao-Jun Tai Lu-Ning Wang Source Type: research

Environmental enrichment for stroke and other non-progressive brain injury
CONCLUSIONS: The gap in current research should not, however, be interpreted as proof that environmental enrichment is ineffective. Further research is needed with robust study designs, such as cluster RCTs, and consistent outcome measurement evaluating the effectiveness of environmental enrichment in different settings (inpatient versus outpatient), the relative effectiveness of various components of environmental enrichment, cost-effectiveness, and safety of the intervention in people following stroke or other non-progressive brain injuries. It should be noted, however, that it is challenging to randomise or double-blind...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Helen Qin Isabella Reid Alexandra Gorelik Louisa Ng Source Type: research

Non-corticosteroid adjuvant therapies for acute bacterial meningitis
CONCLUSIONS: Few adjuvant therapies for bacterial meningitis have been tested in RCTs. Paracetamol may make little or no difference to mortality, with a high level of uncertainty in the absolute effects (low certainty evidence). Paracetamol may make little or no difference to hearing loss, neurological sequelae other than hearing loss, and severe hearing loss (all low certainty evidence). Paracetamol may lead to slightly more short-term and long-term neurological sequelae other than hearing loss (both outcomes low certainty evidence). There is insufficient evidence to determine whether any of the adjuvant therapies include...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Jane Fisher Adam Linder Maria Grazia Calevo Peter Bentzer Source Type: research

Information provision for stroke survivors and their carers
CONCLUSIONS: Active information provision may improve stroke-survivor knowledge and quality of life, and may reduce anxiety and depression. However, the reductions in anxiety and depression scores were small and may not be important. In contrast, providing information passively may slightly worsen stroke-survivor anxiety and depression scores, although again the importance of this is unclear. Evidence relating to carers and to other outcomes of passive information provision is generally very uncertain. Although the best way to provide information is still unclear, the evidence is better for strategies that actively involve...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Thomas F Crocker Lesley Brown Natalie Lam Faye Wray Peter Knapp Anne Forster Source Type: research

Environmental enrichment for stroke and other non-progressive brain injury
CONCLUSIONS: The gap in current research should not, however, be interpreted as proof that environmental enrichment is ineffective. Further research is needed with robust study designs, such as cluster RCTs, and consistent outcome measurement evaluating the effectiveness of environmental enrichment in different settings (inpatient versus outpatient), the relative effectiveness of various components of environmental enrichment, cost-effectiveness, and safety of the intervention in people following stroke or other non-progressive brain injuries. It should be noted, however, that it is challenging to randomise or double-blind...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Helen Qin Isabella Reid Alexandra Gorelik Louisa Ng Source Type: research

Non-corticosteroid adjuvant therapies for acute bacterial meningitis
CONCLUSIONS: Few adjuvant therapies for bacterial meningitis have been tested in RCTs. Paracetamol may make little or no difference to mortality, with a high level of uncertainty in the absolute effects (low certainty evidence). Paracetamol may make little or no difference to hearing loss, neurological sequelae other than hearing loss, and severe hearing loss (all low certainty evidence). Paracetamol may lead to slightly more short-term and long-term neurological sequelae other than hearing loss (both outcomes low certainty evidence). There is insufficient evidence to determine whether any of the adjuvant therapies include...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Jane Fisher Adam Linder Maria Grazia Calevo Peter Bentzer Source Type: research

Information provision for stroke survivors and their carers
CONCLUSIONS: Active information provision may improve stroke-survivor knowledge and quality of life, and may reduce anxiety and depression. However, the reductions in anxiety and depression scores were small and may not be important. In contrast, providing information passively may slightly worsen stroke-survivor anxiety and depression scores, although again the importance of this is unclear. Evidence relating to carers and to other outcomes of passive information provision is generally very uncertain. Although the best way to provide information is still unclear, the evidence is better for strategies that actively involve...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Thomas F Crocker Lesley Brown Natalie Lam Faye Wray Peter Knapp Anne Forster Source Type: research

Renal denervation for resistant hypertension
CONCLUSIONS: In patients with resistant hypertension, there is low-certainty evidence that renal denervation does not improve major cardiovascular outomes and renal function. Conversely, moderate-certainty evidence exists that it may improve 24h ABPM and diastolic office-measured BP. Future trials measuring patient-centred instead of surrogate outcomes, with longer follow-up periods, larger sample size and more standardised procedural methods are necessary to clarify the utility of this procedure in this population.PMID:34806762 | DOI:10.1002/14651858.CD011499.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Anna Pisano Luigi Francesco Iannone Antonio Leo Emilio Russo Giuseppe Coppolino Davide Bolignano Source Type: research

Vaccines for measles, mumps, rubella, and varicella in children
CONCLUSIONS: Existing evidence on the safety and effectiveness of MMR/MMRV vaccines support their use for mass immunisation. Campaigns aimed at global eradication should assess epidemiological and socioeconomic situations of the countries as well as the capacity to achieve high vaccination coverage. More evidence is needed to assess whether the protective effect of MMR/MMRV could wane with time since immunisation.PMID:34806766 | DOI:10.1002/14651858.CD004407.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Carlo Di Pietrantonj Alessandro Rivetti Pasquale Marchione Maria Grazia Debalini Vittorio Demicheli Source Type: research

Macrolides versus placebo for chronic asthma
CONCLUSIONS: Existing evidence suggests an effect of macrolides compared with placebo on the rate of exacerbations requiring hospitalisation. Macrolides probably reduce severe exacerbations (requiring ED visit and/or treatment with systemic steroids) and may reduce symptoms. However, we cannot rule out the possibility of other benefits or harms because the evidence is of very low quality due to heterogeneity among patients and interventions, imprecision and reporting biases. The results were mostly driven by a well-designed, well powered RCT, indicating that azithromycin may reduce exacerbation rate and improve symptom sco...
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Krishna Undela Lucy Goldsmith Kayleigh M Kew Giovanni Ferrara Source Type: research

Growth hormone for in vitro fertilisation (IVF)
CONCLUSIONS: The use of adjuvant GH in IVF treatment protocols has uncertain effect on live birth rates and mean number of oocytes retrieved in normal responders. However, it slightly increases the number of oocytes retrieved and pregnancy rates in poor responders, while there is an uncertain effect on live birth rates in this group. The results however, need to be interpreted with caution, as the included trials were small and few in number, with significant bias and imprecision. Also, the dose and regimen of GH used in trials was variable. Therefore, further research is necessary to fully define the role of GH as adjuvan...
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Akanksha Sood Gadha Mohiyiddeen Gaity Ahmad Cheryl Fitzgerald Andrew Watson Lamiya Mohiyiddeen Source Type: research

Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards
CONCLUSIONS: Given the low-to-very low certainty evidence for all outcomes from non-randomised studies, we have drawn our conclusions from the randomised evidence. This evidence provides low-certainty evidence that EWS and RRS may lead to little or no difference in hospital mortality, unplanned ICU admissions, length of hospital stay or adverse events; and moderate-certainty evidence of little to no difference on composite outcome. The evidence from this review update highlights the diversity in outcome selection and poor methodological quality of most studies investigating EWS and RRS. As a result, no strong recommendatio...
Source: Cochrane Database of Systematic Reviews - November 22, 2021 Category: General Medicine Authors: Jennifer McGaughey Dean A Fergusson Peter Van Bogaert Louise Rose Source Type: research

Vitamin C supplementation for prevention and treatment of pneumonia
CONCLUSIONS: Due to the small number of included studies and very low certainty of the existing evidence, we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia. Further good-quality studies are required to assess the role of vitamin C supplementation in the prevention and treatment of pneumonia.PMID:34791642 | DOI:10.1002/14651858.CD013134.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 18, 2021 Category: General Medicine Authors: Zahra Ali Padhani Zorays Moazzam Alina Ashraf Hasana Bilal Rehana A Salam Jai K Das Zulfiqar A Bhutta Source Type: research

Vitamin C supplementation for prevention and treatment of pneumonia
CONCLUSIONS: Due to the small number of included studies and very low certainty of the existing evidence, we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia. Further good-quality studies are required to assess the role of vitamin C supplementation in the prevention and treatment of pneumonia.PMID:34791642 | DOI:10.1002/14651858.CD013134.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 18, 2021 Category: General Medicine Authors: Zahra Ali Padhani Zorays Moazzam Alina Ashraf Hasana Bilal Rehana A Salam Jai K Das Zulfiqar A Bhutta Source Type: research

Vitamin C supplementation for prevention and treatment of pneumonia
CONCLUSIONS: Due to the small number of included studies and very low certainty of the existing evidence, we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia. Further good-quality studies are required to assess the role of vitamin C supplementation in the prevention and treatment of pneumonia.PMID:34791642 | DOI:10.1002/14651858.CD013134.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 18, 2021 Category: General Medicine Authors: Zahra Ali Padhani Zorays Moazzam Alina Ashraf Hasana Bilal Rehana A Salam Jai K Das Zulfiqar A Bhutta Source Type: research

Vitamin C supplementation for prevention and treatment of pneumonia
CONCLUSIONS: Due to the small number of included studies and very low certainty of the existing evidence, we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia. Further good-quality studies are required to assess the role of vitamin C supplementation in the prevention and treatment of pneumonia.PMID:34791642 | DOI:10.1002/14651858.CD013134.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 18, 2021 Category: General Medicine Authors: Zahra Ali Padhani Zorays Moazzam Alina Ashraf Hasana Bilal Rehana A Salam Jai K Das Zulfiqar A Bhutta Source Type: research

Infusion techniques for peripheral arterial thrombolysis
CONCLUSIONS: There is insufficient evidence to show that any thrombolytic regimen provides a benefit over any other in terms of amputation-free survival, amputation, or 30-day mortality. The rate of CVA or major bleeding requiring surgery or blood transfusion did not clearly differ between regimens but may occur more frequently in high dose and IV regimens. This evidence was limited and of very low certainty. Minor bleeding may be more common with high-dose and IV regimens. In this context, thrombolysis may be an acceptable therapy for patients with marginally threatened limbs (Rutherford grade IIa) compared with surgery. ...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Cathryn Broderick Jai V Patel Source Type: research

Interventions for altering blood pressure in people with acute subarachnoid haemorrhage
CONCLUSIONS: Based on the current evidence, there is a lack of information needed to confirm or reject minimally important intervention effects on patient-important outcomes for both induced hypertension and lowered blood pressure. There is an urgent need for trials assessing the effects of altering blood pressure in people with acute subarachnoid haemorrhage. Such trials should use the SPIRIT statement for their design and the CONSORT statement for their reporting. Moreover, such trials should use methods allowing for blinded altering of blood pressure and report on patient-important outcomes such as mortality, rebleeding...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Mathias Maagaard William K Karlsson Christian Ovesen Christian Gluud Janus C Jakobsen Source Type: research

Vaccines for preventing rotavirus diarrhoea: vaccines in use
CONCLUSIONS: Rotarix, RotaTeq, Rotasiil, and Rotavac prevent episodes of rotavirus diarrhoea. The relative effect estimate is smaller in high-mortality than in low-mortality countries, but more episodes are prevented in high-mortality settings as the baseline risk is higher. In high-mortality countries some results suggest lower efficacy in the second year. We found no increased risk of serious adverse events, including intussusception, from any of the prequalified rotavirus vaccines.PMID:34788488 | DOI:10.1002/14651858.CD008521.pub6 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Hanna Bergman Nicholas Henschke Daniel Hungerford Femi Pitan Duduzile Ndwandwe Nigel Cunliffe Karla Soares-Weiser Source Type: research

Infusion techniques for peripheral arterial thrombolysis
CONCLUSIONS: There is insufficient evidence to show that any thrombolytic regimen provides a benefit over any other in terms of amputation-free survival, amputation, or 30-day mortality. The rate of CVA or major bleeding requiring surgery or blood transfusion did not clearly differ between regimens but may occur more frequently in high dose and IV regimens. This evidence was limited and of very low certainty. Minor bleeding may be more common with high-dose and IV regimens. In this context, thrombolysis may be an acceptable therapy for patients with marginally threatened limbs (Rutherford grade IIa) compared with surgery. ...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Cathryn Broderick Jai V Patel Source Type: research

Interventions for altering blood pressure in people with acute subarachnoid haemorrhage
CONCLUSIONS: Based on the current evidence, there is a lack of information needed to confirm or reject minimally important intervention effects on patient-important outcomes for both induced hypertension and lowered blood pressure. There is an urgent need for trials assessing the effects of altering blood pressure in people with acute subarachnoid haemorrhage. Such trials should use the SPIRIT statement for their design and the CONSORT statement for their reporting. Moreover, such trials should use methods allowing for blinded altering of blood pressure and report on patient-important outcomes such as mortality, rebleeding...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Mathias Maagaard William K Karlsson Christian Ovesen Christian Gluud Janus C Jakobsen Source Type: research

Vaccines for preventing rotavirus diarrhoea: vaccines in use
CONCLUSIONS: Rotarix, RotaTeq, Rotasiil, and Rotavac prevent episodes of rotavirus diarrhoea. The relative effect estimate is smaller in high-mortality than in low-mortality countries, but more episodes are prevented in high-mortality settings as the baseline risk is higher. In high-mortality countries some results suggest lower efficacy in the second year. We found no increased risk of serious adverse events, including intussusception, from any of the prequalified rotavirus vaccines.PMID:34788488 | DOI:10.1002/14651858.CD008521.pub6 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Hanna Bergman Nicholas Henschke Daniel Hungerford Femi Pitan Duduzile Ndwandwe Nigel Cunliffe Karla Soares-Weiser Source Type: research

Siponimod for multiple sclerosis
Cochrane Database Syst Rev. 2021 Nov 16;11:CD013647. doi: 10.1002/14651858.CD013647.pub2.ABSTRACTBACKGROUND: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, with an unpredictable course. Current MS therapies such as disease-modifying therapies focus on treating exacerbations, preventing new exacerbations and avoiding the progression of disability. Siponimod (BAF312) is an oral treatment, a selective sphingosine-1-phosphate (S1P) receptor modulator, for the treatment of adults with relapsing forms of MS including active, secondary progressive MS with relapses.OBJECTIVES: To assess...
Source: Cochrane Database of Systematic Reviews - November 16, 2021 Category: General Medicine Authors: Liujiao Cao Meixuan Li Liang Yao Peijing Yan Xiaoqin Wang Zhen Yang Yongfeng Lao Huijuan Li Kehu Yang Ka Li Source Type: research

Palivizumab for preventing severe respiratory syncytial virus (RSV) infection in children
CONCLUSIONS: The available evidence suggests that prophylaxis with palivizumab reduces hospitalisation due to RSV infection and results in little to no difference in mortality or adverse events. Moreover, palivizumab results in a slight reduction in hospitalisation due to respiratory-related illness and may result in a large reduction in RSV infections. Palivizumab also reduces the number of wheezing days. These results may be applicable to children with a high risk of RSV infection due to comorbidities. Further research is needed to establish the effect of palivizumab on children with other comorbidities known as risk fac...
Source: Cochrane Database of Systematic Reviews - November 16, 2021 Category: General Medicine Authors: Luis Garegnani Lea Styrmisd óttir Pablo Roson Rodriguez Camila Micaela Escobar Liquitay Ignacio Esteban Juan Va Franco Source Type: research

Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta-analysis
CONCLUSIONS: This field of supportive cancer care is very well researched. However, new drugs or drug combinations are continuously emerging and need to be systematically researched and assessed. For people receiving HEC, synthesised evidence does not suggest one superior treatment for prevention and control of chemotherapy-induced nausea and vomiting. For people receiving MEC, synthesised evidence does not suggest superiority for treatments including both NK₁ and 5-HT₃ inhibitors when compared to treatments including 5-HT₃ inhibitors only. Rather, the results of our NMA suggest that the choice of 5-HT₃ inhibitor m...
Source: Cochrane Database of Systematic Reviews - November 16, 2021 Category: General Medicine Authors: Vanessa Piechotta Anne Adams Madhuri Haque Benjamin Scheckel Nina Kreuzberger Ina Monsef Karin Jordan Kathrin Kuhr Nicole Skoetz Source Type: research

Siponimod for multiple sclerosis
Cochrane Database Syst Rev. 2021 Nov 16;11:CD013647. doi: 10.1002/14651858.CD013647.pub2.ABSTRACTBACKGROUND: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, with an unpredictable course. Current MS therapies such as disease-modifying therapies focus on treating exacerbations, preventing new exacerbations and avoiding the progression of disability. Siponimod (BAF312) is an oral treatment, a selective sphingosine-1-phosphate (S1P) receptor modulator, for the treatment of adults with relapsing forms of MS including active, secondary progressive MS with relapses.OBJECTIVES: To assess...
Source: Cochrane Database of Systematic Reviews - November 16, 2021 Category: General Medicine Authors: Liujiao Cao Meixuan Li Liang Yao Peijing Yan Xiaoqin Wang Zhen Yang Yongfeng Lao Huijuan Li Kehu Yang Ka Li Source Type: research

Palivizumab for preventing severe respiratory syncytial virus (RSV) infection in children
CONCLUSIONS: The available evidence suggests that prophylaxis with palivizumab reduces hospitalisation due to RSV infection and results in little to no difference in mortality or adverse events. Moreover, palivizumab results in a slight reduction in hospitalisation due to respiratory-related illness and may result in a large reduction in RSV infections. Palivizumab also reduces the number of wheezing days. These results may be applicable to children with a high risk of RSV infection due to comorbidities. Further research is needed to establish the effect of palivizumab on children with other comorbidities known as risk fac...
Source: Cochrane Database of Systematic Reviews - November 16, 2021 Category: General Medicine Authors: Luis Garegnani Lea Styrmisd óttir Pablo Roson Rodriguez Camila Micaela Escobar Liquitay Ignacio Esteban Juan Va Franco Source Type: research

Immunosuppressive treatment for primary membranous nephropathy in adults with nephrotic syndrome
CONCLUSIONS: This updated review strengthened the evidence that immunosuppressive therapy is probably superior to non-immunosuppressive therapy in inducing remission and reducing the number of patients that progress to ESKD. However, these benefits need to be balanced against the side effects of immunosuppressive drugs. The number of included studies with high-quality design was relatively small and most studies did not have adequate follow-up. Clinicians should inform their patients of the lack of high-quality evidence. An alkylating agent (cyclophosphamide or chlorambucil) combined with a corticosteroid regimen had short...
Source: Cochrane Database of Systematic Reviews - November 15, 2021 Category: General Medicine Authors: Thilo C von Groote Gabrielle Williams Eric H Au Yizhi Chen Anna T Mathew Elisabeth M Hodson David J Tunnicliffe Source Type: research

Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery
CONCLUSIONS: There is high-quality evidence that SSRIs do not make a difference to disability or independence after stroke compared to placebo or usual care, reduced the risk of future depression, increased bone fractures and probably increased seizure risk.PMID:34780067 | DOI:10.1002/14651858.CD009286.pub4 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 15, 2021 Category: General Medicine Authors: Lynn A Legg Ann-Sofie Rudberg Xing Hua Simiao Wu Maree L Hackett Russel Tilney Linnea Lindgren Mansur A Kutlubaev Cheng-Fang Hsieh Amanda J Barugh Graeme J Hankey Erik Lundstr öm Martin Dennis Gillian E Mead Source Type: research

Multidisciplinary rehabilitation for older people with hip fractures
CONCLUSIONS: In a hospital inpatient setting, there is moderate-certainty evidence that rehabilitation after hip fracture surgery, when delivered by a multidisciplinary team and supervised by an appropriate medical specialist, results in fewer cases of 'poor outcome' (death or deterioration in residential status). There is low-certainty evidence that multidisciplinary rehabilitation may result in fewer deaths in hospital and at 4 to 12 months; however, it may also result in slightly more. There is low-certainty evidence that multidisciplinary rehabilitation may reduce the numbers of people with poorer mobility at 12 months...
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Helen Hg Handoll Ian D Cameron Jenson Cs Mak Claire E Panagoda Terence P Finnegan Source Type: research

Dietary supplements for chronic gout
CONCLUSIONS: While dietary supplements may be widely used for gout, this review found no high-quality that supported or refuted the use of glycomacropeptide-enriched skim milk powder or vitamin C for adults with chronic gout.PMID:34767649 | DOI:10.1002/14651858.CD010156.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Mariano Andr és Francisca Sivera Rachelle Buchbinder Jordi Pardo Pardo Loreto Carmona Source Type: research

Multidisciplinary rehabilitation for older people with hip fractures
CONCLUSIONS: In a hospital inpatient setting, there is moderate-certainty evidence that rehabilitation after hip fracture surgery, when delivered by a multidisciplinary team and supervised by an appropriate medical specialist, results in fewer cases of 'poor outcome' (death or deterioration in residential status). There is low-certainty evidence that multidisciplinary rehabilitation may result in fewer deaths in hospital and at 4 to 12 months; however, it may also result in slightly more. There is low-certainty evidence that multidisciplinary rehabilitation may reduce the numbers of people with poorer mobility at 12 months...
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Helen Hg Handoll Ian D Cameron Jenson Cs Mak Claire E Panagoda Terence P Finnegan Source Type: research

Dietary supplements for chronic gout
CONCLUSIONS: While dietary supplements may be widely used for gout, this review found no high-quality that supported or refuted the use of glycomacropeptide-enriched skim milk powder or vitamin C for adults with chronic gout.PMID:34767649 | DOI:10.1002/14651858.CD010156.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Mariano Andr és Francisca Sivera Rachelle Buchbinder Jordi Pardo Pardo Loreto Carmona Source Type: research

Multidisciplinary rehabilitation for older people with hip fractures
CONCLUSIONS: In a hospital inpatient setting, there is moderate-certainty evidence that rehabilitation after hip fracture surgery, when delivered by a multidisciplinary team and supervised by an appropriate medical specialist, results in fewer cases of 'poor outcome' (death or deterioration in residential status). There is low-certainty evidence that multidisciplinary rehabilitation may result in fewer deaths in hospital and at 4 to 12 months; however, it may also result in slightly more. There is low-certainty evidence that multidisciplinary rehabilitation may reduce the numbers of people with poorer mobility at 12 months...
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Helen Hg Handoll Ian D Cameron Jenson Cs Mak Claire E Panagoda Terence P Finnegan Source Type: research

Dietary supplements for chronic gout
CONCLUSIONS: While dietary supplements may be widely used for gout, this review found no high-quality that supported or refuted the use of glycomacropeptide-enriched skim milk powder or vitamin C for adults with chronic gout.PMID:34767649 | DOI:10.1002/14651858.CD010156.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 12, 2021 Category: General Medicine Authors: Mariano Andr és Francisca Sivera Rachelle Buchbinder Jordi Pardo Pardo Loreto Carmona Source Type: research

Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments
CONCLUSIONS: The current update confirms the findings of the previous review. PR may result in lower rates of reattachment and higher rates of recurrence than SB, but carries a lower burden of postoperative complications. The effects of these two procedures on other functional outcomes and quality of life remain uncertain. The available evidence remains insufficient and of low quality.PMID:34762741 | DOI:10.1002/14651858.CD008350.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 11, 2021 Category: General Medicine Authors: Dayse F Sena Raphael Kilian Su-Hsun Liu Stanislao Rizzo Gianni Virgili Source Type: research

Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments
CONCLUSIONS: The current update confirms the findings of the previous review. PR may result in lower rates of reattachment and higher rates of recurrence than SB, but carries a lower burden of postoperative complications. The effects of these two procedures on other functional outcomes and quality of life remain uncertain. The available evidence remains insufficient and of low quality.PMID:34762741 | DOI:10.1002/14651858.CD008350.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 11, 2021 Category: General Medicine Authors: Dayse F Sena Raphael Kilian Su-Hsun Liu Stanislao Rizzo Gianni Virgili Source Type: research

Late ( ≥ 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants
Cochrane Database Syst Rev. 2021 Nov 11;11:CD001145. doi: 10.1002/14651858.CD001145.pub5.ABSTRACTBACKGROUND: Many infants born preterm develop bronchopulmonary dysplasia (BPD), with lung inflammation playing a role. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established BPD. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs.OBJECTIVES: To examine the relative benefits and adverse effects of late (starting at seven or more days after birth) systemic postnatal corticosteroid treatment for preterm infants with evolving or...
Source: Cochrane Database of Systematic Reviews - November 10, 2021 Category: General Medicine Authors: Lex W Doyle Jeanie L Cheong Susanne Hay Brett J Manley Henry L Halliday Source Type: research

Late ( ≥ 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants
Cochrane Database Syst Rev. 2021 Nov 11;11:CD001145. doi: 10.1002/14651858.CD001145.pub5.ABSTRACTBACKGROUND: Many infants born preterm develop bronchopulmonary dysplasia (BPD), with lung inflammation playing a role. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established BPD. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs.OBJECTIVES: To examine the relative benefits and adverse effects of late (starting at seven or more days after birth) systemic postnatal corticosteroid treatment for preterm infants with evolving or...
Source: Cochrane Database of Systematic Reviews - November 10, 2021 Category: General Medicine Authors: Lex W Doyle Jeanie L Cheong Susanne Hay Brett J Manley Henry L Halliday Source Type: research

Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma
CONCLUSIONS: The diagnostic accuracy of 18F-FDG-PET/CT for the detection of bone, lung, and lymph node metastases was reported in only two studies including a total of only 36 participants with newly diagnosed RMS. Because of the small number of studies (and participants), there is currently insufficient evidence to reliably determine the diagnostic accuracy of 18F-FDG-PET/CT in the detection of distant metastases. Larger series evaluating the diagnostic accuracy of 18F-FDG-PET/CT for the detection of metastases in patients with RMS are necessary.PMID:34753195 | DOI:10.1002/14651858.CD012325.pub2 (Source: Cochrane Database...
Source: Cochrane Database of Systematic Reviews - November 9, 2021 Category: General Medicine Authors: Bas Vaarwerk Willemijn B Breunis Lianne M Haveman Bart de Keizer Nina Jehanno Lise Borgwardt Rick R van Rijn Henk van den Berg J érémie F Cohen Elvira C van Dalen Johannes Hm Merks Source Type: research

Perioperative systemic nonsteroidal anti-inflammatory drugs (NSAIDs) in women undergoing breast surgery
CONCLUSIONS: Low-certainty evidence suggests that NSAIDs may reduce postoperative pain, nausea and vomiting, and postoperative opioid use. However, there was very little evidence to indicate whether NSAIDs affect the rate of breast hematoma or bleeding from any location within 90 days of breast surgery, the need for blood transfusion and incidence of other side effects compared to placebo or other analgesics. High-quality large-scale RCTs are required before definitive conclusions can be made.PMID:34753201 | DOI:10.1002/14651858.CD013290.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 9, 2021 Category: General Medicine Authors: Kevin M Klifto Ala Elhelali Rachael M Payne Carisa M Cooney Michele A Manahan Gedge D Rosson Source Type: research

Multi-domain interventions for the prevention of dementia and cognitive decline
CONCLUSIONS: We found no evidence that multi-domain interventions can prevent incident dementia based on two trials. There was a small improvement in cognitive function assessed by a NTB in the group of participants receiving a multi-domain intervention, although this effect was strongest in trials offering cognitive training within the multi-domain intervention, making it difficult to rule out a potential learning effect. Interventions were diverse in terms of their components and intensity.PMID:34748207 | DOI:10.1002/14651858.CD013572.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 8, 2021 Category: General Medicine Authors: Melanie Hafdi Marieke P Hoevenaar-Blom Edo Richard Source Type: research

Surgical interventions for lamellar macular holes
CONCLUSIONS: The included single trial demonstrated improvements in visual and anatomical outcome measures for participants with a LMH who underwent surgery compared with observation only. Therefore, we can conclude that participants who undergo surgery may achieve superior post-operative best corrected visual acuity and anatomical outcomes compared with observation only. However, the results of a single and small RCT provides limited evidence to support or refute surgery as an effective management option for LMHs. Future RCTs with a larger number of participants and with fewer methodological limitations and biases are nec...
Source: Cochrane Database of Systematic Reviews - November 8, 2021 Category: General Medicine Authors: Declan C Murphy Jon Rees David Hw Steel Source Type: research

Rituximab for people with multiple sclerosis
CONCLUSIONS: For preventing relapses in relapsing MS, rituximab as 'first choice' and as 'switching' may compare favourably with a wide range of approved DMTs. A protective effect of rituximab against disability worsening is uncertain. There is limited information to determine the effect of rituximab for progressive MS. The evidence is uncertain about the effect of rituximab on SAEs. They are relatively rare in people with MS, thus difficult to study, and they were not well reported in studies. There is an increased risk of common infections with rituximab, but absolute risk is small. Rituximab is widely used as off-label ...
Source: Cochrane Database of Systematic Reviews - November 8, 2021 Category: General Medicine Authors: Graziella Filippini Jera Kruja Cinzia Del Giovane Source Type: research

Antioxidants to prevent respiratory decline in people with Duchenne muscular dystrophy and progressive respiratory decline
CONCLUSIONS: Idebenone is the only antioxidant agent tested in RCTs for preventing respiratory decline in people with DMD for which evidence was available for assessment. Idebenone may result in slightly less of a decline in FVC and less of a decline in FEV1 and PEF, but probably has little to no measurable effect on change in quality of life. Idebenone is associated with fewer serious adverse events than placebo. Idebenone may result in little to no difference in change in muscle function. Discontinuation due to the futility of the SIDEROS trial and its expanded access programmes may indicate that idebenone research in th...
Source: Cochrane Database of Systematic Reviews - November 8, 2021 Category: General Medicine Authors: Luis Garegnani Martin Hyland Pablo Roson Rodriguez Camila Micaela E Escobar Liquitay Juan Va Franco Source Type: research