Factors that influence parents' and informal caregivers' views and practices regarding routine childhood vaccination: a qualitative evidence synthesis
CONCLUSIONS: Our review has revealed that parents' views and practices regarding childhood vaccination are complex and dynamic social processes that reflect multiple webs of influence, meaning, and logic. We have provided a theorised understanding of the social processes contributing to vaccination acceptance (or not), thereby complementing but also extending more individualistic models of vaccination acceptance. Successful development of interventions to promote acceptance and uptake of childhood vaccination will require an understanding of, and then tailoring to, the specific factors influencing vaccination views and pra...
Source: Cochrane Database of Systematic Reviews - October 27, 2021 Category: General Medicine Authors: Sara Cooper Bey-Marri é Schmidt Evanson Z Sambala Alison Swartz Christopher J Colvin Natalie Leon Charles S Wiysonge Source Type: research

Mammographic density, endocrine therapy and breast cancer risk: a prognostic and predictive biomarker review
CONCLUSIONS: There is low-/very low-certainty evidence to support the hypothesis that breast density change following endocrine therapy is a prognostic biomarker for treatment or prevention. Studies suggested a potentially large effect size with tamoxifen, but the evidence was limited. There was less evidence that breast density change following tamoxifen preventive therapy is a predictive biomarker than prognostic biomarker. Evidence for breast density change as a prognostic treatment biomarker was stronger for tamoxifen than aromatase inhibitors. There were no studies reporting mammographic density change following endoc...
Source: Cochrane Database of Systematic Reviews - October 26, 2021 Category: General Medicine Authors: Emma C Atakpa Mangesh A Thorat Jack Cuzick Adam R Brentnall Source Type: research

Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions
CONCLUSIONS: Despite a total of 23 trials, the paucity of useable data and uncertainty of the evidence means that it remains unclear whether the incidence of UTI or other complications is affected by use of aseptic or clean technique, single (sterile) or multiple-use (clean) catheters, coated or uncoated catheters or different catheter lengths. The current research evidence is uncertain and design and reporting issues are significant. More well-designed trials are needed. Such trials should include analysis of cost-effectiveness because there are likely to be substantial differences associated with the use of different cat...
Source: Cochrane Database of Systematic Reviews - October 26, 2021 Category: General Medicine Authors: Jacqui A Prieto Catherine L Murphy Fiona Stewart Mandy Fader Source Type: research

Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis
CONCLUSIONS: Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowerin...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Takayoshi Kanie Atsushi Mizuno Yoshimitsu Takaoka Takahiro Suzuki Daisuke Yoneoka Yuri Nishikawa Wilson Wai San Tam Jakub Morze Andrzej Rynkiewicz Yiqiao Xin Olivia Wu Rui Providencia Joey Sw Kwong Source Type: research

Calcium supplementation for prevention of primary hypertension
CONCLUSIONS: An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-pow...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Gabriela Cormick Agust ín Ciapponi Mar ía Luisa Cafferata Mar ía Sol Cormick Jos é M Belizán Source Type: research

Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD)
CONCLUSIONS: Remote monitoring plus usual care provided asynchronously may not be beneficial overall compared to usual care alone. Some benefit is seen in reduction of COPD-related hospital re-admissions, but moderate-certainty evidence is based on one study. We have not found any evidence for dyspnoea symptoms nor harms, and there is no difference in fatalities when remote monitoring is provided in addition to usual care. Remote monitoring interventions alone are no better than usual care overall for health outcomes. Multi-component interventions with asynchronous remote monitoring are no better than usual care but may pr...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Sadia Janjua Deborah Carter Christopher Jd Threapleton Samantha Prigmore Rebecca T Disler Source Type: research

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD)
CONCLUSIONS: Evidence is limited regarding the efficacy of CBT for treatment of OCD in ASD. There is much scope for future study, not only examining the efficacy of CBT for OCD in ASD, but also the particular ways that OCD manifests in and affects people with ASD and the role of the family in treatment response.PMID:34693989 | DOI:10.1002/14651858.CD013173.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Sarah J Elliott David Marshall Karen Morley Eleonora Uphoff Mrityunjai Kumar Nicholas Meader Source Type: research

Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia: a network meta-analysis
CONCLUSIONS: Minimally invasive treatments may result in similar or worse effects concerning urinary symptoms and QoL compared to TURP at short-term follow-up. They may result in fewer major adverse events, especially in the case of PUL and PAE; resulting in better rankings for symptoms scores. PUL may result in fewer retreatments compared to other interventions, especially TUMT, which had the highest retreatment rates at long-term follow-up. We are very uncertain about the effects of these interventions on erectile function. There was limited long-term data, especially for CRFWVT and TIND. Future high-quality studies with...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Juan Va Franco Jae Hung Jung Mari Imamura Michael Borofsky Muhammad Imran Omar Camila Micaela Escobar Liquitay Shamar Young Jafar Golzarian Areti Angeliki Veroniki Luis Garegnani Philipp Dahm Source Type: research

Whole-cell pertussis vaccine in early infancy for the prevention of allergy in children
CONCLUSIONS: There is very low-certainty evidence that a first dose of wP given early in infancy, compared to a first dose of aP, affects the risk of atopic diseases in children. The incidence of all-cause SAEs in wP and aP vaccinees was low, and no cases of encephalopathy were reported. The certainty of the evidence was judged as moderate for all-cause SAEs, and low for encephalopathy. Future studies should use sensitive and specific endpoints of clinical relevance, and should be conducted in settings with high prevalence of IgE-mediated food allergy. Safety endpoints should prioritise common vaccine reactions, parental a...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Gladymar Perez Chacon Jessica Ramsay Christopher G Brennan-Jones Marie J Estcourt Peter Richmond Patrick Holt Tom Snelling Source Type: research

Strategies to improve smoking cessation rates in primary care
CONCLUSIONS: There is moderate-certainty evidence that providing adjunctive counseling by an allied health professional, cost-free smoking cessation medications, and tailored printed materials as part of smoking cessation support in primary care can increase the number of people who achieve smoking cessation. There is no clear evidence that providing participants with biomedical risk feedback, or primary care providers with training or incentives to provide smoking cessation support enhance quit rates. However, we rated this evidence as of low or very low certainty, and so conclusions are likely to change as further eviden...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Nicola Lindson Gillian Pritchard Bosun Hong Thomas R Fanshawe Andrew Pipe Sophia Papadakis Source Type: research

Intraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy
CONCLUSIONS: We are very uncertain about the effect estimate of intraperitoneal local anaesthetic for laparoscopic cholecystectomy on all-cause mortality, serious adverse events, and proportion of patients discharged on the same day of surgery because the certainty of evidence was very low. Due to inadequate reporting, we cannot exclude an increase in adverse events. We found that intraperitoneal local anaesthetic probably results in a small reduction in length of stay in hospital after surgery. We found that intraperitoneal local anaesthetic may reduce pain at up to 24 hours for low-risk patients undergoing laparoscopic c...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Duncan Rutherford Eleanor M Massie Calum Worsley Michael Sj Wilson Source Type: research

Interventions targeted at women to encourage the uptake of cervical screening
CONCLUSIONS: There is moderate-certainty evidence to support the use of invitation letters to increase the uptake of cervical screening. Low-certainty evidence showed lay health worker involvement amongst ethnic minority populations may increase screening coverage, and there was also support for educational interventions, but it is unclear what format is most effective. The majority of the studies were from developed countries and so the relevance of low- and middle-income countries (LMICs), is unclear. Overall, the low-certainty evidence that was identified makes it difficult to infer as to which interventions were best, ...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Helen Staley Aslam Shiraz Norman Shreeve Andrew Bryant Pierre Pl Martin-Hirsch Ketankumar Gajjar Source Type: research

Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years
CONCLUSIONS: Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have a small increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. There was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there w...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Rosa Virgara Anna Phillips Lucy K Lewis Katherine Baldock Luke Wolfenden Ty Ferguson Mandy Richardson Anthony Okely Michael Beets Carol Maher Source Type: research

The effect of time spent in rehabilitation on activity limitation and impairment after stroke
CONCLUSIONS: An increase in time spent in the same type of rehabilitation after stroke results in little to no difference in meaningful activities such as activities of daily living and activities of the upper and lower limb but a small benefit in measures of motor impairment (low- to very low-certainty evidence for all findings). If the increase in time spent in rehabilitation exceeds a threshold, this may lead to improved outcomes. There is currently insufficient evidence to recommend a minimum beneficial daily amount in clinical practice. The findings of this study are limited by a lack of studies with a significant con...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Beth Clark Jill Whitall Gert Kwakkel Jan Mehrholz Sean Ewings Jane Burridge Source Type: research

Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis
CONCLUSIONS: Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowerin...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Takayoshi Kanie Atsushi Mizuno Yoshimitsu Takaoka Takahiro Suzuki Daisuke Yoneoka Yuri Nishikawa Wilson Wai San Tam Jakub Morze Andrzej Rynkiewicz Yiqiao Xin Olivia Wu Rui Providencia Joey Sw Kwong Source Type: research

Calcium supplementation for prevention of primary hypertension
CONCLUSIONS: An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-pow...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Gabriela Cormick Agust ín Ciapponi Mar ía Luisa Cafferata Mar ía Sol Cormick Jos é M Belizán Source Type: research

Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease (COPD)
CONCLUSIONS: Remote monitoring plus usual care provided asynchronously may not be beneficial overall compared to usual care alone. Some benefit is seen in reduction of COPD-related hospital re-admissions, but moderate-certainty evidence is based on one study. We have not found any evidence for dyspnoea symptoms nor harms, and there is no difference in fatalities when remote monitoring is provided in addition to usual care. Remote monitoring interventions alone are no better than usual care overall for health outcomes. Multi-component interventions with asynchronous remote monitoring are no better than usual care but may pr...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Sadia Janjua Deborah Carter Christopher Jd Threapleton Samantha Prigmore Rebecca T Disler Source Type: research

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD)
CONCLUSIONS: Evidence is limited regarding the efficacy of CBT for treatment of OCD in ASD. There is much scope for future study, not only examining the efficacy of CBT for OCD in ASD, but also the particular ways that OCD manifests in and affects people with ASD and the role of the family in treatment response.PMID:34693989 | DOI:10.1002/14651858.CD013173.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Sarah J Elliott David Marshall Karen Morley Eleonora Uphoff Mrityunjai Kumar Nicholas Meader Source Type: research

Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia: a network meta-analysis
CONCLUSIONS: Minimally invasive treatments may result in similar or worse effects concerning urinary symptoms and QoL compared to TURP at short-term follow-up. They may result in fewer major adverse events, especially in the case of PUL and PAE; resulting in better rankings for symptoms scores. PUL may result in fewer retreatments compared to other interventions, especially TUMT, which had the highest retreatment rates at long-term follow-up. We are very uncertain about the effects of these interventions on erectile function. There was limited long-term data, especially for CRFWVT and TIND. Future high-quality studies with...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Juan Va Franco Jae Hung Jung Mari Imamura Michael Borofsky Muhammad Imran Omar Camila Micaela Escobar Liquitay Shamar Young Jafar Golzarian Areti Angeliki Veroniki Luis Garegnani Philipp Dahm Source Type: research

Whole-cell pertussis vaccine in early infancy for the prevention of allergy in children
CONCLUSIONS: There is very low-certainty evidence that a first dose of wP given early in infancy, compared to a first dose of aP, affects the risk of atopic diseases in children. The incidence of all-cause SAEs in wP and aP vaccinees was low, and no cases of encephalopathy were reported. The certainty of the evidence was judged as moderate for all-cause SAEs, and low for encephalopathy. Future studies should use sensitive and specific endpoints of clinical relevance, and should be conducted in settings with high prevalence of IgE-mediated food allergy. Safety endpoints should prioritise common vaccine reactions, parental a...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Gladymar Perez Chacon Jessica Ramsay Christopher G Brennan-Jones Marie J Estcourt Peter Richmond Patrick Holt Tom Snelling Source Type: research

Strategies to improve smoking cessation rates in primary care
CONCLUSIONS: There is moderate-certainty evidence that providing adjunctive counseling by an allied health professional, cost-free smoking cessation medications, and tailored printed materials as part of smoking cessation support in primary care can increase the number of people who achieve smoking cessation. There is no clear evidence that providing participants with biomedical risk feedback, or primary care providers with training or incentives to provide smoking cessation support enhance quit rates. However, we rated this evidence as of low or very low certainty, and so conclusions are likely to change as further eviden...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Nicola Lindson Gillian Pritchard Bosun Hong Thomas R Fanshawe Andrew Pipe Sophia Papadakis Source Type: research

Intraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy
CONCLUSIONS: We are very uncertain about the effect estimate of intraperitoneal local anaesthetic for laparoscopic cholecystectomy on all-cause mortality, serious adverse events, and proportion of patients discharged on the same day of surgery because the certainty of evidence was very low. Due to inadequate reporting, we cannot exclude an increase in adverse events. We found that intraperitoneal local anaesthetic probably results in a small reduction in length of stay in hospital after surgery. We found that intraperitoneal local anaesthetic may reduce pain at up to 24 hours for low-risk patients undergoing laparoscopic c...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Duncan Rutherford Eleanor M Massie Calum Worsley Michael Sj Wilson Source Type: research

Interventions targeted at women to encourage the uptake of cervical screening
CONCLUSIONS: There is moderate-certainty evidence to support the use of invitation letters to increase the uptake of cervical screening. Low-certainty evidence showed lay health worker involvement amongst ethnic minority populations may increase screening coverage, and there was also support for educational interventions, but it is unclear what format is most effective. The majority of the studies were from developed countries and so the relevance of low- and middle-income countries (LMICs), is unclear. Overall, the low-certainty evidence that was identified makes it difficult to infer as to which interventions were best, ...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Helen Staley Aslam Shiraz Norman Shreeve Andrew Bryant Pierre Pl Martin-Hirsch Ketankumar Gajjar Source Type: research

Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years
CONCLUSIONS: Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have a small increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. There was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there w...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Rosa Virgara Anna Phillips Lucy K Lewis Katherine Baldock Luke Wolfenden Ty Ferguson Mandy Richardson Anthony Okely Michael Beets Carol Maher Source Type: research

The effect of time spent in rehabilitation on activity limitation and impairment after stroke
CONCLUSIONS: An increase in time spent in the same type of rehabilitation after stroke results in little to no difference in meaningful activities such as activities of daily living and activities of the upper and lower limb but a small benefit in measures of motor impairment (low- to very low-certainty evidence for all findings). If the increase in time spent in rehabilitation exceeds a threshold, this may lead to improved outcomes. There is currently insufficient evidence to recommend a minimum beneficial daily amount in clinical practice. The findings of this study are limited by a lack of studies with a significant con...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Beth Clark Jill Whitall Gert Kwakkel Jan Mehrholz Sean Ewings Jane Burridge Source Type: research

Anticoagulants for acute ischaemic stroke
CONCLUSIONS: Since the last version of this review, four new relevant studies have been published, and conclusions remain consistent. People who have early anticoagulant therapy after acute ischaemic stroke do not demonstrate any net short- or long-term benefit. Treatment with anticoagulants reduced recurrent stroke, deep vein thrombosis, and pulmonary embolism but increased bleeding risk. Data do not support the routine use of any of the currently available anticoagulants for acute ischaemic stroke.PMID:34676532 | DOI:10.1002/14651858.CD000024.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 22, 2021 Category: General Medicine Authors: Xia Wang Menglu Ouyang Jie Yang Lili Song Min Yang Craig S Anderson Source Type: research

Antibiotics for the treatment of COVID-19
CONCLUSIONS: We are certain that risk of death in hospitalised COVID-19 patients is not reduced by treatment with azithromycin after 28 days. Further, based on moderate-certainty evidence, patients in the inpatient setting with moderate and severe disease probably do not benefit from azithromycin used as potential antiviral and anti-inflammatory treatment for COVID-19 regarding clinical worsening or improvement. For the outpatient setting, there is currently low-certainty evidence that azithromycin may have no beneficial effect for COVID-19 individuals. There is no evidence from RCTs available for other antibiotics as anti...
Source: Cochrane Database of Systematic Reviews - October 22, 2021 Category: General Medicine Authors: Maria Popp Miriam Stegemann Manuel Riemer Maria-Inti Metzendorf Carolina S Romero Agata Mikolajewska Peter Kranke Patrick Meybohm Nicole Skoetz Stephanie Weibel Source Type: research

Avoidance of bottles during the establishment of breastfeeds in preterm infants
CONCLUSIONS: Avoiding the use of bottles when preterm infants need supplementary feeds probably increases the extent of any breastfeeding at discharge, and may improve any and full breastfeeding (exclusive) up to six months postdischarge. Most of the evidence demonstrating benefit was for cup feeding. Only one study used a tube feeding strategy. We are uncertain whether a tube alone approach to supplementing breastfeeds improves breastfeeding outcomes; further studies of high certainty are needed to determine this.PMID:34671969 | DOI:10.1002/14651858.CD005252.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Elizabeth Allen Alice R Rumbold Amy Keir Carmel T Collins Jennifer Gillis Hiroki Suganuma Source Type: research

Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias
CONCLUSIONS: This meta-analysis showed that the evidence is uncertain to inform the decision to either interrupt or continue anticoagulation therapy around CA procedure in adults with arrhythmia on outcomes of thromboembolic events, major and minor bleeding, all-cause mortality, asymptomatic thromboembolic events, and a composite endpoint of thromboembolic events (stroke, systemic embolism, major bleeding, and all-cause mortality). Most studies in the review adopted a minimal interruption strategy which has the advantage of reducing the risk of bleeding while maintaining a lower level of anticoagulation to prevent periproc...
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Ghada A Bawazeer Hadeel A Alkofide Aya A Alsharafi Nada O Babakr Arwa M Altorkistani Tarek S Kashour Michael Miligkos Khalid M AlFaleh Lubna A Al-Ansary Source Type: research

Early ( & amp;lt; 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants
CONCLUSIONS: Early systemic postnatal corticosteroid treatment (started during the first six days after birth) prevents BPD and the combined outcome of mortality or BPD. However, it increases risks of gastrointestinal perforation, cerebral palsy, and the combined outcome of mortality or cerebral palsy. Most beneficial and harmful effects are related to early treatment with dexamethasone, rather than to early treatment with hydrocortisone, but early hydrocortisone may prevent mortality, whereas early dexamethasone does not. Longer-term follow-up into late childhood is vital for assessment of important outcomes that cannot b...
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Lex W Doyle Jeanie L Cheong Susanne Hay Brett J Manley Henry L Halliday Source Type: research

Avoidance of bottles during the establishment of breastfeeds in preterm infants
CONCLUSIONS: Avoiding the use of bottles when preterm infants need supplementary feeds probably increases the extent of any breastfeeding at discharge, and may improve any and full breastfeeding (exclusive) up to six months postdischarge. Most of the evidence demonstrating benefit was for cup feeding. Only one study used a tube feeding strategy. We are uncertain whether a tube alone approach to supplementing breastfeeds improves breastfeeding outcomes; further studies of high certainty are needed to determine this.PMID:34671969 | DOI:10.1002/14651858.CD005252.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Elizabeth Allen Alice R Rumbold Amy Keir Carmel T Collins Jennifer Gillis Hiroki Suganuma Source Type: research

Avoidance of bottles during the establishment of breastfeeds in preterm infants
CONCLUSIONS: Avoiding the use of bottles when preterm infants need supplementary feeds probably increases the extent of any breastfeeding at discharge, and may improve any and full breastfeeding (exclusive) up to six months postdischarge. Most of the evidence demonstrating benefit was for cup feeding. Only one study used a tube feeding strategy. We are uncertain whether a tube alone approach to supplementing breastfeeds improves breastfeeding outcomes; further studies of high certainty are needed to determine this.PMID:34671969 | DOI:10.1002/14651858.CD005252.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Elizabeth Allen Alice R Rumbold Amy Keir Carmel T Collins Jennifer Gillis Hiroki Suganuma Source Type: research

Avoidance of bottles during the establishment of breastfeeds in preterm infants
CONCLUSIONS: Avoiding the use of bottles when preterm infants need supplementary feeds probably increases the extent of any breastfeeding at discharge, and may improve any and full breastfeeding (exclusive) up to six months postdischarge. Most of the evidence demonstrating benefit was for cup feeding. Only one study used a tube feeding strategy. We are uncertain whether a tube alone approach to supplementing breastfeeds improves breastfeeding outcomes; further studies of high certainty are needed to determine this.PMID:34671969 | DOI:10.1002/14651858.CD005252.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 21, 2021 Category: General Medicine Authors: Elizabeth Allen Alice R Rumbold Amy Keir Carmel T Collins Jennifer Gillis Hiroki Suganuma Source Type: research

Mindfulness-based interventions for substance use disorders
CONCLUSIONS: In comparison with no treatment, the evidence is uncertain regarding the impact of MBIs on SUD-related outcomes. MBIs result in little to no higher attrition than no treatment. In comparison with other treatments, MBIs may slightly reduce days with substance use at post-treatment and follow-up (4 to 10 months). The evidence is uncertain regarding the impact of MBIs relative to other treatments on abstinence, consumed substance amount, or craving. MBIs result in little to no higher attrition than other treatments. Few studies reported adverse events.PMID:34668188 | DOI:10.1002/14651858.CD011723.pub2 (Source: Co...
Source: Cochrane Database of Systematic Reviews - October 20, 2021 Category: General Medicine Authors: Simon B Goldberg Brian Pace Matas Griskaitis Reinhard Willutzki Nicole Skoetz Sven Thoenes Aleksandra E Zgierska Susanne R ösner Source Type: research

Mindfulness-based interventions for substance use disorders
CONCLUSIONS: In comparison with no treatment, the evidence is uncertain regarding the impact of MBIs on SUD-related outcomes. MBIs result in little to no higher attrition than no treatment. In comparison with other treatments, MBIs may slightly reduce days with substance use at post-treatment and follow-up (4 to 10 months). The evidence is uncertain regarding the impact of MBIs relative to other treatments on abstinence, consumed substance amount, or craving. MBIs result in little to no higher attrition than other treatments. Few studies reported adverse events.PMID:34668188 | DOI:10.1002/14651858.CD011723.pub2 (Source: Co...
Source: Cochrane Database of Systematic Reviews - October 20, 2021 Category: General Medicine Authors: Simon B Goldberg Brian Pace Matas Griskaitis Reinhard Willutzki Nicole Skoetz Sven Thoenes Aleksandra E Zgierska Susanne R ösner Source Type: research

Anti-interleukin-13 and anti-interleukin-4 agents versus placebo, anti-interleukin-5 or anti-immunoglobulin-E agents, for people with asthma
CONCLUSIONS: Based on the totality of the evidence, compared with placebo, anti-interleukin-13/-4 agents are probably associated with a reduction in exacerbations requiring hospitalisation or ED visit, at the cost of increased adverse events, in patients with asthma. No clinically relevant improvements in health-related quality of life or asthma control were identified. Therefore, anti-interleukin-13 or anti-interleukin-4 agents may be appropriate for adults with moderate-to-severe uncontrolled asthma who have not responded to other treatments. These conclusions are generally supported by moderate or high-certainty evidenc...
Source: Cochrane Database of Systematic Reviews - October 19, 2021 Category: General Medicine Authors: Andrew Gallagher Michaela Edwards Parameswaran Nair Stewart Drew Aashish Vyas Rashmi Sharma Paul A Marsden Ran Wang David Jw Evans Source Type: research

Parenting interventions for people with schizophrenia or related serious mental illness
CONCLUSIONS: The only included trial provided inconclusive evidence. There is insufficient evidence to make recommendations to people with schizophrenia (or related serious mental illness) or clinicians, or for policy changes. Although there is no RCT evidence, parenting interventions for people with schizophrenia or related serious mental illness have been developed. Future research should test these in RCTs in order to improve the evidence base for this population.PMID:34666417 | DOI:10.1002/14651858.CD013536.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2021 Category: General Medicine Authors: Jessica Radley Claire Grant Jane Barlow Louise Johns Source Type: research

Colchicine for the treatment of COVID-19
CONCLUSIONS: Based on the current evidence, in people hospitalised with moderate to severe COVID-19 the use of colchicine probably has little to no influence on mortality or clinical progression in comparison to placebo or standard care alone. We do not know whether colchicine increases the risk of (serious) adverse events. We are uncertain about the evidence of the effect of colchicine on all-cause mortality for people with asymptomatic infection or mild disease. However, colchicine probably results in a slight reduction of hospital admissions or deaths within 28 days, and the rate of serious adverse events compared with ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Agata Mikolajewska Anna-Lena Fischer Vanessa Piechotta Anika Mueller Maria-Inti Metzendorf Marie Becker Elena Dorando Rafael L Pacheco Ana Luiza C Martimbianco Rachel Riera Nicole Skoetz Miriam Stegemann Source Type: research

Prophylactic or very early initiation of continuous positive airway pressure (CPAP) for preterm infants
CONCLUSIONS: For preterm and very preterm infants, there is insufficient evidence to evaluate prophylactic CPAP compared to oxygen therapy and other supportive care. When compared to mechanical ventilation, prophylactic nasal CPAP in very preterm infants reduces the incidence of BPD, the combined outcome of death and BPD, and mechanical ventilation. There is probably no difference in neurodevelopmental impairment at 18 to 22 months of age. When prophylactic CPAP is compared to early CPAP, we are very uncertain about whether there is any difference between prophylactic and very early CPAP. There is no information about the ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Prema Subramaniam Jacqueline J Ho Peter G Davis Source Type: research

Screening for aspiration risk associated with dysphagia in acute stroke
CONCLUSIONS: We were unable to identify a single swallow screening tool with high and precisely estimated sensitivity and specificity based on at least one trial with low risk of bias. However, we were able to offer recommendations for further high-quality studies that are needed to improve the accuracy and clinical utility of bedside screening tools.PMID:34661279 | DOI:10.1002/14651858.CD012679.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Elizabeth Boaden Jane Burnell Lucy Hives Paola Dey Andrew Clegg Mary W Lyons C Elizabeth Lightbody Margaret A Hurley Hazel Roddam Elizabeth McInnes Anne Alexandrov Caroline L Watkins Source Type: research

Memory rehabilitation for people with multiple sclerosis
CONCLUSIONS: There is evidence to support the effectiveness of memory rehabilitation on some outcomes assessed in this review at intermediate follow-up. The evidence suggests that memory rehabilitation results in between-group differences favoring the memory rehabilitation group at the intermediate time point for subjective memory, verbal memory, information processing, and quality of life outcomes, suggesting that memory rehabilitation is beneficial and meaningful to people with MS. There are differential effects of memory rehabilitation based on the quality of the trials, with studies of high risk of bias inflating (posi...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Lauren A Taylor Jacqueline R Mhizha-Murira Laura Smith Kristy-Jane Potter Dana Wong Nikos Evangelou Nadina B Lincoln Roshan das Nair Source Type: research

Provision of folic acid for reducing arsenic toxicity in arsenic-exposed children and adults
CONCLUSIONS: There is moderate-certainty evidence that FA supplements may benefit blood arsenic concentration, urinary arsenic methylation profiles, and plasma homocysteine concentration versus placebo. There is low-certainty evidence that FA supplements plus other nutrients may benefit blood arsenic and plasma homocysteine concentrations versus nutrients alone. No studies reported on cancer, all-cause mortality, neurocognitive function, or congenital anomalies. Given the limited number of RCTs, more studies conducted in diverse settings are needed to assess the effects of FA on arsenic-related health outcomes and arsenic ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Sajin Bae Elena Kamynina Heather M Guetterman Adetutu F Farinola Marie A Caudill Robert J Berry Patricia A Cassano Patrick J Stover Source Type: research

Colchicine for the treatment of COVID-19
CONCLUSIONS: Based on the current evidence, in people hospitalised with moderate to severe COVID-19 the use of colchicine probably has little to no influence on mortality or clinical progression in comparison to placebo or standard care alone. We do not know whether colchicine increases the risk of (serious) adverse events. We are uncertain about the evidence of the effect of colchicine on all-cause mortality for people with asymptomatic infection or mild disease. However, colchicine probably results in a slight reduction of hospital admissions or deaths within 28 days, and the rate of serious adverse events compared with ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Agata Mikolajewska Anna-Lena Fischer Vanessa Piechotta Anika Mueller Maria-Inti Metzendorf Marie Becker Elena Dorando Rafael L Pacheco Ana Luiza C Martimbianco Rachel Riera Nicole Skoetz Miriam Stegemann Source Type: research

Prophylactic or very early initiation of continuous positive airway pressure (CPAP) for preterm infants
CONCLUSIONS: For preterm and very preterm infants, there is insufficient evidence to evaluate prophylactic CPAP compared to oxygen therapy and other supportive care. When compared to mechanical ventilation, prophylactic nasal CPAP in very preterm infants reduces the incidence of BPD, the combined outcome of death and BPD, and mechanical ventilation. There is probably no difference in neurodevelopmental impairment at 18 to 22 months of age. When prophylactic CPAP is compared to early CPAP, we are very uncertain about whether there is any difference between prophylactic and very early CPAP. There is no information about the ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Prema Subramaniam Jacqueline J Ho Peter G Davis Source Type: research

Screening for aspiration risk associated with dysphagia in acute stroke
CONCLUSIONS: We were unable to identify a single swallow screening tool with high and precisely estimated sensitivity and specificity based on at least one trial with low risk of bias. However, we were able to offer recommendations for further high-quality studies that are needed to improve the accuracy and clinical utility of bedside screening tools.PMID:34661279 | DOI:10.1002/14651858.CD012679.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Elizabeth Boaden Jane Burnell Lucy Hives Paola Dey Andrew Clegg Mary W Lyons C Elizabeth Lightbody Margaret A Hurley Hazel Roddam Elizabeth McInnes Anne Alexandrov Caroline L Watkins Source Type: research

Memory rehabilitation for people with multiple sclerosis
CONCLUSIONS: There is evidence to support the effectiveness of memory rehabilitation on some outcomes assessed in this review at intermediate follow-up. The evidence suggests that memory rehabilitation results in between-group differences favoring the memory rehabilitation group at the intermediate time point for subjective memory, verbal memory, information processing, and quality of life outcomes, suggesting that memory rehabilitation is beneficial and meaningful to people with MS. There are differential effects of memory rehabilitation based on the quality of the trials, with studies of high risk of bias inflating (posi...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Lauren A Taylor Jacqueline R Mhizha-Murira Laura Smith Kristy-Jane Potter Dana Wong Nikos Evangelou Nadina B Lincoln Roshan das Nair Source Type: research

Provision of folic acid for reducing arsenic toxicity in arsenic-exposed children and adults
CONCLUSIONS: There is moderate-certainty evidence that FA supplements may benefit blood arsenic concentration, urinary arsenic methylation profiles, and plasma homocysteine concentration versus placebo. There is low-certainty evidence that FA supplements plus other nutrients may benefit blood arsenic and plasma homocysteine concentrations versus nutrients alone. No studies reported on cancer, all-cause mortality, neurocognitive function, or congenital anomalies. Given the limited number of RCTs, more studies conducted in diverse settings are needed to assess the effects of FA on arsenic-related health outcomes and arsenic ...
Source: Cochrane Database of Systematic Reviews - October 18, 2021 Category: General Medicine Authors: Sajin Bae Elena Kamynina Heather M Guetterman Adetutu F Farinola Marie A Caudill Robert J Berry Patricia A Cassano Patrick J Stover Source Type: research

Calcium channel blockers versus other classes of drugs for hypertension
CONCLUSIONS: For the treatment of hypertension, there is moderate certainty evidence that diuretics reduce major cardiovascular events and congestive heart failure more than CCBs. There is low to moderate certainty evidence that CCBs probably reduce major cardiovascular events more than beta-blockers. There is low to moderate certainty evidence that CCBs reduced stroke when compared to angiotensin-converting enzyme (ACE) inhibitors and reduced myocardial infarction when compared to angiotensin receptor blockers (ARBs), but increased congestive heart failure when compared to ACE inhibitors and ARBs. Many of the differences ...
Source: Cochrane Database of Systematic Reviews - October 17, 2021 Category: General Medicine Authors: Jiaying Zhu Ning Chen Muke Zhou Jian Guo Cairong Zhu Jie Zhou Mengmeng Ma Li He Source Type: research

Materials for retrograde filling in root canal therapy
CONCLUSIONS: Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.PMID:34647617 | DOI:10.1002/14651858.CD005517.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 14, 2021 Category: General Medicine Authors: Honglin Li Zhiyong Guo Chunjie Li Xiangyu Ma Yan Wang Xuedong Zhou Trevor M Johnson Dingming Huang Source Type: research

Materials for retrograde filling in root canal therapy
CONCLUSIONS: Based on the present limited evidence, there is insufficient evidence to draw any conclusion as to the benefits of any one material over another for retrograde filling in root canal therapy. We conclude that more high-quality RCTs are required.PMID:34647617 | DOI:10.1002/14651858.CD005517.pub3 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 14, 2021 Category: General Medicine Authors: Honglin Li Zhiyong Guo Chunjie Li Xiangyu Ma Yan Wang Xuedong Zhou Trevor M Johnson Dingming Huang Source Type: research