Pain management for medical abortion before 14 weeks' gestation
CONCLUSIONS: The findings of this review provide some support for the use of ibuprofen as a single dose given with misoprostol prophylactically, or in response to pain as needed. The optimal dosing of ibuprofen is unclear, but a single dose of ibuprofen 1600 mg was shown to be effective, and it was less certain whether 800 mg was effective. Paracetamol 2000 mg does not improve pain scores as much as ibuprofen 1600 mg, however its use does not appear to cause greater frequency of side effects or reduce the success of the abortion. A single dose of pregabalin 300 mg does not affect pain scores during medical abortion, but li...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: John J Reynolds-Wright Mulat A Woldetsadik Chelsea Morroni Sharon Cameron Source Type: research

Perioperative pharmacological interventions for fetal immobilisation during fetal surgery and invasive procedures
CONCLUSIONS: We were only able to include one study with a small number of women, from a single centre, a European tertiary hospital. This study was published in 2005 with an abstract of this trial published in 2004. This study evaluated two intravenous medications administered to the mother - remifentanil and diazepam. This study reported our prespecified primary outcome but only evaluated several of our secondary outcomes, which limited further assessment. Low-certainty evidence suggested that remifentanil may be better at reducing fetal movements and surgeons were more satisfied with the procedure. However, maternal sed...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Kate Andrewartha Rosalie M Grivell Source Type: research

Stem cell transplantation for induction of remission in medically refractory Crohn's disease
CONCLUSIONS: SCT shows an uncertain effect on clinical remission with low certainty of evidence. SCT shows an uncertain effect on CDAI score to reach <150 after 24 weeks of treatment, with very low certainty evidence. SCT shows beneficial effects on fistula-closure during short and long-term follow-up with low-certainty evidence in both outcomes. There was no change in the total number of adverse events with SCT as compared to control, with very low certainty evidence. While there was a moderate effect on increasing the number of serious adverse events in the SCT group, as compared to the control with low-certainty evid...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Sarah El-Nakeep Ahmed Shawky Sara F Abbas Osama Abdel Latif Source Type: research

Tocilizumab for giant cell arteritis
CONCLUSIONS: This review indicates that tocilizumab therapy may be beneficial in terms of proportion of participants with sustained remission, relapse-free survival, and the need for escape therapy. While the evidence was of moderate certainty, only two studies were included in the review, suggesting that further research is required to corroborate these findings. Future trials should address issues related to the required duration of therapy, patient-reported outcomes such as quality of life and economic outcomes, as well as the clinical outcomes evaluated in this review.PMID:35560150 | PMC:PMC9105486 | DOI:10.1002/146518...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Aileen A Antonio Ronel N Santos Samuel A Abariga Source Type: research

Pain management for medical abortion before 14 weeks' gestation
CONCLUSIONS: The findings of this review provide some support for the use of ibuprofen as a single dose given with misoprostol prophylactically, or in response to pain as needed. The optimal dosing of ibuprofen is unclear, but a single dose of ibuprofen 1600 mg was shown to be effective, and it was less certain whether 800 mg was effective. Paracetamol 2000 mg does not improve pain scores as much as ibuprofen 1600 mg, however its use does not appear to cause greater frequency of side effects or reduce the success of the abortion. A single dose of pregabalin 300 mg does not affect pain scores during medical abortion, but li...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: John J Reynolds-Wright Mulat A Woldetsadik Chelsea Morroni Sharon Cameron Source Type: research

Perioperative pharmacological interventions for fetal immobilisation during fetal surgery and invasive procedures
CONCLUSIONS: We were only able to include one study with a small number of women, from a single centre, a European tertiary hospital. This study was published in 2005 with an abstract of this trial published in 2004. This study evaluated two intravenous medications administered to the mother - remifentanil and diazepam. This study reported our prespecified primary outcome but only evaluated several of our secondary outcomes, which limited further assessment. Low-certainty evidence suggested that remifentanil may be better at reducing fetal movements and surgeons were more satisfied with the procedure. However, maternal sed...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Kate Andrewartha Rosalie M Grivell Source Type: research

Stem cell transplantation for induction of remission in medically refractory Crohn's disease
CONCLUSIONS: SCT shows an uncertain effect on clinical remission with low certainty of evidence. SCT shows an uncertain effect on CDAI score to reach <150 after 24 weeks of treatment, with very low certainty evidence. SCT shows beneficial effects on fistula-closure during short and long-term follow-up with low-certainty evidence in both outcomes. There was no change in the total number of adverse events with SCT as compared to control, with very low certainty evidence. While there was a moderate effect on increasing the number of serious adverse events in the SCT group, as compared to the control with low-certainty evid...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Sarah El-Nakeep Ahmed Shawky Sara F Abbas Osama Abdel Latif Source Type: research

Tocilizumab for giant cell arteritis
CONCLUSIONS: This review indicates that tocilizumab therapy may be beneficial in terms of proportion of participants with sustained remission, relapse-free survival, and the need for escape therapy. While the evidence was of moderate certainty, only two studies were included in the review, suggesting that further research is required to corroborate these findings. Future trials should address issues related to the required duration of therapy, patient-reported outcomes such as quality of life and economic outcomes, as well as the clinical outcomes evaluated in this review.PMID:35560150 | DOI:10.1002/14651858.CD013484.pub3 ...
Source: Cochrane Database of Systematic Reviews - May 13, 2022 Category: General Medicine Authors: Aileen A Antonio Ronel N Santos Samuel A Abariga Source Type: research

Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures
CONCLUSIONS: There remains no clear evidence about whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in at-risk people who are about to undergo an invasive dental procedure. We cannot determine whether the potential harms and costs of antibiotic administration outweigh any beneficial effect. Ethically, practitioners should discuss the potential benefits and harms of antibiotic prophylaxis with their patients before a decision is made about administration.PMID:35536541 | PMC:PMC9088886 | DOI:10.1002/14651858.CD003813.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 10, 2022 Category: General Medicine Authors: Samantha J Rutherford Anne-Marie Glenny Graham Roberts Lee Hooper Helen V Worthington Source Type: research

Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures
CONCLUSIONS: There remains no clear evidence about whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in at-risk people who are about to undergo an invasive dental procedure. We cannot determine whether the potential harms and costs of antibiotic administration outweigh any beneficial effect. Ethically, practitioners should discuss the potential benefits and harms of antibiotic prophylaxis with their patients before a decision is made about administration.PMID:35536541 | PMC:PMC9088886 | DOI:10.1002/14651858.CD003813.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 10, 2022 Category: General Medicine Authors: Samantha J Rutherford Anne-Marie Glenny Graham Roberts Lee Hooper Helen V Worthington Source Type: research

Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures
CONCLUSIONS: There remains no clear evidence about whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in at-risk people who are about to undergo an invasive dental procedure. We cannot determine whether the potential harms and costs of antibiotic administration outweigh any beneficial effect. Ethically, practitioners should discuss the potential benefits and harms of antibiotic prophylaxis with their patients before a decision is made about administration.PMID:35536541 | DOI:10.1002/14651858.CD003813.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 10, 2022 Category: General Medicine Authors: Samantha J Rutherford Anne-Marie Glenny Graham Roberts Lee Hooper Helen V Worthington Source Type: research

Music therapy for autistic people
CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-interventio...
Source: Cochrane Database of Systematic Reviews - May 9, 2022 Category: General Medicine Authors: Monika Geretsegger Laura Fusar-Poli Cochavit Elefant Karin A M össler Giovanni Vitale Christian Gold Source Type: research

Music therapy for people with substance use disorders
CONCLUSIONS: Results from this review suggest that MT as 'add on' treatment to standard care can lead to moderate reductions in substance craving and can increase motivation for treatment/change for people with SUDs receiving treatment in detoxification and short-term rehabilitation settings. Greater reduction in craving is associated with MT lasting longer than a single session. We have moderate-to-low confidence in our findings as the included studies were downgraded in certainty due to imprecision, and most included studies were conducted by the same researcher in the same detoxification unit, which considerably impacts...
Source: Cochrane Database of Systematic Reviews - May 9, 2022 Category: General Medicine Authors: Claire Ghetti Xi-Jing Chen Annette K Brenner Laurien G Hakvoort Lars Lien Jorg Fachner Christian Gold Source Type: research

Community-based interventions for improving mental health in refugee children and adolescents in high-income countries
CONCLUSIONS: There is insufficient evidence to determine the efficacy and acceptability of community-based mental health interventions for refugee children and adolescents.PMID:35532139 | PMC:PMC9083014 | DOI:10.1002/14651858.CD013657.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 9, 2022 Category: General Medicine Authors: Fatima Soltan Doriana Cristofalo David Marshall Marianna Purgato Henock Taddese Laura Vanderbloemen Corrado Barbui Eleonora Uphoff Source Type: research

Doppler trans-thoracic echocardiography for detection of pulmonary hypertension in adults
CONCLUSIONS: Our evidence assessment of echocardiography for the diagnosis of PH in adult patients revealed several limitations. We were unable to determine the average sensitivity and specificity at any particular index test threshold and to explain the observed variability in results. The high heterogeneity of the collected data and the poor methodological quality would constrain the implementation of this result into clinical practice. Further studies relative to the accuracy of Doppler trans-thoracic echocardiography for the diagnosis of PH in adults, that apply a rigorous methodology for conducting diagnostic test acc...
Source: Cochrane Database of Systematic Reviews - May 9, 2022 Category: General Medicine Authors: Yasushi Tsujimoto Junji Kumasawa Sayaka Shimizu Yoshio Nakano Yuki Kataoka Hiraku Tsujimoto Michihiko Kono Shinji Okabayashi Haruki Imura Takahiro Mizuta Source Type: research