Uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer
CONCLUSIONS: Given the predominance of low- to very low-certainty evidence, this Cochrane review faces challenges in providing definitive clinical guidance. We found the majority of critical outcomes may be comparable between the uncut Roux-en-Y reconstruction and other methods, but we are very uncertain about most of these results. Nevertheless, it indicates that uncut Roux-en-Y reconstruction may reduce the incidence of bile reflux compared to Billroth-II reconstruction, albeit with low certainty. In contrast, compared to Roux-en-Y reconstruction, uncut Roux-en-Y may increase bile reflux incidence, based on very low-cert...
Source: Cochrane Database of Systematic Reviews - February 29, 2024 Category: General Medicine Authors: Zhaolun Cai Mingchun Mu Qin Ma Chunyu Liu Zhiyuan Jiang Baike Liu Gang Ji Bo Zhang Source Type: research

Massage for neck pain
CONCLUSIONS: The contribution of massage to the management of neck pain remains uncertain given the predominance of low-certainty evidence in this field. For subacute and chronic neck pain (closest to 12 weeks follow-up), massage may result in a little or no difference in improving pain, function-disability, health-related quality of life and participant-reported treatment success when compared to a placebo. Inadequate reporting on adverse events precluded analysis. Focused planning for larger, adequately dosed, well-designed trials is needed.PMID:38415786 | PMC:PMC10900303 | DOI:10.1002/14651858.CD004871.pub5 (Source: Coc...
Source: Cochrane Database of Systematic Reviews - February 28, 2024 Category: General Medicine Authors: Anita R Gross Haejung Lee Jeanette Ezzo Nejin Chacko Geoffrey Gelley Mario Forget Annie Morien Nadine Graham Pasqualina L Santaguida Maureen Rice Craig Dixon Source Type: research

Interventions for managing oral submucous fibrosis
CONCLUSIONS: We found moderate-certainty evidence that antioxidants administered systemically probably improve mouth opening slightly at three to six months and improve burning sensation VAS scores up to and beyond six months. We found only low/very low-certainty evidence for all other comparisons and outcomes. There was insufficient evidence to make an informed judgement about potential adverse effects associated with any of these treatments. There was insufficient evidence to support or refute the effectiveness of the other interventions tested. High-quality, adequately powered intervention trials with a low risk of bias...
Source: Cochrane Database of Systematic Reviews - February 28, 2024 Category: General Medicine Authors: Adam Jones Benjamin Veale Tiffany Li Vishal R Aggarwal Joshua Twigg Source Type: research

Therapeutic exercises for idiopathic scoliosis in adolescents
CONCLUSIONS: The evidence on the efficacy of TE is currently sparse due to heterogeneity, small sample size, and many different comparisons. We found only one study following participants to the end of growth showing the efficacy of PSSE over TE. This result was weakened by adding studies with short-term results and unclear preparation of treating physiotherapists. More RCTs are needed to strengthen the current evidence and study other highly clinically relevant outcomes such as QoL, psychological and cosmetic issues, and back pain.PMID:38415871 | PMC:PMC10900302 | DOI:10.1002/14651858.CD007837.pub3 (Source: Cochrane Datab...
Source: Cochrane Database of Systematic Reviews - February 28, 2024 Category: General Medicine Authors: Michele Romano Silvia Minozzi Josette Bettany-Saltikov Fabio Zaina Nachiappan Chockalingam Tomasz Kotwicki Axel Maier-Hennes Chiara Arienti Stefano Negrini Source Type: research

Macrolide antibiotics (including azithromycin) for cystic fibrosis
CONCLUSIONS: Azithromycin therapy is associated with a small but consistent improvement in respiratory function, a decreased risk of exacerbation and longer time to exacerbation at six months; but evidence for treatment efficacy beyond six months remains limited. Azithromycin appears to have a good safety profile (although a weekly dose was associated with more gastrointestinal side effects, which makes it less acceptable for long-term therapy), with a relatively minimal treatment burden for people with CF, and it is inexpensive. A wider concern may be the emergence of macrolide resistance reported in the most recent study...
Source: Cochrane Database of Systematic Reviews - February 27, 2024 Category: General Medicine Authors: Kevin W Southern Arturo Solis-Moya Dominiki Kurz Sherie Smith Source Type: research

Non-clotting factor therapies for preventing bleeds in people with congenital hemophilia A or B
CONCLUSIONS: Evidence from RCTs shows that prophylaxis using non-clotting factor therapies compared with on-demand treatment may reduce bleeding events, increase the percentage of individuals with zero bleeds, increase the incidence of non-serious adverse events, and improve HRQoL. Comparative assessments with other prophylaxis regimens, assessment of long-term joint outcomes, and assessment of economic outcomes will improve evidence-based decision-making for the use of these therapies in bleed prevention.PMID:38411279 | PMC:PMC10897951 | DOI:10.1002/14651858.CD014544.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 27, 2024 Category: General Medicine Authors: Omotola O Olasupo Noella Noronha Megan S Lowe Derek Ansel Mihir Bhatt Davide Matino Source Type: research

Macrolide antibiotics (including azithromycin) for cystic fibrosis
CONCLUSIONS: Azithromycin therapy is associated with a small but consistent improvement in respiratory function, a decreased risk of exacerbation and longer time to exacerbation at six months; but evidence for treatment efficacy beyond six months remains limited. Azithromycin appears to have a good safety profile (although a weekly dose was associated with more gastrointestinal side effects, which makes it less acceptable for long-term therapy), with a relatively minimal treatment burden for people with CF, and it is inexpensive. A wider concern may be the emergence of macrolide resistance reported in the most recent study...
Source: Cochrane Database of Systematic Reviews - February 27, 2024 Category: General Medicine Authors: Kevin W Southern Arturo Solis-Moya Dominiki Kurz Sherie Smith Source Type: research

Non-clotting factor therapies for preventing bleeds in people with congenital hemophilia A or B
CONCLUSIONS: Evidence from RCTs shows that prophylaxis using non-clotting factor therapies compared with on-demand treatment may reduce bleeding events, increase the percentage of individuals with zero bleeds, increase the incidence of non-serious adverse events, and improve HRQoL. Comparative assessments with other prophylaxis regimens, assessment of long-term joint outcomes, and assessment of economic outcomes will improve evidence-based decision-making for the use of these therapies in bleed prevention.PMID:38411279 | DOI:10.1002/14651858.CD014544.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 27, 2024 Category: General Medicine Authors: Omotola O Olasupo Noella Noronha Megan S Lowe Derek Ansel Mihir Bhatt Davide Matino Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity
CONCLUSIONS: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce...
Source: Cochrane Database of Systematic Reviews - February 20, 2024 Category: General Medicine Authors: Maria-Inti Metzendorf L Susan Wieland Bernd Richter Source Type: research

Infliximab for maintenance of medically-induced remission in Crohn's disease
CONCLUSIONS: Infliximab is probably more effective in preventing clinical relapse than placebo (moderate-certainty evidence). Infliximab in combination with purine analogues is probably more effective in preventing clinical and endoscopic relapse than purine analogues alone (moderate-certainty evidence). No conclusions can be drawn regarding prevention of loss of clinical response, occurrence of withdrawals due to adverse events, or total adverse events due to very low-certainty evidence for both of these comparisons. There may be little or no difference in prevention of clinical relapse, withdrawal due to adverse events o...
Source: Cochrane Database of Systematic Reviews - February 19, 2024 Category: General Medicine Authors: Morris Gordon Vassiliki Sinopoulou Anthony K Akobeng Arni Sarian Gordon William Moran Source Type: research