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Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis
CONCLUSIONS: We found that of all the interventions studied, TXA is probably the most effective intervention for preventing bleeding in people undergoing hip or knee replacement surgery. Aprotinin and EACA may not be as effective as TXA at preventing the need for allogeneic blood transfusion. We were not able to draw strong conclusions on the optimal dose, route and timing of administration of TXA. We found that TXA given at higher doses tended to rank higher in the treatment hierarchy, and we also found that it may be more beneficial to use a mixed route of administration (oral and intra-articular, oral and intravenous, o...
Source: Cochrane Database of Systematic Reviews - January 16, 2024 Category: General Medicine Authors: Victoria N Gibbs Rita Champaneria Josie Sandercock Nicky J Welton Louise J Geneen Susan J Brunskill Carolyn Dor ée Catherine Kimber Antony Jr Palmer Lise J Estcourt Source Type: research

Testosterone replacement in men with sexual dysfunction
CONCLUSIONS: In the short term, TRT probably has little to no effect on erectile function, sexual quality of life, or cardiovascular mortality compared to a placebo. It likely results in little to no difference in treatment withdrawals due to adverse events, prostate-related events, or LUTS. In the long term, we are very uncertain about the effects of TRT on erectile function when compared to placebo; we did not find data on its effects on sexual quality of life or cardiovascular mortality. The certainty of evidence ranged from moderate (signaling that we are confident that the reported effect size is likely to be close to...
Source: Cochrane Database of Systematic Reviews - January 15, 2024 Category: General Medicine Authors: Hunju Lee Eu Chang Hwang Cheol Kyu Oh Solam Lee Ho Song Yu Jung Soo Lim Hong Wook Kim Thomas Walsh Myung Ha Kim Jae Hung Jung Philipp Dahm Source Type: research

Alpha-lipoic acid for diabetic peripheral neuropathy
CONCLUSIONS: Our analysis suggests that ALA probably has little or no effect on neuropathy symptoms or adverse events at six months, and may have little or no effect on impairment at six months. All the studies were at high risk of attrition bias. Therefore, future RCTs should ensure complete follow-up and transparent reporting of any participants missing from the analyses.PMID:38205823 | PMC:PMC10782777 | DOI:10.1002/14651858.CD012967.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 11, 2024 Category: General Medicine Authors: Cristian Baicus Adrian Purcarea Erik von Elm Caterina Delcea Florentina L Furtunescu Source Type: research

Psychological interventions for asthma in children and adolescents
CONCLUSIONS: Most studies that reported symptoms of anxiety, depression, asthma attacks, asthma symptoms, and medication use found a positive effect of psychological interventions versus control on at least one measure. However, some findings were mixed, it was difficult to judge clinical significance, and the evidence for all outcomes is very uncertain due to clinical heterogeneity, small sample sizes, incomplete reporting, and risk of bias. There is limited evidence to suggest that psychological interventions can reduce the need for medical contact or improve quality of life, and no studies reported adverse events. It wa...
Source: Cochrane Database of Systematic Reviews - January 11, 2024 Category: General Medicine Authors: Kelsey J Sharrad Olatokunbo Sanwo Sofia Cuevas-Asturias Kayleigh M Kew Kristin V Carson-Chahhoud Katharine C Pike Source Type: research

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents
CONCLUSIONS: Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.PMID:38197473 | PMC:PMC10777456 | DOI:10.1002/14651858.CD012445.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 10, 2024 Category: General Medicine Authors: Rebecca Featherston Jane Barlow Yunshan Song Zoe Haysom Brenda Loy Lea Tufford Aron Shlonsky Source Type: research

Education, incentive, and engineering-based interventions to promote the use of seat belts
CONCLUSIONS: The evidence suggests that behavioural education-based interventions may promote seat belt use and HRA (including incentives) with or without additional interventions likely promote seat belt use. Likewise, for engineering-based interventions using in-vehicle data monitor systems with in-vehicle alerts, with or without notifications/feedback the evidence suggests the interventions may promote the use of seat belts. Well-designed RCTs are needed to further investigate the effectiveness of education and engineering-based interventions. High-quality trials that examine the potential benefits of incentives to prom...
Source: Cochrane Database of Systematic Reviews - January 10, 2024 Category: General Medicine Authors: Andrit Lourens Marion Sinclair Bart Willems Taryn Young Source Type: research

Oral killed cholera vaccines for preventing cholera
CONCLUSIONS: Two doses of Dukoral reduces cases of cholera at two-year follow-up. Two doses of Shanchol reduces cases of cholera at five-year follow-up, and a single dose of Shanchol reduces cases of cholera at two-year follow-up. Overall, the vaccines were safe and well-tolerated. We found no trials on other BivWC vaccines (Euvichol/Euvichol-Plus). However, BivWC products (Shanchol, Euvichol/Euvichol-Plus) are considered to produce comparable vibriocidal responses. Therefore, it is reasonable to apply the results from Shanchol trials to the other BivWC products (Euvichol/Euvichol-Plus).PMID:38197546 | PMC:PMC10777452 | DO...
Source: Cochrane Database of Systematic Reviews - January 10, 2024 Category: General Medicine Authors: K M Saif-Ur-Rahman Razib Mamun Md Hasan James E Meiring Md Arifuzzaman Khan Source Type: research

Retrograde distal access versus femoral access for below the knee angioplasty
CONCLUSIONS: We identified no randomised or quasi-randomised controlled trials that compared retrograde distal access versus femoral access for BTK angioplasty. High-quality studies that compare retrograde distal access versus conventional femoral access for BTK angioplasty are needed.PMID:38193637 | PMC:PMC10775189 | DOI:10.1002/14651858.CD013637.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 9, 2024 Category: General Medicine Authors: Marcos G Toledo Barros Andre V Fonseca Jorge E Amorim Vladimir Vasconcelos Source Type: research

Retrograde distal access versus femoral access for below the knee angioplasty
CONCLUSIONS: We identified no randomised or quasi-randomised controlled trials that compared retrograde distal access versus femoral access for BTK angioplasty. High-quality studies that compare retrograde distal access versus conventional femoral access for BTK angioplasty are needed.PMID:38193637 | DOI:10.1002/14651858.CD013637.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 9, 2024 Category: General Medicine Authors: Marcos G Toledo Barros Andre V Fonseca Jorge E Amorim Vladimir Vasconcelos Source Type: research

Surgical versus non-surgical treatment for carpal tunnel syndrome
CONCLUSIONS: Currently, the efficacy of surgery in people with CTS is unclear. It is also unclear if the results can be applied to people who are not satisfied after trying various non-surgical options. Future studies should preferably blind participants from treatment allocation and randomise people who are dissatisfied after being treated non-surgically. The decision for a patient to opt for surgery should balance the small benefits and potential risks of surgery. Patients with severe symptoms, a high preference for clinical improvement and reluctance to adhere to non-surgical options, and who do not consider potential s...
Source: Cochrane Database of Systematic Reviews - January 8, 2024 Category: General Medicine Authors: Vieda Lusa Teemu V Karjalainen Markus P ääkkönen Tuomas Jaakko Rajam äki Kati Jaatinen Source Type: research

Vitamin B12 supplementation during pregnancy for maternal and child health outcomes
CONCLUSIONS: Oral vitamin B12 supplementation during pregnancy may reduce the risk of maternal vitamin B12 deficiency and may improve maternal vitamin B12 concentrations during pregnancy or postpartum compared to placebo or no vitamin B12 supplementation, but the evidence is very uncertain. The effects of vitamin B12 supplementation on other primary outcomes assessed in this review were not reported, or were not reported in a format for inclusion in quantitative analyses. Vitamin B12 supplementation during pregnancy may improve maternal and infant vitamin B12 status, but the potential impact on longer-term clinical and fun...
Source: Cochrane Database of Systematic Reviews - January 8, 2024 Category: General Medicine Authors: Julia L Finkelstein Amy Fothergill Sudha Venkatramanan Alexander J Layden Jennifer L Williams Krista S Crider Yan Ping Qi Source Type: research

Pressure-garment therapy for preventing hypertrophic scarring after burn injury
CONCLUSIONS: There is insufficient evidence to recommend using either PGT or an alternative for preventing hypertrophic scarring after burn injury. PGT is already commonly used in practice and it is possible that continuing to do so may provide some benefit to some people. However, until more evidence becomes available, it may be appropriate to allow patient preference to guide therapy.PMID:38189494 | PMC:PMC10772976 | DOI:10.1002/14651858.CD013530.pub2 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2024 Category: General Medicine Authors: Isobel M Harris Kwang Chear Lee Jonathan J Deeks David J Moore Naiem S Moiemen Janine Dretzke Source Type: research

Electronic cigarettes for smoking cessation
CONCLUSIONS: There is high-certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate-certainty evidence that they increase quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain due to risk of bias inherent in the study design. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non-nicotine ECs nor between nicotine ECs and NRT. Overall incidence of SAEs was low across all study arms. We did not detect eviden...
Source: Cochrane Database of Systematic Reviews - January 8, 2024 Category: General Medicine Authors: Nicola Lindson Ailsa R Butler Hayden McRobbie Chris Bullen Peter Hajek Rachna Begh Annika Theodoulou Caitlin Notley Nancy A Rigotti Tari Turner Jonathan Livingstone-Banks Tom Morris Jamie Hartmann-Boyce Source Type: research

Anticoagulation for people receiving long-term haemodialysis
CONCLUSIONS: Anticoagulant strategies, including UFH and LMWH, have uncertain comparative risks on extracorporeal circuit thrombosis, while major bleeding and minor bleeding were not adequately reported. Regional citrate may decrease minor bleeding, but the effects on major bleeding and extracorporeal circuit thrombosis were not reported. Evidence supporting clinical decision-making for different forms of anticoagulant strategies for HD is of low and very low certainty, as available studies have not been designed to measure treatment effects on important clinical outcomes.PMID:38189593 | PMC:PMC10772979 | DOI:10.1002/14651...
Source: Cochrane Database of Systematic Reviews - January 8, 2024 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Marinella Ruospo Henrietta Longmuir Benjamin Dodds Ritam Prasad Tracey J Batt Matthew D Jose Giovanni Fm Strippoli Source Type: research

Ibuprofen for acute postoperative pain in children
CONCLUSIONS: Despite identifying 43 RCTs, we remain uncertain about the effect of ibuprofen compared to placebo or active comparators for some critical outcomes and in the comparisons between different doses, schedules and routes for ibuprofen administration. This is largely due to poor reporting on important outcomes such as serious adverse events, and poor study conduct or reporting that reduced our confidence in the results, along with small underpowered studies. Compared to placebo, ibuprofen likely results in pain reduction less than two hours postintervention, however, the efficacy might be lower at two hours to 24 h...
Source: Cochrane Database of Systematic Reviews - January 5, 2024 Category: General Medicine Authors: Sara Pessano Natasha R Gloeck Luca Tancredi Martin Ringsten Ameer Hohlfeld Sumayyah Ebrahim Martina Albertella Tamara Kredo Matteo Bruschettini Source Type: research