Parenteral anticoagulation in ambulatory patients with cancer.
CONCLUSIONS: Heparin appears to have no effect on mortality at 12 months and 24 months. It reduces symptomatic VTE and likely increases major and minor bleeding. Future research should further investigate the survival benefit of different types of anticoagulants in patients with different types and stages of cancer. The decision for a patient with cancer to start heparin therapy should balance the benefits and downsides, and should integrate the patient's values and preferences.Editorial note:This is a living systematic review. Living systematic reviews offer a new approach to review updating in which the review is continu...
Source: Cochrane Database of Systematic Reviews - September 11, 2017 Category: General Medicine Authors: Akl EA, Kahale LA, Hakoum MB, Matar CF, Sperati F, Barba M, Yosuico VED, Terrenato I, Synnot A, Schünemann H Tags: Cochrane Database Syst Rev Source Type: research

Pharmacotherapy for smoking cessation: effects by subgroup defined by genetically informed biomarkers.
id SP Abstract BACKGROUND: Smoking cessation therapies are not effective for all smokers, and researchers are interested in identifying those subgroups of individuals (e.g. based on genotype) who respond best to specific treatments. OBJECTIVES: To assess whether quit rates vary by genetically informed biomarkers within pharmacotherapy treatment arms and as compared with placebo. To assess the effects of pharmacotherapies for smoking cessation in subgroups of smokers defined by genotype for identified genome-wide significant polymorphisms. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group s...
Source: Cochrane Database of Systematic Reviews - September 8, 2017 Category: General Medicine Authors: Schuit E, Panagiotou OA, Munafò MR, Bennett DA, Bergen AW, David SP Tags: Cochrane Database Syst Rev Source Type: research

Probiotics for preventing urinary tract infection in people with neuropathic bladder.
CONCLUSIONS: In this review, there were no studies identified addressing oral probiotics in preventing UTI in people with neuropathic bladder. It is uncertain if the risk of symptomatic UTI is reduced in people with neuropathic bladders via intravesical instillation of non-pathogenic E. coli as data were derived from small studies with high risk of bias.Although very minimal levels of harm was reported with this procedure, due to variable success rates, the need for strict adherence to instillation protocols together with high attrition rates in these studies, it is doubtful bladder instillation will be a widely accepted i...
Source: Cochrane Database of Systematic Reviews - September 8, 2017 Category: General Medicine Authors: Toh SL, Boswell-Ruys CL, Lee BSB, Simpson JM, Clezy KR Tags: Cochrane Database Syst Rev Source Type: research

Certolizumab pegol (CDP870) for rheumatoid arthritis in adults.
Abstract BACKGROUND: Tumour necrosis factor (TNF)-alpha inhibitors are beneficial for the treatment of rheumatoid arthritis (RA) for reducing the risk of joint damage, improving physical function and improving the quality of life. This review is an update of the 2014 Cochrane Review of the treatment of RA with certolizumab pegol. OBJECTIVES: To assess the clinical benefits and harms of certolizumab pegol (CZP) in people with RA who have not responded well to conventional disease-modifying anti-rheumatic drugs (DMARDs). SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRA...
Source: Cochrane Database of Systematic Reviews - September 8, 2017 Category: General Medicine Authors: Ruiz Garcia V, Burls A, Cabello JB, Vela Casasempere P, Bort-Marti S, Bernal JA Tags: Cochrane Database Syst Rev Source Type: research

Placebo response and remission rates in randomised trials of induction and maintenance therapy for ulcerative colitis.
CONCLUSIONS: Placebo response and remission rates vary according to endoscopic disease severity and rectal bleeding score at trial entry, class of agent, disease duration, and the time point at which the primary outcome was measured. These observations have important implications for the design and conduct of future clinical trials in UC and will help researchers design trials, determine required sample sizes and also provide useful information about trial design features which should be considered when planning new trials. PMID: 28886205 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 8, 2017 Category: General Medicine Authors: Jairath V, Zou GY, Parker CE, MacDonald JK, AlAmeel T, Al Beshir M, Almadi MA, Al-Taweel T, Atkinson NS, Biswas S, Chapman T, Dulai PS, Glaire MA, Hoekman DR, Koutsoumpas A, Minas E, Mosli MH, Samaan M, Khanna R, Travis S, D'Haens G, Sandborn WJ, Feagan B Tags: Cochrane Database Syst Rev Source Type: research

Vitamin A supplements for reducing mother-to-child HIV transmission.
CONCLUSIONS: Antepartum or postpartum vitamin A supplementation, or both, probably has little or no effect on mother-to-child transmission of HIV in women living with HIV infection and not on antiretroviral drugs. The intervention has largely been superseded by ART which is widely available and effective in preventing vertical transmission. PMID: 28880995 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 7, 2017 Category: General Medicine Authors: Wiysonge CS, Ndze VN, Kongnyuy EJ, Shey MS Tags: Cochrane Database Syst Rev Source Type: research

Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews.
Conclusions. The trials included in the reviews varied in both size and risk of bias. Interventions were compared to usual care.Moderate-quality evidence indicated that C-reactive protein (CRP) point-of-care testing (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.66 to 0.92, 3284 participants, 6 trials), shared decision making (odds ratio (OR) 0.44, 95% CI 0.26 to 0.75, 3274 participants, 3 trials; RR 0.64, 95% CI 0.49 to 0.84, 4623 participants, 2 trials; risk difference -18.44, 95% CI -27.24 to -9.65, 481,807 participants, 4 trials), and procalcitonin-guided management (adjusted OR 0.10, 95% CI 0.07 to 0.14, 1008 p...
Source: Cochrane Database of Systematic Reviews - September 7, 2017 Category: General Medicine Authors: Tonkin-Crine SK, Tan PS, van Hecke O, Wang K, Roberts NW, McCullough A, Hansen MP, Butler CC, Del Mar CB Tags: Cochrane Database Syst Rev Source Type: research

Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults.
CONCLUSIONS: Available trials showed low to moderate-quality evidence that intercostal tube drainage produced higher rates of immediate success, while simple aspiration resulted in a shorter duration of hospitalization. Although adverse events were reported more commonly for patients treated with tube drainage, the low quality of the evidence warrants caution in interpreting these findings. Similarly, although this review observed no differences between groups when early failure rate, one-year success rate, or hospital admission rate was evaluated, this too needs to be put into the perspective of the quality of evidence, s...
Source: Cochrane Database of Systematic Reviews - September 7, 2017 Category: General Medicine Authors: Carson-Chahhoud KV, Wakai A, van Agteren JE, Smith BJ, McCabe G, Brinn MP, O'Sullivan R Tags: Cochrane Database Syst Rev Source Type: research

Delayed antibiotic prescriptions for respiratory infections.
CONCLUSIONS: For many clinical outcomes, there were no differences between prescribing strategies. Symptoms for acute otitis media and sore throat were modestly improved by immediate antibiotics compared with delayed antibiotics. There were no differences in complication rates. Delaying prescribing did not result in significantly different levels of patient satisfaction compared with immediate provision of antibiotics (86% versus 91%) (moderate quality evidence). However, delay was favoured over no antibiotics (87% versus 82%). Delayed antibiotics achieved lower rates of antibiotic use compared to immediate antibiotics (31...
Source: Cochrane Database of Systematic Reviews - September 7, 2017 Category: General Medicine Authors: Spurling GK, Del Mar CB, Dooley L, Foxlee R, Farley R Tags: Cochrane Database Syst Rev Source Type: research

Amniocentesis and chorionic villus sampling for prenatal diagnosis.
CONCLUSIONS: Second trimester amniocentesis increased the risk of pregnancy loss, but it was not possible to quantify this increase precisely from only one study, carried out more than 30 years ago.Early amniocentesis was not as safe as second trimester amniocentesis, illustrated by increased pregnancy loss and congenital anomalies (talipes). Transcervical chorionic villus sampling compared with second trimester amniocentesis may be associated with a higher risk of pregnancy loss, but results were quite heterogeneous.Diagnostic accuracy of different methods could not be assessed adequately because of incomplete karyotype d...
Source: Cochrane Database of Systematic Reviews - September 4, 2017 Category: General Medicine Authors: Alfirevic Z, Navaratnam K, Mujezinovic F Tags: Cochrane Database Syst Rev Source Type: research

Cerebral near-infrared spectroscopy monitoring for prevention of brain injury in very preterm infants.
CONCLUSIONS: The only eligible randomised clinical trial did not demonstrate any consistent effects of NIRS plus a guideline on the assessed clinical outcomes. The trial was, however, only powered to detect difference in cerebral oxygenation, not morbidities or mortality. Our systematic review did not reach sufficient power to prove or disprove effects on clinical outcomes. Further randomised clinical trials with low risks of bias and low risks of random errors are needed. PMID: 28869278 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 4, 2017 Category: General Medicine Authors: Hyttel-Sorensen S, Greisen G, Als-Nielsen B, Gluud C Tags: Cochrane Database Syst Rev Source Type: research

Internet-based interventions for smoking cessation.
CONCLUSIONS: The evidence from trials in adults suggests that interactive and tailored Internet-based interventions with or without additional behavioural support are moderately more effective than non-active controls at six months or longer, but there was no evidence that these interventions were better than other active smoking treatments. However some of the studies were at high risk of bias, and there was evidence of substantial statistical heterogeneity. Treatment effectiveness in younger people is unknown. PMID: 28869775 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 4, 2017 Category: General Medicine Authors: Taylor GMJ, Dalili MN, Semwal M, Civljak M, Sheikh A, Car J Tags: Cochrane Database Syst Rev Source Type: research

Interventions to improve hand hygiene compliance in patient care.
CONCLUSIONS: With the identified variability in certainty of evidence, interventions, and methods, there remains an urgent need to undertake methodologically robust research to explore the effectiveness of multimodal versus simpler interventions to increase hand hygiene compliance, and to identify which components of multimodal interventions or combinations of strategies are most effective in a particular context. PMID: 28862335 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 1, 2017 Category: General Medicine Authors: Gould DJ, Moralejo D, Drey N, Chudleigh JH, Taljaard M Tags: Cochrane Database Syst Rev Source Type: research

Computer-based versus in-person interventions for preventing and reducing stress in workers.
CONCLUSIONS: We found very low-quality evidence with conflicting results, when comparing the effectiveness of computer-based stress management interventions with in-person stress management interventions in employees. We could include only two studies with small sample sizes. We have very little confidence in the effect estimates. It is very likely that future studies will change these conclusions. PMID: 28853146 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 30, 2017 Category: General Medicine Authors: Kuster AT, Dalsbø TK, Luong Thanh BY, Agarwal A, Durand-Moreau QV, Kirkehei I Tags: Cochrane Database Syst Rev Source Type: research

Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants.
CONCLUSIONS: Available trial data do not provide evidence that advancing enteral feed volumes at daily increments of 15 to 20 mL/kg (compared with 30 to 40 mL/kg) reduces the risk of NEC or death in very preterm or VLBW infants, extremely preterm or ELBW infants, SGA or growth-restricted infants, or infants with antenatal AREDFV. Advancing the volume of enteral feeds at a slow rate results in several days of delay in establishing full enteral feeds and may increase the risk of invasive infection. PMID: 28854319 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 30, 2017 Category: General Medicine Authors: Oddie SJ, Young L, McGuire W Tags: Cochrane Database Syst Rev Source Type: research

Heated, humidified air for the common cold.
CONCLUSIONS: The current evidence does not show any benefits or harms from the use of heated, humidified air delivered via the RhinoTherm device for the treatment of the common cold. There is a need for more double-blind, randomised trials that include standardised treatment modalities. PMID: 28849871 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 29, 2017 Category: General Medicine Authors: Singh M, Singh M, Jaiswal N, Chauhan A Tags: Cochrane Database Syst Rev Source Type: research

Isoniazid for preventing tuberculosis in HIV-infected children.
CONCLUSIONS: Isoniazid prophylaxis given to all children diagnosed with HIV may reduce the risk of active TB and death in HIV-positive children not on ART in studies from Africa. For children on ART, no clear benefit was detected. . PMID: 28850172 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 29, 2017 Category: General Medicine Authors: Zunza M, Gray DM, Young T, Cotton M, Zar HJ Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing and managing advanced liver disease in cystic fibrosis.
CONCLUSIONS: In order to develop the best source of evidence, there is a need to undertake randomised controlled trials of interventions for preventing and managing advanced liver disease in adults and children with cystic fibrosis. PMID: 28850173 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 29, 2017 Category: General Medicine Authors: Palaniappan SK, Than NN, Thein AW, Moe S, van Mourik I Tags: Cochrane Database Syst Rev Source Type: research

Chemotherapy for advanced gastric cancer.
CONCLUSIONS: Chemotherapy improves survival (by an additional 6.7 months) in comparison to BSC, and combination chemotherapy improves survival (by an additional month) compared to single-agent 5-FU. Testing all patients for HER-2 status may help to identify patients with HER-2-positive tumours, for whom, in the absence of contraindications, trastuzumab in combination with capecitabine or 5-FU in combination with cisplatin has been shown to be beneficial. For HER-2 negative people, all different two-and three-drug combinations including irinotecan, docetaxel, oxaliplatin or oral 5-FU prodrugs are valid treatment options for...
Source: Cochrane Database of Systematic Reviews - August 29, 2017 Category: General Medicine Authors: Wagner AD, Syn NL, Moehler M, Grothe W, Yong WP, Tai BC, Ho J, Unverzagt S Tags: Cochrane Database Syst Rev Source Type: research

Retinoic acid postconsolidation therapy for high-risk neuroblastoma patients treated with autologous haematopoietic stem cell transplantation.
CONCLUSIONS: We identified one RCT that evaluated additional retinoic acid as part of a postconsolidation therapy after HDCT followed by autologous HSCT versus no further therapy in people with high-risk neuroblastoma. There was no clear evidence of a difference in overall survival and event-free survival between the treatment alternatives. This could be the result of low power. Information on other outcomes was not available. This trial was performed in the 1990s, since when many changes in treatment and risk classification have occurred. Based on the currently available evidence, we are therefore uncertain about the effe...
Source: Cochrane Database of Systematic Reviews - August 25, 2017 Category: General Medicine Authors: Peinemann F, van Dalen EC, Enk H, Berthold F Tags: Cochrane Database Syst Rev Source Type: research

Harms of off-label erythropoiesis-stimulating agents for critically ill people.
CONCLUSIONS: Low quality of evidence suggests that off-label use of ESAs may reduce mortality in a critical care setting. There was a lack of high-quality evidence about the harm of ESAs in critically-ill people. The information for biosimilar ESAs is less conclusive. Most studies neither evaluated ESAs' harm as a primary outcome nor predefined adverse events. Any further studies of ESA should address the quality of evaluating, recording and reporting of adverse events. PMID: 28841235 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 25, 2017 Category: General Medicine Authors: Mesgarpour B, Heidinger BH, Roth D, Schmitz S, Walsh CD, Herkner H Tags: Cochrane Database Syst Rev Source Type: research

Late ( ≥ 7 days) inhalation corticosteroids to reduce bronchopulmonary dysplasia in preterm infants.
CONCLUSIONS: Based on the results of the currently available evidence, inhalation corticosteroids initiated at ≥ 7 days of life for preterm infants at high risk of developing BPD cannot be recommended at this point in time. More and larger randomised, placebo-controlled trials are needed to establish the efficacy and safety of inhalation corticosteroids. PMID: 28836266 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Onland W, Offringa M, van Kaam A Tags: Cochrane Database Syst Rev Source Type: research

Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes.
CONCLUSIONS: The role of interconception care for women with a history of GDM remains unclear. Randomised controlled trials are required evaluating different forms and protocols of interconception care for these women on perinatal and long-term maternal and infant health outcomes, acceptability of such interventions and cost-effectiveness. PMID: 28836274 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Tieu J, Shepherd E, Middleton P, Crowther CA Tags: Cochrane Database Syst Rev Source Type: research

Home-based multidimensional survivorship programmes for breast cancer survivors.
CONCLUSIONS: The results of this systematic review and meta-analysis revealed that HBMS programmes in breast cancer survivors appear to have a short-term beneficial effect of improving breast cancer-specific quality of life and global quality of life as measured by FACT-B and EORTC-C30, respectively. In addition, HBMS programmes are associated with a reduction in anxiety, fatigue and insomnia immediately after the intervention. We assessed the quality of evidence across studies as moderate for some outcomes, meaning that we are fairly confident about the results, while we assessed other outcomes as being low-quality, meani...
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Cheng KKF, Lim YTE, Koh ZM, Tam WWS Tags: Cochrane Database Syst Rev Source Type: research

Zonisamide for essential tremor.
CONCLUSIONS: Based on currently available data, there is insufficient evidence to assess the efficacy and safety of zonisamide treatment for ET. PMID: 28836659 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Bruno E, Nicoletti A, Filippini G, Quattrocchi G, Colosimo C, Zappia M Tags: Cochrane Database Syst Rev Source Type: research

Whole grain cereals for the primary or secondary prevention of cardiovascular disease.
CONCLUSIONS: There is insufficient evidence from RCTs of an effect of whole grain diets on cardiovascular outcomes or on major CVD risk factors such as blood lipids and blood pressure. Trials were at unclear or high risk of bias with small sample sizes and relatively short-term interventions, and the overall quality of the evidence was low. There is a need for well-designed, adequately powered RCTs with longer durations assessing cardiovascular events as well as cardiovascular risk factors. PMID: 28836672 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Kelly SA, Hartley L, Loveman E, Colquitt JL, Jones HM, Al-Khudairy L, Clar C, Germanò R, Lunn HR, Frost G, Rees K Tags: Cochrane Database Syst Rev Source Type: research

Tailored interventions based on sputum eosinophils versus clinical symptoms for asthma in children and adults.
CONCLUSIONS: In this updated review, tailoring asthma interventions based on sputum eosinophils is beneficial in reducing the frequency of asthma exacerbations in adults with asthma. Adults with frequent exacerbations and severe asthma may derive the greatest benefit from this additional monitoring test, although we were unable to confirm this through subgroup analysis. There is insufficient data available to assess tailoring asthma medications based on sputum eosinophilia in children.Further robust RCTs need to be undertaken and these should include participants with different underlying asthma severities and endotypes. ...
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Petsky HL, Li A, Chang AB Tags: Cochrane Database Syst Rev Source Type: research

Systemic antibiotics for treating malignant wounds.
CONCLUSIONS: It is uncertain whether systemic metronidazole leads to a reduction in malodour in patients with malignant wounds. This is because we were only able to include a single study at high risk of bias with a very small sample size, which focused only on patients with breast cancer. More research is needed to substantiate these findings and to investigate the effects of systemic metronidazole and other antibiotics on quality of life, pain relief, exudate and tumour containment in patients with malignant wounds. PMID: 28837757 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Ramasubbu DA, Smith V, Hayden F, Cronin P Tags: Cochrane Database Syst Rev Source Type: research

Interventions for the management of CMV-associated anterior segment inflammation.
CONCLUSIONS: There is currently no good-quality evidence on the management of CMV-associated anterior segment inflammation. Ideally, a well-designed RCT is needed to evaluate the effectiveness of different anti-CMV medications as well as the optimal dose and duration. PMID: 28838031 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 24, 2017 Category: General Medicine Authors: Anshu A, Tan D, Chee SP, Mehta JS, Htoon HM Tags: Cochrane Database Syst Rev Source Type: research

Drug-eluting stents versus bare-metal stents for acute coronary syndrome.
CONCLUSIONS: The current evidence suggests that drug-eluting stents may lead to fewer serious adverse events compared with bare-metal stents without increasing the risk of all-cause mortality or major cardiovascular events. However, our Trial Sequential Analysis showed that there currently was not enough information to assess a risk ratio reduction of 10% for all-cause mortality, major cardiovascular events, cardiovascular mortality, or myocardial infarction, and there were no data on quality of life or angina. The evidence in this review was of low to very low quality, and the true result may depart substantially from the...
Source: Cochrane Database of Systematic Reviews - August 23, 2017 Category: General Medicine Authors: Feinberg J, Nielsen EE, Greenhalgh J, Hounsome J, Sethi NJ, Safi S, Gluud C, Jakobsen JC Tags: Cochrane Database Syst Rev Source Type: research

Effect of testing for cancer on cancer- and venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE.
CONCLUSIONS: Testing for cancer in people with unprovoked VTE may lead to earlier diagnosis of cancer at an earlier stage of the disease. However, there is currently insufficient evidence to draw definitive conclusions concerning the effectiveness of testing for undiagnosed cancer in people with a first episode of unprovoked VTE (DVT or PE) in reducing cancer and VTE-related morbidity and mortality. The results could be consistent with either benefit or no benefit. Further good-quality large-scale randomised controlled trials are required before firm conclusions can be made. PMID: 28832905 [PubMed - as supplied by pub...
Source: Cochrane Database of Systematic Reviews - August 23, 2017 Category: General Medicine Authors: Robertson L, Yeoh SE, Stansby G, Agarwal R Tags: Cochrane Database Syst Rev Source Type: research

Different strategies for diagnosing gestational diabetes to improve maternal and infant health.
CONCLUSIONS: There is insufficient evidence to suggest which strategy is best for diagnosing GDM. Large randomised trials are required to establish the best strategy for correctly identifying women with GDM. PMID: 28832911 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 23, 2017 Category: General Medicine Authors: Farrar D, Duley L, Dowswell T, Lawlor DA Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for persistent cough or wheeze following acute bronchiolitis in children.
CONCLUSIONS: Current evidence is insufficient to inform whether antibiotics should be used to treat or prevent persistent respiratory symptoms in the post-acute bronchiolitis phase. Future RCTs are needed to evaluate the efficacy of antibiotics for reducing persistent respiratory symptoms. This is particularly important in populations with high acute and post-acute bronchiolitis morbidity (e.g. indigenous populations in Australia, New Zealand, and the USA). PMID: 28828759 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: McCallum GB, Plumb EJ, Morris PS, Chang AB Tags: Cochrane Database Syst Rev Source Type: research

Culture-specific programs for children and adults from minority groups who have asthma.
CONCLUSIONS: The available evidence showed that culture-specific education programmes for adults and children from minority groups are likely effective in improving asthma-related outcomes. This review was limited by few studies and evidence of very low to low quality. Not all asthma-related outcomes improved with culture-specific programs for both adults and children. Nevertheless, while modified culture-specific education programs are usually more time intensive, the findings of this review suggest using culture-specific asthma education programmes for children and adults from minority groups. However, more robust RCTs a...
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: McCallum GB, Morris PS, Brown N, Chang AB Tags: Cochrane Database Syst Rev Source Type: research

Coblation versus other surgical techniques for tonsillectomy.
CONCLUSIONS: The coblation technique may cause less pain on postoperative day 1, but the difference is small and may be clinically meaningless. By postoperative day 3, the difference decreases further and by postoperative day 7 there appears to be little or no difference. We found similar rates of primary bleeding but we cannot rule out a small increased risk of secondary bleeding with coblation. The evidence supporting these findings is of low or very low quality, i.e. there is a very high degree of uncertainty about the results. Moreover, for most outcomes data were only available from a few of the 29 included studies.Th...
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: Pynnonen M, Brinkmeier JV, Thorne MC, Chong LY, Burton MJ Tags: Cochrane Database Syst Rev Source Type: research

Vitamin K supplementation for cystic fibrosis.
CONCLUSIONS: Evidence from randomised controlled trials on the benefits of routine vitamin K supplementation for people with CF is currently weak and limited to two small trials of short duration. However, no harm was found and until further evidence is available, the present recommendations should be adhered to. PMID: 28829533 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: Jagannath VA, Thaker V, Chang AB, Price AI Tags: Cochrane Database Syst Rev Source Type: research

Oxycodone for cancer-related pain.
CONCLUSIONS: The conclusions have not changed since the previous version of this review. The data suggest that oxycodone offers similar levels of pain relief and overall adverse events to other strong opioids including morphine. Although we identified a clinically insignificant benefit on pain relief in favour of CR morphine over CR oxycodone, this did not persist following sensitivity analysis and so we do not consider this important. However, in this updated analysis, we found that hallucinations occurred less often with CR oxycodone than with CR morphine, but the quality of this evidence was very low so this finding sho...
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: Schmidt-Hansen M, Bennett MI, Arnold S, Bromham N, Hilgart JS Tags: Cochrane Database Syst Rev Source Type: research

Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer.
CONCLUSIONS: Based on the available evidence, the addition of esophagectomy to chemoradiotherapy in locally advanced esophageal squamous cell carcinoma, provides little or no difference on overall survival, and may be associated with higher treatment-related mortality. The addition of esophagectomy probably delays locoregional relapse, however, this end point was not well defined in the included studies. It is undetermined whether these results can be applied to the treatment of adenocarcinomas, tumors involving the distal esophagus and gastro-esophageal junction, and to people with poor response to chemoradiation. PM...
Source: Cochrane Database of Systematic Reviews - August 22, 2017 Category: General Medicine Authors: Vellayappan BA, Soon YY, Ku GY, Leong CN, Lu JJ, Tey JC Tags: Cochrane Database Syst Rev Source Type: research

Open versus closed surgical exposure of canine teeth that are displaced in the roof of the mouth.
CONCLUSIONS: Currently, the evidence suggests that neither the open or closed surgical technique for exposing palatally displaced maxillary canine teeth is superior for any of the outcomes included in this review; however, we considered the evidence to be low quality, with two of the three included studies being at high risk of bias. This suggests the need for more high-quality studies. Three ongoing clinical trials have been identified and it is hoped that these will produce data that can be pooled to increase the degree of certainty in these findings. PMID: 28828758 [PubMed - as supplied by publisher] (Source: Cochr...
Source: Cochrane Database of Systematic Reviews - August 21, 2017 Category: General Medicine Authors: Parkin N, Benson PE, Thind B, Shah A, Khalil I, Ghafoor S Tags: Cochrane Database Syst Rev Source Type: research

Welfare-to-work interventions and their effects on the mental and physical health of lone parents and their children.
CONCLUSIONS: The effects of WtW on health are largely of a magnitude that is unlikely to have tangible impacts. Since income and employment are hypothesised to mediate effects on health, it is possible that these negligible health impacts result from the small effects on economic outcomes. Even where employment and income were higher for the lone parents in WtW, poverty was still high for the majority of the lone parents in many of the studies. Perhaps because of this, depression also remained very high for lone parents whether they were in WtW or not. There is a lack of robust evidence on the health effects of WtW for lon...
Source: Cochrane Database of Systematic Reviews - August 20, 2017 Category: General Medicine Authors: Gibson M, Thomson H, Banas K, Lutje V, McKee MJ, Martin SP, Fenton C, Bambra C, Bond L Tags: Cochrane Database Syst Rev Source Type: research

Baclofen for alcohol withdrawal.
CONCLUSIONS: No conclusions can be drawn about the efficacy and safety of baclofen for the management of alcohol withdrawal because we found insufficient and very low quality evidence. PMID: 28822350 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 20, 2017 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Interventions for treating persistent pain in survivors of torture.
CONCLUSIONS: There is insufficient evidence to support or refute the use of any intervention for persistent pain in survivors of torture. PMID: 28820231 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 18, 2017 Category: General Medicine Authors: Baird E, Williams ACC, Hearn L, Amris K Tags: Cochrane Database Syst Rev Source Type: research

Treadmill training and body weight support for walking after stroke.
Abstract BACKGROUND: Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014. OBJECTIVES: To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait-training interventions after stroke. The secondary objective was to determine the sa...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Mehrholz J, Thomas S, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Homocysteine-lowering interventions for preventing cardiovascular events.
CONCLUSIONS: In this third update of the Cochrane review, there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo on myocardial infarction, death from any cause or adverse events. In terms of stroke, this review found a small difference in effect favouring to homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo.There were uncertain effects of enalapril plus folic acid compared with enalapril on stroke; approxima...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Martí-Carvajal AJ, Solà I, Lathyris D, Dayer M Tags: Cochrane Database Syst Rev Source Type: research

Pharmacotherapy for hypertension in adults aged 18 to 59 years.
CONCLUSIONS: Antihypertensive drugs used to treat predominantly healthy adults aged 18 to 59 years with mild to moderate primary hypertension have a small absolute effect to reduce cardiovascular mortality and morbidity primarily due to reduction in cerebrovascular mortality and morbidity. All-cause mortality and coronary heart disease were not reduced. There is lack of good evidence on withdrawal due to adverse events. Future trials in this age group should be at least 10 years in duration and should compare different first-line drug classes and strategies. PMID: 28813123 [PubMed - as supplied by publisher] (Source: ...
Source: Cochrane Database of Systematic Reviews - August 16, 2017 Category: General Medicine Authors: Musini VM, Gueyffier F, Puil L, Salzwedel DM, Wright JM Tags: Cochrane Database Syst Rev Source Type: research

Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults.
CONCLUSIONS: Review results suggest that in comparison with neostigmine, sugammadex can more rapidly reverse rocuronium-induced neuromuscular block regardless of the depth of the block. Sugammadex 2 mg/kg is 10.22 minutes (˜ 6.6 times) faster in reversing moderate neuromuscular blockade (T2) than neostigmine 0.05 mg/kg (GRADE: moderate quality), and sugammadex 4 mg/kg is 45.78 minutes (˜ 16.8 times) faster in reversing deep neuromuscular blockade (PTC 1 to 5) than neostigmine 0.07 mg/kg (GRADE: low quality). With an NNTB of 8 to avoid an adverse event, sugammadex appears to have a better safety profile than neo...
Source: Cochrane Database of Systematic Reviews - August 14, 2017 Category: General Medicine Authors: Hristovska AM, Duch P, Allingstrup M, Afshari A Tags: Cochrane Database Syst Rev Source Type: research

Preconception care for diabetic women for improving maternal and infant health.
CONCLUSIONS: There are insufficient RCT data available to assess the effects of preconception care for diabetic women on health outcomes for mothers and their infants.More high-quality evidence is needed to determine the effects of different protocols of preconception care for diabetic women. Future trials should be powered to evaluate effects on short- and long-term maternal and infant outcomes, and outcomes relating to the use and costs of health services. We have identified three ongoing studies that we will consider in the next review update. PMID: 28799164 [PubMed - as supplied by publisher] (Source: Cochrane Dat...
Source: Cochrane Database of Systematic Reviews - August 11, 2017 Category: General Medicine Authors: Tieu J, Middleton P, Crowther CA, Shepherd E Tags: Cochrane Database Syst Rev Source Type: research

Palliative drug treatments for breathlessness in cystic fibrosis.
CONCLUSIONS: Due to the lack of available evidence, this review cannot provide any information for clinical practice. The authors call for specific research in this area after taking into account relevant ethical considerations. The research should focus on the efficacy and safety of the drugs with efficacy being measured in terms of improvement in quality of life, dyspnoea scores and hospital stay. PMID: 28795404 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 10, 2017 Category: General Medicine Authors: Jaiswal N, Singh M, Agarwal A, Thumburu KK Tags: Cochrane Database Syst Rev Source Type: research

Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy.
CONCLUSIONS: We found low quality evidence suggesting a short-term beneficial effect of flumazenil on hepatic encephalopathy in people with cirrhosis, but no evidence of an effect on all-cause mortality. Additional evidence from large, high quality randomised clinical trials is needed to evaluate the potential benefits and harms of flumazenil in people with cirrhosis and hepatic encephalopathy. PMID: 28796283 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 10, 2017 Category: General Medicine Authors: Goh ET, Andersen ML, Morgan MY, Gluud LL Tags: Cochrane Database Syst Rev Source Type: research

Cytology versus HPV testing for cervical cancer screening in the general population.
CONCLUSIONS: Whilst HPV tests are less likely to miss cases of CIN 2+ and CIN 3+, these tests do lead to more unnecessary referrals. However, a negative HPV test is more reassuring than a negative cytological test, as the cytological test has a greater chance of being falsely negative, which could lead to delays in receiving the appropriate treatment. Evidence from prospective longitudinal studies is needed to establish the relative clinical implications of these tests. PMID: 28796882 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - August 10, 2017 Category: General Medicine Authors: Koliopoulos G, Nyaga VN, Santesso N, Bryant A, Martin-Hirsch PP, Mustafa RA, Schünemann H, Paraskevaidis E, Arbyn M Tags: Cochrane Database Syst Rev Source Type: research