Neuromuscular electrical stimulation (NMES) for patellofemoral pain syndrome.
CONCLUSIONS: This review found insufficient and inconclusive evidence from randomised controlled trials to inform on the role of NMES for treating people with PFP in current clinical practice. The very low-quality evidence available means that we are uncertain whether or not a multiple-session programme of NMES combined with exercise over several weeks versus exercise alone results in clinically important differences in knee pain and function at the end of the treatment period or at one year. There were no data on adverse effects such as muscle fatigue and discomfort. High-quality randomised clinical trials are needed to i...
Source: Cochrane Database of Systematic Reviews - December 12, 2017 Category: General Medicine Authors: Martimbianco ALC, Torloni MRR, Andriolo BN, Porfírio GJ, Riera R Tags: Cochrane Database Syst Rev Source Type: research

Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults.
CONCLUSIONS: At present, the quality of the evidence on the effectiveness and safety of macrolides for treatment of H ducreyi infection in sexually active adults is low, implying that we are uncertain about the estimated treatment effect. There is no statistically significant difference between the available therapeutic alternatives for the treatment of sexually active adults with genital ulcers compatible with chancroid. Low quality evidence suggests that azithromycin could be considered as the first therapeutic alternative, based on their mono-dose oral administration, with a similar safety and effectiveness profile, whe...
Source: Cochrane Database of Systematic Reviews - December 11, 2017 Category: General Medicine Authors: Romero L, Huerfano C, Grillo-Ardila CF Tags: Cochrane Database Syst Rev Source Type: research

Thrombolysis for acute upper extremity deep vein thrombosis.
CONCLUSIONS: There is currently insufficient evidence from which to draw conclusion on the benefits or harms of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis as an add-on therapy to anticoagulation, alone compared with anticoagulation, or alone compared with any other type of medical intervention. Large randomised clinical trials with a low risk of bias are warranted. They should focus on clinical outcomes and not solely on surrogate measures. PMID: 29226949 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 11, 2017 Category: General Medicine Authors: Feinberg J, Nielsen EE, Jakobsen JC Tags: Cochrane Database Syst Rev Source Type: research

Larvivorous fish for preventing malaria transmission.
CONCLUSIONS: We do not know whether introducing larvivorous fish reduces malaria transmission or the density of adult anopheline mosquito populations.In research studies that examined the effects on immature anopheline stages of introducing fish to potential malaria vector larval habitats, high stocking levels of fish may reduce the density or presence of immature anopheline mosquitoes in the short term. We do not know whether this translates into impact on malaria transmission. Our interpretation of the current evidence is that countries should not invest in fish stocking as a stand alone or supplementary larval control m...
Source: Cochrane Database of Systematic Reviews - December 11, 2017 Category: General Medicine Authors: Walshe DP, Garner P, Adeel AA, Pyke GH, Burkot TR Tags: Cochrane Database Syst Rev Source Type: research

Benzodiazepines for psychosis-induced aggression or agitation.
CONCLUSIONS: The evidence from RCTs for the use of benzodiazepines alone is not good. There were relatively few good data. Most trials were too small to highlight differences in either positive or negative effects. Adding a benzodiazepine to other drugs does not seem to confer clear advantage and has potential for adding unnecessary adverse effects. Sole use of older antipsychotics unaccompanied by anticholinergic drugs seems difficult to justify. Much more high-quality research is still needed in this area. PMID: 29219171 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 8, 2017 Category: General Medicine Authors: Zaman H, Sampson SJ, Beck AL, Sharma T, Clay FJ, Spyridi S, Zhao S, Gillies D Tags: Cochrane Database Syst Rev Source Type: research

Yoga for stroke rehabilitation.
CONCLUSIONS: Yoga has the potential for being included as part of patient-centred stroke rehabilitation. However, this review has identified insufficient information to confirm or refute the effectiveness or safety of yoga as a stroke rehabilitation treatment. Further large-scale methodologically robust trials are required to establish the effectiveness of yoga as a stroke rehabilitation treatment. PMID: 29220541 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 8, 2017 Category: General Medicine Authors: Lawrence M, Celestino Junior FT, Matozinho HH, Govan L, Booth J, Beecher J Tags: Cochrane Database Syst Rev Source Type: research

Triage tools for detecting cervical spine injury in pediatric trauma patients.
CONCLUSIONS: There are currently few studies assessing the diagnostic test accuracy of the NEXUS criteria and CCR in children. At the moment, there is not enough evidence to determine the accuracy of the Canadian C-spine Rule to detect CSI in pediatric trauma patients following blunt trauma. The confidence interval of the sensitivity of the NEXUS criteria between the individual studies showed a wide range, with a lower limit varying from 0.18 to 0.91 with a total of four false negative test results, meaning that if physicians use the NEXUS criteria in children, there is a chance of missing CSI. Since missing CSI could have...
Source: Cochrane Database of Systematic Reviews - December 7, 2017 Category: General Medicine Authors: Slaar A, Fockens MM, Wang J, Maas M, Wilson DJ, Goslings JC, Schep NW, van Rijn RR Tags: Cochrane Database Syst Rev Source Type: research

Vocational rehabilitation for enhancing return-to-work in workers with traumatic upper limb injuries.
CONCLUSIONS: There is currently no high-quality evidence to support or refute the efficacy of vocational rehabilitation for enhancing RTW in workers with traumatic upper limb injuries. Since injured people in occupational settings frequently receive vocational rehabilitation with the aim of decreasing work disability, enhancing RTW, increasing productivity, and containing the welfare cost, further high-quality RCTs assessing the efficacy of vocational rehabilitation for workers with traumatic upper limb injury are needed to fill this gap in knowledge. PMID: 29210462 [PubMed - as supplied by publisher] (Source: Cochran...
Source: Cochrane Database of Systematic Reviews - December 6, 2017 Category: General Medicine Authors: Hou WH, Chi CC, Lo HL, Chou YY, Kuo KN, Chuang HY Tags: Cochrane Database Syst Rev Source Type: research

Feed thickener for infants up to six months of age with gastro-oesophageal reflux.
Abstract BACKGROUND: Gastro-oesophageal reflux (GOR) is common in infants, and feed thickeners are often used to manage it in infants as they are simple to use and perceived to be harmless. However, conflicting evidence exists to support the use of feed thickeners. OBJECTIVES: To evaluate the use of feed thickeners in infants up to six months of age with GOR in terms of reduction in a) signs and symptoms of GOR, b) reflux episodes on pH probe monitoring or intraluminal impedance or a combination of both, or c) histological evidence of oesophagitis. SEARCH METHODS: We used the standard search strategy of ...
Source: Cochrane Database of Systematic Reviews - December 5, 2017 Category: General Medicine Authors: Kwok TC, Ojha S, Dorling J Tags: Cochrane Database Syst Rev Source Type: research

Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus.
CONCLUSIONS: There is no firm evidence that diet alone or physical activity alone compared to standard treatment influences the risk of T2DM and especially its associated complications in people at increased risk of developing T2DM. However, diet plus physical activity reduces or delays the incidence of T2DM in people with IGT. Data are lacking for the effect of diet plus physical activity for people with intermediate hyperglycaemia defined by other glycaemic variables. Most RCTs did not investigate patient-important outcomes. PMID: 29205264 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 4, 2017 Category: General Medicine Authors: Hemmingsen B, Gimenez-Perez G, Mauricio D, Roqué I Figuls M, Metzendorf MI, Richter B Tags: Cochrane Database Syst Rev Source Type: research

Antenatal maternal education for improving postnatal perineal healing for women who have birthed in a hospital setting.
CONCLUSIONS: We set out to evaluate the RCT evidence pertaining to the impact of antenatal education on perineal wound healing in postnatal women who have birthed in a hospital setting, and who experienced a break in the skin of the perineum as a result of a tear or episiotomy, or both. However, no studies met the inclusion criteria. There is a lack of evidence concerning whether or not antenatal education relating to perineal wound healing in this cohort of women will change the outcome for these women in relation to wound healing, infection rate, re-attendance or re-admission to hospital, pain, health-related quality of ...
Source: Cochrane Database of Systematic Reviews - December 4, 2017 Category: General Medicine Authors: O'Kelly SM, Moore ZE Tags: Cochrane Database Syst Rev Source Type: research

Invasive versus non-invasive ventilation for acute respiratory failure in neuromuscular disease and chest wall disorders.
CONCLUSIONS: Acute respiratory failure is a life-threatening complication of acute onset neuromuscular disease and of chronic neuromuscular disease and chest wall disorders. We found no randomised trials on which to elaborate evidence-based practice for the use of non-invasive versus invasive mechanical ventilation. For researchers, there is a need to design and conduct new randomised trials to compare NIV with invasive ventilation in acute neuromuscular respiratory failure. These trials should anticipate variations in treatment responses according to disease condition (acute onset versus acute exacerbation on chronic neur...
Source: Cochrane Database of Systematic Reviews - December 4, 2017 Category: General Medicine Authors: Luo F, Annane D, Orlikowski D, He L, Yang M, Zhou M, Liu GJ Tags: Cochrane Database Syst Rev Source Type: research

Peritoneal dialysis for acute kidney injury.
CONCLUSIONS: Based on moderate (mortality, recovery of kidney function), low (infectious complications), or very low certainty evidence (correction of acidosis) there is probably little or no difference between PD and extracorporeal therapy for treating AKI. Fluid removal (low certainty) and weekly delivered Kt/V (very low certainty) may be higher with extracorporeal therapy. PMID: 29199769 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 4, 2017 Category: General Medicine Authors: Liu L, Zhang L, Liu GJ, Fu P Tags: Cochrane Database Syst Rev Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vas...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Acupuncture for neuropathic pain in adults.
CONCLUSIONS: Due to the limited data available, there is insufficient evidence to support or refute the use of acupuncture for neuropathic pain in general, or for any specific neuropathic pain condition when compared with sham acupuncture or other active therapies. Five studies are still ongoing and seven studies are awaiting classification due to the unclear treatment duration, and the results of these studies may influence the current findings. PMID: 29197180 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Ju ZY, Wang K, Cui HS, Yao Y, Liu SM, Zhou J, Chen TY, Xia J Tags: Cochrane Database Syst Rev Source Type: research

Pentasaccharides for the treatment of deep vein thrombosis.
CONCLUSIONS: We found moderate-quality evidence that the effects of fondaparinux at doses of 5.0 mg, 7.5 mg, and 10.0 mg plus vitamin K antagonist are similar in terms of recurrent VTE and risk of major bleeding compared with standard treatment for DVT.Low-quality evidence suggests equal efficacy of idraparinux at 2.5 mg and the equimolar dose of 3.0 mg of idrabiotaparinux with regard to recurrent VTE, but a higher frequency of major bleeding was observed in participants treated with idraparinux.We judged evidence on the effectiveness of idraparinux compared with standard therapy, with or without initial treatment with LMW...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Brandao GM, Junqueira DR, Rollo HA, Sobreira ML Tags: Cochrane Database Syst Rev Source Type: research

Oxcarbazepine for neuropathic pain.
CONCLUSIONS: This review found little evidence to support the effectiveness of oxcarbazepine in painful diabetic neuropathy, neuropathic pain from radiculopathy and a mixture of neuropathies. Some very-low-quality evidence suggests efficacy but small trials, low event rates, heterogeneity in some measures and a high risk of publication bias means that we have very low confidence in the measures of effect. Adverse effects, serious adverse effects and adverse effects leading to discontinuation are probably more common with oxcarbazepine than placebo; however, the numbers of participants and event rates are low. More well-des...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Zhou M, Chen N, He L, Yang M, Zhu C, Wu F Tags: Cochrane Database Syst Rev Source Type: research

Bisphosphonates for Paget's disease of bone in adults.
CONCLUSIONS: We found moderate-quality evidence that bisphosphonates improved pain in people with Paget's disease of bone when compared with placebo. We are uncertain about the results of head-to-head studies investigating bisphosphonates. We found insufficient evidence of benefit in terms of pain or quality of life from intensive treatment. Information about adverse effects was limited, but serious side effects were rare, and rate of withdrawals due to side effects was low. PMID: 29192423 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 1, 2017 Category: General Medicine Authors: Corral-Gudino L, Tan AJ, Del Pino-Montes J, Ralston SH Tags: Cochrane Database Syst Rev Source Type: research

Interventions for Old World cutaneous leishmaniasis.
CONCLUSIONS: There was very low-certainty evidence to support the effectiveness of itraconazole and paromomycin ointment for OWCL in terms of cure (i.e. microbiological or histopathological cure and percentage of participants completely cured). Both of these interventions incited more adverse effects, which were mild in nature, than their comparisons, but we could draw no conclusions regarding safety due to the very low certainty of the evidence for this outcome.We downgraded the key outcomes in these two comparisons due to high risk of bias, inconsistency between the results, and imprecision. There is a need for large, we...
Source: Cochrane Database of Systematic Reviews - December 1, 2017 Category: General Medicine Authors: Heras-Mosteiro J, Monge-Maillo B, Pinart M, Lopez Pereira P, Reveiz L, Garcia-Carrasco E, Campuzano Cuadrado P, Royuela A, Mendez Roman I, López-Vélez R Tags: Cochrane Database Syst Rev Source Type: research

Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity.
CONCLUSIONS: We found little convincing evidence for a clinically-important effect on participants' weight or BMI of any of the evaluated interventions. While pooled results from three studies indicate that educational interventions targeting healthcare professionals may lead to a slight weight reduction in adults, the certainty of these results is low. Two trials evaluating CDS tools (unpooled results) for improved weight management suggest little or no effect on weight or BMI change in adults or children with overweight or obesity. Evidence for all the other interventions evaluated came mostly from single studies. The ce...
Source: Cochrane Database of Systematic Reviews - November 30, 2017 Category: General Medicine Authors: Flodgren G, Gonçalves-Bradley DC, Summerbell CD Tags: Cochrane Database Syst Rev Source Type: research

Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy.
CONCLUSIONS: We are very uncertain about the effects of oral prednisone compared with no treatment, because the quality of evidence from the only RCT that exists is very low. Nevertheless, corticosteroids are commonly used in practice, supported by very low-quality evidence from observational studies. We also know from observational studies that corticosteroids carry the long-term risk of serious side effects. The efficacy of high-dose monthly oral dexamethasone is probably little different from that of daily standard-dose oral prednisolone. Most side effects occurred with similar frequencies in both groups, but with high-...
Source: Cochrane Database of Systematic Reviews - November 29, 2017 Category: General Medicine Authors: Hughes RA, Mehndiratta MM, Rajabally YA Tags: Cochrane Database Syst Rev Source Type: research

Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease.
CONCLUSIONS: Given the very low quality of the available evidence, it is uncertain whether the strategies tested improve implementation of the targeted school-based policies or practices, student health behaviours, or the knowledge or attitudes of school staff. It is also uncertain if strategies to improve implementation are cost-effective or if they result in unintended adverse consequences. Further research is required to guide efforts to facilitate the translation of evidence into practice in this setting. PMID: 29185627 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 29, 2017 Category: General Medicine Authors: Wolfenden L, Nathan NK, Sutherland R, Yoong SL, Hodder RK, Wyse RJ, Delaney T, Grady A, Fielding A, Tzelepis F, Clinton-McHarg T, Parmenter B, Butler P, Wiggers J, Bauman A, Milat A, Booth D, Williams CM Tags: Cochrane Database Syst Rev Source Type: research

Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.
CONCLUSIONS: Our updated review suggests that metformin alone may be beneficial over placebo for live birth, although the evidence quality was low. When metformin was compared with clomiphene citrate, data for live birth were inconclusive, and our findings were limited by lack of evidence. Results differed by body mass index (BMI), emphasising the importance of stratifying results by BMI. An improvement in clinical pregnancy and ovulation suggests that clomiphene citrate remains preferable to metformin for ovulation induction in obese women with PCOS.An improved clinical pregnancy and ovulation rate with metformin and clom...
Source: Cochrane Database of Systematic Reviews - November 29, 2017 Category: General Medicine Authors: Morley LC, Tang T, Yasmin E, Norman RJ, Balen AH Tags: Cochrane Database Syst Rev Source Type: research

Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed stud...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Ray A, Ray S Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors.
CONCLUSIONS: We are confident that KGF is beneficial in the prevention of oral mucositis in adults who are receiving: a) radiotherapy to the head and neck with cisplatin or fluorouracil; or b) chemotherapy alone for mixed solid and haematological cancers. We are less confident about a benefit for KGF in adults receiving bone marrow/stem cell transplant after conditioning therapy for haematological cancers because of multiple factors involved in that population, such as whether or not they received total body irradiation (TBI) and whether the transplant was autologous (the patients' own cells) or allogeneic (cells from a do...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Riley P, Glenny AM, Worthington HV, Littlewood A, Fernandez Mauleffinch LM, Clarkson JE, McCabe MG Tags: Cochrane Database Syst Rev Source Type: research

Palliative chemotherapy and targeted therapies for esophageal and gastroesophageal junction cancer.
CONCLUSIONS: People who receive more chemotherapeutic or targeted therapeutic agents have an increased overall survival compared to people who receive less. These agents, administered as both first-line or second-line treatments, also led to better overall survival than best supportive care. With the exception of ramucirumab, it remains unclear which other individual agents cause the survival benefit. Although treatment-associated toxicities of grade 3 or more occurred more frequently in arms with an additional chemotherapy or targeted therapy agent, there is no evidence that palliative chemotherapy and/or targeted therapy...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Janmaat VT, Steyerberg EW, van der Gaast A, Mathijssen RH, Bruno MJ, Peppelenbosch MP, Kuipers EJ, Spaander MC Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological interventions for pain relief during orthodontic treatment.
CONCLUSIONS: Analgesics are more effective at reducing pain following orthodontic treatment than placebo or no treatment. Low-quality evidence did not show a difference in effectiveness between systemic NSAIDs compared with paracetamol, or topical NSAIDs compared with local anaesthetic. More high-quality research is needed to investigate these comparisons, and to evaluate pre-emptive versus post-treatment administration of analgesics. PMID: 29182798 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Monk AB, Harrison JE, Worthington HV, Teague A Tags: Cochrane Database Syst Rev Source Type: research

Inhaled magnesium sulfate in the treatment of acute asthma.
CONCLUSIONS: Treatment with nebulised MgSO₄ may result in modest additional benefits for lung function and hospital admission when added to inhaled β₂-agonists and ipratropium bromide, but our confidence in the evidence is low and there remains substantial uncertainty. The recent large, well-designed trials have generally not demonstrated clinically important benefits. Nebulised MgSO₄ does not appear to be associated with an increase in serious adverse events. Individual studies suggest that those with more severe attacks and attacks of shorter duration may experience a greater benefit but further research into ...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Knightly R, Milan SJ, Hughes R, Knopp-Sihota JA, Rowe BH, Normansell R, Powell C Tags: Cochrane Database Syst Rev Source Type: research

Interventions to increase tuberculosis case detection at primary healthcare or community-level services.
CONCLUSIONS: The available evidence demonstrates that when used in appropriate settings, active case-finding approaches may result in increase in tuberculosis case detection in the short term. The effect of active case finding on treatment outcome needs to be further evaluated in sufficiently powered studies. PMID: 29182800 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Mhimbira FA, Cuevas LE, Dacombe R, Mkopi A, Sinclair D Tags: Cochrane Database Syst Rev Source Type: research

Probiotics for vulvovaginal candidiasis in non-pregnant women.
CONCLUSIONS: Low and very low quality evidence shows that, compared with conventional treatment, the use of probiotics as an adjuvant therapy could increases the rate of short-term clinical and mycological cure and decrease the relapse rate at one month but this did not translate into a higher frequency of long-term clinical or mycological cure. Probiotics use does not seem to increase the frequency of serious or non-serious adverse events. There is a need for well-designed RCTs with standardized methodologies, longer follow-up and larger sample size. PMID: 29168557 [PubMed - as supplied by publisher] (Source: Cochran...
Source: Cochrane Database of Systematic Reviews - November 23, 2017 Category: General Medicine Authors: Xie HY, Feng D, Wei DM, Mei L, Chen H, Wang X, Fang F Tags: Cochrane Database Syst Rev Source Type: research

Point-of-use fortification of foods with micronutrient powders containing iron in children of preschool and school-age.
CONCLUSIONS: Point-of-use fortification of foods with MNPs containing iron reduces anaemia and iron deficiency in preschool- and school-age children. However, information on mortality, morbidity, developmental outcomes and adverse effects is still scarce. PMID: 29168569 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 23, 2017 Category: General Medicine Authors: De-Regil LM, Jefferds MED, Peña-Rosas JP Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic platelet transfusions prior to surgery for people with a low platelet count.
The objectives are as follows: To determine the clinical effectiveness and safety of prophylactic platelet transfusions prior to surgery for people with a low platelet count or platelet dysfunction (inherited or acquired). PMID: 29151812 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 22, 2017 Category: General Medicine Authors: Estcourt LJ, Malouf R, Doree C, Trivella M, Hopewell S, Birchall J Tags: Cochrane Database Syst Rev Source Type: research

Silodosin for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia.
CONCLUSIONS: Silodosin may reduce urologic symptom scores in an appreciable number of men compared to placebo. Quality of life and treatment withdrawals for any reason appears similar. Its efficacy appears similar to that of other alpha blockers (tamsulosin, naftopidil and alfuzosin) but the rate of sexual side effects is likely higher. Our certainty in the estimates of effect was lowered due to study limitations, inconsistency and imprecision. PMID: 29161773 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 22, 2017 Category: General Medicine Authors: Jung JH, Kim J, MacDonald R, Reddy B, Kim MH, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Methylphenidate for children and adolescents with autism spectrum disorder.
We report parent-rated outcomes separately. Risk of bias: we considered three trials to be at high risk of bias due to selective reporting and all trials to be at unclear risk of bias for blinding of participants and assessors, due to the potential for recognising the side effects of methylphenidate. We judged all trials to be at low or unclear risk of bias for other items. Primary outcomes: the meta-analysis suggested that high-dose methylphenidate (0.43 mg/kg/dose to 0.60 mg/kg/dose) had a significant and clinically relevant benefit on hyperactivity, as rated by teachers (SMD -0.78, 95% confidence interval (CI) -1.13 to ...
Source: Cochrane Database of Systematic Reviews - November 21, 2017 Category: General Medicine Authors: Sturman N, Deckx L, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Mass media interventions for smoking cessation in adults.
CONCLUSIONS: There is evidence that comprehensive tobacco control programmes which include mass media campaigns can be effective in changing smoking behaviour in adults, but the evidence comes from a heterogeneous group of studies of variable methodological quality. One state-wide tobacco control programme (Massachusetts) showed positive results up to eight years after the campaign. Another (California) showed positive results during the period of adequate funding and implementation and in final evaluation since the beginning of the programme. Six of nine studies carried out in communities or regions showed some positive e...
Source: Cochrane Database of Systematic Reviews - November 21, 2017 Category: General Medicine Authors: Bala MM, Strzeszynski L, Topor-Madry R Tags: Cochrane Database Syst Rev Source Type: research

Proton pump inhibitors for functional dyspepsia.
CONCLUSIONS: There is evidence that PPIs are effective for the treatment of FD, independent of the dose and duration of treatment compared with placebo. PPIs may be slightly more effective than prokinetics for the treatment of FD; however, the evidence is scarce. The trials evaluating PPIs versus prokinetics are difficult to interpret as they are at risk of bias. Although the effect of these drugs seems to be small, the drugs are well tolerated. PMID: 29161458 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 21, 2017 Category: General Medicine Authors: Pinto-Sanchez MI, Yuan Y, Hassan A, Bercik P, Moayyedi P Tags: Cochrane Database Syst Rev Source Type: research

Neuromuscular electrical stimulation for the prevention of venous thromboembolism.
CONCLUSIONS: Low-quality evidence shows no clear difference in the risk of DVT between NMES and alternative methods of prophylaxis but suggest that NMES may be associated with lower risk of DVT compared with no prophylaxis (moderate-quality evidence) and higher risk of DVT compared with low-dose heparin (low-quality evidence). The best available evidence about the effectiveness of NMES in the prevention of VTE is not adequately robust to allow definitive conclusions. Adequately powered high-quality randomised controlled trials are required to provide adequately robust evidence. PMID: 29161465 [PubMed - as supplied by ...
Source: Cochrane Database of Systematic Reviews - November 21, 2017 Category: General Medicine Authors: Hajibandeh S, Hajibandeh S, Antoniou GA, Scurr JR, Torella F Tags: Cochrane Database Syst Rev Source Type: research

Enzyme replacement therapy for infantile-onset Pompe disease.
CONCLUSIONS: The search found no trials comparing the effectiveness and safety of enzyme replacement therapy to another intervention, no intervention or placebo. One small randomized controlled trial provided no robust evidence for which dosing schedule of alglucosidase alfa was more effective to treat infantile-onset Pompe disease. It is not deemed ethical to proceed with new placebo-controlled trials, therefore a randomized controlled trial with a large sample size comparing different dosing schedules of enzyme replacement therapy is needed. The main clinical outcomes (i.e. cardiac function, invasive ventilation, surviva...
Source: Cochrane Database of Systematic Reviews - November 20, 2017 Category: General Medicine Authors: Chen M, Zhang L, Quan S Tags: Cochrane Database Syst Rev Source Type: research

Virtual reality for stroke rehabilitation.
CONCLUSIONS: We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the ty...
Source: Cochrane Database of Systematic Reviews - November 20, 2017 Category: General Medicine Authors: Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M Tags: Cochrane Database Syst Rev Source Type: research

Tobacco cessation interventions for young people.
CONCLUSIONS: There is limited evidence that either behavioural support or smoking cessation medication increases the proportion of young people that stop smoking in the long-term. Findings are most promising for group-based behavioural interventions, but evidence remains limited for all intervention types. There continues to be a need for well-designed, adequately powered, randomized controlled trials of interventions for this population of smokers. PMID: 29148565 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 17, 2017 Category: General Medicine Authors: Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone-Banks J, Hartmann-Boyce J Tags: Cochrane Database Syst Rev Source Type: research

Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.
CONCLUSIONS: Many factors influence the care that SBAs are able to provide to mothers during childbirth. These include access to training and supervision; staff numbers and workloads; salaries and living conditions; and access to well-equipped, well-organised healthcare facilities with water, electricity, and transport. Other factors that may play a role include the existence of teamwork and of trust, collaboration, and communication between health workers and with mothers. Skilled birth attendants reported many problems tied to all of these factors. PMID: 29148566 [PubMed - as supplied by publisher] (Source: Cochrane...
Source: Cochrane Database of Systematic Reviews - November 17, 2017 Category: General Medicine Authors: Munabi-Babigumira S, Glenton C, Lewin S, Fretheim A, Nabudere H Tags: Cochrane Database Syst Rev Source Type: research

Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under.
CONCLUSIONS: Implications for practiceWe are unable to draw definitive conclusions about the comparative effects of cuffed or non-cuffed endotracheal tubes in children undergoing general anaesthesia. Our confidence is limited by risks of bias, imprecision and indirectness. The lower requirement for exchange of tubes with cuffed ETTs was very low-quality evidence, and the requirement for less medical gas used and consequent lower cost was low-quality evidence. In some cases, tracheal re-intubation is required to guarantee an open airway when adequate oxygenation is difficult after removal of the tube, for a variety of reaso...
Source: Cochrane Database of Systematic Reviews - November 17, 2017 Category: General Medicine Authors: De Orange FA, Andrade RG, Lemos A, Borges PS, Figueiroa JN, Kovatsis PG Tags: Cochrane Database Syst Rev Source Type: research

Interventions for Old World cutaneous leishmaniasis.
CONCLUSIONS: There was very low-certainty evidence to support the effectiveness of itraconazole and paromomycin ointment for OWCL in terms of cure (i.e. microbiological or histopathological cure and percentage of participants completely cured). Both of these interventions incited more adverse effects, which were mild in nature, than their comparisons, but we could draw no conclusions regarding safety due to the very low certainty of the evidence for this outcome.We downgraded the key outcomes in these two comparisons due to high risk of bias, inconsistency between the results, and imprecision. There is a need for large, we...
Source: Cochrane Database of Systematic Reviews - November 17, 2017 Category: General Medicine Authors: Heras-Mosteiro J, Monge-Maillo B, Pinart M, Lopez Pereira P, Garcia-Carrasco E, Campuzano Cuadrado P, Royuela A, Mendez Roman I, López-Vélez R Tags: Cochrane Database Syst Rev Source Type: research

Music therapy for depression.
CONCLUSIONS: Findings of the present meta-analysis indicate that music therapy provides short-term beneficial effects for people with depression. Music therapy added to treatment as usual (TAU) seems to improve depressive symptoms compared with TAU alone. Additionally, music therapy plus TAU is not associated with more or fewer adverse events than TAU alone. Music therapy also shows efficacy in decreasing anxiety levels and improving functioning of depressed individuals.Future trials based on adequate design and larger samples of children and adolescents are needed to consolidate our findings. Researchers should consider i...
Source: Cochrane Database of Systematic Reviews - November 16, 2017 Category: General Medicine Authors: Aalbers S, Fusar-Poli L, Freeman RE, Spreen M, Ket JC, Vink AC, Maratos A, Crawford M, Chen XJ, Gold C Tags: Cochrane Database Syst Rev Source Type: research

Zuclopenthixol dihydrochloride for schizophrenia.
CONCLUSIONS: Zuclopenthixol dihydrochloride appears to cause more EPSEs than clozapine, risperidone or perphenazine, but there was no difference in EPSEs when compared to placebo or chlorpromazine. Similar numbers required hypnotics/sedatives when zuclopenthixol dihydrochloride was compared to sulpiride, and similar numbers of reported side-effects were found when its isomers were compared. The other comparisons did not report adverse-effect data.Reported data indicate zuclopenthixol dihydrochloride demonstrates no difference in mental or global states compared to placebo, chlorpromazine, chlorprothixene, clozapine, halope...
Source: Cochrane Database of Systematic Reviews - November 16, 2017 Category: General Medicine Authors: Bryan EJ, Purcell MA, Kumar A Tags: Cochrane Database Syst Rev Source Type: research

Early erythropoiesis-stimulating agents in preterm or low birth weight infants.
CONCLUSIONS: Early administration of ESAs reduces the use of red blood cell (RBC) transfusions, the volume of RBCs transfused, and donor exposure after study entry. Small reductions are likely to be of limited clinical importance. Donor exposure probably is not avoided, given that all but one study included infants who had received RBC transfusions before trial entry. This update found no significant difference in the rate of ROP (stage ≥ 3) for studies that initiated EPO treatment at less than eight days of age, which has been a topic of concern in earlier versions of this review. Early EPO treatment significantly decr...
Source: Cochrane Database of Systematic Reviews - November 16, 2017 Category: General Medicine Authors: Ohlsson A, Aher SM Tags: Cochrane Database Syst Rev Source Type: research

Preoperative medical therapy before surgery for uterine fibroids.
CONCLUSIONS: A rationale for the use of preoperative medical therapy before surgery for fibroids is to make surgery easier. There is clear evidence that preoperative GnRHa reduces uterine and fibroid volume, and increases preoperative haemoglobin levels, although GnRHa increases the incidence of hot flushes. During hysterectomy, blood loss, operation time and complication rates were also reduced. Evidence suggests that ulipristal acetate may offer similar advantages (reduced fibroid volume and fibroid-related bleeding and increased haemoglobin levels) although replication of these studies is advised before firm conclusions...
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Lethaby A, Puscasiu L, Vollenhoven B Tags: Cochrane Database Syst Rev Source Type: research

Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low- and middle-income countries.
CONCLUSIONS: This body of evidence suggests that unconditional cash transfers (UCTs) may not impact a summary measure of health service use in children and adults in LMICs. However, UCTs probably or may improve some health outcomes (i.e. the likelihood of having had any illness, the likelihood of having been food secure, and the level of dietary diversity), one social determinant of health (i.e. the likelihood of attending school), and healthcare expenditure. The evidence on the relative effectiveness of UCTs and CCTs remains very uncertain. PMID: 29139110 [PubMed - as supplied by publisher] (Source: Cochrane Database...
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Pega F, Liu SY, Walter S, Pabayo R, Saith R, Lhachimi SK Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Electrical cardioversion for atrial fibrillation and flutter.
CONCLUSIONS: Electrical cardioversion (rhythm control) led to a non-significant increase in stroke risk but improved three domains of quality of life. PMID: 29140555 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Mead GE, Elder A, Flapan AD, Cordina J Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Transcendental meditation for the primary prevention of cardiovascular disease.
CONCLUSIONS: Currently, there are few trials with limited outcomes examining the effectiveness of TM for the primary prevention of CVD. Due to the limited evidence to date, we could draw no conclusions as to the effectiveness of TM for the primary prevention of CVD. There was considerable heterogeneity between trials and the included studies were small, short term and at overall serious risk of bias. More and larger long-term, high-quality trials are needed. PMID: 29140556 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 15, 2017 Category: General Medicine Authors: Hartley L, Mavrodaris A, Flowers N, Ernst E, Rees K Tags: Cochrane Database Syst Rev Source Type: research