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Surgery for nasal polyposis in cystic fibrosis
CONCLUSIONS: Very low-certainty evidence means we are not certain if endoscopic sinus surgery to treat chronic rhinosinusitis with nasal polyposis in cystic fibrosis is effective. Future research should be multicentric to increase the number of participants and increase statistical power. Adequate randomization and allocation concealment are important to guarantee that the groups are similar. Blinding, however, may not be possible in an ethical trial; even without blinding, results can achieve high-level evidence if the outcomes used are objective parameters. Future research should follow participants of all ages for at le...
Source: Cochrane Database of Systematic Reviews - December 8, 2023 Category: General Medicine Authors: Paula Ribeiro Lopes Almeida Osmar C Person Maria Es Puga Álvaro N Atallah Virginia Fm Trevisani Source Type: research

Anticholinergic deprescribing interventions for reducing risk of cognitive decline or dementia in older adults with and without prior cognitive impairment
CONCLUSIONS: There is insufficient evidence to reach any conclusions on the effects of anticholinergic burden reduction interventions on cognitive outcomes in older adults with or without prior cognitive impairment. The evidence from RCTs was of very low certainty so cannot support or refute the hypothesis that actively reducing or stopping prescription of medications with anticholinergic properties can improve cognitive outcomes in older people. There is no evidence from RCTs that anticholinergic burden reduction interventions improve other clinical outcomes such as mortality, quality of life, clinical global impression, ...
Source: Cochrane Database of Systematic Reviews - December 8, 2023 Category: General Medicine Authors: Martin Taylor-Rowan Ahmed A Alharthi Anna H Noel-Storr Phyo K Myint Carrie Stewart Jenny McCleery Terry J Quinn Source Type: research

Interventions for improving coverage of childhood immunisation in low- and middle-income countries
CONCLUSIONS: Health education, home-based records, a combination of involvement of community leaders with health provider intervention, and integration of immunisation services may improve vaccine uptake. The certainty of the evidence for the included interventions ranged from moderate to very low. Low certainty of the evidence implies that the true effect of the interventions might be markedly different from the estimated effect. Further, more rigorous RCTs are, therefore, required to generate high-certainty evidence to inform policy and practice.PMID:38054505 | PMC:PMC10698843 | DOI:10.1002/14651858.CD008145.pub4 (Source...
Source: Cochrane Database of Systematic Reviews - December 6, 2023 Category: General Medicine Authors: Angela Oyo-Ita Olabisi Oduwole Dachi Arikpo Emmanuel E Effa Ekpereonne B Esu Yusentha Balakrishna Moriam T Chibuzor Chioma M Oringanje Chukwuemeka E Nwachukwu Charles S Wiysonge Martin M Meremikwu Source Type: research

Inhaled corticosteroids with combination inhaled long-acting beta2-agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease
CONCLUSIONS: The available evidence suggests that triple therapy may reduce rates of COPD exacerbations (low-certainty evidence) and results in an improvement in health-related quality of life (high-certainty evidence) compared to combination LABA/LAMA inhalers, but probably confers an increased pneumonia risk as a serious adverse event (moderate-certainty evidence). Triple therapy probably improves respiratory symptoms and may improve lung function (moderate- and low-certainty evidence, respectively); however, these benefits do not appear to be clinically significant. Triple therapy may reduce the risk of all-cause mortal...
Source: Cochrane Database of Systematic Reviews - December 6, 2023 Category: General Medicine Authors: Wouter H van Geffen Daniel J Tan Julia Ae Walters E Haydn Walters Source Type: research

Limited versus full sternotomy for aortic valve replacement
CONCLUSIONS: The evidence was of very low to moderate certainty. Sample sizes were small and underpowered to demonstrate differences in some outcomes. Clinical heterogeneity was also noted. Considering these limitations, there may be little to no effect on mortality. Differences in extracorporeal support times are uncertain, comparing upper hemi-sternotomy to full sternotomy for aortic valve replacement. Before widespread adoption of the minimally invasive approach can be recommended, there is a need for a well-designed and adequately powered prospective randomised controlled trial. Such a study would benefit from also per...
Source: Cochrane Database of Systematic Reviews - December 6, 2023 Category: General Medicine Authors: Bilal H Kirmani Sion G Jones Andrew Muir S Chris Malaisrie Darryl A Chung Richard Jnn Williams Enoch Akowuah Source Type: research

Corticosteroids for preventing postherpetic neuralgia
CONCLUSIONS: Based on the current available evidence, we are uncertain about the effects of corticosteroids given orally during an acute herpes zoster infection on preventing postherpetic neuralgia. Corticosteroids given orally or intramuscularly may result in little to no difference in the risk of adverse events in people with acute herpes zoster. Some researchers have recommended using corticosteroids to relieve the zoster-associated pain in the acute phase of the disease. If further research is designed to evaluate the efficacy of corticosteroids for herpes zoster, long-term follow-up should be included to observe their...
Source: Cochrane Database of Systematic Reviews - December 5, 2023 Category: General Medicine Authors: Xin Jiang Yanbo Li Ning Chen Muke Zhou Li He Source Type: research

Nirmatrelvir combined with ritonavir for preventing and treating COVID-19
CONCLUSIONS: Low-certainty evidence suggests nirmatrelvir/ritonavir reduces the risk of all-cause mortality and hospital admission or death in high-risk, unvaccinated COVID-19 outpatients infected with the Delta variant of SARS-CoV-2. There is low- to moderate-certainty evidence of the safety of nirmatrelvir/ritonavir. Very low-certainty evidence exists regarding the effects of nirmatrelvir/ritonavir on all-cause mortality and viral clearance in mildly to moderately affected, mostly unvaccinated COVID-19 inpatients infected with the Omicron variant of SARS-CoV-2. Insufficient and inconsistent information prevents the asses...
Source: Cochrane Database of Systematic Reviews - November 30, 2023 Category: General Medicine Authors: Stefanie Reis Maria-Inti Metzendorf Rebecca Kuehn Maria Popp Ildiko Gagyor Peter Kranke Patrick Meybohm Nicole Skoetz Stephanie Weibel Source Type: research

Methods to increase response to postal and electronic questionnaires
CONCLUSIONS: Researchers using postal and electronic questionnaires can increase response using the strategies shown to be effective in this Cochrane review.PMID:38032037 | PMC:PMC10687884 | DOI:10.1002/14651858.MR000008.pub5 (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 30, 2023 Category: General Medicine Authors: Philip James Edwards Ian Roberts Mike J Clarke Carolyn DiGuiseppi Benjamin Woolf Chloe Perkins Source Type: research

Progestogens for prevention of luteinising hormone (LH) surge in women undergoing controlled ovarian hyperstimulation as part of an assisted reproductive technology (ART) cycle
CONCLUSIONS: Little or no differences in LBR may exist when comparing MPA 4 mg with GnRH agonists in normo-responders. OPCR may be slightly increased in the MPA 4 mg group, but MPA 4 mg reduces the doses of gonadotropins in comparison to GnRH agonists. Little or no differences in OPCR may exist between progestogens and GnRH antagonists in normo-responders and donors. However, micronised progesterone could improve by 2 to 6 MII oocytes. When comparing one progestogen to another, dydrogesterone suggested slightly lower OPCR than MPA and micronised progesterone, and MPA suggested slightly lower OPCR than the micronised proges...
Source: Cochrane Database of Systematic Reviews - November 30, 2023 Category: General Medicine Authors: Demi án Glujovsky Romina Pesce Mariana Miguens Carlos Sueldo Agust ín Ciapponi Source Type: research