Benzodiazepines for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: There is only evidence of very low quality from a few small and poorly reported trials on the effect of benzodiazepines as an adjunctive treatment for antipsychotic-induced TD. These inconclusive results mean routine clinical use is not indicated and these treatments remain experimental. New and better trials are indicated in this under-researched area; however, as benzodiazepines are addictive, we feel that other techniques or medications should be adequately evaluated before benzodiazepines are chosen. PMID: 29352477 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 20, 2018 Category: General Medicine Authors: Bergman H, Bhoopathi PS, Soares-Weiser K Tags: Cochrane Database Syst Rev Source Type: research

Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients und...
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Yu Y, Zhang K, Zhang L, Zong H, Meng L, Han R Tags: Cochrane Database Syst Rev Source Type: research

Vitamin E for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation. PMID: 29341067 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Soares-Weiser K, Maayan N, Bergman H Tags: Cochrane Database Syst Rev Source Type: research

Anticholinergic medication for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: Based on currently available evidence, no confident statement can be made about the effectiveness of anticholinergics to treat people with antipsychotic-induced tardive dyskinesia. The same applies for the withdrawal of such medications. Whether the withdrawal of anticholinergics may benefit people with antipsychotic-induced TD should be evaluated in a parallel-group, placebo-controlled randomised trial, with adequate sample size and at least 6 weeks of follow-up. PMID: 29341071 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Bergman H, Soares-Weiser K Tags: Cochrane Database Syst Rev Source Type: research

Gefitinib for advanced non-small cell lung cancer.
Abstract BACKGROUND: The role of gefitinib for the treatment of advanced non-small cell lung cancer (NSCLC) is evolving. We undertook a systematic review to evaluate the available evidence from all randomised trials. OBJECTIVES: To determine the effectiveness and safety of gefitinib as first-line, second-line or maintenance treatment for advanced NSCLC. SEARCH METHODS: We performed searches in CENTRAL, MEDLINE and Embase from inception to 17 February 2017. We handsearched relevant conference proceedings, clinical trial registries and references lists of retrieved articles. SELECTION CRITERIA: We inc...
Source: Cochrane Database of Systematic Reviews - January 16, 2018 Category: General Medicine Authors: Sim EH, Yang IA, Wood-Baker R, Bowman RV, Fong KM Tags: Cochrane Database Syst Rev Source Type: research

Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis.
CONCLUSIONS: While the UCEIS, UCCIS and Mayo Clinic Endoscopic Subscore have undergone extensive validation, none of these instruments have been fully validated and only two studies assessed responsiveness. Further research on the operating properties of these indices is needed given the lack of a fully-validated endoscopic scoring instrument for the evaluation of disease activity in ulcerative colitis. PMID: 29338066 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 16, 2018 Category: General Medicine Authors: Mohammed Vashist N, Samaan M, Mosli MH, Parker CE, MacDonald JK, Nelson SA, Zou GY, Feagan BG, Khanna R, Jairath V Tags: Cochrane Database Syst Rev Source Type: research

Interventions to increase attendance for diabetic retinopathy screening.
CONCLUSIONS: The results of this review provide evidence that QI interventions targeting patients, healthcare professionals or the healthcare system are associated with meaningful improvements in DRS attendance compared to usual care. There was no statistically significant difference between interventions specifically aimed at DRS and those which were part of a general QI strategy for improving diabetes care. This is a significant finding, due to the additional benefits of general QI interventions in terms of improving glycaemic control, vascular risk management and screening for other microvascular complications. It is li...
Source: Cochrane Database of Systematic Reviews - January 15, 2018 Category: General Medicine Authors: Lawrenson JG, Graham-Rowe E, Lorencatto F, Burr J, Bunce C, Francis JJ, Aluko P, Rice S, Vale L, Peto T, Presseau J, Ivers N, Grimshaw JM Tags: Cochrane Database Syst Rev Source Type: research

Prostanoids for critical limb ischaemia.
CONCLUSIONS: We found high-quality evidence showing that prostanoids have no effect on the incidence of total amputations when compared against placebo. Moderate-quality evidence showed small beneficial effects of prostanoids for rest-pain relief and ulcer healing when compared with placebo. Additionally, moderate-quality evidence showed a greater incidence of adverse effects with the use of prostanoids, and low-quality evidence suggests that prostanoids have no effect on cardiovascular mortality when compared with placebo. None of the included studies reported quality of life measurements. The balance between benefits and...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: Vietto V, Franco JV, Saenz V, Cytryn D, Chas J, Ciapponi A Tags: Cochrane Database Syst Rev Source Type: research

Providing physicians with feedback on medication adherence for people with chronic diseases taking long-term medication.
CONCLUSIONS: Across nine studies, we observed little or no evidence that provision of feedback to physicians regarding their patients adherence to prescribed medication improved medication adherence, patient outcomes, or health resource use. Feedback about medication adherence may improve processes of care, but due to the small number of studies assessing this outcome and high risk of bias, we cannot draw firm conclusions on the effect of feedback on this outcome. Future research should use a clear, standardised definition of medication adherence and cluster-randomisation to avoid the risk of contamination. PMID: 2932...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: Zaugg V, Korb-Savoldelli V, Durieux P, Sabatier B Tags: Cochrane Database Syst Rev Source Type: research

Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.
CONCLUSIONS: We have not identified any new high-quality evidence on the efficacy or safety of an anticonvulsant in stopping an acute tonic-clonic convulsion that would inform clinical practice. There appears to be a very low risk of adverse events, specifically respiratory depression. Intravenous lorazepam and diazepam appear to be associated with similar rates of seizure cessation and respiratory depression. Although intravenous lorazepam and intravenous diazepam lead to more rapid seizure cessation, the time taken to obtain intravenous access may undermine this effect. In the absence of intravenous access, buccal midazo...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: McTague A, Martland T, Appleton R Tags: Cochrane Database Syst Rev Source Type: research

Home versus in-patient treatment for deep vein thrombosis.
CONCLUSIONS: Low-quality evidence suggests that patients treated at home with LMWH are less likely to have recurrence of VTE than those treated in hospital. However, data show no clear differences in major or minor bleeding, nor in mortality (low-quality evidence), indicating that home treatment is no worse than in-patient treatment for these outcomes. Because most healthcare systems are moving towards more LMWH usage in the home setting it is unlikely that additional large trials will be undertaken to compare these treatments. Therefore, home treatment is likely to become the norm, and further research will be directed to...
Source: Cochrane Database of Systematic Reviews - January 9, 2018 Category: General Medicine Authors: Othieno R, Okpo E, Forster R Tags: Cochrane Database Syst Rev Source Type: research

Aripiprazole (intramuscular) for psychosis-induced aggression or agitation (rapid tranquillisation).
CONCLUSIONS: The available evidence is of poor quality but there is some evidence aripiprazole is effective compared to placebo and haloperidol, but not when compared to olanzapine. However, considering that evidence comes from only three studies, caution is required in generalising these results to real-world practice. This review firmly highlights the need for more high-quality trials on intramuscular aripiprazole in the management of people with acute aggression or agitation. PMID: 29308601 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Ostinelli EG, Jajawi S, Spyridi S, Sayal K, Jayaram MB Tags: Cochrane Database Syst Rev Source Type: research

Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity.
CONCLUSIONS: Implications for practice: Intravitreal bevacizumab/ranibizumab, when used as monotherapy, reduces the risk of refractive errors during childhood but does not reduce the risk of retinal detachment or recurrence of ROP in infants with type 1 ROP. While the intervention might reduce the risk of recurrence of ROP in infants with zone I ROP, it can potentially result in higher risk of recurrence requiring retreatment in those with zone II ROP. Intravitreal pegaptanib, when used in conjunction with laser therapy, reduces the risk of retinal detachment as well as the recurrence of ROP in infants with type 1 ROP. How...
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Sankar MJ, Sankar J, Chandra P Tags: Cochrane Database Syst Rev Source Type: research

Propofol for the promotion of sleep in adults in the intensive care unit.
CONCLUSIONS: We found insufficient evidence to determine whether administration of propofol would improve the quality and quantity of sleep in adults in the ICU. We noted differences in study designs, methodology, comparative agents and illness severity amongst study participants. We did not pool data and we used the GRADE approach to downgrade the certainty of our evidence to very low. PMID: 29308828 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Radical multimodality therapy for malignant pleural mesothelioma.
CONCLUSIONS: The overall strength of the evidence gathered in this review is low and there is a lack of available evidence to support the use of radical multimodality therapy in routine clinical practice (particularly as one trial suggests greater harm). Given the added cost of multimodality treatment and the possible increase in risk of adverse effects, the lack of evidence of their effectiveness probably means that these interventions should currently be limited to clinical trials alone. PMID: 29309720 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Abdel-Rahman O, Elsayed Z, Mohamed H, Eltobgy M Tags: Cochrane Database Syst Rev Source Type: research

Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.
CONCLUSIONS: There is limited evidence to inform implications for practice. The available data are not of high quality and lack power to detect possible important differences in either benefit or harm. There is an urgent need for high-quality trials evaluating the effectiveness of planned birth at or near term gestation for women with gestational diabetes compared with an expectant approach. PMID: 29303230 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 5, 2018 Category: General Medicine Authors: Biesty LM, Egan AM, Dunne F, Dempsey E, Meskell P, Smith V, Ni Bhuinneain GM, Devane D Tags: Cochrane Database Syst Rev Source Type: research

Botulinum toxin for motor and phonic tics in Tourette's syndrome.
CONCLUSIONS: We are uncertain about botulinum toxin effects in the treatment of focal motor and phonic tics in select cases, as we assessed the quality of the evidence as very low. Additional randomised controlled studies are needed to demonstrate the benefits and harms of botulinum toxin therapy for the treatment of motor and phonic tics in patients with Tourette's syndrome. PMID: 29304272 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 5, 2018 Category: General Medicine Authors: Pandey S, Srivanitchapoom P, Kirubakaran R, Berman BD Tags: Cochrane Database Syst Rev Source Type: research

Embolisation for pulmonary arteriovenous malformation.
CONCLUSIONS: There is no evidence from randomised controlled trials for embolisation of pulmonary arteriovenous malformations. However, randomised controlled trials are not always feasible on ethical grounds. Accumulated data from observational studies suggest that embolisation is a safe procedure which reduces morbidity and mortality. A standardised approach to reporting with long-term follow-up through registry studies can help to strengthen the evidence for embolisation in the absence of randomised controlled trials. PMID: 29298459 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 4, 2018 Category: General Medicine Authors: Hsu CC, Kwan GN, Evans-Barns H, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Cyclophosphamide for connective tissue disease-associated interstitial lung disease.
CONCLUSIONS: This review, which is based on studies of varying methodological quality, demonstrates that overall, in this population, small benefit may be derived from the use of cyclophosphamide in terms of mean difference in % FVC when compared with placebo, but not of the difference in % DLCO, or when compared with mycophenolate. Modest clinical improvement in dyspnoea may be noted with the use of cyclophosphamide. Clinical practice guidelines should advise clinicians to consider individual patient characteristics and to expect only modest benefit at best in preserving FVC. Clinicians should carefully monitor for advers...
Source: Cochrane Database of Systematic Reviews - January 3, 2018 Category: General Medicine Authors: Barnes H, Holland AE, Westall GP, Goh NS, Glaspole IN Tags: Cochrane Database Syst Rev Source Type: research

Treatment of fatigue in amyotrophic lateral sclerosis/motor neuron disease.
CONCLUSIONS: It is impossible to draw firm conclusions about the effectiveness of interventions to improve fatigue for people with ALS/MND as there are few randomised studies, and the quality of available evidence is very low. PMID: 29293261 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 2, 2018 Category: General Medicine Authors: Gibbons C, Pagnini F, Friede T, Young CA Tags: Cochrane Database Syst Rev Source Type: research

Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis.
CONCLUSIONS: Overall, there is insufficient evidence to determine the superiority of different protocols or adjunctive strategies to improve tooth maintenance during SPT. No trials evaluated SPT versus monitoring only. The evidence available for the comparisons evaluated is of low to very low quality, and hampered by dissimilarities in outcome reporting. More trials using uniform definitions and outcomes are required to address the objectives of this review. PMID: 29291254 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 1, 2018 Category: General Medicine Authors: Manresa C, Sanz-Miralles EC, Twigg J, Bravo M Tags: Cochrane Database Syst Rev Source Type: research

Oral anticoagulation in people with cancer who have no therapeutic or prophylactic indication for anticoagulation.
CONCLUSIONS: The existing evidence does not show a mortality benefit from oral anticoagulation in people with cancer but suggests an increased risk for bleeding.Editorial note: this is a living systematic review. Living systematic reviews offer a new approach to review updating in which the review is continually updated, incorporating relevant new evidence, as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review. PMID: 29285754 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 29, 2017 Category: General Medicine Authors: Kahale LA, Hakoum MB, Tsolakian IG, Matar CF, Barba M, Yosuico VED, Terrenato I, Sperati F, Schünemann H, Akl EA Tags: Cochrane Database Syst Rev Source Type: research

Fitness training for cardiorespiratory conditioning after traumatic brain injury.
CONCLUSIONS: There is low-quality evidence that fitness training is effective at improving cardiorespiratory deconditioning after TBI; there is insufficient evidence to draw any definitive conclusions about the other outcomes. Whilst the intervention appears to be accepted by people with TBI, and there is no evidence of harm, more adequately powered and well-designed studies are required to determine a more precise estimate of the effect on cardiorespiratory fitness, as well as the effects across a range of important outcome measures and in people with different characteristics (e.g. children). In the absence of high quali...
Source: Cochrane Database of Systematic Reviews - December 29, 2017 Category: General Medicine Authors: Hassett L, Moseley AM, Harmer AR Tags: Cochrane Database Syst Rev Source Type: research

Elevation of the head during intensive care management in people with severe traumatic brain injury.
CONCLUSIONS: The lack of consistency among studies, scarcity of data and the absence of evidence to show a correlation between physiological measurements such as ICP, CCP and clinical outcomes, mean that we are uncertain about the effects of HBE during intensive care management in people with severe TBI.Well-designed and larger trials that measure long-term clinical outcomes are needed to understand how and when different backrest positions can affect the management of severe TBI. PMID: 29283434 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 28, 2017 Category: General Medicine Authors: Alarcon JD, Rubiano AM, Okonkwo DO, Alarcón J, Martinez-Zapata MJ, Urrútia G, Bonfill Cosp X Tags: Cochrane Database Syst Rev Source Type: research

Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries.
CONCLUSIONS: Low-quality evidence suggests that ART using H-GIC may have a higher risk of restoration failure than conventional treatment for caries lesions in primary teeth. The effects of ART using composite and RM-GIC are uncertain due to the very low quality of the evidence and we cannot rely on the findings. Most studies evaluated the effects of ART on the primary dentition.Well-designed RCTs are required that report on restoration failure at clinically meaningful time points, as well as participant-reported outcomes such as pain and discomfort. Due to the potential confounding effects from the use of different dental...
Source: Cochrane Database of Systematic Reviews - December 28, 2017 Category: General Medicine Authors: Dorri M, Martinez-Zapata MJ, Walsh T, Marinho VC, Sheiham Deceased A, Zaror C Tags: Cochrane Database Syst Rev Source Type: research

Bisphosphonates for advanced prostate cancer.
CONCLUSIONS: Based on low quality evidence, there may be no clinically relevant difference in the proportion of men with pain response between bisphosphonates and control regimens in men with bone metastases from prostate cancer. Bisphosphonates probably decrease the number of skeletal-related events and disease progression. These benefits need to be weighed against the increased risk of renal impairment and nausea in men receiving bisphosphonates. Future studies should explicitly evaluate patient important outcomes such as quality of life and pain by using standardized and comparable assessment tools. PMID: 29278410 ...
Source: Cochrane Database of Systematic Reviews - December 26, 2017 Category: General Medicine Authors: Macherey S, Monsef I, Jahn F, Jordan K, Yuen KK, Heidenreich A, Skoetz N Tags: Cochrane Database Syst Rev Source Type: research

Exercise for intermittent claudication.
Abstract BACKGROUND: Exercise programmes are a relatively inexpensive, low-risk option compared with other, more invasive therapies for treatment of leg pain on walking (intermittent claudication (IC)). This is the fourth update of a review first published in 1998. OBJECTIVES: Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication. Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease, reducing cardiovascu...
Source: Cochrane Database of Systematic Reviews - December 26, 2017 Category: General Medicine Authors: Lane R, Harwood A, Watson L, Leng GC Tags: Cochrane Database Syst Rev Source Type: research

Newborn screening for galactosaemia.
CONCLUSIONS: We were unable to identify any eligible studies for inclusion in this review and hence it is not possible to draw any conclusions based on randomised controlled studies. However, we are aware of uncontrolled studies which support the efficacy of newborn screening for galactosaemia. There are a number of reviews and economic analyses of non-trial literature suggesting that screening is appropriate. PMID: 29274129 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 23, 2017 Category: General Medicine Authors: Lak R, Yazdizadeh B, Davari M, Nouhi M, Kelishadi R Tags: Cochrane Database Syst Rev Source Type: research

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.
CONCLUSIONS: Targeting continent antenatal women early in pregnancy and offering a structured PFMT programme may prevent the onset of urinary incontinence in late pregnancy and postpartum. However, the cost-effectiveness of this is unknown. Population approaches (recruiting antenatal women regardless of continence status) may have a smaller effect on urinary incontinence, although the reasons for this are unclear. It is uncertain whether a population-based approach for delivering postnatal PFMT is effective in reducing urinary incontinence. Uncertainty surrounds the effects of PFMT as a treatment for urinary incontinence i...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC Tags: Cochrane Database Syst Rev Source Type: research

Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.
CONCLUSIONS: Our review shows that compared to placebo, the biologics ixekizumab, secukinumab, brodalumab, guselkumab, certolizumab, and ustekinumab are the best choices for achieving PASI 90 in people with moderate to severe psoriasis on the basis of moderate- to high-certainty evidence. At class level, the biologic treatments anti-IL17, anti-IL12/23, anti-IL23, and anti-TNF alpha were significantly more effective than the small molecules and the conventional systemic agents, too. This NMA evidence is limited to induction therapy (outcomes were measured between 12 to 16 weeks after randomisation) and is not sufficiently r...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Sbidian E, Chaimani A, Garcia-Doval I, Do G, Hua C, Mazaud C, Droitcourt C, Hughes C, Ingram JR, Naldi L, Chosidow O, Le Cleach L Tags: Cochrane Database Syst Rev Source Type: research

Electrical stimulation with non-implanted devices for stress urinary incontinence in women.
CONCLUSIONS: The current evidence base indicated that electrical stimulation is probably more effective than no active or sham treatment, but it is not possible to say whether ES is similar to PFMT or other active treatments in effectiveness or not. Overall, the quality of the evidence was too low to provide reliable results. Without sufficiently powered trials measuring clinically important outcomes, such as subjective assessment of urinary incontinence, we cannot draw robust conclusions about the overall effectiveness or cost-effectiveness of electrical stimulation for stress urinary incontinence in women. PMID: 292...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Stewart F, Berghmans B, Bø K, Glazener CM Tags: Cochrane Database Syst Rev Source Type: research

Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes.
CONCLUSIONS: There was no evidence from RCTs that evaluated the effects of exercise interventions for improving maternal and fetal outcomes in women with pre-existing diabetes.Good quality, large randomised controlled trials are urgently needed to identify exercise interventions that are safe, and improve health outcomes for women with pre-existing diabetes and their babies. Future studies in this area could utilise the standardised outcomes in this review, in order to improve consistency between trials in this area, and aid future meta-analysis. PMID: 29264871 [PubMed - as supplied by publisher] (Source: Cochrane Dat...
Source: Cochrane Database of Systematic Reviews - December 21, 2017 Category: General Medicine Authors: Brown J, Ceysens G, Boulvain M Tags: Cochrane Database Syst Rev Source Type: research

Nebulised hypertonic saline solution for acute bronchiolitis in infants.
Abstract BACKGROUND: Airway oedema (swelling) and mucus plugging are the principal pathological features in infants with acute viral bronchiolitis. Nebulised hypertonic saline solution (≥ 3%) may reduce these pathological changes and decrease airway obstruction. This is an update of a review first published in 2008, and previously updated in 2010 and 2013. OBJECTIVES: To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants with acute bronchiolitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE Epub Ahead of Print, ...
Source: Cochrane Database of Systematic Reviews - December 21, 2017 Category: General Medicine Authors: Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP Tags: Cochrane Database Syst Rev Source Type: research

Respiratory muscle training for multiple sclerosis.
CONCLUSIONS: This review provides low-quality evidence that resistive inspiratory muscle training with a resistive threshold device is moderately effective postintervention for improving predicted maximal inspiratory pressure in people with mild to moderate MS, whereas expiratory muscle training showed no significant effects. The sustainability of the favourable effect of inspiratory muscle training is unclear, as is the impact of the observed effects on quality of life. PMID: 29267988 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 21, 2017 Category: General Medicine Authors: Rietberg MB, Veerbeek JM, Gosselink R, Kwakkel G, van Wegen EE Tags: Cochrane Database Syst Rev Source Type: research

School dental screening programmes for oral health.
CONCLUSIONS: The trials included in this review evaluated short-term effects of screening, assessing follow-up periods of three to eight months. We found very low certainty evidence that was insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening there was no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty e...
Source: Cochrane Database of Systematic Reviews - December 21, 2017 Category: General Medicine Authors: Arora A, Khattri S, Ismail NM, Kumbargere Nagraj S, Prashanti E Tags: Cochrane Database Syst Rev Source Type: research

Interventions for managing taste disturbances.
CONCLUSIONS: We found very low-quality evidence that was insufficient to conclude on the role of zinc supplements to improve taste acuity reported by patients and very low-quality evidence that zinc supplements improve taste acuity in patients with zinc deficiency/idiopathic taste disorders. We did not find any evidence to conclude the role of zinc supplements for improving taste discrimination, or any evidence addressing health-related quality of life due to taste disorders.We found very low-quality evidence that is not sufficient to conclude on the role of acupuncture for improving taste discrimination in cases of idiopa...
Source: Cochrane Database of Systematic Reviews - December 20, 2017 Category: General Medicine Authors: Kumbargere Nagraj S, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A Tags: Cochrane Database Syst Rev Source Type: research

Metal-free materials for fixed prosthodontic restorations.
CONCLUSIONS: There is insufficient evidence to support or refute the effectiveness of metal-free materials for fixed prosthodontic treatment over metal-ceramic or other type of standard restorations. The overall quality of existing evidence was very low, therefore great caution should be exercised when generalising the results of the included trials. Until more evidence becomes available clinicians should continue to base decisions on which material to use for fixed prosthodontic treatment on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients. Ther...
Source: Cochrane Database of Systematic Reviews - December 20, 2017 Category: General Medicine Authors: Poggio CE, Ercoli C, Rispoli L, Maiorana C, Esposito M Tags: Cochrane Database Syst Rev Source Type: research

Bilateral versus unilateral hearing aids for bilateral hearing impairment in adults.
CONCLUSIONS: This review identified only four studies comparing the use of one hearing aid with two. The studies were small and included participants of widely varying ages. There was also considerable variation in the types and degree of sensorineural hearing loss that the participants were experiencing.For the most part, the types of hearing aid evaluated would now be regarded, in high-income settings, as 'old technology', with only one study looking at 'modern' digital aids. However, the relevance of this is uncertain, as this review did not evaluate the differences in outcomes between the different types of technology....
Source: Cochrane Database of Systematic Reviews - December 19, 2017 Category: General Medicine Authors: Schilder AG, Chong LY, Ftouh S, Burton MJ Tags: Cochrane Database Syst Rev Source Type: research

Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.
CONCLUSIONS: Based on this systematic review and meta-analysis of 31 randomized controlled trials including 8672 patients, moderate certainty evidence suggests that probiotics are effective for preventing CDAD (NNTB = 42 patients, 95% CI 32 to 58). Our post hoc subgroup analyses to explore heterogeneity indicated that probiotics are effective among trials with a CDAD baseline risk>5% (NNTB = 12; moderate certainty evidence), but not among trials with a baseline risk ≤5% (low to moderate certainty evidence). Although adverse effects were reported among 32 included trials, there were more adverse events among patients ...
Source: Cochrane Database of Systematic Reviews - December 19, 2017 Category: General Medicine Authors: Goldenberg JZ, Yap C, Lytvyn L, Lo CK, Beardsley J, Mertz D, Johnston BC Tags: Cochrane Database Syst Rev Source Type: research

Long-acting inhaled bronchodilators for cystic fibrosis.
CONCLUSIONS: Neither long-acting beta-2 agonists nor long-acting muscarinic antagonist bronchodilators demonstrate improvement in our primary outcome of FEV1. No difference was observed between intervention and placebo in terms of quality of life or adverse events. The quality of evidence for the use of beta-2 agonists was very low. The use of a long-acting inhaled bronchodilator may help to reduce the burden of treatment for people with cystic fibrosis as it is taken less often than a short-acting inhaled bronchodilator, but future trials would benefit from looking at the effects on our primary outcomes (spirometric chang...
Source: Cochrane Database of Systematic Reviews - December 19, 2017 Category: General Medicine Authors: Smith S, Edwards CT Tags: Cochrane Database Syst Rev Source Type: research

Singing for adults with chronic obstructive pulmonary disease (COPD).
CONCLUSIONS: There is low to very low-quality evidence that singing is safe for people with COPD and improves physical health (as measured by the SF-36 physical component score), but not dyspnoea or respiratory-specific quality of life. The evidence is limited due to the low number of studies and the small sample size of each study. No evidence exists examining the long-term effect of singing for people with COPD. The absence of studies examining singing performed in conjunction with pulmonary rehabilitation precludes the formulation of conclusions about the effects of singing in this context. More randomised controlled tr...
Source: Cochrane Database of Systematic Reviews - December 19, 2017 Category: General Medicine Authors: McNamara RJ, Epsley C, Coren E, McKeough ZJ Tags: Cochrane Database Syst Rev Source Type: research

Bisphosphonates in multiple myeloma: an updated network meta-analysis.
CONCLUSIONS: Use of bisphosphonates in participants with MM reduces pathological vertebral fractures, SREs and pain. Bisphosphonates were associated with an increased risk of developing ONJ. For every 1000 participants treated with bisphosphonates, about one patient will suffer from the ONJ. We found no evidence of superiority of any specific aminobisphosphonate (zoledronate, pamidronate or ibandronate) or non-aminobisphosphonate (etidronate or clodronate) for any outcome. However, zoledronate was found to be better than placebo and first-generation bisposphonate (etidronate) in pooled direct and indirect analyses for impr...
Source: Cochrane Database of Systematic Reviews - December 18, 2017 Category: General Medicine Authors: Mhaskar R, Kumar A, Miladinovic B, Djulbegovic B Tags: Cochrane Database Syst Rev Source Type: research

Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent.
CONCLUSIONS: The current literature does not provide evidence that suggests a survival benefit from adding immunotherapy (excluding checkpoint inhibitors) to conventional curative surgery or radiotherapy, for patients with localised NSCLC (stages I to III). The addition of vaccine-based immunotherapy might increase the risk of adverse events. Several ongoing trials with immune checkpoints inhibitors (PD-1/PD-L1) might bring new insights for role of immunotherapy for patients with stages I to III NSCLC. PMID: 29247502 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 16, 2017 Category: General Medicine Authors: Zhu J, Li R, Tiselius E, Roudi R, Teghararian O, Suo C, Song H Tags: Cochrane Database Syst Rev Source Type: research

Nursing interventions for smoking cessation.
CONCLUSIONS: There is moderate quality evidence that behavioural support to motivate and sustain smoking cessation delivered by nurses can lead to a modest increase in the number of people who achieve prolonged abstinence. There is insufficient evidence to assess whether more intensive interventions, those incorporating additional follow-up, or those incorporating pathophysiological feedback are more effective than one-off support. There was no evidence that the effect of support differed by patient group or across healthcare settings. PMID: 29243221 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 15, 2017 Category: General Medicine Authors: Rice VH, Heath L, Livingstone-Banks J, Hartmann-Boyce J Tags: Cochrane Database Syst Rev Source Type: research

Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data.
CONCLUSIONS: Overall, the high-quality evidence provided by this review supports current guidance (e.g. NICE) that carbamazepine and lamotrigine are suitable first-line treatments for individuals with partial onset seizures and also demonstrates that levetiracetam may be a suitable alternative. High-quality evidence from this review also supports the use of sodium valproate as the first-line treatment for individuals with generalised tonic-clonic seizures (with or without other generalised seizure types) and also demonstrates that lamotrigine and levetiracetam would be suitable alternatives to either of these first-line tr...
Source: Cochrane Database of Systematic Reviews - December 15, 2017 Category: General Medicine Authors: Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

One-incision versus two-incision techniques for arthroscopically assisted anterior cruciate ligament reconstruction in adults.
CONCLUSIONS: The very low-quality and often absent evidence means that we are uncertain whether one-incision arthroscopically assisted ACL reconstruction techniques yield better, worse, or equivalent results compared with two-incision techniques in terms of short-, intermediate-, or long-term subjective function, quality of life, adverse outcomes, activity levels, and objectively rated knee function. The evidence was available only for single-bundle ACL reconstruction using patella tendon grafts.When considering priorities for high-quality randomised trials on techniques for ACL reconstruction, it is important to note the ...
Source: Cochrane Database of Systematic Reviews - December 15, 2017 Category: General Medicine Authors: Rezende FC, Moraes VY, Franciozi CE, Debieux P, Luzo MV, Belloti JC Tags: Cochrane Database Syst Rev Source Type: research

Secondary prevention of recurrent venous thromboembolism after initial oral anticoagulation therapy in patients with unprovoked venous thromboembolism.
CONCLUSIONS: Evidence is currently insufficient to permit definitive conclusions concerning the effectiveness and safety of extended thromboprophylaxis in prevention of recurrent VTE after initial oral anticoagulation therapy among participants with unprovoked VTE. Additional good-quality large-scale randomised controlled trials are required before firm conclusions can be reached. PMID: 29244199 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 15, 2017 Category: General Medicine Authors: Robertson L, Yeoh SE, Ramli A Tags: Cochrane Database Syst Rev Source Type: research

Antioxidants for preventing and reducing muscle soreness after exercise.
CONCLUSIONS: There is moderate to low-quality evidence that high dose antioxidant supplementation does not result in a clinically relevant reduction of muscle soreness after exercise at up to 6 hours or at 24, 48, 72 and 96 hours after exercise. There is no evidence available on subjective recovery and only limited evidence on the adverse effects of taking antioxidant supplements. The findings of, and messages from, this review provide an opportunity for researchers and other stakeholders to come together and consider what are the priorities, and underlying justifications, for future research in this area. PMID: 29238...
Source: Cochrane Database of Systematic Reviews - December 14, 2017 Category: General Medicine Authors: Ranchordas MK, Rogerson D, Soltani H, Costello JT Tags: Cochrane Database Syst Rev Source Type: research

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.
CONCLUSIONS: The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infarction and ischaemic stroke, and an increased risk of major and minor bleeding compared with aspirin alone. According to GRADE criteria, the quality of evidence was moderate for all outcomes except all-cause mortality (low quality evidence) and adverse events (very low quality evidence). PMID: 29240976 [PubMed - as supplied by publisher] (Source: ...
Source: Cochrane Database of Systematic Reviews - December 14, 2017 Category: General Medicine Authors: Squizzato A, Bellesini M, Takeda A, Middeldorp S, Donadini MP Tags: Cochrane Database Syst Rev Source Type: research

Corticosteroids for pneumonia.
CONCLUSIONS: Corticosteroid therapy reduced mortality and morbidity in adults with severe CAP; the number needed to treat for an additional beneficial outcome was 18 patients (95% CI 12 to 49) to prevent one death. Corticosteroid therapy reduced morbidity, but not mortality, for adults and children with non-severe CAP. Corticosteroid therapy was associated with more adverse events, especially hyperglycaemia, but the harms did not seem to outweigh the benefits. PMID: 29236286 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 13, 2017 Category: General Medicine Authors: Stern A, Skalsky K, Avni T, Carrara E, Leibovici L, Paul M Tags: Cochrane Database Syst Rev Source Type: research