Histologic scoring indices for evaluation of disease activity in Crohn's disease.
CONCLUSIONS: Currently there is no fully validated histological scoring index for evaluation of Crohn's disease activity. Development of a validated histological scoring index for Crohn's disease is a clinical and research priority. PMID: 28731502 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 21, 2017 Category: General Medicine Authors: Novak G, Parker CE, Pai RK, MacDonald JK, Feagan BG, Sandborn WJ, D'Haens G, Jairath V, Khanna R Tags: Cochrane Database Syst Rev Source Type: research

Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients.
CONCLUSIONS: In reversing first acute cellular rejection and preventing graft loss, any antibody is probably better than steroid, but there is little or no difference in subsequent rejection and patient survival. In reversing steroid-resistant rejection there was little or no difference between different antibodies over a period of 12 months, with limited data beyond that time frame. In treating acute humoral rejection, there was no evidence that the use of antibody therapy conferred additional benefit in terms of reversal of rejection, or death or graft loss.Although this is an updated review, the majority of newer includ...
Source: Cochrane Database of Systematic Reviews - July 20, 2017 Category: General Medicine Authors: Webster AC, Wu S, Tallapragada K, Park MY, Chapman JR, Carr SJ Tags: Cochrane Database Syst Rev Source Type: research

ProSeal versus Classic laryngeal mask airway (LMA) for positive pressure ventilation in adults undergoing elective surgery.
Abstract BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery. ...
Source: Cochrane Database of Systematic Reviews - July 20, 2017 Category: General Medicine Authors: Qamarul Hoda M, Samad K, Ullah H Tags: Cochrane Database Syst Rev Source Type: research

Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.
CONCLUSIONS: Given the imprecision of the estimate, results of this systematic review are consistent with beneficial or detrimental effects of a supine head midline position versus a lateral position and do not provide a definitive answer to the review question. PMID: 28727900 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 20, 2017 Category: General Medicine Authors: Romantsik O, Calevo MG, Bruschettini M Tags: Cochrane Database Syst Rev Source Type: research

Occupational therapy for adults with problems in activities of daily living after stroke.
CONCLUSIONS: We found low-quality evidence that occupational therapy targeted towards activities of daily living after stroke can improve performance in activities of daily living and reduce the risk of deterioration in these abilities. Because the included studies had methodological flaws, this research does not provide a reliable indication of the likely effect of occupational therapy for adults with stroke. PMID: 28721691 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2017 Category: General Medicine Authors: Legg LA, Lewis SR, Schofield-Robinson OJ, Drummond A, Langhorne P Tags: Cochrane Database Syst Rev Source Type: research

Opioids for cancer-related pain in children and adolescents.
CONCLUSIONS: No conclusions can be drawn about efficacy or harm in the use of opioids to treat chronic cancer-related pain in children and adolescents. As a result, there is no RCT evidence to support or refute the use of opioids to treat cancer-related pain in children and adolescents. PMID: 28722116 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 19, 2017 Category: General Medicine Authors: Wiffen PJ, Cooper TE, Anderson AK, Gray AL, Grégoire MC, Ljungman G, Zernikow B Tags: Cochrane Database Syst Rev Source Type: research

Saline irrigation for the management of skin extravasation injury in neonates.
Abstract BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase inf...
Source: Cochrane Database of Systematic Reviews - July 19, 2017 Category: General Medicine Authors: Gopalakrishnan PN, Goel N, Banerjee S Tags: Cochrane Database Syst Rev Source Type: research

Felbamate as an add-on therapy for refractory partial epilepsy.
CONCLUSIONS: In view of the methodological deficiencies, limited number of individual studies and differences in outcome measures, we have found no reliable evidence to support the use of felbamate as an add-on therapy in people with refractory partial-onset epilepsy. A large-scale, randomised controlled trial conducted over a longer period of time is required to inform clinical practice. PMID: 28718506 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 18, 2017 Category: General Medicine Authors: Shi LL, Dong J, Ni H, Geng J, Wu T Tags: Cochrane Database Syst Rev Source Type: research

Deep brain and cortical stimulation for epilepsy.
CONCLUSIONS: Except for one very small RCT, only short-term RCTs on intracranial neurostimulation for epilepsy are available. Compared to sham stimulation, one to three months of anterior thalamic DBS ((multi)focal epilepsy), responsive ictal onset zone stimulation ((multi)focal epilepsy) and hippocampal DBS (temporal lobe epilepsy) moderately reduce seizure frequency in refractory epilepsy patients. Anterior thalamic DBS is associated with higher rates of self-reported depression and subjective memory impairment. There is insufficient evidence to make firm conclusive statements on the efficacy and safety of hippocampal DB...
Source: Cochrane Database of Systematic Reviews - July 18, 2017 Category: General Medicine Authors: Sprengers M, Vonck K, Carrette E, Marson AG, Boon P Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Drugs for preventing postoperative nausea and vomiting.
CONCLUSIONS: Either nausea or vomiting is reported to affect, at most, 80 out of 100 people after surgery. If all 100 of these people are given one of the listed drugs, about 28 would benefit and 72 would not. Nausea and vomiting are usually less common and, therefore, drugs are less useful. For 100 people, of whom 30 would vomit or feel sick after surgery if given placebo, 10 people would benefit from a drug and 90 would not. Between one to five patients out of every 100 people may experience a mild side effect, such as sedation or headache, when given an antiemetic drug. Collaborative research should focus on determining...
Source: Cochrane Database of Systematic Reviews - July 17, 2017 Category: General Medicine Authors: Carlisle J, Stevenson CA Tags: Cochrane Database Syst Rev Source Type: research

Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes.
CONCLUSIONS: Sustained inflation was not better than intermittent ventilation for reducing mortality in the delivery room and during hospitalisation. The number of events across trials was limited, so differences cannot be excluded. When considering secondary outcomes, such as need for intubation, need for or duration of respiratory support, or bronchopulmonary dysplasia, we found no evidence of relevant benefit for sustained inflation over intermittent ventilation. The duration of mechanical ventilation was shortened in the SLI group. This result should be interpreted cautiously, as it can be influenced by study character...
Source: Cochrane Database of Systematic Reviews - July 14, 2017 Category: General Medicine Authors: Bruschettini M, O'Donnell CP, Davis PG, Morley CJ, Moja L, Zappettini S, Calevo MG Tags: Cochrane Database Syst Rev Source Type: research

Oral antifungal medication for toenail onychomycosis.
CONCLUSIONS: We found high-quality evidence that compared to placebo, terbinafine and azoles are effective treatments for the mycological and clinical cure of onychomycosis, with moderate-quality evidence of excess harm. However, terbinafine probably leads to better cure rates than azoles with the same risk of adverse events (moderate-quality evidence).Azole and griseofulvin were shown to probably have a similar effect on cure, but more adverse events appeared to occur with the latter (moderate-quality evidence). Terbinafine may improve cure and be associated with fewer adverse effects when compared to griseofulvin (low-qu...
Source: Cochrane Database of Systematic Reviews - July 14, 2017 Category: General Medicine Authors: Kreijkamp-Kaspers S, Hawke K, Guo L, Kerin G, Bell-Syer SE, Magin P, Bell-Syer SV, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Psychosocial interventions for fatigue during cancer treatment with palliative intent.
CONCLUSIONS: We found little evidence around the benefits of psychosocial interventions provided to reduce fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. Additional studies with larger samples are required to assess whether psychosocial interventions are beneficial for addressing fatigue in patients with incurable cancer. PMID: 28708236 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 14, 2017 Category: General Medicine Authors: Poort H, Peters M, Bleijenberg G, Gielissen MF, Goedendorp MM, Jacobsen P, Verhagen S, Knoop H Tags: Cochrane Database Syst Rev Source Type: research

Psychological interventions for acute pain after open heart surgery.
CONCLUSIONS: In line with the conclusions of our previous review, there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery. We found moderate-quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery. Given the small numbers of studies, it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use, mobility, and time to extubation respectively on adverse events or harms of psychological intervent...
Source: Cochrane Database of Systematic Reviews - July 13, 2017 Category: General Medicine Authors: Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S Tags: Cochrane Database Syst Rev Source Type: research

Interventions for treating lymphocytic colitis.
CONCLUSIONS: Low quality evidence suggests that budesonide may be effective for the treatment of active lymphocytic colitis. This benefit needs to be confirmed by a large placebo -controlled trial. Low quality evidence also suggests that mesalazine with or without cholestyramine and beclometasone dipropionate may be effective for the treatment of lymphocytic colitis, however this needs to be confirmed by large placebo-controlled studies. No conclusions can be made regarding bismuth subsalicylate due to the very small number of patients in the study, Further trials studying interventions for lymphocytic colitis are warrante...
Source: Cochrane Database of Systematic Reviews - July 13, 2017 Category: General Medicine Authors: Chande N, Al Yatama N, Bhanji T, Nguyen TM, McDonald JW, MacDonald JK Tags: Cochrane Database Syst Rev Source Type: research

Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease.
CONCLUSIONS: Data from good quality randomised controlled trials show that NIV is beneficial as a first-line intervention in conjunction with usual care for reducing the likelihood of mortality and endotracheal intubation in patients admitted with acute hypercapnic respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease (COPD). The magnitude of benefit for these outcomes appears similar for patients with acidosis of a mild (pH 7.30 to 7.35) versus a more severe nature (pH
Source: Cochrane Database of Systematic Reviews - July 13, 2017 Category: General Medicine Authors: Osadnik CR, Tee VS, Carson-Chahhoud KV, Picot J, Wedzicha JA, Smith BJ Tags: Cochrane Database Syst Rev Source Type: research

Early supported discharge services for people with acute stroke.
Abstract BACKGROUND: People with stroke conventionally receive a substantial part of their rehabilitation in hospital. Services have now been developed that offer people in hospital an early discharge with rehabilitation at home (early supported discharge: ESD). OBJECTIVES: To establish if, in comparison with conventional care, services that offer people in hospital with stroke a policy of early discharge with rehabilitation provided in the community (ESD) can: 1) accelerate return home, 2) provide equivalent or better patient and carer outcomes, 3) be acceptable satisfactory to patients and carers, and 4) ha...
Source: Cochrane Database of Systematic Reviews - July 13, 2017 Category: General Medicine Authors: Langhorne P, Baylan S, Early Supported Discharge Trialists Tags: Cochrane Database Syst Rev Source Type: research

Antiseptics for burns.
CONCLUSIONS: It was often uncertain whether antiseptics were associated with any difference in healing, infections, or other outcomes. Where there is moderate or high certainty evidence, decision makers need to consider the applicability of the evidence from the comparison to their patients. Reporting was poor, to the extent that we are not confident that most trials are free from risk of bias. PMID: 28700086 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 12, 2017 Category: General Medicine Authors: Norman G, Christie J, Liu Z, Westby MJ, Jefferies JM, Hudson T, Edwards J, Mohapatra DP, Hassan IA, Dumville JC Tags: Cochrane Database Syst Rev Source Type: research

Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults.
CONCLUSIONS: There is no high-quality evidence to support or refute the use of NSAIDs alone or in combination with opioids for the three steps of the three-step WHO cancer pain ladder. There is very low-quality evidence that some people with moderate or severe cancer pain can obtain substantial levels of benefit within one or two weeks. PMID: 28700091 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 12, 2017 Category: General Medicine Authors: Derry S, Wiffen PJ, Moore RA, McNicol ED, Bell RF, Carr DB, McIntyre M, Wee B Tags: Cochrane Database Syst Rev Source Type: research

Oral paracetamol (acetaminophen) for cancer pain.
CONCLUSIONS: There is no high-quality evidence to support or refute the use of paracetamol alone or in combination with opioids for the first two steps of the three-step WHO cancer pain ladder. It is not clear whether any additional analgesic benefit of paracetamol could be detected in the available studies, in view of the doses of opioids used. PMID: 28700092 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 12, 2017 Category: General Medicine Authors: Wiffen PJ, Derry S, Moore RA, McNicol ED, Bell RF, Carr DB, McIntyre M, Wee B Tags: Cochrane Database Syst Rev Source Type: research

Probing for congenital nasolacrimal duct obstruction.
CONCLUSIONS: The effects and costs of immediate versus deferred probing for NLDO are uncertain. Children who have unilateral NLDO may have better success from immediate office probing, though few children have participated in these trials, and investigators examined outcomes at disparate time points. Determining whether to perform the procedure and its optimal timing will require additional studies with greater power and larger, well-run clinical trials to help our understanding of the comparison. PMID: 28700811 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 12, 2017 Category: General Medicine Authors: Petris C, Liu D Tags: Cochrane Database Syst Rev Source Type: research

Desmopressin use for minimising perioperative blood transfusion.
CONCLUSIONS: Most of the evidence derived by comparing DDAVP versus placebo was obtained in cardiac surgery, where DDAVP was administered after cardiopulmonary bypass. In adults undergoing cardiac surgery, the reduction in volume of red cells transfused and total blood loss was small and was unlikely to be clinically important. It is less clear whether DDAVP may be of benefit for children and for those undergoing non-cardiac surgery. A key area for researchers is examining the effects of DDAVP for people with platelet dysfunction. Few trials have compared DDAVP versus tranexamic acid or aprotinin; consequently, we are unce...
Source: Cochrane Database of Systematic Reviews - July 10, 2017 Category: General Medicine Authors: Desborough MJ, Oakland K, Brierley C, Bennett S, Doree C, Trivella M, Hopewell S, Stanworth SJ, Estcourt LJ Tags: Cochrane Database Syst Rev Source Type: research

Rituximab for treating inhibitors in people with inherited severe hemophilia.
CONCLUSIONS: We were unable to identify any relevant trials on the efficacy and safety of rituximab for treating inhibitors in people with hemophilia. The research evidence available is from case reports and case series. Randomized controlled trials are needed to evaluate the efficacy and safety of rituximab for this condition. However, prior to the publication of any possible future randomized controlled trials, meta-analysis of case reports and case series may provide some evidence. PMID: 28685500 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 7, 2017 Category: General Medicine Authors: Jiang L, Liu Y, Zhang L, Santoro C, Rodriguez A Tags: Cochrane Database Syst Rev Source Type: research

Interventions to prevent occupational noise-induced hearing loss.
CONCLUSIONS: There is very low-quality evidence that implementation of stricter legislation can reduce noise levels in workplaces. Controlled studies of other engineering control interventions in the field have not been conducted. There is moderate-quality evidence that training of proper insertion of earplugs significantly reduces noise exposure at short-term follow-up but long-term follow-up is still needed.There is very low-quality evidence that the better use of hearing protection devices as part of HLPPs reduces the risk of hearing loss, whereas for other programme components of HLPPs we did not find such an effect. T...
Source: Cochrane Database of Systematic Reviews - July 7, 2017 Category: General Medicine Authors: Tikka C, Verbeek JH, Kateman E, Morata TC, Dreschler WA, Ferrite S Tags: Cochrane Database Syst Rev Source Type: research

Statins for children with familial hypercholesterolemia.
CONCLUSIONS: Statin treatment is an effective lipid-lowering therapy in children with familial hypercholesterolemia. No significant safety issues were identified. Statin treatment seems to be safe in the short term, but long-term safety remains unknown. Children treated with statins should be carefully monitored and followed up by their pediatricians and their care transferred to an adult lipidologist once they reach 18 years of age. Large long-term randomized controlled trials are needed to establish the long-term safety issues of statins. PMID: 28685504 [PubMed - as supplied by publisher] (Source: Cochrane Database ...
Source: Cochrane Database of Systematic Reviews - July 7, 2017 Category: General Medicine Authors: Vuorio A, Kuoppala J, Kovanen PT, Humphries SE, Tonstad S, Wiegman A, Drogari E, Ramaswami U Tags: Cochrane Database Syst Rev Source Type: research

Computer-generated reminders delivered on paper to healthcare professionals: effects on professional practice and healthcare outcomes.
CONCLUSIONS: There is moderate-certainty evidence that computer-generated reminders delivered on paper to healthcare professionals probably slightly improves quality of care, in terms of compliance with preventive guidelines and compliance with disease management guidelines. It is uncertain whether reminders improve patient outcomes because the certainty of the evidence is very low. The heterogeneity of the reminder interventions included in this review also suggests that reminders can probably improve quality of care in various settings under various conditions. PMID: 28681432 [PubMed - as supplied by publisher] (Sou...
Source: Cochrane Database of Systematic Reviews - July 6, 2017 Category: General Medicine Authors: Arditi C, Rège-Walther M, Durieux P, Burnand B Tags: Cochrane Database Syst Rev Source Type: research

Continuous support for women during childbirth.
CONCLUSIONS: Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences. We found no evidence of harms of continuous labour support. Subgroup analyses should be interpreted with caution, and considered as exploratory and hypothesis-generating, but evidence suggests continuous support with certain provider characteristics, in settings where epidural...
Source: Cochrane Database of Systematic Reviews - July 6, 2017 Category: General Medicine Authors: Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A Tags: Cochrane Database Syst Rev Source Type: research

Opioids for cancer pain - an overview of Cochrane reviews.
CONCLUSIONS: The amount and quality of evidence around the use of opioids for treating cancer pain is disappointingly low, although the evidence we have indicates that around 19 out of 20 people with moderate or severe pain who are given opioids and can tolerate them should have that pain reduced to mild or no pain within 14 days. This accords with the clinical experience in treating many people with cancer pain, but overstates to some extent the effectiveness found for the WHO pain ladder. Most people will experience adverse events, and help may be needed to manage the more common undesirable adverse effects such as const...
Source: Cochrane Database of Systematic Reviews - July 6, 2017 Category: General Medicine Authors: Wiffen PJ, Wee B, Derry S, Bell RF, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

Vortioxetine for depression in adults.
CONCLUSIONS: The place of vortioxetine in the treatment of acute depression is unclear. Our analyses showed vortioxetine may be more effective than placebo in terms of response, remission and depressive symptoms, but the clinical relevance of these effects is uncertain. Furthermore, the quality of evidence to support these findings was generally low. In comparison to SNRIs, we found no advantage for vortioxetine. Vortioxetine was less effective than duloxetine, but fewer people reported adverse effects when treated with vortioxetine compared to duloxetine. However, these findings are uncertain and not well supported by evi...
Source: Cochrane Database of Systematic Reviews - July 5, 2017 Category: General Medicine Authors: Koesters M, Ostuzzi G, Guaiana G, Breilmann J, Barbui C Tags: Cochrane Database Syst Rev Source Type: research

Cycle regimens for frozen-thawed embryo transfer.
CONCLUSIONS: This review did not find sufficient evidence to support the use of one cycle regimen in preference to another in preparation for FET in subfertile women with regular ovulatory cycles. The most common modalities for FET are natural cycle with or without HCG trigger or endometrial preparation with HT, with or without GnRHa suppression. We identified only four direct comparisons of these two modalities and there was insufficient evidence to support the use of either one in preference to the other. PMID: 28675921 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 5, 2017 Category: General Medicine Authors: Ghobara T, Gelbaya TA, Ayeleke RO Tags: Cochrane Database Syst Rev Source Type: research

Intravenous immunoglobulins for epilepsy.
CONCLUSIONS: We cannot draw any reliable conclusions regarding the efficacy of IVIg as a treatment for epilepsy. Further randomized controlled trials are needed. PMID: 28675262 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 4, 2017 Category: General Medicine Authors: Geng J, Dong J, Li Y, Ni H, Jiang K, Shi LL, Wang G Tags: Cochrane Database Syst Rev Source Type: research

Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery.
CONCLUSIONS: We found insufficient evidence from this review to inform practice for treatment of postoperative inflammation after uncomplicated phacoemulsification. Based on the RCTs included in this review, we could not conclude the equivalence or superiority of NSAIDs with or without corticosteroids versus corticosteroids alone. There may be some risk reduction of CME in the NSAID-alone group and the combination of NSAID plus corticosteroid group. Future RCTs on these interventions should standardize the type of medication used, dosing, and treatment regimen; data should be collected and presented using the Standardizati...
Source: Cochrane Database of Systematic Reviews - July 3, 2017 Category: General Medicine Authors: Juthani VV, Clearfield E, Chuck RS Tags: Cochrane Database Syst Rev Source Type: research

Later school start times for supporting the education, health, and well-being of high school students.
CONCLUSIONS: This systematic review on later school start times suggests several potential benefits for this intervention and points to the need for higher quality primary studies. However, as a result of the limited evidence base, we could not determine the effects of later school start times with any confidence. PMID: 28670711 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 3, 2017 Category: General Medicine Authors: Marx R, Tanner-Smith EE, Davison CM, Ufholz LA, Freeman J, Shankar R, Newton L, Brown RS, Parpia AS, Cozma I, Hendrikx S Tags: Cochrane Database Syst Rev Source Type: research

Corticosteroids for adult patients with advanced cancer who have nausea and vomiting (not related to chemotherapy, radiotherapy, or surgery).
CONCLUSIONS: There are few studies assessing the effects of corticosteroids on nausea and vomiting not related to chemotherapy, radiotherapy, or surgery in adult cancer patients. This review found very low-quality evidence which neither supported nor refuted corticosteroid use in this setting. Further high quality studies are needed to determine if corticosteroids are efficacious in this setting. PMID: 28671265 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - July 3, 2017 Category: General Medicine Authors: Vayne-Bossert P, Haywood A, Good P, Khan S, Rickett K, Hardy JR Tags: Cochrane Database Syst Rev Source Type: research

Interventions for chronic kidney disease in people with sickle cell disease.
CONCLUSIONS: In young children aged 9 months to 18 months, we are very uncertain if hydroxyurea improves glomerular filtration rate or reduces hyperfiltration, but it may improve young children's ability to concentrate urine and may make little or no difference on the incidence of acute chest syndrome, painful crises and hospitalisations.We are very uncertain if giving ACEI to adults with normal blood pressure and microalbuminuria has any effect on preventing or reducing kidney complications.This review identified no trials that looked at red cell transfusions nor any combinations of interventions to prevent or reduce kidn...
Source: Cochrane Database of Systematic Reviews - July 3, 2017 Category: General Medicine Authors: Roy NB, Fortin PM, Bull KR, Doree C, Trivella M, Hopewell S, Estcourt LJ Tags: Cochrane Database Syst Rev Source Type: research

Home-based versus centre-based cardiac rehabilitation.
CONCLUSIONS: This update supports previous conclusions that home- and centre-based forms of cardiac rehabilitation seem to be similarly effective in improving clinical and health-related quality of life outcomes in patients after myocardial infarction or revascularisation, or with heart failure. This finding supports the continued expansion of evidence-based, home-based cardiac rehabilitation programmes. The choice of participating in a more traditional and supervised centre-based programme or a home-based programme may reflect local availability and consider the preference of the individual patient. Further data are neede...
Source: Cochrane Database of Systematic Reviews - June 30, 2017 Category: General Medicine Authors: Anderson L, Sharp GA, Norton RJ, Dalal H, Dean SG, Jolly K, Cowie A, Zawada A, Taylor RS Tags: Cochrane Database Syst Rev Source Type: research

Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in women with gynaecological malignancies.
CONCLUSIONS: Placement of retroperitoneal tube drains has no benefit in the prevention of lymphocyst formation after pelvic lymphadenectomy in women with gynaecological malignancies. When the pelvic peritoneum is left open, the tube drain placement is associated with a higher risk of short- and long-term symptomatic lymphocyst formation. We found the quality of evidence using the GRADE approach to be moderate to high for most outcomes, except for symptomatic lymphocyst formation at 12 months after surgery, and unclear or low risk of bias. PMID: 28660687 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 29, 2017 Category: General Medicine Authors: Charoenkwan K, Kietpeerakool C 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 - June 29, 2017 Category: General Medicine Authors: Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain.
CONCLUSIONS: On average, people with subacute LBP who receive MBR will do better than if they receive usual care, but it is not clear whether they do better than people who receive some other type of treatment. However, the available research provides mainly low to very low-quality evidence, thus additional high-quality trials are needed before we can describe the value of MBP for clinical practice. PMID: 28656659 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Marin TJ, Van Eerd D, Irvin E, Couban R, Koes BW, Malmivaara A, van Tulder MW, Kamper SJ Tags: Cochrane Database Syst Rev Source Type: research

Phototherapy for treating foot ulcers in people with diabetes.
CONCLUSIONS: This systematic review of randomised trials suggested that phototherapy, when compared to no phototherapy/placebo, may increase the proportion of wounds completely healed during follow-up and may reduce wound size in people with diabetes, but there was no evidence that phototherapy improves quality of life. Due to the small sample size and methodological flaws in the original trials, the quality of the evidence was low, which reduces our confidence in these results. Large, well-designed randomised controlled trials are needed to confirm whether phototherapy could be an effective option for the treatment of foo...
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Wang HT, Yuan JQ, Zhang B, Dong ML, Mao C, Hu D Tags: Cochrane Database Syst Rev Source Type: research

Ketamine as an adjuvant to opioids for cancer pain.
CONCLUSIONS: Current evidence is insufficient to assess the benefits and harms of ketamine as an adjuvant to opioids for the relief of refractory cancer pain. The evidence was of very low quality, meaning that it does not provide a reliable indication of the likely effect, and the likelihood that the effect will be substantially different is high. Rapid dose escalation of ketamine to high dose (500 mg) does not appear to have clinical benefit and may be associated with serious adverse events. More randomised controlled trials (RCTs) examining specific low-dose ketamine clinical regimens in current use are needed. PMID...
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Bell RF, Eccleston C, Kalso EA Tags: Cochrane Database Syst Rev Source Type: research

Wendan decoction (Traditional Chinese medicine) for schizophrenia.
CONCLUSIONS: Limited evidence suggests that WDD may have some positive short-term antipsychotic global effects compared to placebo or no treatment. However when WDD was compared with other antipsychotics there was no effect on global or mental state, but WDD was associated with fewer adverse effects. When WDD was combined with an antipsychotic, positive effects were found for global and mental state and the combination caused fewer adverse effects. The available evidence is not high quality. Better designed large studies are needed to fully and fairly test the effects of WDD for people with schizophrenia. PMID: 286576...
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Deng H, Xu J Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for neonates born through meconium-stained amniotic fluid.
CONCLUSIONS: Upon review of available evidence, we found no differences in infection rates following antibiotic treatment among neonates born through meconium-stained fluid and those with meconium aspiration syndrome. The overall quality of evidence is low owing to the small number of included studies. Well-controlled studies of adequate power are needed. PMID: 28658507 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Kelly LE, Shivananda S, Murthy P, Srinivasjois R, Shah PS Tags: Cochrane Database Syst Rev Source Type: research

Antipsychotic combinations for schizophrenia.
CONCLUSIONS: Currently, most evidence regarding the use of antipsychotic combinations comes from short-term trials, limiting the assessment of long-term efficacy and safety. We found very low-quality evidence that a combination of antipsychotics may improve the clinical response. We also found low-quality evidence that a combination of antipsychotics is may make no difference at preventing participants from leaving the study early, preventing relapse and/or causing more serious adverse events than monotherapy. PMID: 28658515 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Ortiz-Orendain J, Castiello-de Obeso S, Colunga-Lozano LE, Hu Y, Maayan N, Adams CE Tags: Cochrane Database Syst Rev Source Type: research

Patient education in the management of coronary heart disease.
CONCLUSIONS: We found no reduction in total mortality, in people who received education delivered as part of cardiac rehabilitation, compared to people in control groups (moderate quality evidence). There were no improvements in fatal or non fatal MI, total revascularisations or hospitalisations, with education. There was some evidence of a reduction in fatal and/or non-fatal cardiovascular events with education, but this was based on only two studies. There was also some evidence to suggest that education-based interventions may improve HRQoL. Our findings are supportive of current national and international clinical guid...
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Anderson L, Brown JP, Clark AM, Dalal H, Rossau HK, Bridges C, Taylor RS Tags: Cochrane Database Syst Rev Source Type: research

Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants.
Abstract BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1. To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or perive...
Source: Cochrane Database of Systematic Reviews - June 28, 2017 Category: General Medicine Authors: Pammi M, Suresh G Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing high altitude illness: Part 1. Commonly-used classes of drugs.
CONCLUSIONS: Our assessment of the most commonly-used pharmacological interventions suggests that acetazolamide is an effective pharmacological agent to prevent acute HAI in dosages of 250 to 750 mg/day. This information is based on evidence of moderate quality. Acetazolamide is associated with an increased risk of paraesthesia, although there are few reports about other adverse events from the available evidence. The clinical benefits and harms of other pharmacological interventions such as ibuprofen, budenoside and dexamethasone are unclear. Large multicentre studies are needed for most of the pharmacological agents eval...
Source: Cochrane Database of Systematic Reviews - June 27, 2017 Category: General Medicine Authors: Nieto Estrada VH, Molano Franco D, Medina RD, Gonzalez Garay AG, Martí-Carvajal AJ, Arevalo-Rodriguez I Tags: Cochrane Database Syst Rev Source Type: research

Epidermal growth factor receptor (EGFR) inhibitors for metastatic colorectal cancer.
CONCLUSIONS: The addition of EGFR MAb to either chemotherapy or best supportive care improves progression-free survival (moderate- to high-quality evidence), overall survival (high-quality evidence), and tumour response rate (moderate- to high-quality evidence), but may increase toxicity in people with KRAS exon 2 wild-type or extended RAS wild-type metastatic colorectal cancer (moderate-quality evidence). The addition of EGFR TKI to standard therapy does not improve clinical outcomes. EGFR MAb combined with bevacizumab is of no clinical value (very low-quality evidence). Future studies should focus on optimal sequencing a...
Source: Cochrane Database of Systematic Reviews - June 27, 2017 Category: General Medicine Authors: Chan DLH, Segelov E, Wong RS, Smith A, Herbertson RA, Li BT, Tebbutt N, Price T, Pavlakis N Tags: Cochrane Database Syst Rev Source Type: research

Punctal occlusion for dry eye syndrome.
CONCLUSIONS: Although the investigators of the individual trials concluded that punctal plugs are an effective means for treating dry eye signs and symptoms, the evidence in this systematic review suggests that improvements in symptoms and commonly tested dry eye signs are inconclusive. Despite the inclusion of 11 additional trials, the findings of this updated review are consistent with the previous review published in 2010. The type of punctal plug investigated, the type and severity of dry eye being treated, and heterogeneity in trial methodology confounds our ability to make decisive statements regarding the effectiven...
Source: Cochrane Database of Systematic Reviews - June 26, 2017 Category: General Medicine Authors: Ervin AM, Law A, Pucker AD Tags: Cochrane Database Syst Rev Source Type: research

Early discharge hospital at home.
CONCLUSIONS: Despite increasing interest in the potential of early discharge hospital at home services as a less expensive alternative to inpatient care, this review provides insufficient evidence of economic benefit (through a reduction in hospital length of stay) or improved health outcomes. PMID: 28651296 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 26, 2017 Category: General Medicine Authors: Gonçalves-Bradley DC, Iliffe S, Doll HA, Broad J, Gladman J, Langhorne P, Richards SH, Shepperd S Tags: Cochrane Database Syst Rev Source Type: research