Antibiotic prophylaxis for elective hysterectomy.
CONCLUSIONS: Antibiotic prophylaxis appears to be effective in preventing postoperative infection in women undergoing elective vaginal or abdominal hysterectomy, regardless of the dose regimen. However, evidence is insufficient to show whether use of prophylactic antibiotics influences rates of adverse effects. Similarly, evidence is insufficient to show which (if any) individual antibiotic, dose regimen, or route of administration is safest and most effective. The most recent studies included in this review were 14 years old at the time of our search. Thus findings from included studies may not reflect current practice in...
Source: Cochrane Database of Systematic Reviews - June 18, 2017 Category: General Medicine Authors: Ayeleke RO, Mourad S, Marjoribanks J, Calis KA, Jordan V Tags: Cochrane Database Syst Rev Source Type: research

Tramadol for neuropathic pain in adults.
CONCLUSIONS: There is only modest information about the use of tramadol in neuropathic pain, coming from small, largely inadequate studies with potential risk of bias. That bias would normally increase the apparent benefits of tramadol. The evidence of benefit from tramadol was of low or very low quality, meaning that it does not provide a reliable indication of the likely effect, and the likelihood is very high that the effect will be substantially different from the estimate in this systematic review. PMID: 28616956 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 15, 2017 Category: General Medicine Authors: Duehmke RM, Derry S, Wiffen PJ, Bell RF, Aldington D, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

Effect of the treatment of Type 2 diabetes mellitus on the development of cognitive impairment and dementia.
CONCLUSIONS: We found no good evidence that any specific treatment or treatment strategy for Type 2 diabetes can prevent or delay cognitive impairment. The best available evidence related to the comparison of intensive with standard glycaemic control strategies. Here there was moderate-quality evidence that the strategies do not differ in their effect on global cognitive functioning over 40 to 60 months. PMID: 28617932 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 15, 2017 Category: General Medicine Authors: Areosa Sastre A, Vernooij RW, González-Colaço Harmand M, Martínez G Tags: Cochrane Database Syst Rev Source Type: research

Niacin for primary and secondary prevention of cardiovascular events.
CONCLUSIONS: Moderate- to high-quality evidence suggests that niacin does not reduce mortality, cardiovascular mortality, non-cardiovascular mortality, the number of fatal or non-fatal myocardial infarctions, nor the number of fatal or non-fatal strokes but is associated with side effects. Benefits from niacin therapy in the prevention of cardiovascular disease events are unlikely. PMID: 28616955 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 14, 2017 Category: General Medicine Authors: Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ Tags: Cochrane Database Syst Rev Source Type: research

Clozapine dose for schizophrenia.
CONCLUSIONS: We found no evidence of effect on mental state between standard, low and very low dose regimes, but we did not identify any trials on high or very high doses of clozapine. BMI measurements were similar between groups in the short term, although weight gain was less at very low dose compared to standard dose in one study. There was limited evidence that the incidence of some adverse effects was greater at standard dose compared to lower dose regimes. We found very little useful data and the evidence available is generally of low or very low quality. More studies are needed to validate our findings and report on...
Source: Cochrane Database of Systematic Reviews - June 14, 2017 Category: General Medicine Authors: Subramanian S, Völlm BA, Huband N Tags: Cochrane Database Syst Rev Source Type: research

Pre-admission antibiotics for suspected cases of meningococcal disease.
CONCLUSIONS: We found no reliable evidence to support the use pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Moderate-quality evidence from one RCT indicated that single intramuscular injections of ceftriaxone and long-acting chloramphenicol were equally effective, safe, and economical in reducing serious outcomes. The choice between these antibiotics should be based on affordability, availability, and patterns of antibiotic resistance.Further RCTs comparing different pre-admission antibiotics, accompanied by intensive supportive measures, are ethically justified in people with less seve...
Source: Cochrane Database of Systematic Reviews - June 14, 2017 Category: General Medicine Authors: Sudarsanam TD, Rupali P, Tharyan P, Abraham OC, Thomas K Tags: Cochrane Database Syst Rev Source Type: research

Topical antimicrobial agents for treating foot ulcers in people with diabetes.
CONCLUSIONS: The randomised controlled trial data on the effectiveness and safety of topical antimicrobial treatments for diabetic foot ulcers is limited by the availability of relatively few, mostly small, and often poorly designed trials. Based on our systematic review and analysis of the literature, we suggest that: 1) use of an antimicrobial dressing instead of a non-antimicrobial dressing may increase the number of diabetic foot ulcers healed over a medium-term follow-up period (low-certainty evidence); and 2) there is probably little difference in the risk of adverse events related to treatment between systemic antib...
Source: Cochrane Database of Systematic Reviews - June 14, 2017 Category: General Medicine Authors: Dumville JC, Lipsky BA, Hoey C, Cruciani M, Fiscon M, Xia J Tags: Cochrane Database Syst Rev Source Type: research

Communication skills training for mental health professionals working with people with severe mental illness.
CONCLUSIONS: The evidence available is from one pilot cluster-randomised controlled trial, it is not adequate enough to draw any robust conclusions. There were relatively few good quality data and the trial is too small to highlight differences in most outcome measures. Adding a CST programme appears to have a modest positive effect on patients' experiences of the therapeutic relationship. More high-quality research is needed in this area. PMID: 28613384 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 13, 2017 Category: General Medicine Authors: Papageorgiou A, Loke YK, Fromage M Tags: Cochrane Database Syst Rev Source Type: research

Fetal and umbilical Doppler ultrasound in high-risk pregnancies.
CONCLUSIONS: Current evidence suggests that the use of Doppler ultrasound on the umbilical artery in high-risk pregnancies reduces the risk of perinatal deaths and may result in fewer obstetric interventions. The results should be interpreted with caution, as the evidence is not of high quality. Serial monitoring of Doppler changes in ductus venosus may be beneficial, but more studies of high quality with follow-up including neurological development are needed for evidence to be conclusive. PMID: 28613398 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 13, 2017 Category: General Medicine Authors: Alfirevic Z, Stampalija T, Dowswell T Tags: Cochrane Database Syst Rev Source Type: research

Perineal techniques during the second stage of labour for reducing perineal trauma.
CONCLUSIONS: Moderate-quality evidence suggests that warm compresses, and massage, may reduce third- and fourth-degree tears but the impact of these techniques on other outcomes was unclear or inconsistent. Poor-quality evidence suggests hands-off techniques may reduce episiotomy, but this technique had no clear impact on other outcomes. There were insufficient data to show whether other perineal techniques result in improved outcomes.Further research could be performed evaluating perineal techniques, warm compresses and massage, and how different types of oil used during massage affect women and their babies. It is import...
Source: Cochrane Database of Systematic Reviews - June 13, 2017 Category: General Medicine Authors: Aasheim V, Nilsen ABV, Reinar LM, Lukasse M Tags: Cochrane Database Syst Rev Source Type: research

Early palliative care for adults with advanced cancer.
CONCLUSIONS: This systematic review of a small number of trials indicates that early palliative care interventions may have more beneficial effects on quality of life and symptom intensity among patients with advanced cancer than among those given usual/standard cancer care alone. Although we found only small effect sizes, these may be clinically relevant at an advanced disease stage with limited prognosis, at which time further decline in quality of life is very common. At this point, effects on mortality and depression are uncertain. We have to interpret current results with caution owing to very low to low certainty of ...
Source: Cochrane Database of Systematic Reviews - June 12, 2017 Category: General Medicine Authors: Haun MW, Estel S, Rücker G, Friederich HC, Villalobos M, Thomas M, Hartmann M Tags: Cochrane Database Syst Rev Source Type: research

Treating periodontal disease for preventing adverse birth outcomes in pregnant women.
Abstract BACKGROUND: Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health. OBJECTIVES: To assess the effects ...
Source: Cochrane Database of Systematic Reviews - June 12, 2017 Category: General Medicine Authors: Iheozor-Ejiofor Z, Middleton P, Esposito M, Glenny AM Tags: Cochrane Database Syst Rev Source Type: research

Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes.
CONCLUSIONS: This review found no evidence that any glucose monitoring technique is superior to any other technique among pregnant women with pre-existing type 1 or type 2 diabetes. The evidence base for the effectiveness of monitoring techniques is weak and additional evidence from large well-designed randomised trials is required to inform choices of glucose monitoring techniques. PMID: 28602020 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 11, 2017 Category: General Medicine Authors: Moy FM, Ray A, Buckley BS, West HM Tags: Cochrane Database Syst Rev Source Type: research

Assistive technology for memory support in dementia.
CONCLUSIONS: This review highlights the current lack of high-quality evidence to determine whether AT is effective in supporting people with dementia to manage their memory problems. PMID: 28602027 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 11, 2017 Category: General Medicine Authors: Van der Roest HG, Wenborn J, Pastink C, Dröes RM, Orrell M Tags: Cochrane Database Syst Rev Source Type: research

Exercise interventions for cerebral palsy.
CONCLUSIONS: The quality of evidence for all conclusions is low to very low. As included trials have small sample sizes, heterogeneity may be underestimated, resulting in considerable uncertainty relating to effect estimates. For children with CP, there is evidence that aerobic exercise may result in a small improvement in gross motor function, though it does not improve gait speed. There is evidence that resistance training does not improve gait speed, gross motor function, participation or quality of life among children with CP.Based on the evidence available, exercise appears to be safe for people with CP; only 55% of t...
Source: Cochrane Database of Systematic Reviews - June 11, 2017 Category: General Medicine Authors: Ryan JM, Cassidy EE, Noorduyn SG, O'Connell NE Tags: Cochrane Database Syst Rev Source Type: research

Injected corticosteroids for treating plantar heel pain in adults.
Abstract BACKGROUND: Plantar heel pain, commonly resulting from plantar fasciitis, often results in significant morbidity. Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), orthoses, physical therapy, physical agents (e.g. extracorporeal shock wave therapy (ESWT), laser) and invasive procedures including steroid injections. OBJECTIVES: To assess the effects (benefits and harms) of injected corticosteroids for treating plantar heel pain in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Contr...
Source: Cochrane Database of Systematic Reviews - June 11, 2017 Category: General Medicine Authors: David JA, Sankarapandian V, Christopher PR, Chatterjee A, Macaden AS Tags: Cochrane Database Syst Rev Source Type: research

Gabapentin for chronic neuropathic pain in adults.
Conclusions have not changed since the previous update of this review. PMID: 28597471 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 9, 2017 Category: General Medicine Authors: Wiffen PJ, Derry S, Bell RF, Rice AS, Tölle TR, Phillips T, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

Celecoxib for rheumatoid arthritis.
CONCLUSIONS: Celecoxib may improve clinical symptoms, alleviate pain and contribute to little or no difference in physical function compared with placebo. Celecoxib was associated with fewer numbers of participant withdrawals. Results for incidence of gastroduodenal ulcers (≥ 3 mm) and short-term serious adverse events were uncertain; however, there were few reported events for either.Celecoxib may slightly improve clinical symptoms compared with tNSAIDs. Results for reduced pain and improved physical function were uncertain. Particpants taking celecoxib had lower incidence of gastroduodenal ulcers (≥ 3 mm) and there...
Source: Cochrane Database of Systematic Reviews - June 9, 2017 Category: General Medicine Authors: Fidahic M, Jelicic Kadic A, Radic M, Puljak L Tags: Cochrane Database Syst Rev Source Type: research

Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair.
Abstract BACKGROUND: People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. OBJECTIVES: To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS)...
Source: Cochrane Database of Systematic Reviews - June 9, 2017 Category: General Medicine Authors: Abraha I, Luchetta ML, De Florio R, Cozzolino F, Casazza G, Duca P, Parente B, Orso M, Germani A, Eusebi P, Montedori A Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Celecoxib for rheumatoid arthritis.
CONCLUSIONS: For an individual with RA the potential benefits of celecoxib need to be balanced against the uncertainty that the short-term reduced incidence of upper GI complications are maintained in the long-term and its increased cost in comparison to traditional NSAIDs. PMID: 28598564 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 9, 2017 Category: General Medicine Authors: Garner SE, Fidan D, Frankish RR, Judd M, Shea B, Towheed T, Tugwell P, Wells GA Tags: Cochrane Database Syst Rev Source Type: research

Methods of term labour induction for women with a previous caesarean section.
CONCLUSIONS: RCT evidence on methods of induction of labour for women with a prior caesarean section is inadequate, and studies are underpowered to detect clinically relevant differences for many outcomes. Several studies reported few of our prespecified outcomes and reporting of infant outcomes was especially scarce. The GRADE level for quality of evidence was moderate to very low, due to imprecision and study design limitations.High-quality, adequately-powered RCTs would be the best approach to determine the optimal method for induction of labour in women with a prior caesarean birth. However, such trials are unlikely to...
Source: Cochrane Database of Systematic Reviews - June 9, 2017 Category: General Medicine Authors: West HM, Jozwiak M, Dodd JM Tags: Cochrane Database Syst Rev Source Type: research

Glucose targets for preventing diabetic kidney disease and its progression.
Abstract BACKGROUND: Diabetes is the leading cause of end-stage kidney disease (ESKD) around the world. Blood pressure lowering and glucose control are used to reduce diabetes-associated disability including kidney failure. However there is a lack of an overall evidence summary of the optimal target range for blood glucose control to prevent kidney failure. OBJECTIVES: To evaluate the benefits and harms of intensive (HbA1c
Source: Cochrane Database of Systematic Reviews - June 8, 2017 Category: General Medicine Authors: Ruospo M, Saglimbene VM, Palmer SC, De Cosmo S, Pacilli A, Lamacchia O, Cignarelli M, Fioretto P, Vecchio M, Craig JC, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Growth factors for angiogenesis in peripheral arterial disease.
CONCLUSIONS: The results of this review do not support the use of therapy with the growth factors FGF, HGF or VEGF in people with PAD of the lower extremities to prevent death or major limb amputation or to improve walking ability. However, the use of these growth factors may improve haemodynamic measures and decrease the rate of any limb amputations (probably due to preventing minor amputations) with an uncertain effect on adverse events; an improvement of ulceration and rest pain is very uncertain. New trials at low risk of bias are needed to generate evidence with more certainty. PMID: 28594443 [PubMed - as supplie...
Source: Cochrane Database of Systematic Reviews - June 8, 2017 Category: General Medicine Authors: Gorenoi V, Brehm MU, Koch A, Hagen A Tags: Cochrane Database Syst Rev Source Type: research

Preoperative exercise training for patients with non-small cell lung cancer.
CONCLUSIONS: Preoperative exercise training may reduce the risk of developing a postoperative pulmonary complication, the duration of intercostal catheter use, postoperative length of hospital stay, and improve both exercise capacity and FVC in people undergoing lung resection for NSCLC. The findings of this review should be interpreted with caution due to disparities between the studies, risk of bias, and small sample sizes. This review emphasises the need for larger RCTs. PMID: 28589547 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 7, 2017 Category: General Medicine Authors: Cavalheri V, Granger C Tags: Cochrane Database Syst Rev Source Type: research

Focal laser treatment in addition to chemotherapy for retinoblastoma.
CONCLUSIONS: No evidence from randomised controlled trials was found to support or refute laser therapy in addition to systemic chemotherapy for postequatorial retinoblastoma. PMID: 28589646 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 7, 2017 Category: General Medicine Authors: Fabian ID, Johnson KP, Stacey AW, Sagoo MS, Reddy MA Tags: Cochrane Database Syst Rev Source Type: research

Carotid endarterectomy for symptomatic carotid stenosis.
CONCLUSIONS: Endarterectomy was of some benefit for participants with 50% to 69% symptomatic stenosis (moderate-quality evidence), and highly beneficial for those with 70% to 99% stenosis without near-occlusion (moderate-quality evidence). We found no benefit in people with carotid near-occlusion (high-quality evidence). PMID: 28590505 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 7, 2017 Category: General Medicine Authors: Orrapin S, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research

Incentives for preventing smoking in children and adolescents.
CONCLUSIONS: The very limited evidence currently available suggests that incentive programmes do not prevent smoking initiation among youth. However, there are relatively few published studies and these are of variable quality. In addition, trials included in the meta-analyses were all studies of the SFC, which distributed small to moderately-sized prizes to whole classes, usually through a lottery system. It is therefore possible that other incentive programmes could be more successful at preventing smoking uptake in young people.Future studies might investigate the efficacy of a wider range of incentives, including those...
Source: Cochrane Database of Systematic Reviews - June 6, 2017 Category: General Medicine Authors: Hefler M, Liberato SC, Thomas DP Tags: Cochrane Database Syst Rev Source Type: research

Direct-acting antivirals for chronic hepatitis C.
Abstract BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs) are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). However, it is still questionable if eradication of hepatitis C virus in the blood eliminates hepatitis C in the body, and improves survival and leads to fewer complications. OBJECTIVES: To assess the benefits and harms of DAAs in people with ...
Source: Cochrane Database of Systematic Reviews - June 6, 2017 Category: General Medicine Authors: Jakobsen JC, Nielsen EE, Feinberg J, Katakam KK, Fobian K, Hauser G, Poropat G, Djurisic S, Weiss KH, Bjelakovic M, Bjelakovic G, Klingenberg SL, Liu JP, Nikolova D, Koretz RL, Gluud C Tags: Cochrane Database Syst Rev Source Type: research

Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.
CONCLUSIONS: Cervical cerclage reduces the risk of preterm birth in women at high-risk of preterm birth and probably reduces risk of perinatal deaths. There was no evidence of any differential effect of cerclage based on previous obstetric history or short cervix indications, but data were limited for all clinical groups. The question of whether cerclage is more or less effective than other preventative treatments, particularly vaginal progesterone, remains unanswered. PMID: 28586127 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 6, 2017 Category: General Medicine Authors: Alfirevic Z, Stampalija T, Medley N Tags: Cochrane Database Syst Rev Source Type: research

Empirical antibiotics targeting gram-positive bacteria for the treatment of febrile neutropenic patients with cancer.
CONCLUSIONS: Based on very low- or low-quality evidence using the GRADE approach and overall low risk of bias, the current evidence shows that the empirical routine addition of antiGP treatment, namely glycopeptides, does not improve the outcomes of febrile neutropenic patients with cancer. PMID: 28577308 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 3, 2017 Category: General Medicine Authors: Beyar-Katz O, Dickstein Y, Borok S, Vidal L, Leibovici L, Paul M Tags: Cochrane Database Syst Rev Source Type: research

Circuit class therapy for improving mobility after stroke.
CONCLUSIONS: There is moderate evidence that CCT is effective in improving mobility for people after stroke - they may be able to walk further, faster, with more independence and confidence in their balance. The effects may be greater later after the stroke, and are of clinical significance. Further high-quality research is required, investigating quality of life, participation and cost-benefits, that compares CCT with standard care and that also investigates the influence of factors such as stroke severity and age. The potential risk of increased falls during CCT needs to be monitored. PMID: 28573757 [PubMed - as sup...
Source: Cochrane Database of Systematic Reviews - June 2, 2017 Category: General Medicine Authors: English C, Hillier SL, Lynch EA Tags: Cochrane Database Syst Rev Source Type: research

Mass media interventions for preventing smoking in young people.
CONCLUSIONS: Certainty about the effects of mass media campaigns on smoking behaviour in youth is very low, due to inconsistency between studies in both design and results, and due to methodological issues amongst the included studies. It would therefore be unwise to offer firm conclusions based on the evidence in this review. Methodologically rigorous studies investigating the effect of social media and novel forms of technology as part of tobacco prevention campaigns for youth are needed. PMID: 28574573 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 2, 2017 Category: General Medicine Authors: Carson KV, Ameer F, Sayehmiri K, Hnin K, van Agteren JE, Sayehmiri F, Brinn MP, Esterman AJ, Chang AB, Smith BJ Tags: Cochrane Database Syst Rev Source Type: research

Early versus delayed appendicectomy for appendiceal phlegmon or abscess.
CONCLUSIONS: It is unclear whether early appendicectomy prevents complications compared to delayed appendicectomy for people with appendiceal phlegmon or abscess. The evidence indicating increased length of hospital stay and time away from normal activities in people with early open appendicectomy is of very low quality. The evidence for better health-related quality of life following early laparoscopic appendicectomy compared with delayed appendicectomy is based on very low quality evidence. For both comparisons addressed in this review, data are sparse, and we cannot rule out significant benefits or harms of early versus...
Source: Cochrane Database of Systematic Reviews - June 2, 2017 Category: General Medicine Authors: Cheng Y, Xiong X, Lu J, Wu S, Zhou R, Cheng N Tags: Cochrane Database Syst Rev Source Type: research

Management for intussusception in children.
CONCLUSIONS: This review identified a small number of trials that assessed a variety of interventions. All included trials provided evidence of low quality and were subject to serious concerns about imprecision, high risk of bias, or both. Air enema may be superior to liquid enema for successfully reducing intussusception in children; however, this finding is based on a few studies including small numbers of participants. Dexamethasone as an adjuvant may be more effective in reducing intussusception recurrence rates following air enema or liquid enema, but these results are also based on a few studies of small numbers of p...
Source: Cochrane Database of Systematic Reviews - June 1, 2017 Category: General Medicine Authors: Gluckman S, Karpelowsky J, Webster AC, McGee RG Tags: Cochrane Database Syst Rev Source Type: research

Nd:YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters.
CONCLUSIONS: There are currently no RCTs that compare Nd:YAG laser vitreolysis with pars plana vitrectomy for the treatment of symptomatic floaters. Properly designed RCTs are needed to evaluate the treatment outcomes from the interventions described. We recommend future studies randomise participants to either a Nd:YAG laser vitreolysis group or a vitrectomy group, with participants in each group assigned to either receive treatment or a sham intervention. Future studies should follow participants at six months and 12 months after the intervention. Also they should use best corrected visual acuity (BCVA) using an Early Tr...
Source: Cochrane Database of Systematic Reviews - June 1, 2017 Category: General Medicine Authors: Kokavec J, Wu Z, Sherwin JC, Ang AJ, Ang GS Tags: Cochrane Database Syst Rev Source Type: research

High-flow nasal cannulae for respiratory support in adult intensive care patients.
CONCLUSIONS: We were unable to demonstrate whether HFNC was a more effective or safe oxygen delivery device compared with other oxygenation devices in adult ICU patients. Meta-analysis could be performed for few studies for each outcome, and data for comparisons with CPAP or BiPAP were very limited. In addition, we identified some risks of bias among included studies, differences in patient groups, and high levels of statistical heterogeneity for some outcomes, leading to uncertainty regarding the results of our analysis. Consequently, evidence is insufficient to show whether HFNC provides safe and efficacious respiratory ...
Source: Cochrane Database of Systematic Reviews - May 30, 2017 Category: General Medicine Authors: Corley A, Rickard CM, Aitken LM, Johnston A, Barnett A, Fraser JF, Lewis SR, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Opioid antagonists with minimal sedation for opioid withdrawal.
CONCLUSIONS: Using opioid antagonists plus alpha2-adrenergic agonists is a feasible approach for managing opioid withdrawal. However, it is unclear whether this approach reduces the duration of withdrawal or facilitates transfer to naltrexone treatment to a greater extent than withdrawal managed primarily with an adrenergic agonist.A high level of monitoring and support is desirable for several hours following administration of opioid antagonists because of the possibility of vomiting, diarrhoea and delirium.Using opioid antagonists to induce and accelerate opioid withdrawal is not currently an active area of research or c...
Source: Cochrane Database of Systematic Reviews - May 29, 2017 Category: General Medicine Authors: Gowing L, Ali R, White JM Tags: Cochrane Database Syst Rev Source Type: research

Music therapy for people with schizophrenia and schizophrenia-like disorders.
CONCLUSIONS: Moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcome measures in relation to music the...
Source: Cochrane Database of Systematic Reviews - May 29, 2017 Category: General Medicine Authors: Geretsegger M, Mössler KA, Bieleninik Ł, Chen XJ, Heldal TO, Gold C Tags: Cochrane Database Syst Rev Source Type: research

Endovascular treatment for ruptured abdominal aortic aneurysm.
CONCLUSIONS: The conclusions of this review are currently limited by the paucity of data. We found from the data available moderate-quality evidence suggesting there is no difference in 30-day mortality between eEVAR and open repair. Not enough information was provided for complications for us to make a well-informed conclusion, although it is possible that eEVAR is associated with a reduction in bowel ischaemia. Long-term data were lacking for both survival and late complications. More high-quality randomised controlled trials comparing eEVAR and open repair for the treatment of RAAA are needed to better understand if one...
Source: Cochrane Database of Systematic Reviews - May 26, 2017 Category: General Medicine Authors: Badger S, Forster R, Blair PH, Ellis P, Kee F, Harkin DW Tags: Cochrane Database Syst Rev Source Type: research

Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever.
CONCLUSIONS: In 37 studies that evaluated the diagnostic accuracy of RDTs for enteric fever, few studies were at a low risk of bias. The three main RDT tests and variants had moderate diagnostic accuracy. There was no evidence of a difference between the average sensitivity and specificity of the three main RDT tests. More robust evaluations of alternative RDTs for enteric fever are needed. PMID: 28545155 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 26, 2017 Category: General Medicine Authors: Wijedoru L, Mallett S, Parry CM Tags: Cochrane Database Syst Rev Source Type: research

Position in the second stage of labour for women without epidural anaesthesia.
CONCLUSIONS: The findings of this review suggest several possible benefits for upright posture in women without epidural anaesthesia, such as a very small reduction in the duration of second stage of labour (mainly from the primigravid group), reduction in episiotomy rates and assisted deliveries. However, there is an increased risk blood loss greater than 500 mL and there may be an increased risk of second degree tears, though we cannot be certain of this. In view of the variable risk of bias of the trials reviewed, further trials using well-designed protocols are needed to ascertain the true benefits and risks of various...
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Gupta JK, Sood A, Hofmeyr GJ, Vogel JP Tags: Cochrane Database Syst Rev Source Type: research

Single dose oral ketoprofen or dexketoprofen for acute postoperative pain in adults.
CONCLUSIONS: Ketoprofen at doses of 25 mg to 100 mg is an effective analgesic in moderate to severe acute postoperative pain with an NNT for at least 50% pain relief of 2.9 with a 50 mg dose. This is similar to that of commonly used NSAIDs such as ibuprofen (NNT 2.5 for 400 mg dose) and diclofenac (NNT 2.7 for 50 mg dose). Dexketoprofen is also effective with an NNT of 4.1 in the dose range 10 mg to 25 mg. Differential efficacy between dental surgery and other types of surgery seen for both drugs is unusual. Both drugs were well tolerated in single doses. PMID: 28540716 [PubMed - as supplied by publisher] (Source: Coc...
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Gaskell H, Derry S, Wiffen PJ, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

Antithrombotic treatment after stroke due to intracerebral haemorrhage.
CONCLUSIONS: There is insufficient evidence from RCTs to support or discourage the use of antithrombotic treatment after ICH. RCTs comparing starting versus avoiding antiplatelet or anticoagulant drugs after ICH appear justified and are needed in clinical practice. PMID: 28540976 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Perry LA, Berge E, Bowditch J, Forfang E, Rønning OM, Hankey GJ, Villanueva E, Al-Shahi Salman R Tags: Cochrane Database Syst Rev Source Type: research

Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques.
CONCLUSIONS: Among women undergoing ovarian stimulation in antagonist protocols, COCP pretreatment was associated with a lower rate of live birth or ongoing pregnancy than no pretreatment. There was insufficient evidence to determine whether rates of live birth or ongoing pregnancy were influenced by pretreatment with progestogens or oestrogens, or by COCP pretreatment using other stimulation protocols. Findings on adverse events were inconclusive, except that progesterone pretreatment may reduce the risk of ovarian cysts in agonist cycles, and COCP in antagonist cycles may reduce the risk of pregnancy loss compared with n...
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Farquhar C, Rombauts L, Kremer JA, Lethaby A, Ayeleke RO Tags: Cochrane Database Syst Rev Source Type: research

Comparison of first-line chemotherapy including escalated BEACOPP versus chemotherapy including ABVD for people with early unfavourable or advanced stage Hodgkin lymphoma.
CONCLUSIONS: This meta-analysis provides moderate- to high-quality evidence that adult patients between 16 and 60 years of age with early unfavourable and advanced stage HL benefit regarding OS and PFS from first-line chemotherapy including escalated BEACOPP. The proven benefit in OS for patients with advanced HL is a new finding of this updated review due to the inclusion of the results from the EORTC 20012 trial. Furthermore, there is only low-quality evidence of a difference in the total number of secondary malignancies, as the follow-up period might be too short to detect meaningful differences. Low-quality evidence al...
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Skoetz N, Will A, Monsef I, Brillant C, Engert A, von Tresckow B Tags: Cochrane Database Syst Rev Source Type: research

Histologic scoring indices for evaluation of disease activity in ulcerative colitis.
CONCLUSIONS: The Nancy Index and the Robarts Histopathology Index have undergone the most validation in that four operating properties including reliability, content validity, construct validity (hypothesis testing) and criterion validity have been tested. However, none of the currently available histologic scoring indices have been fully validated. In order to determine the optimal endpoint for histologic healing in UC, more research is required. The optimal index would need to be fully validated. PMID: 28542712 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Mosli MH, Parker CE, Nelson SA, Baker KA, MacDonald JK, Zou GY, Feagan BG, Khanna R, Levesque BG, Jairath V Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Infant formulas containing hydrolysed protein for prevention of allergic disease and food allergy.
CONCLUSIONS: We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergy. Very low-quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA.In infants at high risk of allergy not exclusively breast fed, very low-quality evidence suggests that prolonged hydrolysed formula feeding compared with CMF feeding reduces infant allergy and infant CMA. Studies have found no difference in childhood allergy and no difference in specific allergy, including infant and childhood asthma, eczema and rhin...
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Osborn DA, Sinn JK, Jones LJ Tags: Cochrane Database Syst Rev Source Type: research

Interleukin-2 as an adjunct to antiretroviral therapy for HIV-positive adults.
CONCLUSIONS: There is high certainty evidence that IL-2 in combination with ART increases the CD4 cell count in HIV-positive adults. However, IL-2 does not confer any significant benefit in mortality, there is probably no difference in the incidence of opportunistic infections, and there is probably an increase in grade 3 or 4 adverse effects. Our findings do not support the use of IL-2 as an adjunct to ART in HIV-positive adults. Based on our findings, further trials are not justified. PMID: 28542796 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Onwumeh J, Okwundu CI, Kredo T Tags: Cochrane Database Syst Rev Source Type: research

Recombinant luteinizing hormone (rLH) and recombinant follicle stimulating hormone (rFSH) for ovarian stimulation in IVF/ICSI cycles.
CONCLUSIONS: We found no clear evidence of a difference between rLH combined with rFSH and rFSH alone in rates of live birth or OHSS. The evidence for these comparisons was of very low-quality for live birth and low quality for OHSS. We found moderate quality evidence that the use of rLH combined with rFSH may lead to more ongoing pregnancies than rFSH alone. There was also moderate-quality evidence suggesting little or no difference between the groups in rates of miscarriage. There was no clear evidence of a difference between the groups in rates of cancellation due to low response or imminent OHSS, but the evidence for t...
Source: Cochrane Database of Systematic Reviews - May 24, 2017 Category: General Medicine Authors: Mochtar MH, Danhof NA, Ayeleke RO, Van der Veen F, van Wely M Tags: Cochrane Database Syst Rev Source Type: research

Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in children (excluding neonates).
Abstract BACKGROUND: Direct laryngoscopy is the method currently used for tracheal intubation in children. It occasionally offers unexpectedly poor laryngeal views. Indirect laryngoscopy involves visualizing the vocal cords by means other than obtaining a direct sight, with the potential to improve outcomes. We reviewed the current available literature and performed a meta-analysis to compare direct versus indirect laryngoscopy, or videolaryngoscopy, with regards to efficacy and adverse effects. OBJECTIVES: To assess the efficacy of indirect laryngoscopy, or videolaryngoscopy, versus direct laryngoscopy for i...
Source: Cochrane Database of Systematic Reviews - May 24, 2017 Category: General Medicine Authors: Abdelgadir IS, Phillips RS, Singh D, Moncreiff MP, Lumsden JL Tags: Cochrane Database Syst Rev Source Type: research