Stepping down the dose of inhaled corticosteroids for adults with asthma.
CONCLUSIONS: The strength of the evidence is not sufficient to determine whether stepping down the dose of ICS is of net benefit (in terms of fewer adverse effects) or harm (in terms of reduced effectiveness of treatment) for adult patients with well-controlled asthma. A small number of relevant studies and varied outcome measures limited the number of meta-analyses that we could perform. Additional well-designed RCTs of longer duration are needed to inform clinical practice regarding use of a 'stepping down ICS' strategy for patients with well-controlled asthma. PMID: 28146601 [PubMed - as supplied by publisher] (Sou...
Source: Cochrane Database of Systematic Reviews - January 31, 2017 Category: Journals (General) Authors: Crossingham I, Evans DJ, Halcovitch NR, Marsden PA Tags: Cochrane Database Syst Rev Source Type: research

Medical treatments for incomplete miscarriage.
CONCLUSIONS: The available evidence suggests that medical treatment, with misoprostol, and expectant care are both acceptable alternatives to routine surgical evacuation given the availability of health service resources to support all three approaches. Further studies, including long-term follow-up, are clearly needed to confirm these findings. There is an urgent need for studies on women who miscarry at more than 13 weeks' gestation. PMID: 28138973 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 30, 2017 Category: Journals (General) Authors: Kim C, Barnard S, Neilson JP, Hickey M, Vazquez JC, Dou L Tags: Cochrane Database Syst Rev Source Type: research

Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit.
CONCLUSIONS: Data are insufficient to promote the use of intravenous midazolam infusion as a sedative for neonates undergoing intensive care. This review raises concerns about the safety of midazolam in neonates. Further research on the effectiveness and safety of midazolam in neonates is needed. PMID: 28141899 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 30, 2017 Category: Journals (General) Authors: Ng E, Taddio A, Ohlsson A Tags: Cochrane Database Syst Rev Source Type: research

High-volume haemofiltration for sepsis in adults.
CONCLUSIONS: Investigators reported no adverse effects of HVHF (low-quality evidence). The results of this meta-analysis show that very few studies have been conducted to investigate the use of HVHF in critically ill patients with severe sepsis or septic shock (four studies, 201 participants, low-quality evidence). Researchers should consider additional randomized controlled trials that are large and multi-centred and have clinically relevant outcome measures. The cost-effectiveness of HVHF should also be studied. . PMID: 28141912 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 30, 2017 Category: Journals (General) Authors: Borthwick EM, Hill CJ, Rabindranath KS, Maxwell AP, McAuley DF, Blackwood B Tags: Cochrane Database Syst Rev Source Type: research

Systemic corticosteroid regimens for prevention of bronchopulmonary dysplasia in preterm infants.
CONCLUSIONS: Despite the fact that some studies reported a modulating effect of treatment regimens in favor of higher-dosage regimens on the incidence of BPD and neurodevelopmental impairment, recommendations on the optimal type of corticosteroid, the optimal dosage, or the optimal timing of initiation for the prevention of BPD in preterm infants cannot be made based on current level of evidence. A well-designed large RCT is urgently needed to establish the optimal systemic postnatal corticosteroid dosage regimen. PMID: 28141913 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 30, 2017 Category: Journals (General) Authors: Onland W, De Jaegere AP, Offringa M, van Kaam A Tags: Cochrane Database Syst Rev Source Type: research

Exercise for hand osteoarthritis.
CONCLUSIONS: When we pooled results from five studies, we found low-quality evidence showing small beneficial effects of exercise on hand pain, function and finger joint stiffness. Estimated effect sizes were small, and whether they represent a clinically important change may be debated. One study reported quality of life, and the effect is uncertain. Three studies reported on adverse events, which were very few and were not severe. PMID: 28141914 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 30, 2017 Category: Journals (General) Authors: Østerås N, Kjeken I, Smedslund G, Moe RH, Slatkowsky-Christensen B, Uhlig T, Hagen KB Tags: Cochrane Database Syst Rev Source Type: research

Interventions for prevention of bullying in the workplace.
CONCLUSIONS: There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well-designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow-up. PMID: 28134445 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 29, 2017 Category: Journals (General) Authors: Gillen PA, Sinclair M, Kernohan WG, Begley CM, Luyben AG Tags: Cochrane Database Syst Rev Source Type: research

Immediate referral to colposcopy versus cytological surveillance for minor cervical cytological abnormalities in the absence of HPV test.
CONCLUSIONS: Based on low- or moderate-quality evidence using the GRADE approach and generally low risk of bias, the detection rate of CIN2+ or CIN3+ after two years does not appear to differ between immediate colposcopy and cytological surveillance in the absence of HPV testing, although women may default from follow-up. Immediate colposcopy probably leads to earlier detection of high-grade lesions, but also detects more clinically insignificant low-grade lesions. Colposcopy may therefore be the first choice when good compliance is not assured. These results emphasize the need for an accurate reflex HPV triage test to dis...
Source: Cochrane Database of Systematic Reviews - January 26, 2017 Category: Journals (General) Authors: Kyrgiou M, Kalliala IE, Mitra A, Fotopoulou C, Ghaem-Maghami S, Martin-Hirsch PP, Cruickshank M, Arbyn M, Paraskevaidis E Tags: Cochrane Database Syst Rev Source Type: research

Vitamin E for Alzheimer's dementia and mild cognitive impairment.
CONCLUSIONS: We found no evidence that the alpha-tocopherol form of vitamin E given to people with MCI prevents progression to dementia, or that it improves cognitive function in people with MCI or dementia due to AD. However, there is moderate quality evidence from a single study that it may slow functional decline in AD. Vitamin E was not associated with an increased risk of serious adverse events or mortality in the trials in this review. These conclusions have changed since the previous update, however they are still based on small numbers of trials and participants and further research is quite likely to affect the re...
Source: Cochrane Database of Systematic Reviews - January 26, 2017 Category: Journals (General) Authors: Farina N, Llewellyn D, Isaac MG, Tabet N Tags: Cochrane Database Syst Rev Source Type: research

Second-line systemic therapy for metastatic colorectal cancer.
CONCLUSIONS: Systemic therapy offers a survival benefit to people with metastatic CRC who did not respond to first-line treatment, especially when targeted agents are combined with conventional chemotherapeutic drugs. Further research is needed to define the optimal regimen and to identify people who most benefit from each treatment. PMID: 28128439 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 26, 2017 Category: Journals (General) Authors: Mocellin S, Baretta Z, Roqué I Figuls M, Solà I, Martin-Richard M, Hallum S, Bonfill Cosp X Tags: Cochrane Database Syst Rev Source Type: research

Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support.
CONCLUSIONS: Findings from this review were based on four studies and 240 participants.There is low-quality evidence that a restrictive RBC transfusion policy reduces the number of RBC transfusions per participant. There is low-quality evidence that a restrictive RBC transfusion policy has little or no effect on: mortality at 30 to 100 days, bleeding, or hospital stay. This evidence is mainly based on adults with acute leukaemia who are having chemotherapy. Although, the two ongoing studies (530 participants) are due to be completed by January 2018 and will provide additional information for adults with haematological mali...
Source: Cochrane Database of Systematic Reviews - January 26, 2017 Category: Journals (General) Authors: Estcourt LJ, Malouf R, Trivella M, Fergusson DA, Hopewell S, Murphy MF Tags: Cochrane Database Syst Rev Source Type: research

Corticosteroids for the treatment of Kawasaki disease in children.
CONCLUSIONS: Moderate-quality evidence shows that use of steroids in the acute phase of KD can be associated with improved coronary artery abnormalities, shorter duration of hospital stay and a decreased duration of clinical symptoms. High-quality evidence shows reduced inflammatory marker levels. There were insufficient data available regarding incidence of adverse effects attributable to steroids, mortality and long-term (> 1 year) coronary morbidity. Certain groups, including those based in Asia, those with higher risk scores, and those receiving longer steroid treatment may have greater benefit from steroid use, esp...
Source: Cochrane Database of Systematic Reviews - January 26, 2017 Category: Journals (General) Authors: Wardle AJ, Connolly GM, Seager MJ, Tulloh RM Tags: Cochrane Database Syst Rev Source Type: research

Imaging for the exclusion of pulmonary embolism in pregnancy.
CONCLUSIONS: Both CTPA and lung scintigraphy seem appropriate for exclusion of pulmonary embolism during pregnancy. However, the quality of the evidence mandates cautious adoption of this conclusion. Important limitations included poor reference standards, necessary assumptions in the analysis regarding inconclusive test results and the inherent inability of included studies to identify false positives. It is unclear which test has the highest accuracy. There is a need for direct comparisons between diagnostic methods, including MR, in prospective randomized diagnostic studies. PMID: 28124411 [PubMed - as supplied by ...
Source: Cochrane Database of Systematic Reviews - January 25, 2017 Category: Journals (General) Authors: van Mens TE, Scheres LJ, de Jong PG, Leeflang MM, Nijkeuter M, Middeldorp S Tags: Cochrane Database Syst Rev Source Type: research

Corticosteroids as adjuvant therapy for ocular toxoplasmosis.
CONCLUSIONS: Although research has identified a wide variation in practice regarding the use of corticosteroids, our review did not identify any evidence from randomized controlled trials for or against the role of corticosteroids in the management of ocular toxoplasmosis. Several questions remain unanswered by well-conducted randomized trials in this context, including whether the use of corticosteroids as an adjunctive agent is more effective than the use of anti-parasitic therapy alone; if so, when corticosteroids should be initiated in the treatment regimen (early versus late course of treatment), and what would be the...
Source: Cochrane Database of Systematic Reviews - January 25, 2017 Category: Journals (General) Authors: Jasper S, Vedula SS, John SS, Horo S, Sepah YJ, Nguyen QD Tags: Cochrane Database Syst Rev Source Type: research

Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing.
Abstract BACKGROUND: The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother's admission to the labour ward. This is an update of a review published in 2012. OBJECTIVES: To compare the effects of admission cardiotocography with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register to ...
Source: Cochrane Database of Systematic Reviews - January 25, 2017 Category: Journals (General) Authors: Devane D, Lalor JG, Daly S, McGuire W, Cuthbert A, Smith V Tags: Cochrane Database Syst Rev Source Type: research

Oral anti-diabetic pharmacological therapies for the treatment of women with gestational diabetes.
CONCLUSIONS: There were insufficient data comparing oral anti-diabetic pharmacological therapies with placebo/standard care (lifestyle advice) to inform clinical practice. There was insufficient high-quality evidence to be able to draw any meaningful conclusions as to the benefits of one oral anti-diabetic pharmacological therapy over another due to limited reporting of data for the primary and secondary outcomes in this review. Short- and long-term clinical outcomes for this review were inadequately reported or not reported. Current choice of oral anti-diabetic pharmacological therapy appears to be based on clinical prefe...
Source: Cochrane Database of Systematic Reviews - January 24, 2017 Category: Journals (General) Authors: Brown J, Martis R, Hughes B, Rowan J, Crowther CA Tags: Cochrane Database Syst Rev Source Type: research

Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury.
CONCLUSIONS: We found no definitive, adequately powered RCTs of interventions for people with dysarthria. We found limited evidence to suggest there may be an immediate beneficial effect on impairment level measures; more, higher quality research is needed to confirm this finding.Although we evaluated five studies, the benefits and risks of interventions remain unknown and the emerging evidence justifies the need for adequately powered clinical trials into this condition.People with dysarthria after stroke or brain injury should continue to receive rehabilitation according to clinical guidelines. PMID: 28121021 [PubMe...
Source: Cochrane Database of Systematic Reviews - January 24, 2017 Category: Journals (General) Authors: Mitchell C, Bowen A, Tyson S, Butterfint Z, Conroy P Tags: Cochrane Database Syst Rev Source Type: research

Neuroprotection for treatment of glaucoma in adults.
CONCLUSIONS: Although the only trial we included in this review found less visual field loss in the brimonidine-treated group, the evidence was of such low certainty that we can draw no conclusions from this finding. Further clinical research is needed to determine whether neuroprotective agents may be beneficial for individuals with OAG. Such research should focus on outcomes important to patients, such as preservation of vision, and how these outcomes relate to cell death and optic nerve damage. As OAG is a chronic, progressive disease with variability in symptoms, RCTs designed to measure the effectiveness of neuro...
Source: Cochrane Database of Systematic Reviews - January 24, 2017 Category: Journals (General) Authors: Sena DF, Lindsley K Tags: Cochrane Database Syst Rev Source Type: research

Pneumococcal vaccines for preventing pneumonia in chronic obstructive pulmonary disease.
CONCLUSIONS: Injectable polyvalent pneumococcal vaccination provides significant protection against community-acquired pneumonia, although no evidence indicates that vaccination reduced the risk of confirmed pneumococcal pneumonia, which was a relatively rare event. Vaccination reduced the likelihood of a COPD exacerbation, and moderate-quality evidence suggests the benefits of pneumococcal vaccination in people with COPD. Evidence was insufficient for comparison of different pneumococcal vaccine types. PMID: 28116747 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 23, 2017 Category: Journals (General) Authors: Walters JA, Tang JN, Poole P, Wood-Baker R Tags: Cochrane Database Syst Rev Source Type: research

Psychological interventions for post-traumatic stress disorder (PTSD) in people with severe mental illness.
CONCLUSIONS: Very few trials have investigated TFPIs for individuals with SMI and PTSD. Results from trials of TF-CBT are limited and inconclusive regarding its effectiveness on PTSD, or on psychotic symptoms or other symptoms of psychological distress. Only one trial evaluated EMDR and provided limited preliminary evidence favouring EMDR compared to waiting list. Comparing TF-CBT head-to-head with EMDR and brief psychoeducation respectively, showed no clear effect for either therapy. Both TF-CBT and EMDR do not appear to cause more (or less) adverse effects, compared to waiting list or usual care; these findings however, ...
Source: Cochrane Database of Systematic Reviews - January 23, 2017 Category: Journals (General) Authors: Sin J, Spain D, Furuta M, Murrells T, Norman I Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological treatment for antipsychotic-related constipation.
CONCLUSIONS: We had hoped to find clinically useful evidence appraising the relative merits of the interventions routinely used to manage antipsychotic-related constipation, a common and potentially serious adverse effect of the use of these drugs. The results were disappointing. There were no data comparing the common pharmacological interventions for constipation, such as lactulose, polyethylene glycol, stool softeners, lubricant laxatives, or of novel treatments such as linaclotide. Data available were very poor quality and the trials had a high risk of bias. Data from these biased studies suggested that mannitol, an os...
Source: Cochrane Database of Systematic Reviews - January 23, 2017 Category: Journals (General) Authors: Every-Palmer S, Newton-Howes G, Clarke MJ Tags: Cochrane Database Syst Rev Source Type: research

Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy.
CONCLUSIONS: We know of no high-quality evidence from RCTs to guide use of treatments to prevent or treat corticosteroid-induced osteoporosis and reduce the risk of fragility fractures in children and adults with DMD; only limited results from two trials reported in abstracts were available. We await formal trial reports. Findings from two ongoing relevant studies and two trials, for which only abstracts are available, will be important in future updates of this review. PMID: 28117876 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 23, 2017 Category: Journals (General) Authors: Bell JM, Shields MD, Watters J, Hamilton A, Beringer T, Elliott M, Quinlivan R, Tirupathi S, Blackwood B Tags: Cochrane Database Syst Rev Source Type: research

Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination for subfertility associated with polycystic ovary syndrome.
CONCLUSIONS: Preliminary evidence suggests that metformin may increase the live birth rate among women undergoing ovulation induction with gonadotrophins. At this moment, evidence is insufficient to show an effect of metformin on multiple pregnancy rates and adverse events. Additional trials are necessary before we can provide further conclusions that may affect clinical practice. PMID: 28118681 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 23, 2017 Category: Journals (General) Authors: Bordewijk EM, Nahuis M, Costello MF, Van der Veen F, Tso LO, Mol BW, van Wely M Tags: Cochrane Database Syst Rev Source Type: research

Interventions for the prevention of OHSS in ART cycles: an overview of Cochrane reviews.
CONCLUSIONS: Currently, 27 reviews in the Cochrane Library were conducted to report on or to try to report on OHSS in ART cycles. We identified four review protocols but no new registered titles that can potentially be included in this overview in the future. This overview provides the most up-to-date evidence on prevention of OHSS in ART cycles from all currently published Cochrane reviews on ART. Clinicians can use the evidence summarised in this overview to choose the best treatment regimen for individual patients - a regimen that not only reduces the chance of developing OHSS but does not compromise other outcomes such...
Source: Cochrane Database of Systematic Reviews - January 22, 2017 Category: Journals (General) Authors: Mourad S, Brown J, Farquhar C Tags: Cochrane Database Syst Rev Source Type: research

Surgery for tubal infertility.
CONCLUSIONS: The effectiveness of tubal surgery relative to expectant management and IVF in terms of livebirth rates for women with tubal infertility remains unknown. Large trials with adequate power are warranted to establish the effectiveness of surgery in these women. Future trials should not only report livebirth rates per patient but should compare adverse effects and costs of treatment over a longer time. Factors that have a major effect on these outcomes, such as fertility treatment, female partner's age, duration of infertility and previous pregnancy history, should be considered. Researchers should report livebirt...
Source: Cochrane Database of Systematic Reviews - January 22, 2017 Category: Journals (General) Authors: Chua SJ, Akande VA, Mol BW Tags: Cochrane Database Syst Rev Source Type: research

Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis.
CONCLUSIONS: Owing to lack of high-quality evidence and lack of reporting of outcomes of interest for this review, we can make no judgement as to whether NSAIDs (naproxen) are effective in managing pain caused by endometriosis. No evidence shows whether any individual NSAID is more effective than another. As shown in other Cochrane reviews, women taking NSAIDs must be aware that these drugs may cause unintended effects. PMID: 28114727 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 22, 2017 Category: Journals (General) Authors: Brown J, Crawford TJ, Allen C, Hopewell S, Prentice A Tags: Cochrane Database Syst Rev Source Type: research

Cromolyn sodium for the prevention of chronic lung disease in preterm infants.
CONCLUSIONS: There is currently no evidence from randomised trials that cromolyn sodium has a role in the prevention of CLD. Cromolyn sodium cannot be recommended for the prevention of CLD in preterm infants. PMID: 28114736 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 22, 2017 Category: Journals (General) Authors: Ng G, Ohlsson A Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for infection prevention after excision of the cervical transformation zone.
CONCLUSIONS: As only limited data are available from three trials with overall moderate to high risk of bias, there is insufficient evidence to support use of antibiotics to reduce infectious complications following excision of the cervical transformation zone. In addition, there were minimal data about antibiotic-related adverse events and no information on the risk of developing antibiotic resistance. Antibiotics given for infection prevention after excision of the cervical transformation zone should only be used in the context of clinical research, to avoid unnecessary prescription of antibiotics and to prevent further ...
Source: Cochrane Database of Systematic Reviews - January 20, 2017 Category: Journals (General) Authors: Kietpeerakool C, Chumworathayi B, Thinkhamrop J, Ussahgij B, Lumbiganon P Tags: Cochrane Database Syst Rev Source Type: research

Music interventions for acquired brain injury.
We examined studies that included people older than 16 years of age who had ABI of a non-degenerative nature and were participating in treatment programmes offered in hospital, outpatient, or community settings. We included studies in any language, published and unpublished. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed the risk of bias of the included studies. We contacted trial researchers to obtain missing data or for additional information when necessary. Where possible, we presented results for continuous outcomes in meta-analyses using mean differences (MDs) and stand...
Source: Cochrane Database of Systematic Reviews - January 19, 2017 Category: Journals (General) Authors: Magee WL, Clark I, Tamplin J, Bradt J Tags: Cochrane Database Syst Rev Source Type: research

Vitamin D supplementation for sickle cell disease.
CONCLUSIONS: We included only one low-quality clinical study which had a high risk of bias with regards to incomplete outcome data. Therefore, we consider that the evidence is not of sufficient quality to guide clinical practice. Until further evidence becomes available, clinicians should consider the relevant existing guidelines for vitamin D supplementation (e.g. the Endocrine Society Clinical Practice Guidelines) and dietary reference intakes for calcium and vitamin D (e.g. from the USA Institute of Medicine). Evidence of vitamin D supplementation in sickle cell disease from high quality studies is needed. Well-designed...
Source: Cochrane Database of Systematic Reviews - January 19, 2017 Category: Journals (General) Authors: Soe HH, Abas AB, Than NN, Ni H, Singh J, Said AR, Osunkwo I Tags: Cochrane Database Syst Rev Source Type: research

Beta-blockers for hypertension.
CONCLUSIONS: Most outcome RCTs on beta-blockers as initial therapy for hypertension have high risk of bias. Atenolol was the beta-blocker most used. Current evidence suggests that initiating treatment of hypertension with beta-blockers leads to modest CVD reductions and little or no effects on mortality. These beta-blocker effects are inferior to those of other antihypertensive drugs. Further research should be of high quality and should explore whether there are differences between different subtypes of beta-blockers or whether beta-blockers have differential effects on younger and older people. PMID: 28107561 [PubMe...
Source: Cochrane Database of Systematic Reviews - January 19, 2017 Category: Journals (General) Authors: Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH Tags: Cochrane Database Syst Rev Source Type: research

Ataluren and similar compounds (specific therapies for premature termination codon class I mutations) for cystic fibrosis.
CONCLUSIONS: There is currently insufficient evidence to determine the effect of ataluren as a therapy for people with cystic fibrosis with class I mutations. Future trials should carefully assess for adverse events, notably renal impairment and consider the possibility of drug interactions. Cross-over trials should be avoided given the potential for the treatment to change the natural history of cystic fibrosis. PMID: 28102546 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 18, 2017 Category: Journals (General) Authors: Aslam AA, Higgins C, Sinha IP, Southern KW Tags: Cochrane Database Syst Rev Source Type: research

Exercise-based rehabilitation programmes for pulmonary hypertension.
CONCLUSIONS: In people with PH, exercise-based rehabilitation results in clinically relevant improvements in exercise capacity. Exercise training was not associated with any serious adverse events. Whilst most studies reported improvements in HRQoL, these may not be clinically important. Overall, we assessed the quality of the evidence to be low. The small number of studies and lack of information on participant selection makes it difficult to generalise these results across the spectrum of people with PH. PMID: 28099988 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 18, 2017 Category: Journals (General) Authors: Morris NR, Kermeen FD, Holland AE Tags: Cochrane Database Syst Rev Source Type: research

Effectiveness and safety of procalcitonin evaluation for reducing mortality in adults with sepsis, severe sepsis or septic shock.
CONCLUSIONS: Up-to-date evidence of very low to moderate quality, with insufficient sample power per outcome, does not clearly support the use of procalcitonin-guided antimicrobial therapy to minimize mortality, mechanical ventilation, clinical severity, reinfection or duration of antimicrobial therapy of patients with septic conditions. PMID: 28099689 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 17, 2017 Category: Journals (General) Authors: Andriolo BN, Andriolo RB, Salomão R, Atallah ÁN Tags: Cochrane Database Syst Rev Source Type: research

Septum resection for women of reproductive age with a septate uterus.
CONCLUSIONS: Hysteroscopic septum resection in women of reproductive age with a septate uterus is performed worldwide to improve reproductive outcomes. At present, there is no evidence to support the surgical procedure in these women. Randomised controlled trials are urgently needed. Two trials are currently underway. PMID: 28093720 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Rikken JF, Kowalik CR, Emanuel MH, Mol BW, Van der Veen F, van Wely M, Goddijn M Tags: Cochrane Database Syst Rev Source Type: research

Long-term hormone therapy for perimenopausal and postmenopausal women.
CONCLUSIONS: Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT, provided they do not have specific contraindications. HT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer (such as breast cancer, in women with a uterus). The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well docu...
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Marjoribanks J, Farquhar C, Roberts H, Lethaby A, Lee J Tags: Cochrane Database Syst Rev Source Type: research

Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.
CONCLUSIONS: There is no evidence for managing adults, or children who do not have HbSS sickle cell disease.In children who are at higher risk of stroke and have not had previous long-term transfusions, there is moderate quality evidence that long-term red cell transfusions reduce the risk of stroke, and low quality evidence they also reduce the risk of other sickle cell disease-related complications.In primary and secondary prevention of stroke there is low quality evidence that switching to hydroxyurea with phlebotomy has little or no effect on the liver iron concentration.In secondary prevention of stroke there is low-q...
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Estcourt LJ, Fortin PM, Hopewell S, Trivella M, Wang WC Tags: Cochrane Database Syst Rev Source Type: research

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.
CONCLUSIONS: The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews.There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life.The available evidence suggests physica...
Source: Cochrane Database of Systematic Reviews - January 13, 2017 Category: Journals (General) Authors: Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH Tags: Cochrane Database Syst Rev Source Type: research

Aspirin for acute treatment of episodic tension-type headache in adults.
CONCLUSIONS: A single dose of aspirin between 500 mg and 1000 mg provided some benefit in terms of less frequent use of rescue medication and more participants satisfied with treatment compared with placebo in adults with frequent episodic TTH who have an acute headache of moderate or severe intensity. There was no difference between a single dose of aspirin and placebo for the number of people experiencing adverse events. The amount and quality of the evidence was very limited and should be interpreted with caution. PMID: 28084009 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 12, 2017 Category: Journals (General) Authors: Derry S, Wiffen PJ, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

First-line combination therapy versus first-line monotherapy for primary hypertension.
CONCLUSIONS: The numbers of included participants and, hence the number of events, were too small to draw any conclusion about the relative efficacy of monotherapy versus combination therapy as initial treatment for primary hypertension. There is a need for large clinical trials that address the question and report clinically relevant endpoints. PMID: 28084624 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 12, 2017 Category: Journals (General) Authors: Garjón J, Saiz LC, Azparren A, Elizondo JJ, Gaminde I, Ariz MJ, Erviti J Tags: Cochrane Database Syst Rev Source Type: research

Treatments for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): an overview of systematic reviews.
CONCLUSIONS: We cannot be certain based on available evidence whether daily oral prednisone improves impairment compared to no treatment. However, corticosteroids are commonly used, based on widespread availability, low cost, very low-quality evidence from observational studies, and clinical experience. The weakness of the evidence does not necessarily mean that corticosteroids are ineffective. High-dose monthly oral dexamethasone for six months is probably no more or less effective than daily oral prednisolone. Plasma exchange produces short-term improvement in impairment as determined by neurological examination, and pro...
Source: Cochrane Database of Systematic Reviews - January 12, 2017 Category: Journals (General) Authors: Oaklander AL, Lunn MP, Hughes RA, van Schaik IN, Frost C, Chalk CH Tags: Cochrane Database Syst Rev Source Type: research

Topical capsaicin (high concentration) for chronic neuropathic pain in adults.
CONCLUSIONS: High-concentration topical capsaicin used to treat postherpetic neuralgia, HIV-neuropathy, and painful diabetic neuropathy generated more participants with moderate or substantial levels of pain relief than control treatment using a much lower concentration of capsaicin. These results should be interpreted with caution as the quality of the evidence was moderate or very low. The additional proportion who benefited over control was not large, but for those who did obtain high levels of pain relief, there were usually additional improvements in sleep, fatigue, depression, and quality of life. High-concentration ...
Source: Cochrane Database of Systematic Reviews - January 12, 2017 Category: Journals (General) Authors: Derry S, Rice AS, Cole P, Tan T, Moore RA Tags: Cochrane Database Syst Rev Source Type: research

Fibrin glue for pilonidal sinus disease.
Abstract BACKGROUND: Pilonidal sinus disease is a common condition that mainly affects young adults. This condition can cause significant pain and impairment of normal activities. No consensus currently exists on the optimum treatment for pilonidal sinus and current therapies have various advantages and disadvantages. Fibrin glue has emerged as a potential treatment as both monotherapy and an adjunct to surgery. OBJECTIVES: To assess the effects of fibrin glue alone or in combination with surgery compared with surgery alone in the treatment of pilonidal sinus disease. SEARCH METHODS: In December 2016 we ...
Source: Cochrane Database of Systematic Reviews - January 12, 2017 Category: Journals (General) Authors: Lund J, Tou S, Doleman B, Williams JP Tags: Cochrane Database Syst Rev Source Type: research

Pharmacological treatment of vascular risk factors for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm.
CONCLUSIONS: Due to the limited number of included trials, there is insufficient evidence to draw any conclusions about the effectiveness of cardiovascular prophylaxis in reducing mortality and cardiovascular events in people with AAA. Further good-quality randomised controlled trials that examine many types of prophylaxis with long-term follow-up are required before firm conclusions can be made. PMID: 28079254 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 11, 2017 Category: Journals (General) Authors: Robertson L, Atallah E, Stansby G Tags: Cochrane Database Syst Rev Source Type: research

Yoga treatment for chronic non-specific low back pain.
CONCLUSIONS: There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance. It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone. Yoga is associated with more adverse events than non-exercise controls, but may have t...
Source: Cochrane Database of Systematic Reviews - January 11, 2017 Category: Journals (General) Authors: Wieland LS, Skoetz N, Pilkington K, Vempati R, D'Adamo CR, Berman BM Tags: Cochrane Database Syst Rev Source Type: research

Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation.
Abstract BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear. ...
Source: Cochrane Database of Systematic Reviews - January 10, 2017 Category: Journals (General) Authors: Rose L, Adhikari NK, Leasa D, Fergusson DA, McKim D Tags: Cochrane Database Syst Rev Source Type: research

Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.
CONCLUSIONS: Overall, combination inhaled therapy with SAAC and SABA reduced hospitalisation and improved pulmonary function in adults presenting to the ED with acute asthma. In particular, combination inhaled therapy was more effective in preventing hospitalisation in adults with severe asthma exacerbations who are at increased risk of hospitalisation, compared to those with mild-moderate exacerbations, who were at a lower risk to be hospitalised. A single dose of combination therapy and multiple doses both showed reductions in the risk of hospitalisation among adults with acute asthma. However, adults receiving combinati...
Source: Cochrane Database of Systematic Reviews - January 10, 2017 Category: Journals (General) Authors: Kirkland SW, Vandenberghe C, Voaklander B, Nikel T, Campbell S, Rowe BH Tags: Cochrane Database Syst Rev Source Type: research

Polyclonal and monoclonal antibodies for induction therapy in kidney transplant recipients.
CONCLUSIONS: ATG reduces acute rejection but has uncertain effects on death, graft survival, malignancy and NODAT, and increases CMV infection, thrombocytopenia and leucopenia. Given a 45% acute rejection risk without ATG induction, seven patients would need treatment to prevent one having rejection, while incurring an additional patient experiencing CMV disease for every 12 treated. Excluding non-CNI studies, the risk of rejection was 37% without induction with six patients needing treatment to prevent one having rejection.In the context of steroid minimisation, alemtuzumab prevents acute rejection at 1 year compared to A...
Source: Cochrane Database of Systematic Reviews - January 10, 2017 Category: Journals (General) Authors: Hill P, Cross NB, Barnett AN, Palmer SC, Webster AC Tags: Cochrane Database Syst Rev Source Type: research

Psychosocial interventions for recurrent abdominal pain in childhood.
Abstract BACKGROUND: This review supersedes the original Cochrane review first published in 2008 (Huertas-Ceballos 2008).Between 4% and 25% of school-aged children complain of recurrent abdominal pain (RAP) severe enough to interfere with their daily activities. No organic cause for this pain can be found on physical examination or investigation for the majority of such children. Although many children are managed by reassurance and simple measures, a large range of psychosocial interventions involving cognitive and behavioural components have been recommended. OBJECTIVES: To determine the effectiveness of ps...
Source: Cochrane Database of Systematic Reviews - January 9, 2017 Category: Journals (General) Authors: Abbott RA, Martin AE, Newlove-Delgado TV, Bethel A, Thompson-Coon J, Whear R, Logan S Tags: Cochrane Database Syst Rev Source Type: research

Symptomatic treatments for amyotrophic lateral sclerosis/motor neuron disease.
CONCLUSIONS: This overview has highlighted the lack of robust evidence in Cochrane Systematic Reviews on interventions to manage symptoms resulting from MND. It is important to recognise that clinical trials may fail to demonstrate efficacy of an intervention for reasons other than a true lack of efficacy, for example because of insufficient statistical power, the wrong choice of dose, insensitive outcome measures or inappropriate participant eligibility. The trials were mostly too small to reliably assess adverse effects of the treatments. The nature of MND makes it difficult to research clinically accepted or recommended...
Source: Cochrane Database of Systematic Reviews - January 9, 2017 Category: Journals (General) Authors: Ng L, Khan F, Young CA, Galea M Tags: Cochrane Database Syst Rev Source Type: research