Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis.
CONCLUSIONS: We found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found. PMID: 29112241 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 7, 2017 Category: General Medicine Authors: Li C, Lv Z, Shi Z, Zhu Y, Wu Y, Li L, Iheozor-Ejiofor Z Tags: Cochrane Database Syst Rev Source Type: research

Tumour bed boost radiotherapy for women after breast-conserving surgery.
CONCLUSIONS: It appears that local control rates are increased with the boost to the tumour bed, but we found no evidence of a benefit for other oncological outcomes. Subgroup analysis including women older than 40 years of age yielded similarly significant results. Objective percentage of breast retraction assessment appears similar between groups. It appears that the cosmetic outcome is worse with the boost to the tumour bed, but only when measured by a panel, not when assessed by a physician. PMID: 29105051 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kindts I, Laenen A, Depuydt T, Weltens C Tags: Cochrane Database Syst Rev Source Type: research

Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.
CONCLUSIONS: Our findings indicate that DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding. The major limitation is that the results of this study chiefly reflect CKD stage G3. Application of the results to CKD stage G4 patients requires additional investigation. Furthermore, we could not assess CKD stage G5 patients. Future reviews should assess participants at more advanced CKD stages. Additio...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S Tags: Cochrane Database Syst Rev Source Type: research

Tests for detecting strabismus in children aged 1 to 6 years in the community.
CONCLUSIONS: There is very limited data in the literature to ascertain the accuracy of tests for detecting strabismus in the community as performed by non-expert screeners. A large prospective study to compare methods would be required to determine which tests have the greatest accuracy. PMID: 29105728 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Hull S, Tailor V, Balduzzi S, Rahi J, Schmucker C, Virgili G, Dahlmann-Noor A Tags: Cochrane Database Syst Rev Source Type: research

Hypothalamic-pituitary-adrenal (HPA) axis suppression after treatment with glucocorticoid therapy for childhood acute lymphoblastic leukaemia.
CONCLUSIONS: We concluded that adrenal insufficiency commonly occurs in the first days after cessation of glucocorticoid therapy for childhood ALL, but the exact duration is unclear. No data were available on the levels of the hypothalamus and the pituitary; therefore, we could draw no conclusions regarding these outcomes. Clinicians may consider prescribing glucocorticoid replacement therapy during periods of serious stress in the first weeks after cessation of glucocorticoid therapy for childhood ALL to reduce the risk of life-threatening complications. However, additional high-quality research is needed to inform eviden...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Rensen N, Gemke RJ, van Dalen EC, Rotteveel J, Kaspers GJ Tags: Cochrane Database Syst Rev Source Type: research

Insulin for the treatment of women with gestational diabetes.
CONCLUSIONS: The main comparison in this review is insulin versus oral anti-diabetic pharmacological therapies. Insulin and oral anti-diabetic pharmacological therapies have similar effects on key health outcomes. The quality of the evidence ranged from very low to moderate, with downgrading decisions due to imprecision, risk of bias and inconsistency.For the other comparisons of this review (insulin compared with non-pharmacological interventions, different insulin analogies or different insulin regimens), there is insufficient volume of high-quality evidence to determine differences for key health outcomes.Long-term mate...
Source: Cochrane Database of Systematic Reviews - November 5, 2017 Category: General Medicine Authors: Brown J, Grzeskowiak L, Williamson K, Downie MR, Crowther CA Tags: Cochrane Database Syst Rev Source Type: research

Closure methods for laparotomy incisions for preventing incisional hernias and other wound complications.
CONCLUSIONS: Based on this moderate-quality body of evidence, monofilament sutures may reduce the risk of incisional hernia. Absorbable sutures may also reduce the risk of sinus or fistula tract formation, but this finding is based on low-quality evidence.We had serious concerns about the design or reporting of several of the 55 included trials. The comparator arms in many trials differed by more than one component, making it impossible to attribute differences between groups to any one component. In addition, the patient population included in many of the studies was very heterogeneous. Trials included both emergency...
Source: Cochrane Database of Systematic Reviews - November 3, 2017 Category: General Medicine Authors: Patel SV, Paskar DD, Nelson RL, Vedula SS, Steele SR Tags: Cochrane Database Syst Rev Source Type: research

Chloral hydrate as a sedating agent for neurodiagnostic procedures in children.
CONCLUSIONS: The quality of evidence for the comparisons of oral chloral hydrate against several other methods of sedation was very variable. Oral chloral hydrate appears to have a lower sedation failure rate when compared with oral promethazine for children undergoing paediatric neurodiagnostic procedures. The sedation failure was similar for other comparisons such as oral dexmedetomidine, oral hydroxyzine hydrochloride, and oral midazolam. When compared with intravenous pentobarbital and music therapy, oral chloral hydrate had a higher sedation failure rate. However, it must be noted that the evidence for the outcomes fo...
Source: Cochrane Database of Systematic Reviews - November 3, 2017 Category: General Medicine Authors: Fong CY, Tay CG, Ong LC, Lai NM Tags: Cochrane Database Syst Rev Source Type: research

Vitamin D supplementation for chronic liver diseases in adults.
CONCLUSIONS: We are uncertain as to whether vitamin D supplements in the form of vitamin D3, vitamin D2, 1,25-dihydroxyvitamin D, or 25-dihydroxyvitamin D have important effect on all-cause mortality, liver-related mortality, or on serious or non-serious adverse events because the results were imprecise. There is no evidence on the effect of vitamin D supplementation on liver-related morbidity and health-related quality of life. Our conclusions are based on few trials with an insufficient number of participants and on lack of data on clinically important outcomes. In addition, the analysed trials are at high risk of bias w...
Source: Cochrane Database of Systematic Reviews - November 3, 2017 Category: General Medicine Authors: Bjelakovic G, Nikolova D, Bjelakovic M, Gluud C Tags: Cochrane Database Syst Rev Source Type: research

Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease.
CONCLUSIONS: Women with CIN have a higher baseline risk for prematurity. Excisional and ablative treatment appears to further increases that risk. The frequency and severity of adverse sequelae increases with increasing cone depth and is higher for excision than it is for ablation. However, the results should be interpreted with caution as they were based on low or very low quality (GRADE assessment) observational studies, most of which were retrospective. PMID: 29095502 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 2, 2017 Category: General Medicine Authors: Kyrgiou M, Athanasiou A, Kalliala IEJ, Paraskevaidi M, Mitra A, Martin-Hirsch PP, Arbyn M, Bennett P, Paraskevaidis E Tags: Cochrane Database Syst Rev Source Type: research

Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation.
CONCLUSIONS: We found no conclusive evidence indicating that clomiphene citrate or letrozole with or without gonadotropins differed from gonadotropins in GnRH agonist or antagonist protocols with respect to their effects on live-birth or pregnancy rates, either in the general population of women undergoing IVF treatment or in women who were poor responders. Use of clomiphene or letrozole led to a reduction in the amount of gonadotropins required and the incidence of OHSS. However, use of clomiphene citrate or letrozole may be associated with a significant increase in the incidence of cycle cancellations, as well as reducti...
Source: Cochrane Database of Systematic Reviews - November 2, 2017 Category: General Medicine Authors: Kamath MS, Maheshwari A, Bhattacharya S, Lor KY, Gibreel A Tags: Cochrane Database Syst Rev Source Type: research

Antibiotic prophylaxis for episiotomy repair following vaginal birth.
CONCLUSIONS: There was insufficient evidence to assess the clinical benefits or harms of routine antibiotic prophylaxis for episiotomy repair after normal birth. The only trial included in this review had several methodological limitations, with very serious limitations in design, and imprecision of effect estimates. In addition, the trial tested an antibiotic with limited application in current clinical practice. There is a need for a careful and rigorous assessment of the comparative benefits and harms of prophylactic antibiotics on infection morbidity after episiotomy, in well-designed randomised controlled trials, usin...
Source: Cochrane Database of Systematic Reviews - November 2, 2017 Category: General Medicine Authors: Bonet M, Ota E, Chibueze CE, Oladapo OT Tags: Cochrane Database Syst Rev Source Type: research

Glucocorticosteroids for people with alcoholic hepatitis.
CONCLUSIONS: We found no evidence of a difference between glucocorticosteroids and placebo or no intervention on all-cause mortality, health-related quality of life, and serious adverse events during treatment. The risk of bias was high and the quality of evidence was very low or low. Therefore, we are very uncertain about this effect estimate. Due to inadequate reporting, we cannot exclude increases in adverse events. As the confidence intervals were wide, we cannot rule out significant benefits and harms of glucocorticosteroids. Therefore, we need placebo-controlled, randomised clinical trials, designed according to the ...
Source: Cochrane Database of Systematic Reviews - November 2, 2017 Category: General Medicine Authors: Pavlov CS, Varganova DL, Casazza G, Tsochatzis E, Nikolova D, Gluud C Tags: Cochrane Database Syst Rev Source Type: research

Yoga for treatment of urinary incontinence in women.
The objectives are as follows: To assess the effectiveness and safety of yoga for treatment of urinary incontinence in women, compared to no specific treatment, to another active treatment, or to an active treatment without adjuvant yoga, with a focus on patient symptoms and quality of life. PMID: 29081716 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 1, 2017 Category: General Medicine Authors: Wieland LS, Shrestha N, Lassi ZS, Panda S, Chiaramonte D, Skoetz N Tags: Cochrane Database Syst Rev Source Type: research

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.
CONCLUSIONS: Overall, for women with a multiple pregnancy, the administration of progesterone (either IM or vaginal) does not appear to be associated with a reduction in risk of preterm birth or improved neonatal outcomes.Future research could focus on a comprehensive individual participant data meta-analysis including all of the available data relating to both IM and vaginal progesterone administration in women with a multiple pregnancy, before considering the need to conduct trials in subgroups of high-risk women (for example, women with a multiple pregnancy and a short cervical length identified on ultrasound). PMI...
Source: Cochrane Database of Systematic Reviews - October 31, 2017 Category: General Medicine Authors: Dodd JM, Grivell RM, OBrien CM, Dowswell T, Deussen AR Tags: Cochrane Database Syst Rev Source Type: research

Nerve blocks or no nerve blocks for pain control after elective hip replacement (arthroplasty) surgery in adults.
CONCLUSIONS: Compared to systemic analgesia alone, there is moderate-quality evidence that peripheral nerve blocks reduce postoperative pain, low-quality evidence that patient satisfaction is increased and very low-quality evidence for reductions in acute confusional status, pruritus and hospital length of stay .We found moderate-quality evidence that peripheral nerve blocks reduce pruritus compared with neuraxial blocks.The 11 ongoing studies, once completed, and the three studies awaiting classification may alter the conclusions of the review once assessed. PMID: 29087547 [PubMed - as supplied by publisher] (Source:...
Source: Cochrane Database of Systematic Reviews - October 31, 2017 Category: General Medicine Authors: Guay J, Johnson RL, Kopp S Tags: Cochrane Database Syst Rev Source Type: research

Bisphosphonates and other bone agents for breast cancer.
Abstract BACKGROUND: Bone is the most common site of metastatic disease associated with breast cancer (BC). Bisphosphonates inhibit osteoclast-mediated bone resorption, and novel targeted therapies such as denosumab inhibit other key bone metabolism pathways. We have studied these agents in both early breast cancer and advanced breast cancer settings. This is an update of the review originally published in 2002 and subsequently updated in 2005 and 2012. OBJECTIVES: To assess the effects of bisphosphonates and other bone agents in addition to anti-cancer treatment: (i) in women with early breast canc...
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: O'Carrigan B, Wong MH, Willson ML, Stockler MR, Pavlakis N, Goodwin A Tags: Cochrane Database Syst Rev Source Type: research

Mefloquine for preventing malaria during travel to endemic areas.
CONCLUSIONS: The absolute risk of malaria during short-term travel appears low with all three established antimalarial agents (mefloquine, doxycycline, and atovaquone-proguanil).The choice of antimalarial agent depends on how individual travellers assess the importance of specific adverse effects, pill burden, and cost. Some travellers will prefer mefloquine for its once-weekly regimen, but this should be balanced against the increased frequency of abnormal dreams, anxiety, insomnia, and depressed mood. PMID: 29083100 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: Tickell-Painter M, Maayan N, Saunders R, Pace C, Sinclair D Tags: Cochrane Database Syst Rev Source Type: research

Intracavity lavage and wound irrigation for prevention of surgical site infection.
CONCLUSIONS: The evidence base for intracavity lavage and wound irrigation is generally of low certainty. Therefore where we identified a possible difference in the incidence of SSI (in comparisons of antibacterial and non-antibacterial interventions, and pulsatile versus standard methods) these should be considered in the context of uncertainty, particularly given the possibility of publication bias for the comparison of antibacterial and non-antibacterial interventions. Clinicians should also consider whether the evidence is relevant to the surgical populations under consideration, the varying reporting of other prophyla...
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: Norman G, Atkinson RA, Smith TA, Rowlands C, Rithalia AD, Crosbie EJ, Dumville JC Tags: Cochrane Database Syst Rev Source Type: research

Uric acid lowering therapies for preventing or delaying the progression of chronic kidney disease.
CONCLUSIONS: There is limited data which suggests uric acid lowering therapy may prevent progression of chronic kidney disease but the conclusion is very uncertain. Benefits were not observed at all time points and study quality was generally low. Larger studies are required to study the effect of uric acid lowering therapy on CKD progression. Three ongoing studies will hopefully provide much needed high quality data. PMID: 29084343 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: Sampson AL, Singer RF, Walters GD Tags: Cochrane Database Syst Rev Source Type: research

Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews.
CONCLUSIONS: A number of adverse events, including serious adverse events, are associated with the medium- and long-term use of opioids for CNCP. The absolute event rate for any adverse event with opioids in trials using a placebo as comparison was 78%, with an absolute event rate of 7.5% for any serious adverse event. Based on the adverse events identified, clinically relevant benefit would need to be clearly demonstrated before long-term use could be considered in people with CNCP in clinical practice. A number of adverse events that we would have expected to occur with opioid use were not reported in the included Cochra...
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: Els C, Jackson TD, Kunyk D, Lappi VG, Sonnenberg B, Hagtvedt R, Sharma S, Kolahdooz F, Straube S Tags: Cochrane Database Syst Rev Source Type: research

High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews.
CONCLUSIONS: There is a critical lack of high-quality evidence regarding how well high-dose opioids work for the management of chronic non-cancer pain in adults, and regarding the presence and severity of adverse events. No evidence-based argument can be made on the use of high-dose opioids, i.e. 200 mg morphine equivalent or more daily, in clinical practice. Trials typically used doses below our cut-off; we need to know the efficacy and harm of higher doses, which are often used in clinical practice. PMID: 29084358 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2017 Category: General Medicine Authors: Els C, Jackson TD, Hagtvedt R, Kunyk D, Sonnenberg B, Lappi VG, Straube S Tags: Cochrane Database Syst Rev Source Type: research

Different methods and settings for glucose monitoring for gestational diabetes during pregnancy.
CONCLUSIONS: Evidence from 11 RCTs assessing different methods or settings for glucose monitoring for GDM suggests no clear differences for the primary outcomes or other secondary outcomes assessed in this review.However, current evidence is limited by the small number of RCTs for the comparisons assessed, small sample sizes, and the variable methodological quality of the RCTs. More evidence is needed to assess the effects of different methods and settings for glucose monitoring for GDM on outcomes for mothers and their children, including use and costs of health care. Future RCTs may consider collecting and reporting on t...
Source: Cochrane Database of Systematic Reviews - October 29, 2017 Category: General Medicine Authors: Raman P, Shepherd E, Dowswell T, Middleton P, Crowther CA Tags: Cochrane Database Syst Rev Source Type: research

Metformin for endometrial hyperplasia.
CONCLUSIONS: At present, evidence is insufficient to support or refute the use of metformin alone or in combination with standard therapy - specifically, megestrol acetate - versus megestrol acetate alone, for treatment of endometrial hyperplasia. Robustly designed and adequately powered randomised controlled trials yielding long-term outcome data are needed to address this clinical question. PMID: 29077194 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 27, 2017 Category: General Medicine Authors: Clement NS, Oliver TR, Shiwani H, Sanner JR, Mulvaney CA, Atiomo W Tags: Cochrane Database Syst Rev Source Type: research

Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support.
CONCLUSIONS: Risks and benefits of NAVA compared to other forms of ventilation for neonates are uncertain. Well-designed trials are required to evaluate this new form of triggered ventilation. PMID: 29077984 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 27, 2017 Category: General Medicine Authors: Rossor TE, Hunt KA, Shetty S, Greenough A Tags: Cochrane Database Syst Rev Source Type: research

Psychological treatments for people with epilepsy.
Abstract BACKGROUND: Given the significant impact epilepsy can have on the health-related quality of life (HRQoL) of individuals with epilepsy and their families, there is great clinical interest in evidence-based psychological treatments, aimed at enhancing psychological well-being in people with epilepsy. A review of the current evidence was needed to assess the effects of psychological treatments for people with epilepsy on HRQoL outcomes, in order to inform future therapeutic recommendations and research designs. OBJECTIVES: To assess the effects of psychological treatments for people with epilepsy on HRQ...
Source: Cochrane Database of Systematic Reviews - October 27, 2017 Category: General Medicine Authors: Michaelis R, Tang V, Wagner JL, Modi AC, LaFrance WC, Goldstein LH, Lundgren T, Reuber M Tags: Cochrane Database Syst Rev Source Type: research

Eslicarbazepine acetate add-on for drug-resistant partial epilepsy.
CONCLUSIONS: ESL reduces seizure frequency when used as an add-on treatment for people with drug-resistant partial epilepsy. The trials included in this review were of short-term duration and focused on adults. One new trial has been included in this update, but the conclusions are unchanged. PMID: 29067682 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 25, 2017 Category: General Medicine Authors: Chang XC, Yuan H, Wang Y, Xu HQ, Hong WK, Zheng RY Tags: Cochrane Database Syst Rev Source Type: research

Early ( < 8 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants.
Early (
Source: Cochrane Database of Systematic Reviews - October 24, 2017 Category: General Medicine Authors: Doyle LW, Cheong JL, Ehrenkranz RA, Halliday HL Tags: Cochrane Database Syst Rev Source Type: research

Late ( > 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants.
CONCLUSIONS: Benefits of late corticosteroid therapy may not outweigh actual or potential adverse effects. This review of postnatal systemic corticosteroid treatment for bronchopulmonary dysplasia initiated after seven days of age suggests that late therapy may reduce neonatal mortality without significantly increasing the risk of adverse long-term neurodevelopmental outcomes. However, the methodological quality of studies determining long-term outcomes is limited in some cases (some studies assessed surviving children only before school age, when some important neurological outcomes cannot be determined with certainty), a...
Source: Cochrane Database of Systematic Reviews - October 24, 2017 Category: General Medicine Authors: Doyle LW, Cheong JL, Ehrenkranz RA, Halliday HL Tags: Cochrane Database Syst Rev Source Type: research

Different communication strategies for disclosing a diagnosis of schizophrenia and related disorders.
CONCLUSIONS: Good communication of diagnosis can affect treatment planning, compliance and patient outcomes, especially in the case of conditions such as schizophrenia, which has the potential to cause serious life disruption for both people with schizophrenia and their carers. Currently, there is no evidence based on findings from RCTs assessing the effects of communication strategies for disclosing the diagnosis of schizophrenia and related disorders. Research is required. PMID: 29064090 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 24, 2017 Category: General Medicine Authors: Farooq S, Johal RK, Ziff C, Naeem F Tags: Cochrane Database Syst Rev Source Type: research

Planned caesarean section versus planned vaginal birth for severe pre-eclampsia.
CONCLUSIONS: There is a lack of robust evidence from randomised controlled trials that can inform practice regarding planned caesarean section versus planned vaginal birth for women with severe pre-eclampsia. There is a need for high-quality randomised controlled trials to assess the short- and long-term effects of caesarean section and vaginal birth for these women and their babies. PMID: 29058762 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2017 Category: General Medicine Authors: Amorim MM, Souza ASR, Katz L Tags: Cochrane Database Syst Rev Source Type: research

Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children.
CONCLUSIONS: There is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring. PMID: 29059464 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2017 Category: General Medicine Authors: Takahashi R, Ota E, Hoshi K, Naito T, Toyoshima Y, Yuasa H, Mori R, Nango E Tags: Cochrane Database Syst Rev Source Type: research

Desmopressin for treating nocturia in men.
CONCLUSIONS: Desmopressin may reduce the number of nocturnal voids in an appreciable number of participants compared to placebo in intermediate-term (three to 12 months) follow-up without increase in major adverse events. We found no evidence to compare its effects to behavior modification. The effect on the number of nocturnal voids is likely similar to that of alpha-blockers short-term with very infrequent major adverse events. There appears to be no added benefit in the combined use of desmopressin with an alpha-blocker or an anticholinergic. The findings of this review were limited by short-term follow-up, study limita...
Source: Cochrane Database of Systematic Reviews - October 21, 2017 Category: General Medicine Authors: Han J, Jung JH, Bakker CJ, Ebell MH, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Pharmacotherapy for social anxiety disorder (SAnD).
CONCLUSIONS: We found evidence of treatment efficacy for the SSRIs, but it is based on very low- to moderate-quality evidence. Tolerability of SSRIs was lower than placebo, but absolute withdrawal rates were low.While a small number of trials did report treatment efficacy for benzodiazepines, anticonvulsants, MAOIs, and RIMAs, readers should consider this finding in the context of potential for abuse or unfavourable side effects. PMID: 29048739 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2017 Category: General Medicine Authors: Williams T, Hattingh CJ, Kariuki CM, Tromp SA, van Balkom AJ, Ipser JC, Stein DJ Tags: Cochrane Database Syst Rev Source Type: research

Hematopoietic stem cell transplantation for Gaucher disease.
CONCLUSIONS: HSCT is a form of treatment that offers the potential of permanent cure. However, there are no clinical trials that have assessed the safety and efficacy of this treatment in comparison to other conservative measures (enzyme replacement therapy, substrate reduction therapy) now in use.There are no trials included in the review and we have not identified any relevant trials up to March 2017. We therefore do not plan to update this review until new trials are published. PMID: 29044482 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 18, 2017 Category: General Medicine Authors: Somaraju UR, Tadepalli K Tags: Cochrane Database Syst Rev Source Type: research

Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes.
CONCLUSIONS: There are insufficient RCT data to evaluate the use of oral anti-diabetic agents in women with established diabetes, impaired glucose tolerance or previous gestational diabetes who are planning a pregnancy, or in pregnant women with pre-existing diabetes. Low to very low-quality evidence suggests possible reductions in pregnancy-induced hypertension, caesarean section birth and neonatal hypoglycaemia with metformin compared with insulin for women with type 2 diabetes diagnosed before or during their pregnancy, and no clear differences in pre-eclampsia, induction of labour and babies that are large-for-gestatio...
Source: Cochrane Database of Systematic Reviews - October 18, 2017 Category: General Medicine Authors: Tieu J, Coat S, Hague W, Middleton P, Shepherd E Tags: Cochrane Database Syst Rev Source Type: research

Influenza vaccines for preventing acute otitis media in infants and children.
CONCLUSIONS: Influenza vaccine results in a small reduction in AOM. The observed reduction in the use of antibiotics needs to be considered in light of current recommended practices aimed at avoiding antibiotic overuse. Safety data from these trials were limited. The benefits may not justify the use of influenza vaccine without taking into account the vaccine efficacy in reducing influenza and safety data. We judged the quality of the evidence to be low to moderate. Additional research is needed. PMID: 29039160 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 17, 2017 Category: General Medicine Authors: Norhayati MN, Ho JJ, Azman MY Tags: Cochrane Database Syst Rev Source Type: research

Volume-targeted versus pressure-limited ventilation in neonates.
CONCLUSIONS: Infants ventilated using VTV modes had reduced rates of death or BPD, pneumothoraces, hypocarbia, severe cranial ultrasound pathologies and duration of ventilation compared with infants ventilated using PLV modes. Further studies are needed to identify whether VTV modes improve neurodevelopmental outcomes and to compare and refine VTV strategies. PMID: 29039883 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 17, 2017 Category: General Medicine Authors: Klingenberg C, Wheeler KI, McCallion N, Morley CJ, Davis PG Tags: Cochrane Database Syst Rev Source Type: research

Ocriplasmin for symptomatic vitreomacular adhesion.
CONCLUSIONS: Evidence from a limited number of RCTs suggests that ocriplasmin is useful in the treatment of sVMA. However, up to 20% of eyes treated with ocriplasmin will still require additional treatment with PPV within six months. There were more ocular adverse events in eyes treated with ocriplasmin than control (sham or placebo injection) treatment. Many of these adverse events, particularly vitreous floaters and photopsia, are known to be associated with posterior vitreous detachment. At present however, there is minimal published long-term safety data on eyes treated with ocriplasmin. Further large RCTs comparing oc...
Source: Cochrane Database of Systematic Reviews - October 17, 2017 Category: General Medicine Authors: Neffendorf JE, Kirthi V, Pringle E, Jackson TL Tags: Cochrane Database Syst Rev Source Type: research

Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates.
CONCLUSIONS: We found no evidence that early inhaled steroids confer important advantages over systemic steroids in the management of ventilator-dependent preterm infants. Based on this review inhaled steroids cannot be recommended over systemic steroids as a part of standard practice for ventilated preterm infants. Because they might have fewer adverse effects than systemic steroids, further randomised controlled trials of inhaled steroids are needed that address risk/benefit ratio of different delivery techniques, dosing schedules and long-term effects, with particular attention to neurodevelopmental outcome. PMID: ...
Source: Cochrane Database of Systematic Reviews - October 17, 2017 Category: General Medicine Authors: Shah SS, Ohlsson A, Halliday HL, Shah VS Tags: Cochrane Database Syst Rev Source Type: research

Acupuncture or acupressure for induction of labour.
Abstract BACKGROUND: This is one of a series of reviews of methods of cervical ripening and labour induction. The use of complementary therapies is increasing. Women may look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. Acupressure is using the thumbs or fingers to apply pressure to specific points. The limited observational studies to date suggest acupuncture for induction of labour has no known adverse effects to the fetus, and may be effective. However, the ...
Source: Cochrane Database of Systematic Reviews - October 17, 2017 Category: General Medicine Authors: Smith CA, Armour M, Dahlen HG Tags: Cochrane Database Syst Rev Source Type: research

Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth weight preterm infants.
CONCLUSIONS: We found no evidence that inhaled corticosteroids confer net advantages over systemic corticosteroids in the management of ventilator-dependent preterm infants. There was no evidence of difference in effectiveness or adverse event profiles for inhaled versus systemic steroids.A better delivery system guaranteeing selective delivery of inhaled steroids to the alveoli might result in beneficial clinical effects without increasing adverse events.To resolve this issue, studies are needed to identify the risk/benefit ratio of different delivery techniques and dosing schedules for administration of these medications...
Source: Cochrane Database of Systematic Reviews - October 16, 2017 Category: General Medicine Authors: Shah SS, Ohlsson A, Halliday HL, Shah VS Tags: Cochrane Database Syst Rev Source Type: research

Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.
de Lange DW, Deliberato RO, Lima SS, Maravić-Stojković V, Verduri A, Cao B, Shehabi Y, Beishuizen A, Jensen JS, Corti C, Van Oers JA, Falsey AR, de Jong E, Oliveira CF, Beghe B, Briel M, Mueller B Abstract BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the...
Source: Cochrane Database of Systematic Reviews - October 13, 2017 Category: General Medicine Authors: Schuetz P, Wirz Y, Sager R, Christ-Crain M, Stolz D, Tamm M, Bouadma L, Luyt CE, Wolff M, Chastre J, Tubach F, Kristoffersen KB, Burkhardt O, Welte T, Schroeder S, Nobre V, Wei L, Bucher HC, Bhatnagar N, Annane D, Reinhart K, Branche A, Damas P, Nijsten M Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic intravenous calcium therapy for exchange blood transfusion in the newborn.
CONCLUSIONS: Very low-quality data from one quasi-randomised controlled trial suggested that the mean serum total and ionised calcium increased in the study group but decreased in the control group immediately after EBT. However, the mean values of total and ionised calcium in both arms of studies remained within international reference ranges. Unfortunately, data were not available to assess the trend of total and ionised serum calcium to the end of the first week after EBT. Therefore, due to the very low quality of evidence available, it is difficult to support or reject the continual use of prophylactic intravenous calc...
Source: Cochrane Database of Systematic Reviews - October 12, 2017 Category: General Medicine Authors: Ogunlesi TA, Lesi FE, Oduwole O Tags: Cochrane Database Syst Rev Source Type: research

Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia.
CONCLUSIONS: Moderate-quality evidence shows no differences in effects of adenosine and calcium channel antagonists for treatment of SVT on reverting to sinus rhythm, and low-quality evidence suggests no appreciable differences in the incidence of hypotension. A study comparing patient experiences and prospectively studied adverse events would provide evidence on which treatment is preferable for management of SVT. PMID: 29025197 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 12, 2017 Category: General Medicine Authors: Alabed S, Sabouni A, Providencia R, Atallah E, Qintar M, Chico TJ Tags: Cochrane Database Syst Rev Source Type: research

Foam dressings for treating pressure ulcers.
CONCLUSIONS: It is uncertain whether foam dressings are more clinically effective, more acceptable to users, or more cost effective compared to alternative dressings in treating pressure ulcers. It was difficult to make accurate comparisons between foam dressings and other dressings due to the lack of data on reduction of wound size, complete wound healing, treatment costs, or insufficient time-frames. Quality of life and patient (or carer) acceptability/satisfaction associated with foam dressings were not systematically measured in any of the included studies. We assessed the certainty of the evidence in the included tria...
Source: Cochrane Database of Systematic Reviews - October 12, 2017 Category: General Medicine Authors: Walker RM, Gillespie BM, Thalib L, Higgins NS, Whitty JA Tags: Cochrane Database Syst Rev Source Type: research

Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.
CONCLUSIONS: No evidence of a difference in total mortality and serious adverse events was found between treating to a lower or to a standard blood pressure target in people with hypertension and cardiovascular disease. This suggests no net health benefit from a lower systolic blood pressure target despite the small absolute reduction in total cardiovascular serious adverse events. There was very limited evidence on adverse events, which lead to high uncertainty. At present there is insufficient evidence to justify lower blood pressure targets (≤ 135/85 mmHg) in people with hypertension and established cardiovascular di...
Source: Cochrane Database of Systematic Reviews - October 11, 2017 Category: General Medicine Authors: Saiz LC, Gorricho J, Garjón J, Celaya MC, Muruzábal L, Malón MDM, Montoya R, López A Tags: Cochrane Database Syst Rev Source Type: research

Short-course versus long-course intravenous therapy with the same antibiotic for severe community-acquired pneumonia in children aged two months to 59 months.
CONCLUSIONS: We identified no randomised controlled trials comparing a short course (two to three days) of intravenous antibiotics compared to a long course (five days) for severe pneumonia in children aged two months to 59 months that met our inclusion criteria. PMID: 29020436 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 11, 2017 Category: General Medicine Authors: Lassi ZS, Imdad A, Bhutta ZA Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease.
CONCLUSIONS: The evidence examined suggests that prophylactic penicillin significantly reduces risk of pneumococcal infection in children with homozygous SCD, and is associated with minimal adverse reactions. Further research may help to determine the ideal age to safely withdraw penicillin. PMID: 28994899 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 10, 2017 Category: General Medicine Authors: Rankine-Mullings AE, Owusu-Ofori S Tags: Cochrane Database Syst Rev Source Type: research

Early planned removal of umbilical venous catheters to prevent infection in newborn infants.
CONCLUSIONS: Currently available trial data are insufficient to show whether early planned removal of umbilical venous catheters reduces risk of infection, mortality, or other morbidity in newborn infants. A large, simple, and pragmatic randomised controlled trial is needed to resolve this ongoing uncertainty. PMID: 29017005 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 10, 2017 Category: General Medicine Authors: Gordon A, Greenhalgh M, McGuire W Tags: Cochrane Database Syst Rev Source Type: research