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Endoscopic sphincterotomy for adults with biliary sphincter of Oddi dysfunction
CONCLUSIONS: Based on very low-certainty evidence from the trials included in this review, we do not know if endoscopic sphincterotomy versus sham or versus dual endoscopic sphincterotomy increases, reduces, or makes no difference to the number of people with treatment success; if endoscopic sphincterotomy versus sham or versus endoscopic papillary balloon dilation increases, reduces, or makes no difference to serious adverse events; or if endoscopic sphincterotomy versus sham improves, worsens, or makes no difference to health-related quality of life and liver function tests in adults with biliary sphincter of Oddi dysfun...
Source: Cochrane Database of Systematic Reviews - March 22, 2024 Category: General Medicine Authors: Cho Naing Han Ni Htar Htar Aung Chavdar S Pavlov Source Type: research

Triage tools for detecting cervical spine injury in paediatric trauma patients
CONCLUSIONS: There is insufficient evidence to determine the diagnostic test accuracy of CDRs to detect CSIs in children following blunt trauma, particularly for children under eight years of age. Although most studies had a high sensitivity, this was often achieved at the expense of low specificity and should be interpreted with caution due to a small number of CSIs and wide CIs. Well-designed, large studies are required to evaluate the accuracy of CDRs for the cervical spine clearance in children following blunt trauma, ideally in direct comparison with each other.PMID:38517085 | PMC:PMC10958760 | DOI:10.1002/14651858.CD...
Source: Cochrane Database of Systematic Reviews - March 22, 2024 Category: General Medicine Authors: Emma Tavender Nitaa Eapen Junfeng Wang Vanessa C Rausa Franz E Babl Natalie Phillips Source Type: research

Triage tools for detecting cervical spine injury in paediatric trauma patients
CONCLUSIONS: There is insufficient evidence to determine the diagnostic test accuracy of CDRs to detect CSIs in children following blunt trauma, particularly for children under eight years of age. Although most studies had a high sensitivity, this was often achieved at the expense of low specificity and should be interpreted with caution due to a small number of CSIs and wide CIs. Well-designed, large studies are required to evaluate the accuracy of CDRs for the cervical spine clearance in children following blunt trauma, ideally in direct comparison with each other.PMID:38517085 | DOI:10.1002/14651858.CD011686.pub3 (Sourc...
Source: Cochrane Database of Systematic Reviews - March 22, 2024 Category: General Medicine Authors: Emma Tavender Nitaa Eapen Junfeng Wang Vanessa C Rausa Franz E Babl Natalie Phillips Source Type: research

Community views on active case finding for tuberculosis in low- and middle-income countries: a qualitative evidence synthesis
CONCLUSIONS: Tuberculosis active case finding (ACF) and contact tracing bring a diagnostic service to people who may otherwise not receive it, such as those who are well or without symptoms and those who are sick but who have fewer resources and live further from health facilities. However, capturing these 'missing cases' may in itself be insufficient without appropriate health system strengthening to retain people in care. People who receive a tuberculosis diagnosis must contend with a complex and unsustainable cascade of care, and this affects their perception of ACF and their decision to engage with it.PMID:38511668 | P...
Source: Cochrane Database of Systematic Reviews - March 21, 2024 Category: General Medicine Authors: Melissa Taylor Nancy Medley Susanna S van Wyk Sandy Oliver Source Type: research

Community views on active case finding for tuberculosis in low- and middle-income countries: a qualitative evidence synthesis
CONCLUSIONS: Tuberculosis active case finding (ACF) and contact tracing bring a diagnostic service to people who may otherwise not receive it, such as those who are well or without symptoms and those who are sick but who have fewer resources and live further from health facilities. However, capturing these 'missing cases' may in itself be insufficient without appropriate health system strengthening to retain people in care. People who receive a tuberculosis diagnosis must contend with a complex and unsustainable cascade of care, and this affects their perception of ACF and their decision to engage with it.PMID:38511668 | D...
Source: Cochrane Database of Systematic Reviews - March 21, 2024 Category: General Medicine Authors: Melissa Taylor Nancy Medley Susanna S van Wyk Sandy Oliver Source Type: research

Prophylactic corticosteroids for cardiopulmonary bypass in adult cardiac surgery
CONCLUSIONS: A systematic review of trials evaluating the organ protective effects of corticosteroids in cardiac surgery demonstrated little or no treatment effect on mortality, gastrointestinal bleeding, and renal failure. There were opposing treatment effects on cardiac and pulmonary complications, with evidence that corticosteroids may increase cardiac complications but reduce pulmonary complications; however, the level of certainty for these estimates was low. There were minor benefits from corticosteroid therapy for infectious complications, but the evidence on hospital length of stay was very uncertain. The inconsist...
Source: Cochrane Database of Systematic Reviews - March 20, 2024 Category: General Medicine Authors: Riccardo Giuseppe Abbasciano Guido Maria Olivieri Rachel Chubsey Francesca Gatta Nathan Tyson Keertana Easwarakumar Daniel P Fudulu Roberto Marsico Markus Kofler Ghazi Elshafie Florence Lai Mahmoud Loubani Simon Kendall Mustafa Zakkar Gavin J Murphy Source Type: research

High-flow nasal cannula therapy for infants with bronchiolitis
CONCLUSIONS: High-flow nasal cannula therapy may have some benefits over low-flow oxygen for infants with bronchiolitis in terms of a greater improvement in respiratory and heart rates, as well as a modest reduction in the length of hospital stay and duration of oxygen therapy, with a reduced incidence of treatment escalation. There does not appear to be a difference in the number of adverse events. Further studies comparing high-flow nasal cannula therapy and CPAP are required to demonstrate the efficacy of one modality over the other. A standardised clinical definition of bronchiolitis, as well as the use of a validated ...
Source: Cochrane Database of Systematic Reviews - March 20, 2024 Category: General Medicine Authors: Michael Armarego Hannah Forde Karen Wills Sean A Beggs Source Type: research

Psychological therapies for depression in older adults residing in long-term care settings
CONCLUSIONS: This systematic review suggests that cognitive behavioural therapy, behavioural therapy, and reminiscence therapy may reduce depressive symptoms compared with usual care for LTC residents, but the evidence is very uncertain. Psychological therapies may also improve quality of life and psychological well-being amongst depressed LTC residents in the short term, but may have no effect on symptoms of anxiety in depressed LTC residents, compared to control conditions. However, the evidence for these effects is very uncertain, limiting our confidence in the findings. The evidence could be strengthened by better repo...
Source: Cochrane Database of Systematic Reviews - March 19, 2024 Category: General Medicine Authors: Tanya E Davison Sunil Bhar Yvonne Wells Patrick J Owen Emily You Colleen Doyle Steven J Bowe Leon Flicker Source Type: research

Prebiotics for induction and maintenance of remission in ulcerative colitis
CONCLUSIONS: There may be no difference in occurrence of clinical relapse when adjuvant treatment with prebiotics is compared with adjuvant treatment with placebo for maintenance of remission in UC. Adjuvant treatment with prebiotics may result in more total adverse events when compared to adjuvant treatment with placebo for maintenance of remission. We could draw no conclusions for any of the other outcomes in this comparison due to the very low certainty of the evidence. The evidence for all other comparisons and outcomes was also of very low certainty, precluding any conclusions. It is difficult to make any clear recomm...
Source: Cochrane Database of Systematic Reviews - March 19, 2024 Category: General Medicine Authors: Vassiliki Sinopoulou Morris Gordon Vicki Gregory Anas Saadeh Anthony K Akobeng Source Type: research