Chlorpromazine versus piperacetazine for schizophrenia.
CONCLUSIONS: The results of this review show chlorpromazine and piperacetazine may have similar clinical efficacy, but data are based on very small numbers of participants and the evidence is very low quality. We can not make firm conclusions based on such data. Currently, should clinicians and people with schizophrenia need to choose between chlorpromazine and piperacetazine they should be aware there is no good quality evidence to base decisions. More high quality research is needed. PMID: 30378678 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Eslami Shahrbabaki M, Dehnavieh R, Vali L, Sharafkhani R Tags: Cochrane Database Syst Rev Source Type: research

Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease).
CONCLUSIONS: Very low-quality evidence suggests there may be an effect of the use of bone marrow-derived stem cells in the healing of ulcers and improvement in the pain-free walking distance in patients with Buerger's disease. High-quality trials assessing the effectiveness of stem cell therapy for treatment of patients with thromboangiitis obliterans (Buerger's disease) are needed. PMID: 30378681 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Cacione DG, do Carmo Novaes F, Moreno DH Tags: Cochrane Database Syst Rev Source Type: research

Laparoscopy versus laparotomy for the management of early stage endometrial cancer.
CONCLUSIONS: This review found low to moderate-certainty evidence to support the role of laparoscopy for the management of early endometrial cancer. For presumed early stage primary endometrioid adenocarcinoma of the endometrium, laparoscopy is associated with similar OS and DFS. Furthermore, laparoscopy is associated with reduced operative morbidity and hospital stay. There is no significant difference in severe postoperative morbidity between the two modalities.The certainty of evidence for OS and RFS was moderate and was downgraded for unclear risk of bias profiles and imprecision in effect estimates. However, most stud...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Galaal K, Donkers H, Bryant A, Lopes AD Tags: Cochrane Database Syst Rev Source Type: research

Gene therapy for peripheral arterial disease.
CONCLUSIONS: Moderate-quality evidence shows no clear differences in amputation-free survival, major amputation, and all-cause mortality between those treated with gene therapy and those not receiving gene therapy. Some evidence suggests that gene therapy may lead to improved complete ulcer healing, but this outcome needs to be explored with improved reporting of the measure, such as decreased ulcer area in cm², and better description of ulcer types and healing. Further standardised data that are amenable to meta-analysis are needed to evaluate other outcomes such as quality of life, ankle brachial index, symptom scor...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Forster R, Liew A, Bhattacharya V, Shaw J, Stansby G Tags: Cochrane Database Syst Rev Source Type: research

One-to-one oral hygiene advice provided in a dental setting for oral health.
CONCLUSIONS: There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review. PMID: 30380139 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Soldani FA, Lamont T, Jones K, Young L, Walsh T, Lala R, Clarkson JE Tags: Cochrane Database Syst Rev Source Type: research

Action observation for upper limb rehabilitation after stroke.
CONCLUSIONS: We found evidence that AO is beneficial in improving upper limb motor function and dependence in activities of daily living (ADL) in people with stroke, when compared with any control group; however, we considered the quality of the evidence to be low. We considered the effect of AO on hand function to be large, but it does not appear to be clinically relevant, although we considered the quality of the evidence as moderate. As such, our confidence in the effect estimate is limited because it will likely change with future research. PMID: 30380586 [PubMed - as supplied by publisher] (Source: Cochrane Datab...
Source: Cochrane Database of Systematic Reviews - October 31, 2018 Category: General Medicine Authors: Borges LR, Fernandes AB, Melo LP, Guerra RO, Campos TF Tags: Cochrane Database Syst Rev Source Type: research

Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis.
CONCLUSIONS: There is little useful high-level evidence to judge the effectiveness of inhaled antibiotics for the treatment of pulmonary exacerbations in people with cystic fibrosis. The included trials were not sufficiently powered to achieve their goals. Hence, we are unable to demonstrate whether one treatment was superior to the other or not. Further research is needed to establish whether inhaled tobramycin may be used as an alternative to intravenous tobramycin for some pulmonary exacerbations. PMID: 30376155 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Smith S, Rowbotham NJ, Charbek E Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).
Abstract BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS: We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018. SELECTION CRITERIA: Randomised...
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Herath SC, Normansell R, Maisey S, Poole P Tags: Cochrane Database Syst Rev Source Type: research

Gamma aminobutyric acid (GABA) receptor agonists for acute stroke.
CONCLUSIONS: This review provides moderate-quality evidence that fails to support the use of GABA receptor agonists (chlormethiazole or diazepam) for the treatment of people with acute stroke. More well-designed RCTs with large samples of participants with total anterior circulation syndrome are required to determine if there are benefits for this subgroup. Somnolence and rhinitis are frequent adverse events related to chlormethiazole. PMID: 30376593 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Liu J, Zhang J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Swallowing therapy for dysphagia in acute and subacute stroke.
CONCLUSIONS: Moderate- and low-quality evidence suggests that swallowing therapy did not have a significant effect on the outcomes of death or dependency/disability, case fatality at the end of the trial, or penetration aspiration score. However, swallowing therapy may have reduced length of hospital stay, dysphagia, and chest infections, and may have improved swallowing ability. However, these results are based on evidence of variable quality, involving a variety of interventions. Further high-quality trials are needed to test whether specific interventions are effective. PMID: 30376602 [PubMed - as supplied by publi...
Source: Cochrane Database of Systematic Reviews - October 30, 2018 Category: General Medicine Authors: Bath PM, Lee HS, Everton LF Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for exacerbations of chronic obstructive pulmonary disease.
CONCLUSIONS: Researchers have found that antibiotics have some effect on inpatients and outpatients, but these effects are small, and they are inconsistent for some outcomes (treatment failure) and absent for other outcomes (mortality, length of hospital stay). Analyses show a strong beneficial effect of antibiotics among ICU patients. Few data are available on the effects of antibiotics on health-related quality of life or on other patient-reported symptoms, and data show no statistically significant increase in the risk of adverse events with antibiotics compared to placebo. These inconsistent effects call for research i...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Vollenweider DJ, Frei A, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA Tags: Cochrane Database Syst Rev Source Type: research

Heliox for croup in children.
CONCLUSIONS: Due to very limited evidence, uncertainty remains about the effectiveness and safety of heliox. Heliox may not be more effective than 30% humidified oxygen for children with mild croup, but may be beneficial in the short term for children with moderate to severe croup treated with dexamethasone. The effect may be similar to 100% oxygen given with one or two doses of adrenaline. Adverse events were not reported, and it is unclear if these were monitored in the included studies. Adequately powered RCTs comparing heliox with standard treatments are needed to further assess the role of heliox in the treatment of c...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Moraa I, Sturman N, McGuire TM, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia.
CONCLUSIONS: Overall prognosis of people with IH worsened over time. T2DM cumulative incidence generally increased over the course of follow-up but varied with IH definition. Regression from IH to normoglycaemia decreased over time but was observed even after 11 years of follow-up. The risk of developing T2DM when comparing IH with normoglycaemia at baseline varied by IH definition. Taking into consideration the uncertainty of the available evidence, as well as the fluctuating stages of normoglycaemia, IH and T2DM, which may transition from one stage to another in both directions even after years of follow-up, practitioner...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Richter B, Hemmingsen B, Metzendorf MI, Takwoingi Y Tags: Cochrane Database Syst Rev Source Type: research

Carvedilol versus traditional, non-selective beta-blockers for adults with cirrhosis and gastroesophageal varices.
CONCLUSIONS: We found no clear beneficial or harmful effects of carvedilol versus traditional, non-selective beta-blockers on mortality, upper gastrointestinal bleeding, serious or non-serious adverse events despite the fact that carvedilol was more effective at reducing the hepatic venous pressure gradient. However, the evidence was of low or very low quality, and hence the findings are uncertain. Additional evidence is required from adequately powered, long-term, double-blind, randomised clinical trials, which evaluate both clinical and haemodynamic outcomes. PMID: 30372514 [PubMed - as supplied by publisher] (Sourc...
Source: Cochrane Database of Systematic Reviews - October 29, 2018 Category: General Medicine Authors: Zacharias AP, Jeyaraj R, Hobolth L, Bendtsen F, Gluud LL, Morgan MY Tags: Cochrane Database Syst Rev Source Type: research

Biocompatible dialysis fluids for peritoneal dialysis.
CONCLUSIONS: This updated review strengthens evidence that neutral pH, low GDP PD solution improves RRF and urine volume preservation with high certainty. These effects may be related to increased peritoneal solute transport and reduced peritoneal ultrafiltration, although the evidence for these outcomes is of low certainty due to significant heterogeneity and suboptimal methodological quality. Icodextrin prescription increased peritoneal ultrafiltration and mitigated uncontrolled fluid overload with moderate certainty. The effects of either neutral pH, low GDP solution or icodextrin on peritonitis, technique survival and ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Htay H, Johnson DW, Wiggins KJ, Badve SV, Craig JC, Strippoli GF, Cho Y Tags: Cochrane Database Syst Rev Source Type: research

Extended-field radiotherapy for locally advanced cervical cancer.
CONCLUSIONS: Moderate-certainty evidence shows that, compared with pelvic RT alone, extended-field RT probably improves overall survival and reduces risk of para-aortic lymph node recurrence. However, pelvic RT alone would now be considered substandard treatment, so this result cannot be extrapolated to modern standards of care. Low- to moderate-certainty evidence suggests that pelvic CRT may increase overall and progression-free survival compared to extended-field RT, although there may or may not be a higher rate of para-aortic recurrence and acute adverse events. Extended-field CRT versus pelvic CRT may improve overall ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Thamronganantasakul K, Supakalin N, Kietpeerakool C, Pattanittum P, Lumbiganon P Tags: Cochrane Database Syst Rev Source Type: research

Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke.
CONCLUSIONS: The present review directly compared intravenous thrombolytic treatment with percutaneous vascular interventions for ischaemic stroke. We found no evidence from RCTs that percutaneous vascular interventions are superior to intravenous thrombolytic treatment with respect to functional outcome. Quality of evidence was low (outcome assessment was blinded, but not the treating physician or participants). New trials with adequate sample sizes are warranted because of the rapid development of new techniques and devices for such interventions. PMID: 30365156 [PubMed - as supplied by publisher] (Source: Cochrane ...
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Lindekleiv H, Berge E, Bruins Slot KM, Wardlaw JM Tags: Cochrane Database Syst Rev Source Type: research

Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications.
Abstract BACKGROUND: This is an update of the review last published in 2011. It focuses on early postoperative enteral nutrition after lower gastrointestinal surgery. Traditional management consisted of 'nil by mouth', where patients receive fluids followed by solids after bowel function has returned. Although several trials have reported lower incidence of infectious complications and faster wound healing upon early feeding, other trials have shown no effect. The immediate advantage of energy intake (carbohydrates, protein or fat) could enhance recovery with fewer complications, and this warrants a systematic eva...
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Herbert G, Perry R, Andersen HK, Atkinson C, Penfold C, Lewis SJ, Ness AR, Thomas S Tags: Cochrane Database Syst Rev Source Type: research

Carbamazepine versus phenobarbitone monotherapy for epilepsy: an individual participant data review.
CONCLUSIONS: Moderate-quality evidence from this review suggests that carbamazepine is likely to be a more effective drug than phenobarbitone in terms of treatment retention (treatment failures due to lack of efficacy or adverse events or both). Moderate- to low-quality evidence from this review also suggests an association between treatment efficacy and seizure type in terms of seizure recurrence and seizure remission, with an advantage for phenobarbitone for focal onset seizures and an advantage for carbamazepine for generalised onset seizures.However, some of the trials contributing to the analyses had methodological in...
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Nevitt SJ, Marson AG, Tudur Smith C Tags: Cochrane Database Syst Rev Source Type: research

Gabapentin add-on treatment for drug-resistant focal epilepsy.
CONCLUSIONS: Gabapentin has efficacy as an add-on treatment in people with drug-resistant focal epilepsy. However, the trials reviewed were of relatively short duration and provide no evidence for the long-term efficacy of gabapentin beyond a three-month period. The results cannot be extrapolated to monotherapy or to people with other epilepsy types. PMID: 30357813 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 24, 2018 Category: General Medicine Authors: Panebianco M, Al-Bachari S, Weston J, Hutton JL, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Oxcarbazepine versus phenytoin monotherapy for epilepsy: an individual participant data review.
CONCLUSIONS: High-quality evidence provided by this review indicates that treatment failure due to adverse events occurs significantly later with oxcarbazepine than phenytoin. For individuals with focal onset seizures, moderate-quality evidence suggests that oxcarbazepine may be superior to phenytoin in terms of treatment failure for any reason, seizure recurrence and seizure remission. Therefore, oxcarbazepine may be a preferable alternative treatment than phenytoin, particularly for individuals with focal onset seizures. The evidence in this review which relates to individuals with generalised onset seizures is of low qu...
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Nevitt SJ, Tudur Smith C, Marson AG Tags: Cochrane Database Syst Rev Source Type: research

Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral amputation.
CONCLUSIONS: The limited evidence presented in this review is of very low quality and is insufficient to inform the choice of prosthetic rehabilitation, including the optimum weight of the prosthesis, after unilateral transfemoral amputation in older dysvascular people. A programme of research that includes randomised controlled trials to examine key interventions is urgently required in this area. PMID: 30350430 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Barr S, Howe TE Tags: Cochrane Database Syst Rev Source Type: research

Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers.
CONCLUSIONS: We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs. For other physical ergonomic interventions there is no evidence of an effect. For organisational interventions, in the form of supplementary breaks, there is very low-quality evidence of an effect on upper limb discomfort. For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort. Further high-quality studies are needed to determine the effectiveness of these interventions among office workers. PMID: 3035085...
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR Tags: Cochrane Database Syst Rev Source Type: research

Penile rehabilitation for postprostatectomy erectile dysfunction.
CONCLUSIONS: Based on mostly very-low and some low-quality evidence, penile rehabilitation strategies consisting of scheduled PDE5I use following radical prostatectomy may not promote self-reported potency and erectile function any more than on demand use. PMID: 30352488 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 23, 2018 Category: General Medicine Authors: Philippou YA, Jung JH, Steggall MJ, O'Driscoll ST, Bakker CJ, Bodie JA, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Skin preparation for preventing infection following caesarean section.
CONCLUSIONS: There was insufficient evidence available from the included RCTs to fully evaluate different agents and methods of skin preparation for preventing infection following caesarean section. Therefore, it is not yet clear what sort of skin preparation may be most effective for preventing postcaesarean surgical site infection, or for reducing other undesirable outcomes for mother and baby.Most of the evidence in this review was deemed to be very low or low quality. This means that for most findings, our confidence in any evidence of an intervention effect is limited, and indicates the need for more high-quality rese...
Source: Cochrane Database of Systematic Reviews - October 22, 2018 Category: General Medicine Authors: Hadiati DR, Hakimi M, Nurdiati DS, da Silva Lopes K, Ota E Tags: Cochrane Database Syst Rev Source Type: research

Leukotriene receptor antagonists for eczema.
CONCLUSIONS: The findings of this review are limited to montelukast. There was a lack of evidence addressing the review question, and the quality of the available evidence for most of the measured outcomes was low. Some primary and secondary outcomes were not addressed at all, including long-term control.We found no evidence of a difference between montelukast (10 mg) and placebo on disease severity, pruritus improvement, and topical corticosteroid use. Very low-quality evidence means we are uncertain of the effect of montelukast (10 mg) compared with conventional treatment on disease severity. Participants in only one stu...
Source: Cochrane Database of Systematic Reviews - October 21, 2018 Category: General Medicine Authors: Ferguson L, Futamura M, Vakirlis E, Kojima R, Sasaki H, Roberts A, Mori R Tags: Cochrane Database Syst Rev Source Type: research

Intrauterine administration of human chorionic gonadotropin (hCG) for subfertile women undergoing assisted reproduction.
Abstract BACKGROUND: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone that is synthesised and released by the syncytiotrophoblast and has a fundamental role in embryo implantation and the early stages of pregnancy. Intrauterine administration of hCG via ET catheter during a mock procedure around the time of ET is a novel approach that has been suggested to improve the outcomes of assisted reproduction. ...
Source: Cochrane Database of Systematic Reviews - October 20, 2018 Category: General Medicine Authors: Craciunas L, Tsampras N, Raine-Fenning N, Coomarasamy A Tags: Cochrane Database Syst Rev Source Type: research

Interventions for reducing inflammation in familial Mediterranean fever.
CONCLUSIONS: There were limited RCTs assessing interventions for people with familial Mediterranean fever. Based on the evidence, three times daily colchicine appears to reduce the number of people experiencing attacks, colchicine single dose and divided dose might not be different for children with familial Mediterranean fever and anakinra might reduce C-reactive protein in colchicine-resistant participants; however, only a few RCTs contributed data for analysis. Further RCTs examining active interventions, not only colchicine, are necessary before a comprehensive conclusion regarding the efficacy and safety of interventi...
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Wu B, Xu T, Li Y, Yin X Tags: Cochrane Database Syst Rev Source Type: research

Drugs for preventing red blood cell dehydration in people with sickle cell disease.
CONCLUSIONS: While the results of zinc for reducing sickle-related crises are encouraging, larger and longer-term multicenter studies are needed to evaluate the effectiveness of this therapy for people with sickle cell disease.While the Phase II and the prematurely terminated phase III studies of senicapoc showed that the drug improved red blood cell survival (depending on dose), this did not lead to fewer painful crises.Given this is no longer an active area of research, this review will no longer be regularly updated. PMID: 30338520 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Nagalla S, Ballas SK Tags: Cochrane Database Syst Rev Source Type: research

Infant formulas containing hydrolysed protein for prevention of allergic disease.
CONCLUSIONS: We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergic disease. Very low-quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA. Further trials are recommended before implementation of this practice.We found no evidence to support prolonged feeding with a hydrolysed formula compared with a CMF for prevention of allergic disease in infants unable to be exclusively breast fed. PMID: 30338526 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 19, 2018 Category: General Medicine Authors: Osborn DA, Sinn JK, Jones LJ Tags: Cochrane Database Syst Rev Source Type: research

Zonisamide add-on therapy for focal epilepsy.
CONCLUSIONS: When used as an add-on treatment in people with focal epilepsy uncontrolled by one or more concomitant antiepileptic drugs, moderate-quality evidence found that zonisamide was more successful than placebo at reducing the frequency of seizures by at least 50%. We were unable to identify minimum effective and maximum tolerated doses. The included trials evaluated a maximum stable-dose phase of 18 weeks, so results cannot be used to confirm longer periods of efficacy in seizure control. The results cannot be extrapolated to monotherapy or to people with other seizure types or epilepsy syndromes. PMID: 303352...
Source: Cochrane Database of Systematic Reviews - October 18, 2018 Category: General Medicine Authors: Brigo F, Lattanzi S, Igwe SC, Behzadifar M, Bragazzi NL Tags: Cochrane Database Syst Rev Source Type: research

Prokinetics for functional dyspepsia.
Abstract BACKGROUND: Dyspepsia is a common condition associated with gastrointestinal (GI) disease. Prokinetics are the treatment of choice for functional dyspepsia (FD). However, the role of prokinetics in FD treatment is still controversial. OBJECTIVES: We conducted a systematic review and meta-analysis of randomised control trials (RCTs) examining the efficacy of prokinetics in the treatment of FD. The primary outcome was overall absence of or improvement of symptoms and symptom scores at the end of treatment. We also evaluated quality of life (QoL) and adverse events as secondary outcomes. SEARCH MET...
Source: Cochrane Database of Systematic Reviews - October 18, 2018 Category: General Medicine Authors: Pittayanon R, Yuan Y, Bollegala NP, Khanna R, Leontiadis GI, Moayyedi P Tags: Cochrane Database Syst Rev Source Type: research

Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus.
CONCLUSIONS: There is low-certainty evidence to suggest that NPWT, when compared with wound dressings, may increase the proportion of wounds healed and reduce the time to healing for postoperative foot wounds and ulcers of the foot in people with DM. For the comparisons of different pressures of NPWT for treating foot ulcers in people with DM, it is uncertain whether there is a difference in the number of wounds closed or covered with surgery, and adverse events. None of the included studies provided evidence on time to closure or coverage surgery, health-related quality of life or cost-effectiveness. The limitations in cu...
Source: Cochrane Database of Systematic Reviews - October 17, 2018 Category: General Medicine Authors: Liu Z, Dumville JC, Hinchliffe RJ, Cullum N, Game F, Stubbs N, Sweeting M, Peinemann F Tags: Cochrane Database Syst Rev Source Type: research

Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.
CONCLUSIONS: Anti-VEGF drugs are effective at improving vision in people with DMO with three to four in every 10 people likely to experience an improvement of 3 or more lines VA at one year. Aflibercept may confer some advantage over ranibizumab and bevacizumab in people with DMO at one year in visual and anatomic terms but it is unclear whether this applies to the long-term. There is a need for more evidence on the long-term (greater than two years) comparative effects of these anti-VEGF agents. Evidence from RCTs may not apply to real-world practice, where people in need of antiangiogenic treatment are often under-treate...
Source: Cochrane Database of Systematic Reviews - October 16, 2018 Category: General Medicine Authors: Virgili G, Parravano M, Evans JR, Gordon I, Lucenteforte E Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing and treating cardiac complications in Duchenne and Becker muscular dystrophy and X-linked dilated cardiomyopathy.
CONCLUSIONS: Based on the available evidence from RCTs, early treatment with ACE inhibitors or ARBs may be comparably beneficial for people with a dystrophinopathy; however, the certainty of evidence is very low. Very low-certainty evidence indicates that adding eplerenone might give additional benefit when early cardiomyopathy is detected. No clinically meaningful effect was seen for growth hormone or idebenone, although the certainty of the evidence is also very low. PMID: 30326162 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 16, 2018 Category: General Medicine Authors: Bourke JP, Bueser T, Quinlivan R Tags: Cochrane Database Syst Rev Source Type: research

Very early versus delayed mobilisation after stroke.
CONCLUSIONS: VEM, which usually involved first mobilisation within 24 hours of stroke onset, did not increase the number of people who survived or made a good recovery after their stroke. VEM may have reduced the length of stay in hospital by about one day, but this was based on low-quality evidence. Based on the potential hazards reported in the single largest RCT, the sensitivity analysis of trials commencing mobilisation within 24 hours, and the NMA, there was concern that VEM commencing within 24 hours may carry an increased risk, at least in some people with stroke. Given the uncertainty around these effect estimates,...
Source: Cochrane Database of Systematic Reviews - October 16, 2018 Category: General Medicine Authors: Langhorne P, Collier JM, Bate PJ, Thuy MN, Bernhardt J Tags: Cochrane Database Syst Rev Source Type: research

Epidermal growth factor receptor blockers for the treatment of ovarian cancer.
CONCLUSIONS: Current evidence suggests that an anti-EGFR single-agent biological treatment (EGFR TKI or anti-EGFR antibody) makes little or no difference to survival, either as maintenance treatment after first-line chemotherapy or in association with chemotherapy in recurrent cancer. Anti-EGFR therapy may increase some side effects and may or may not reduce quality of life. PMID: 30321910 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 16, 2018 Category: General Medicine Authors: Morrison J, Thoma C, Goodall RJ, Lyons TJ, Gaitskell K, Wiggans AJ, Bryant A Tags: Cochrane Database Syst Rev Source Type: research

Exercise for reducing falls in people living with and beyond cancer.
CONCLUSIONS: There is a paucity of evidence for exercise training to reduce fall rates in people living with and beyond cancer. Exercise training may improve strength, flexibility and balance for people in this population, but the evidence is very low quality. PMID: 30320433 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Williams AD, Bird ML, Hardcastle SG, Kirschbaum M, Ogden KJ, Walters JA Tags: Cochrane Database Syst Rev Source Type: research

Family therapy approaches for anorexia nervosa.
CONCLUSIONS: There is a limited amount of low-quality evidence to suggest that family therapy approaches may be effective compared to treatment as usual in the short term. This finding is based on two trials that included only a small number of participants, and both had issues about potential bias. There is insufficient evidence to determine whether there is an advantage of family therapy approaches in people of any age compared to educational interventions (one study, very low quality) or psychological therapies (five studies, very low quality). Most studies contributing to this finding were undertaken in adolescents and...
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Fisher CA, Skocic S, Rutherford KA, Hetrick SE Tags: Cochrane Database Syst Rev Source Type: research

Taxane-based chemohormonal therapy for metastatic hormone-sensitive prostate cancer.
CONCLUSIONS: Compared to ADT alone, the early (within 120 days of beginning ADT) addition of taxane-based chemotherapy to ADT for hormone-sensitive prostate cancer probably prolongs both overall and disease-specific survival and delays disease progression. There may be an increase in toxicity with taxane-based chemotherapy in combination with ADT. There may also be a small, clinically unimportant improvement in quality of life at 12 months with taxane-based chemotherapy and ADT treatment. PMID: 30320443 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Sathianathen NJ, Philippou YA, Kuntz GM, Konety BR, Gupta S, Lamb AD, Dahm P Tags: Cochrane Database Syst Rev Source Type: research

Ergonomic interventions for preventing musculoskeletal disorders in dental care practitioners.
CONCLUSIONS: There is very low-quality evidence from one study showing that a multi-faceted intervention has no clear effect on dentists' risk of WMSD in the thighs or feet when compared to no intervention over a six-month period. This was a poorly conducted study with several shortcomings and errors in statistical analysis of data. There is low-quality evidence from one study showing no clear difference in elbow pain or shoulder pain in participants using light weight, wider handled curettes or heavier and narrow handled curettes for scaling over a 16-week period.We did not find any studies evaluating the effectiveness of...
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Mulimani P, Hoe VC, Hayes MJ, Idiculla JJ, Abas AB, Karanth L Tags: Cochrane Database Syst Rev Source Type: research

Monotherapy laser photocoagulation for diabetic macular oedema.
CONCLUSIONS: Laser photocoagulation reduces the chances of visual loss and increases those of partial to complete resolution of DMO compared to no intervention at one to three years. Subthreshold photocoagulation, particularly the micropulse technique, may be as effective as standard photocoagulation and RCTs are ongoing to assess whether this minimally invasive technique is preferable to treat milder or non-central cases of DMO. PMID: 30320466 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Jorge EC, Jorge EN, Botelho M, Farat JG, Virgili G, El Dib R Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome.
CONCLUSIONS: Although studies examining the use of TCM herbal products for chronic fatigue were located, methodologic limitations resulted in the exclusion of all studies. Of note, many of the studies labelled as RCTs and conducted in China did not utilize rigorous randomization procedures. Improvements in methodology in future studies is required for meaningful synthesis of data. PMID: 30321452 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: Adams D, Wu T, Yang X, Tai S, Vohra S Tags: Cochrane Database Syst Rev Source Type: research

Parent-mediated interventions for promoting communication and language development in young children with Down syndrome.
CONCLUSIONS: There is currently insufficient evidence to determine the effects of parent-mediated interventions for improving the language and communication of children with Down syndrome. We found only three small studies of very low quality. This review highlights the need for well-designed studies, including RCTs, to evaluate the effectiveness of parent-mediated interventions. Trials should use valid, reliable and similar measures of language development, and they should include measures of secondary outcomes more distal to the intervention, such as family well-being. Treatment fidelity, in particular parental dosage of...
Source: Cochrane Database of Systematic Reviews - October 15, 2018 Category: General Medicine Authors: O'Toole C, Lee AS, Gibbon FE, van Bysterveldt AK, Hart NJ Tags: Cochrane Database Syst Rev Source Type: research

Information provision for people with multiple sclerosis.
CONCLUSIONS: Information provision for people with MS seems to increase disease-related knowledge, with less clear results on decision making and quality of life. The included studies in this review reported no negative side effects of providing disease-related information to people with MS. Interpretation of study results remains challenging due to the marked heterogeneity of interventions and outcome measures. PMID: 30317542 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 14, 2018 Category: General Medicine Authors: Köpke S, Solari A, Rahn A, Khan F, Heesen C, Giordano A Tags: Cochrane Database Syst Rev Source Type: research

Information or education interventions for adult intensive care unit (ICU) patients and their carers.
CONCLUSIONS: We are uncertain of the effects of information or education interventions given to adult ICU patients and their carers, as the evidence in all cases was of very low certainty, and our confidence in the evidence was limited. Ongoing studies may contribute more data and introduce more certainty when incorporated into future updates of the review. PMID: 30316199 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 13, 2018 Category: General Medicine Authors: Lewis SR, Pritchard MW, Schofield-Robinson OJ, Evans DJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Naloxone for opioid-exposed newborn infants.
CONCLUSIONS: The existing evidence from randomised controlled trials is insufficient to determine whether naloxone confers any important benefits to newborn infants with cardiorespiratory or neurological depression that may be due to intrauterine exposure to opioid. Given concerns about the safety of naloxone in this context, it may be appropriate to limit its use to randomised controlled trials that aim to resolve these uncertainties. PMID: 30311212 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 12, 2018 Category: General Medicine Authors: Moe-Byrne T, Brown JVE, McGuire W Tags: Cochrane Database Syst Rev Source Type: research

Type II or type III radical hysterectomy compared to chemoradiotherapy as a primary intervention for stage IB2 cervical cancer.
CONCLUSIONS: There is an absence of high-certainty evidence on the relative benefits and harms of primary radical hysterectomy versus primary chemoradiotherapy for stage IB2 cervical cancer. More research is needed on the different treatment options in stage IB2 cervical cancer, particularly with respect to survival, adverse effects, and quality of life to facilitate informed decision-making and individualised care. PMID: 30311942 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 12, 2018 Category: General Medicine Authors: Nama V, Angelopoulos G, Twigg J, Murdoch JB, Bailey J, Lawrie TA Tags: Cochrane Database Syst Rev Source Type: research

Vasodilators for women undergoing fertility treatment.
CONCLUSIONS: Evidence was insufficient to show whether vasodilators increase the live birth rate in women undergoing fertility treatment. However, low-quality evidence suggests that vasodilators may slightly increase clinical pregnancy rates. Moderate-quality evidence shows that vasodilators increase overall side effects in comparison with placebo or no treatment. Adequately powered studies are needed so that each treatment can be evaluated more accurately. PMID: 30312988 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 12, 2018 Category: General Medicine Authors: Gutarra-Vilchez RB, Bonfill Cosp X, Glujovsky D, Viteri-García A, Runzer-Colmenares FM, Martinez-Zapata MJ Tags: Cochrane Database Syst Rev Source Type: research

Implementing systematic reviews of prognosis studies in Cochrane.
PMID: 30306538 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 11, 2018 Category: General Medicine Authors: Moons KG, Hooft L, Williams K, Hayden JA, Damen JA, Riley RD Tags: Cochrane Database Syst Rev Source Type: research