Selenium for preventing cancer.
CONCLUSIONS: Well-designed and well-conducted RCTs have shown no beneficial effect of selenium supplements in reducing cancer risk (high certainty of evidence). Some RCTs have raised concerns by reporting a higher incidence of high-grade prostate cancer and type 2 diabetes in participants with selenium supplementation. No clear evidence of an influence of baseline participant selenium status on outcomes has emerged in these studies.Observational longitudinal studies have shown an inverse association between selenium exposure and risk of some cancer types, but null and direct relations have also been reported, and no system...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Vinceti M, Filippini T, Del Giovane C, Dennert G, Zwahlen M, Brinkman M, Zeegers MP, Horneber M, D'Amico R, Crespi CM Tags: Cochrane Database Syst Rev Source Type: research

Physical activity for women with breast cancer after adjuvant therapy.
CONCLUSIONS: No conclusions regarding breast cancer-related and all-cause mortality or breast cancer recurrence were possible. However, physical activity interventions may have small-to-moderate beneficial effects on HRQoL, and on emotional or perceived physical and social function, anxiety, cardiorespiratory fitness, and self-reported and objectively measured physical activity. The positive results reported in the current review must be interpreted cautiously owing to very low-to-moderate quality of evidence, heterogeneity of interventions and outcome measures, imprecision of some estimates, and risk of bias in many trial...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Lahart IM, Metsios GS, Nevill AM, Carmichael AR Tags: Cochrane Database Syst Rev Source Type: research

Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome.
CONCLUSIONS: Apart from low quality of evidence data suggesting a short-term mortality benefit of levosimendan compared with dobutamine, at present there are no robust and convincing data to support a distinct inotropic or vasodilator drug-based therapy as a superior solution to reduce mortality in haemodynamically unstable people with cardiogenic shock or LCOS.Considering the limited evidence derived from the present data due to a generally high risk of bias and imprecision, it should be emphasised that there remains a great need for large, well-designed randomised trials on this topic to close the gap between daily pract...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Schumann J, Henrich EC, Strobl H, Prondzinsky R, Weiche S, Thiele H, Werdan K, Frantz S, Unverzagt S Tags: Cochrane Database Syst Rev Source Type: research

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.
CONCLUSIONS: Despite the large number of childhood and adolescent obesity treatment trials, we were only able to partially assess the impact of obesity treatment interventions on school achievement and cognitive abilities. School and community-based physical activity interventions as part of an obesity prevention or treatment programme can benefit executive functions of children with obesity or overweight specifically. Similarly, school-based dietary interventions may benefit general school achievement in children with obesity. These findings might assist health and education practitioners to make decisions related to prom...
Source: Cochrane Database of Systematic Reviews - January 29, 2018 Category: General Medicine Authors: Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH Tags: Cochrane Database Syst Rev Source Type: research

Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome.
CONCLUSIONS: Some of the interventions can decrease prostatitis symptoms in an appreciable number without a greater incidence of adverse events. The QoE was mostly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes. PMID: 29372565 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 26, 2018 Category: General Medicine Authors: Franco JV, Turk T, Jung JH, Xiao YT, Iakhno S, Garrote V, Vietto V Tags: Cochrane Database Syst Rev Source Type: research

Intrauterine insemination versus intracervical insemination in donor sperm treatment.
CONCLUSIONS: There was insufficient evidence to determine whether there was a clear difference in live birth rates between IUI and ICI in natural or gonadotrophin-stimulated cycles in women who started with donor sperm treatment. There was insufficient evidence available for the effect of timing of IUI or ICI on live birth rates. Very low-quality data suggested that in gonadotrophin-stimulated cycles, ICI may be associated with a higher clinical pregnancy rate than IUI, but also with a higher risk of multiple pregnancy rate. We concluded that the current evidence was too limited to choose between IUI or ICI, in natural cyc...
Source: Cochrane Database of Systematic Reviews - January 25, 2018 Category: General Medicine Authors: Kop PA, Mochtar MH, O'Brien PA, Van der Veen F, van Wely M Tags: Cochrane Database Syst Rev Source Type: research

Selective noradrenaline reuptake inhibitors for schizophrenia.
CONCLUSIONS: Our results provide tentative very low quality evidence that compared to placebo, NRIs (specifically reboxetine) may have a benefit on the negative symptoms of schizophrenia. Limited evidence also suggests that NRIs have no effect on the positive symptoms of schizophrenia or cognitive functioning. NRIs appear generally well tolerated with no real differences in adverse effects such as nausea noted between NRIs and placebo. However, these results are based on short-term follow-up and are poor quality - there is need for more good-quality evidence. A large RCT of reboxetine over a longer period of time, focusing...
Source: Cochrane Database of Systematic Reviews - January 25, 2018 Category: General Medicine Authors: Matthews PRL, Horder J, Pearce M Tags: Cochrane Database Syst Rev Source Type: research

Interventions for increasing fruit and vegetable consumption in children aged five years and under.
CONCLUSIONS: Despite identifying 55 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains sparse. There was very low-quality evidence that child-feeding practice interventions are effective in increasing vegetable consumption in children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption in children aged five years and younger....
Source: Cochrane Database of Systematic Reviews - January 25, 2018 Category: General Medicine Authors: Hodder RK, Stacey FG, O'Brien KM, Wyse RJ, Clinton-McHarg T, Tzelepis F, James EL, Bartlem KM, Nathan NK, Sutherland R, Robson E, Yoong SL, Wolfenden L Tags: Cochrane Database Syst Rev Source Type: research

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases.
Abstract BACKGROUND: This is an update to the review published in the Cochrane Library (2012, Issue 4).It is estimated that 20% to 40% of people with cancer will develop brain metastases during the course of their illness. The burden of brain metastases impacts quality and length of survival. OBJECTIVES: To assess the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other therapies to adults with newly diagnosed multiple brain metastases. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase to ...
Source: Cochrane Database of Systematic Reviews - January 25, 2018 Category: General Medicine Authors: Tsao MN, Xu W, Wong RK, Lloyd N, Laperriere N, Sahgal A, Rakovitch E, Chow E Tags: Cochrane Database Syst Rev Source Type: research

Anticoagulation for the initial treatment of venous thromboembolism in people with cancer.
CONCLUSIONS: LMWH is possibly superior to UFH in the initial treatment of VTE in people with cancer. Additional trials focusing on patient-important outcomes will further inform the questions addressed in this review. The decision for a person with cancer to start LMWH therapy should balance the benefits and harms and consider the person's values and preferences. PMID: 29363105 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 24, 2018 Category: General Medicine Authors: Hakoum MB, Kahale LA, Tsolakian IG, Matar CF, Yosuico VE, Terrenato I, Sperati F, Barba M, Schünemann H, Akl EA Tags: Cochrane Database Syst Rev Source Type: research

Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic cancers.
CONCLUSIONS: Conformal radiotherapy techniques are an improvement on older radiotherapy techniques. IMRT may be better than 3DCRT in terms of GI toxicity, but the evidence to support this is uncertain. There is no high-quality evidence to support the use of any other prophylactic intervention evaluated. However, evidence on some potential interventions shows that they probably have no role to play in reducing RT-related GI toxicity. More RCTs are needed for interventions with limited evidence suggesting potential benefits. PMID: 29360138 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 23, 2018 Category: General Medicine Authors: Lawrie TA, Green JT, Beresford M, Wedlake L, Burden S, Davidson SE, Lal S, Henson CC, Andreyev HJN Tags: Cochrane Database Syst Rev Source Type: research

Antidepressants for depression in adults with HIV infection.
CONCLUSIONS: This review demonstrates that antidepressant therapy may be more beneficial than placebo for the treatment of depression in PLWH. The low quality of the evidence contributing to this assessment and the lack of studies representing PLWH from generalized epidemics in low- to middle-income countries make the relevance of these finding in today's context limited. Future studies that evaluate the effectiveness of antidepressant therapy should be designed and conducted rigorously. Such studies should incorporate evaluation of stepped care models and health system strengthening interventions in the study design. In a...
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Eshun-Wilson I, Siegfried N, Akena DH, Stein DJ, Obuku EA, Joska JA Tags: Cochrane Database Syst Rev Source Type: research

Antibiotic therapy for preventing infections in people with acute stroke.
CONCLUSIONS: Preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of 'overall' infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found. PMID: 29355906 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Vermeij JD, Westendorp WF, Dippel DW, van de Beek D, Nederkoorn PJ Tags: Cochrane Database Syst Rev Source Type: research

Losigamone add-on therapy for focal epilepsy.
CONCLUSIONS: The results of this review showed that losigamone did reduce seizure frequency but was associated with more treatment withdrawals when used as an add-on therapy for people with focal epilepsy. However, the included trials were of short-term duration and uncertain quality. Future well-designed randomized, double-blind, placebo-controlled trials with a longer-term duration are needed. No new studies have been found since the last version of this review. We judged the overall quality of the evidence for the outcomes assessed as moderate. PMID: 29355908 [PubMed - as supplied by publisher] (Source: Cochrane Da...
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Xiao Y, Luo M, Wang J, Luo H Tags: Cochrane Database Syst Rev Source Type: research

Risperidone versus other antipsychotics for people with severe mental illness and co-occurring substance misuse.
CONCLUSIONS: There is not sufficient good-quality evidence available to determine the effects of risperidone compared with other antipsychotics in people with a dual diagnosis. Few trials compared risperidone with first-generation agents, leading to limited applicability to settings where access to second-generation agents is limited, such as in low- and middle-income countries. Moreover, heterogeneity in trial design and measurement of outcomes precluded the use of many trials in our analyses. Future trials in this area need to be sufficiently powered but also need to conform to consistent methods in study population sele...
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Temmingh HS, Williams T, Siegfried N, Stein DJ Tags: Cochrane Database Syst Rev Source Type: research

Intraoperative imaging technology to maximise extent of resection for glioma.
CONCLUSIONS: Intra-operative imaging technologies, specifically iMRI and 5-ALA, may be of benefit in maximising extent of resection in participants with high grade glioma. However, this is based on low to very low quality evidence, and is therefore very uncertain. The short- and long-term neurological effects are uncertain. Effects of image-guided surgery on overall survival, progression-free survival, and quality of life are unclear. A brief economic commentary found limited economic evidence for the equivocal use of iMRI compared with conventional surgery. In terms of costs, a non-systematic review of economic studies su...
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Jenkinson MD, Barone DG, Bryant A, Vale L, Bulbeck H, Lawrie TA, Hart MG, Watts C Tags: Cochrane Database Syst Rev Source Type: research

Magnetic resonance perfusion for differentiating low-grade from high-grade gliomas at first presentation.
We present a summary of the study characteristics and QUADAS-2 results, and rate studies as good quality when they have low risk of bias in the domains of reference standard of tissue diagnosis and flow and timing between MR perfusion and tissue diagnosis.In the quantitative analysis, LGGs were considered disease positive, while HGGs were disease negative. The sensitivity refers to the proportion of LGGs detected by MR perfusion, and specificity as the proportion of detected HGGs. We constructed two-by-two tables with true positives and false negatives as the number of correctly and incorrectly diagnosed LGG, respectively,...
Source: Cochrane Database of Systematic Reviews - January 22, 2018 Category: General Medicine Authors: Abrigo JM, Fountain DM, Provenzale JM, Law EK, Kwong JS, Hart MG, Tam WWS Tags: Cochrane Database Syst Rev Source Type: research

E-learning for health professionals.
CONCLUSIONS: When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading. PMID: 29355907 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 21, 2018 Category: General Medicine Authors: Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, Tramacere I, Moja L Tags: Cochrane Database Syst Rev Source Type: research

Benzodiazepines for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: There is only evidence of very low quality from a few small and poorly reported trials on the effect of benzodiazepines as an adjunctive treatment for antipsychotic-induced TD. These inconclusive results mean routine clinical use is not indicated and these treatments remain experimental. New and better trials are indicated in this under-researched area; however, as benzodiazepines are addictive, we feel that other techniques or medications should be adequately evaluated before benzodiazepines are chosen. PMID: 29352477 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 20, 2018 Category: General Medicine Authors: Bergman H, Bhoopathi PS, Soares-Weiser K Tags: Cochrane Database Syst Rev Source Type: research

Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients und...
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Yu Y, Zhang K, Zhang L, Zong H, Meng L, Han R Tags: Cochrane Database Syst Rev Source Type: research

Vitamin E for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation. PMID: 29341067 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Soares-Weiser K, Maayan N, Bergman H Tags: Cochrane Database Syst Rev Source Type: research

Anticholinergic medication for antipsychotic-induced tardive dyskinesia.
CONCLUSIONS: Based on currently available evidence, no confident statement can be made about the effectiveness of anticholinergics to treat people with antipsychotic-induced tardive dyskinesia. The same applies for the withdrawal of such medications. Whether the withdrawal of anticholinergics may benefit people with antipsychotic-induced TD should be evaluated in a parallel-group, placebo-controlled randomised trial, with adequate sample size and at least 6 weeks of follow-up. PMID: 29341071 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 17, 2018 Category: General Medicine Authors: Bergman H, Soares-Weiser K Tags: Cochrane Database Syst Rev Source Type: research

Gefitinib for advanced non-small cell lung cancer.
Abstract BACKGROUND: The role of gefitinib for the treatment of advanced non-small cell lung cancer (NSCLC) is evolving. We undertook a systematic review to evaluate the available evidence from all randomised trials. OBJECTIVES: To determine the effectiveness and safety of gefitinib as first-line, second-line or maintenance treatment for advanced NSCLC. SEARCH METHODS: We performed searches in CENTRAL, MEDLINE and Embase from inception to 17 February 2017. We handsearched relevant conference proceedings, clinical trial registries and references lists of retrieved articles. SELECTION CRITERIA: We inc...
Source: Cochrane Database of Systematic Reviews - January 16, 2018 Category: General Medicine Authors: Sim EH, Yang IA, Wood-Baker R, Bowman RV, Fong KM Tags: Cochrane Database Syst Rev Source Type: research

Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis.
CONCLUSIONS: While the UCEIS, UCCIS and Mayo Clinic Endoscopic Subscore have undergone extensive validation, none of these instruments have been fully validated and only two studies assessed responsiveness. Further research on the operating properties of these indices is needed given the lack of a fully-validated endoscopic scoring instrument for the evaluation of disease activity in ulcerative colitis. PMID: 29338066 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 16, 2018 Category: General Medicine Authors: Mohammed Vashist N, Samaan M, Mosli MH, Parker CE, MacDonald JK, Nelson SA, Zou GY, Feagan BG, Khanna R, Jairath V Tags: Cochrane Database Syst Rev Source Type: research

Interventions to increase attendance for diabetic retinopathy screening.
CONCLUSIONS: The results of this review provide evidence that QI interventions targeting patients, healthcare professionals or the healthcare system are associated with meaningful improvements in DRS attendance compared to usual care. There was no statistically significant difference between interventions specifically aimed at DRS and those which were part of a general QI strategy for improving diabetes care. This is a significant finding, due to the additional benefits of general QI interventions in terms of improving glycaemic control, vascular risk management and screening for other microvascular complications. It is li...
Source: Cochrane Database of Systematic Reviews - January 15, 2018 Category: General Medicine Authors: Lawrenson JG, Graham-Rowe E, Lorencatto F, Burr J, Bunce C, Francis JJ, Aluko P, Rice S, Vale L, Peto T, Presseau J, Ivers N, Grimshaw JM Tags: Cochrane Database Syst Rev Source Type: research

Prostanoids for critical limb ischaemia.
CONCLUSIONS: We found high-quality evidence showing that prostanoids have no effect on the incidence of total amputations when compared against placebo. Moderate-quality evidence showed small beneficial effects of prostanoids for rest-pain relief and ulcer healing when compared with placebo. Additionally, moderate-quality evidence showed a greater incidence of adverse effects with the use of prostanoids, and low-quality evidence suggests that prostanoids have no effect on cardiovascular mortality when compared with placebo. None of the included studies reported quality of life measurements. The balance between benefits and...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: Vietto V, Franco JV, Saenz V, Cytryn D, Chas J, Ciapponi A Tags: Cochrane Database Syst Rev Source Type: research

Providing physicians with feedback on medication adherence for people with chronic diseases taking long-term medication.
CONCLUSIONS: Across nine studies, we observed little or no evidence that provision of feedback to physicians regarding their patients adherence to prescribed medication improved medication adherence, patient outcomes, or health resource use. Feedback about medication adherence may improve processes of care, but due to the small number of studies assessing this outcome and high risk of bias, we cannot draw firm conclusions on the effect of feedback on this outcome. Future research should use a clear, standardised definition of medication adherence and cluster-randomisation to avoid the risk of contamination. PMID: 2932...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: Zaugg V, Korb-Savoldelli V, Durieux P, Sabatier B Tags: Cochrane Database Syst Rev Source Type: research

Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.
CONCLUSIONS: We have not identified any new high-quality evidence on the efficacy or safety of an anticonvulsant in stopping an acute tonic-clonic convulsion that would inform clinical practice. There appears to be a very low risk of adverse events, specifically respiratory depression. Intravenous lorazepam and diazepam appear to be associated with similar rates of seizure cessation and respiratory depression. Although intravenous lorazepam and intravenous diazepam lead to more rapid seizure cessation, the time taken to obtain intravenous access may undermine this effect. In the absence of intravenous access, buccal midazo...
Source: Cochrane Database of Systematic Reviews - January 10, 2018 Category: General Medicine Authors: McTague A, Martland T, Appleton R Tags: Cochrane Database Syst Rev Source Type: research

Home versus in-patient treatment for deep vein thrombosis.
CONCLUSIONS: Low-quality evidence suggests that patients treated at home with LMWH are less likely to have recurrence of VTE than those treated in hospital. However, data show no clear differences in major or minor bleeding, nor in mortality (low-quality evidence), indicating that home treatment is no worse than in-patient treatment for these outcomes. Because most healthcare systems are moving towards more LMWH usage in the home setting it is unlikely that additional large trials will be undertaken to compare these treatments. Therefore, home treatment is likely to become the norm, and further research will be directed to...
Source: Cochrane Database of Systematic Reviews - January 9, 2018 Category: General Medicine Authors: Othieno R, Okpo E, Forster R Tags: Cochrane Database Syst Rev Source Type: research

Aripiprazole (intramuscular) for psychosis-induced aggression or agitation (rapid tranquillisation).
CONCLUSIONS: The available evidence is of poor quality but there is some evidence aripiprazole is effective compared to placebo and haloperidol, but not when compared to olanzapine. However, considering that evidence comes from only three studies, caution is required in generalising these results to real-world practice. This review firmly highlights the need for more high-quality trials on intramuscular aripiprazole in the management of people with acute aggression or agitation. PMID: 29308601 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Ostinelli EG, Jajawi S, Spyridi S, Sayal K, Jayaram MB Tags: Cochrane Database Syst Rev Source Type: research

Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity.
CONCLUSIONS: Implications for practice: Intravitreal bevacizumab/ranibizumab, when used as monotherapy, reduces the risk of refractive errors during childhood but does not reduce the risk of retinal detachment or recurrence of ROP in infants with type 1 ROP. While the intervention might reduce the risk of recurrence of ROP in infants with zone I ROP, it can potentially result in higher risk of recurrence requiring retreatment in those with zone II ROP. Intravitreal pegaptanib, when used in conjunction with laser therapy, reduces the risk of retinal detachment as well as the recurrence of ROP in infants with type 1 ROP. How...
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Sankar MJ, Sankar J, Chandra P Tags: Cochrane Database Syst Rev Source Type: research

Propofol for the promotion of sleep in adults in the intensive care unit.
CONCLUSIONS: We found insufficient evidence to determine whether administration of propofol would improve the quality and quantity of sleep in adults in the ICU. We noted differences in study designs, methodology, comparative agents and illness severity amongst study participants. We did not pool data and we used the GRADE approach to downgrade the certainty of our evidence to very low. PMID: 29308828 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Lewis SR, Schofield-Robinson OJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Radical multimodality therapy for malignant pleural mesothelioma.
CONCLUSIONS: The overall strength of the evidence gathered in this review is low and there is a lack of available evidence to support the use of radical multimodality therapy in routine clinical practice (particularly as one trial suggests greater harm). Given the added cost of multimodality treatment and the possible increase in risk of adverse effects, the lack of evidence of their effectiveness probably means that these interventions should currently be limited to clinical trials alone. PMID: 29309720 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 8, 2018 Category: General Medicine Authors: Abdel-Rahman O, Elsayed Z, Mohamed H, Eltobgy M Tags: Cochrane Database Syst Rev Source Type: research

Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.
CONCLUSIONS: There is limited evidence to inform implications for practice. The available data are not of high quality and lack power to detect possible important differences in either benefit or harm. There is an urgent need for high-quality trials evaluating the effectiveness of planned birth at or near term gestation for women with gestational diabetes compared with an expectant approach. PMID: 29303230 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 5, 2018 Category: General Medicine Authors: Biesty LM, Egan AM, Dunne F, Dempsey E, Meskell P, Smith V, Ni Bhuinneain GM, Devane D Tags: Cochrane Database Syst Rev Source Type: research

Botulinum toxin for motor and phonic tics in Tourette's syndrome.
CONCLUSIONS: We are uncertain about botulinum toxin effects in the treatment of focal motor and phonic tics in select cases, as we assessed the quality of the evidence as very low. Additional randomised controlled studies are needed to demonstrate the benefits and harms of botulinum toxin therapy for the treatment of motor and phonic tics in patients with Tourette's syndrome. PMID: 29304272 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 5, 2018 Category: General Medicine Authors: Pandey S, Srivanitchapoom P, Kirubakaran R, Berman BD Tags: Cochrane Database Syst Rev Source Type: research

Embolisation for pulmonary arteriovenous malformation.
CONCLUSIONS: There is no evidence from randomised controlled trials for embolisation of pulmonary arteriovenous malformations. However, randomised controlled trials are not always feasible on ethical grounds. Accumulated data from observational studies suggest that embolisation is a safe procedure which reduces morbidity and mortality. A standardised approach to reporting with long-term follow-up through registry studies can help to strengthen the evidence for embolisation in the absence of randomised controlled trials. PMID: 29298459 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 4, 2018 Category: General Medicine Authors: Hsu CC, Kwan GN, Evans-Barns H, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Cyclophosphamide for connective tissue disease-associated interstitial lung disease.
CONCLUSIONS: This review, which is based on studies of varying methodological quality, demonstrates that overall, in this population, small benefit may be derived from the use of cyclophosphamide in terms of mean difference in % FVC when compared with placebo, but not of the difference in % DLCO, or when compared with mycophenolate. Modest clinical improvement in dyspnoea may be noted with the use of cyclophosphamide. Clinical practice guidelines should advise clinicians to consider individual patient characteristics and to expect only modest benefit at best in preserving FVC. Clinicians should carefully monitor for advers...
Source: Cochrane Database of Systematic Reviews - January 3, 2018 Category: General Medicine Authors: Barnes H, Holland AE, Westall GP, Goh NS, Glaspole IN Tags: Cochrane Database Syst Rev Source Type: research

Treatment of fatigue in amyotrophic lateral sclerosis/motor neuron disease.
CONCLUSIONS: It is impossible to draw firm conclusions about the effectiveness of interventions to improve fatigue for people with ALS/MND as there are few randomised studies, and the quality of available evidence is very low. PMID: 29293261 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 2, 2018 Category: General Medicine Authors: Gibbons C, Pagnini F, Friede T, Young CA Tags: Cochrane Database Syst Rev Source Type: research

Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis.
CONCLUSIONS: Overall, there is insufficient evidence to determine the superiority of different protocols or adjunctive strategies to improve tooth maintenance during SPT. No trials evaluated SPT versus monitoring only. The evidence available for the comparisons evaluated is of low to very low quality, and hampered by dissimilarities in outcome reporting. More trials using uniform definitions and outcomes are required to address the objectives of this review. PMID: 29291254 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 1, 2018 Category: General Medicine Authors: Manresa C, Sanz-Miralles EC, Twigg J, Bravo M Tags: Cochrane Database Syst Rev Source Type: research

Oral anticoagulation in people with cancer who have no therapeutic or prophylactic indication for anticoagulation.
CONCLUSIONS: The existing evidence does not show a mortality benefit from oral anticoagulation in people with cancer but suggests an increased risk for bleeding.Editorial note: this is a living systematic review. Living systematic reviews offer a new approach to review updating in which the review is continually updated, incorporating relevant new evidence, as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review. PMID: 29285754 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 29, 2017 Category: General Medicine Authors: Kahale LA, Hakoum MB, Tsolakian IG, Matar CF, Barba M, Yosuico VED, Terrenato I, Sperati F, Schünemann H, Akl EA Tags: Cochrane Database Syst Rev Source Type: research

Fitness training for cardiorespiratory conditioning after traumatic brain injury.
CONCLUSIONS: There is low-quality evidence that fitness training is effective at improving cardiorespiratory deconditioning after TBI; there is insufficient evidence to draw any definitive conclusions about the other outcomes. Whilst the intervention appears to be accepted by people with TBI, and there is no evidence of harm, more adequately powered and well-designed studies are required to determine a more precise estimate of the effect on cardiorespiratory fitness, as well as the effects across a range of important outcome measures and in people with different characteristics (e.g. children). In the absence of high quali...
Source: Cochrane Database of Systematic Reviews - December 29, 2017 Category: General Medicine Authors: Hassett L, Moseley AM, Harmer AR Tags: Cochrane Database Syst Rev Source Type: research

Elevation of the head during intensive care management in people with severe traumatic brain injury.
CONCLUSIONS: The lack of consistency among studies, scarcity of data and the absence of evidence to show a correlation between physiological measurements such as ICP, CCP and clinical outcomes, mean that we are uncertain about the effects of HBE during intensive care management in people with severe TBI.Well-designed and larger trials that measure long-term clinical outcomes are needed to understand how and when different backrest positions can affect the management of severe TBI. PMID: 29283434 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 28, 2017 Category: General Medicine Authors: Alarcon JD, Rubiano AM, Okonkwo DO, Alarcón J, Martinez-Zapata MJ, Urrútia G, Bonfill Cosp X Tags: Cochrane Database Syst Rev Source Type: research

Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries.
CONCLUSIONS: Low-quality evidence suggests that ART using H-GIC may have a higher risk of restoration failure than conventional treatment for caries lesions in primary teeth. The effects of ART using composite and RM-GIC are uncertain due to the very low quality of the evidence and we cannot rely on the findings. Most studies evaluated the effects of ART on the primary dentition.Well-designed RCTs are required that report on restoration failure at clinically meaningful time points, as well as participant-reported outcomes such as pain and discomfort. Due to the potential confounding effects from the use of different dental...
Source: Cochrane Database of Systematic Reviews - December 28, 2017 Category: General Medicine Authors: Dorri M, Martinez-Zapata MJ, Walsh T, Marinho VC, Sheiham Deceased A, Zaror C Tags: Cochrane Database Syst Rev Source Type: research

Bisphosphonates for advanced prostate cancer.
CONCLUSIONS: Based on low quality evidence, there may be no clinically relevant difference in the proportion of men with pain response between bisphosphonates and control regimens in men with bone metastases from prostate cancer. Bisphosphonates probably decrease the number of skeletal-related events and disease progression. These benefits need to be weighed against the increased risk of renal impairment and nausea in men receiving bisphosphonates. Future studies should explicitly evaluate patient important outcomes such as quality of life and pain by using standardized and comparable assessment tools. PMID: 29278410 ...
Source: Cochrane Database of Systematic Reviews - December 26, 2017 Category: General Medicine Authors: Macherey S, Monsef I, Jahn F, Jordan K, Yuen KK, Heidenreich A, Skoetz N Tags: Cochrane Database Syst Rev Source Type: research

Exercise for intermittent claudication.
Abstract BACKGROUND: Exercise programmes are a relatively inexpensive, low-risk option compared with other, more invasive therapies for treatment of leg pain on walking (intermittent claudication (IC)). This is the fourth update of a review first published in 1998. OBJECTIVES: Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication. Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease, reducing cardiovascu...
Source: Cochrane Database of Systematic Reviews - December 26, 2017 Category: General Medicine Authors: Lane R, Harwood A, Watson L, Leng GC Tags: Cochrane Database Syst Rev Source Type: research

Newborn screening for galactosaemia.
CONCLUSIONS: We were unable to identify any eligible studies for inclusion in this review and hence it is not possible to draw any conclusions based on randomised controlled studies. However, we are aware of uncontrolled studies which support the efficacy of newborn screening for galactosaemia. There are a number of reviews and economic analyses of non-trial literature suggesting that screening is appropriate. PMID: 29274129 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 23, 2017 Category: General Medicine Authors: Lak R, Yazdizadeh B, Davari M, Nouhi M, Kelishadi R Tags: Cochrane Database Syst Rev Source Type: research

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.
CONCLUSIONS: Targeting continent antenatal women early in pregnancy and offering a structured PFMT programme may prevent the onset of urinary incontinence in late pregnancy and postpartum. However, the cost-effectiveness of this is unknown. Population approaches (recruiting antenatal women regardless of continence status) may have a smaller effect on urinary incontinence, although the reasons for this are unclear. It is uncertain whether a population-based approach for delivering postnatal PFMT is effective in reducing urinary incontinence. Uncertainty surrounds the effects of PFMT as a treatment for urinary incontinence i...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC Tags: Cochrane Database Syst Rev Source Type: research

Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.
CONCLUSIONS: Our review shows that compared to placebo, the biologics ixekizumab, secukinumab, brodalumab, guselkumab, certolizumab, and ustekinumab are the best choices for achieving PASI 90 in people with moderate to severe psoriasis on the basis of moderate- to high-certainty evidence. At class level, the biologic treatments anti-IL17, anti-IL12/23, anti-IL23, and anti-TNF alpha were significantly more effective than the small molecules and the conventional systemic agents, too. This NMA evidence is limited to induction therapy (outcomes were measured between 12 to 16 weeks after randomisation) and is not sufficiently r...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Sbidian E, Chaimani A, Garcia-Doval I, Do G, Hua C, Mazaud C, Droitcourt C, Hughes C, Ingram JR, Naldi L, Chosidow O, Le Cleach L Tags: Cochrane Database Syst Rev Source Type: research

Electrical stimulation with non-implanted devices for stress urinary incontinence in women.
CONCLUSIONS: The current evidence base indicated that electrical stimulation is probably more effective than no active or sham treatment, but it is not possible to say whether ES is similar to PFMT or other active treatments in effectiveness or not. Overall, the quality of the evidence was too low to provide reliable results. Without sufficiently powered trials measuring clinically important outcomes, such as subjective assessment of urinary incontinence, we cannot draw robust conclusions about the overall effectiveness or cost-effectiveness of electrical stimulation for stress urinary incontinence in women. PMID: 292...
Source: Cochrane Database of Systematic Reviews - December 22, 2017 Category: General Medicine Authors: Stewart F, Berghmans B, Bø K, Glazener CM Tags: Cochrane Database Syst Rev Source Type: research

Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes.
CONCLUSIONS: There was no evidence from RCTs that evaluated the effects of exercise interventions for improving maternal and fetal outcomes in women with pre-existing diabetes.Good quality, large randomised controlled trials are urgently needed to identify exercise interventions that are safe, and improve health outcomes for women with pre-existing diabetes and their babies. Future studies in this area could utilise the standardised outcomes in this review, in order to improve consistency between trials in this area, and aid future meta-analysis. PMID: 29264871 [PubMed - as supplied by publisher] (Source: Cochrane Dat...
Source: Cochrane Database of Systematic Reviews - December 21, 2017 Category: General Medicine Authors: Brown J, Ceysens G, Boulvain M Tags: Cochrane Database Syst Rev Source Type: research