Positron emission tomography (PET) and magnetic resonance imaging (MRI) for assessing tumour resectability in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer.
CONCLUSIONS: Studies suggested a high specificity and moderate sensitivity for FDG-PET/CT and MRI to assess macroscopic incomplete debulking. However, the certainty of the evidence was insufficient to advise routine addition of FDG-PET/CT or MRI to clinical practice..In a research setting, adding an alternative imaging method could be considered for women identified as suitable for primary debulking by abdominal CT, in an attempt to filter out false-negatives (i.e. debulking, feasible based on abdominal CT, unfeasible at actual surgery). PMID: 30298516 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 8, 2018 Category: General Medicine Authors: Roze JF, Hoogendam JP, van de Wetering FT, Spijker R, Verleye L, Vlayen J, Veldhuis WB, Scholten RJ, Zweemer RP Tags: Cochrane Database Syst Rev Source Type: research

Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology.
CONCLUSIONS: For women with unexplained recurrent miscarriages, supplementation with progestogen therapy probably reduces the rate of miscarriage in subsequent pregnancies. PMID: 30298541 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 8, 2018 Category: General Medicine Authors: Haas DM, Hathaway TJ, Ramsey PS Tags: Cochrane Database Syst Rev Source Type: research

Valproate preparations for agitation in dementia.
CONCLUSIONS: This updated review corroborates earlier findings that valproate preparations are probably ineffective in treating agitation in people with dementia, but are associated with a higher rate of adverse effects, and possibly of SAEs. On the basis of this evidence, valproate therapy cannot be recommended for management of agitation in dementia. Further research may not be justified, particularly in light of the increased risk of adverse effects in this often frail group of people. Research would be better focused on effective non-pharmacological interventions for this patient group, or, for those situations where m...
Source: Cochrane Database of Systematic Reviews - October 5, 2018 Category: General Medicine Authors: Baillon SF, Narayana U, Luxenberg JS, Clifton AV Tags: Cochrane Database Syst Rev Source Type: research

Occupational therapy delivered by specialists versus non-specialists for people with schizophrenia.
CONCLUSIONS: Currently there are no randomised controlled trials comparing delivery of occupational therapy for people diagnosed with schizophrenia by occupational therapists with delivery of similar interventions by anyone other than occupational therapists. Research studies employing methodologically robust trial designs are needed to establish whether or not there are better outcomes for people with a diagnosis of schizophrenia with occupational therapy that is delivered by trained occupational therapists. PMID: 30293234 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 5, 2018 Category: General Medicine Authors: Morris K, Reid G, Spencer S Tags: Cochrane Database Syst Rev Source Type: research

Individual-, family-, and school-level interventions targeting multiple risk behaviours in young people.
CONCLUSIONS: Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. Results of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk ...
Source: Cochrane Database of Systematic Reviews - October 5, 2018 Category: General Medicine Authors: MacArthur G, Caldwell DM, Redmore J, Watkins SH, Kipping R, White J, Chittleborough C, Langford R, Er V, Lingam R, Pasch K, Gunnell D, Hickman M, Campbell R Tags: Cochrane Database Syst Rev Source Type: research

Interventionist versus expectant care for severe pre-eclampsia between 24 and 34 weeks' gestation.
CONCLUSIONS: This review suggested that an expectant approach to the management of women with severe early onset pre-eclampsia may be associated with decreased morbidity for the baby. However, this evidence was based on data from only six trials. Further large, high-quality trials are needed to confirm or refute these findings, and establish if this approach is safe for the mother. PMID: 30289565 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 5, 2018 Category: General Medicine Authors: Churchill D, Duley L, Thornton JG, Moussa M, Ali HS, Walker KF Tags: Cochrane Database Syst Rev Source Type: research

Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women.
CONCLUSIONS: Based on the data available, we can be confident that PFMT can cure or improve symptoms of SUI and all other types of UI. It may reduce the number of leakage episodes, the quantity of leakage on the short pad tests in the clinic and symptoms on UI-specific symptom questionnaires. The authors of the one economic evaluation identified for the Brief Economic Commentary reported that the cost-effectiveness of PFMT looks promising. The findings of the review suggest that PFMT could be included in first-line conservative management programmes for women with UI. The long-term effectiveness and cost-effectiveness of P...
Source: Cochrane Database of Systematic Reviews - October 4, 2018 Category: General Medicine Authors: Dumoulin C, Cacciari LP, Hay-Smith EJC Tags: Cochrane Database Syst Rev Source Type: research

Psychological interventions for needle-related procedural pain and distress in children and adolescents.
CONCLUSIONS: We identified evidence supporting the efficacy of distraction, hypnosis, combined CBT, and breathing interventions for reducing children's needle-related pain or distress, or both. Support for the efficacy of combined CBT and breathing interventions is new from our last review update due to the availability of new evidence. The quality of trials and overall evidence remains low to very low, underscoring the need for improved methodological rigor and trial reporting. Despite low-quality evidence, the potential benefits of reduced pain or distress or both support the evidence in favor of using these intervention...
Source: Cochrane Database of Systematic Reviews - October 4, 2018 Category: General Medicine Authors: Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA Tags: Cochrane Database Syst Rev Source Type: research

Low protein diets for non-diabetic adults with chronic kidney disease.
CONCLUSIONS: This review found that very low protein diets probably reduce the number of people with CKD 4 or 5, who progress to ESKD. In contrast low protein diets may make little difference to the number of people who progress to ESKD. Low or very low protein diets probably do not influence death. However there are limited data on adverse effects such as weight differences and protein energy wasting. There are no data on whether quality of life is impacted by difficulties in adhering to protein restriction. Studies evaluating the adverse effects and the impact on quality of life of dietary protein restriction are require...
Source: Cochrane Database of Systematic Reviews - October 4, 2018 Category: General Medicine Authors: Hahn D, Hodson EM, Fouque D Tags: Cochrane Database Syst Rev Source Type: research

Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma.
CONCLUSIONS: We found moderate-quality evidence that PRT reduces overall mortality. Subgroup analysis did not confirm this effect in people undergoing TME surgery. We found consistent evidence that PRT reduces local recurrence. Risk of sepsis and postsurgical complications may be higher with PRT.The main limitation of the findings of the present review concerns their applicability. The included trials only assessed short-course radiotherapy and did not use chemotherapy, which is widely used in the contemporary management of rectal cancer disease. The differences between the trials regarding the criteria used to define rect...
Source: Cochrane Database of Systematic Reviews - October 3, 2018 Category: General Medicine Authors: Abraha I, Aristei C, Palumbo I, Lupattelli M, Trastulli S, Cirocchi R, De Florio R, Valentini V Tags: Cochrane Database Syst Rev Source Type: research

Root coverage procedures for treating localised and multiple recession-type defects.
Abstract BACKGROUND: Gingival recession is defined as the oral exposure of the root surface due to a displacement of the gingival margin apical to the cemento-enamel junction and it is regularly linked to the deterioration of dental aesthetics. Successful treatment of recession-type defects is based on the use of predictable root coverage periodontal plastic surgery (RCPPS) procedures. This review is an update of the original version that was published in 2009. OBJECTIVES: To evaluate the efficacy of different root coverage procedures in the treatment of single and multiple recession-type defects. SEARCH...
Source: Cochrane Database of Systematic Reviews - October 2, 2018 Category: General Medicine Authors: Chambrone L, Salinas Ortega MA, Sukekava F, Rotundo R, Zamira K, Buti J, Pini Prato GP Tags: Cochrane Database Syst Rev Source Type: research

Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.
CONCLUSIONS: Antihypertensive drug therapy for mild to moderate hypertension during pregnancy reduces the risk of severe hypertension. The effect on other clinically important outcomes remains unclear. If antihypertensive drugs are used, beta blockers and calcium channel blockers appear to be more effective than the alternatives for preventing severe hypertension. High-quality large sample-sized randomised controlled trials are required in order to provide reliable estimates of the benefits and adverse effects of antihypertensive treatment for mild to moderate hypertension for both mother and baby, as well as costs to the ...
Source: Cochrane Database of Systematic Reviews - October 1, 2018 Category: General Medicine Authors: Abalos E, Duley L, Steyn DW, Gialdini C Tags: Cochrane Database Syst Rev Source Type: research

Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.
ni MR Abstract BACKGROUND: Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. This is an update of a review last published in 2014. OBJECTIVES: To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (18 September 2017), and ref...
Source: Cochrane Database of Systematic Reviews - October 1, 2018 Category: General Medicine Authors: Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR Tags: Cochrane Database Syst Rev Source Type: research

Exercise-based cardiac rehabilitation for people with implantable ventricular assist devices.
CONCLUSIONS: The evidence is currently inadequate to assess the safety and efficacy of exercise-based CR for people with implantable VADs compared with usual care. The amount of RCT evidence was very limited and of very low quality. In addition, the training duration was very short term, that is from six to eight weeks. Further high-quality and well-reported RCTs of exercise-based CR for people with implantable VADs are needed. Such trials need to collect data on events (mortality and rehospitalisation), patient-related outcomes (including quality of life), and cost-effectiveness. PMID: 30270428 [PubMed - in process] ...
Source: Cochrane Database of Systematic Reviews - September 30, 2018 Category: General Medicine Authors: Yamamoto S, Hotta K, Ota E, Matsunaga A, Mori R Tags: Cochrane Database Syst Rev Source Type: research

Psychological therapies for the management of chronic and recurrent pain in children and adolescents.
Abstract BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. OBJECTIVES: The aim of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents.The primary objective of this updated review was to dete...
Source: Cochrane Database of Systematic Reviews - September 29, 2018 Category: General Medicine Authors: Fisher E, Law E, Dudeney J, Palermo TM, Stewart G, Eccleston C Tags: Cochrane Database Syst Rev Source Type: research

Non-clinical interventions for reducing unnecessary caesarean section.
CONCLUSIONS: We evaluated a wide range of non-clinical interventions to reduce unnecessary caesarean section, mostly in high-income settings. Few interventions with moderate- or high-certainty evidence, mainly targeting healthcare professionals (implementation of guidelines combined with mandatory second opinion, implementation of guidelines combined with audit and feedback, physician education by local opinion leader) have been shown to safely reduce caesarean section rates. There are uncertainties in existing evidence related to very-low or low-certainty evidence, applicability of interventions and lack of studies, parti...
Source: Cochrane Database of Systematic Reviews - September 28, 2018 Category: General Medicine Authors: Chen I, Opiyo N, Tavender E, Mortazhejri S, Rader T, Petkovic J, Yogasingam S, Taljaard M, Agarwal S, Laopaiboon M, Wasiak J, Khunpradit S, Lumbiganon P, Gruen RL, Betran AP Tags: Cochrane Database Syst Rev Source Type: research

Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants.
CONCLUSIONS: Ibuprofen is as effective as indomethacin in closing a PDA. Ibuprofen reduces the risk of NEC and transient renal insufficiency. Therefore, of these two drugs, ibuprofen appears to be the drug of choice. The effectiveness of ibuprofen versus paracetamol is assessed in a separate review. Oro-gastric administration of ibuprofen appears as effective as IV administration. To make further recommendations, studies are needed to assess the effectiveness of high-dose versus standard-dose ibuprofen, early versus expectant administration of ibuprofen, echocardiographically-guided versus standard IV ibuprofen, and contin...
Source: Cochrane Database of Systematic Reviews - September 28, 2018 Category: General Medicine Authors: Ohlsson A, Walia R, Shah SS Tags: Cochrane Database Syst Rev Source Type: research

Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.
CONCLUSIONS: There is very low-quality evidence that is insufficient to determine the effects of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess. PMID: 30259968 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 27, 2018 Category: General Medicine Authors: Cope AL, Francis N, Wood F, Chestnutt IG Tags: Cochrane Database Syst Rev Source Type: research

Nebulised hypertonic saline for cystic fibrosis.
CONCLUSIONS: Regular use of nebulised hypertonic saline by adults and children over the age of 12 years with CF results in an improvement in lung function after four weeks (very low-quality evidence from three trials), but this was not sustained at 48 weeks (low-quality evidence from one trial). The review did show that nebulised hypertonic saline reduced the frequency of pulmonary exacerbations (although we found insufficient evidence for this outcome in children under six years of age) and may have a small effect on improvement in quality of life in adults.Evidence from one small cross-over trial in children indicates th...
Source: Cochrane Database of Systematic Reviews - September 27, 2018 Category: General Medicine Authors: Wark P, McDonald VM Tags: Cochrane Database Syst Rev Source Type: research

Oral care measures for preventing nursing home-acquired pneumonia.
CONCLUSIONS: Although low-quality evidence suggests that professional oral care could reduce mortality due to pneumonia in nursing home residents when compared to usual care, this finding must be considered with caution. Evidence for other outcomes is inconclusive. We found no high-quality evidence to determine which oral care measures are most effective for reducing nursing home-acquired pneumonia. Further trials are needed to draw reliable conclusions. PMID: 30264525 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 27, 2018 Category: General Medicine Authors: Liu C, Cao Y, Lin J, Ng L, Needleman I, Walsh T, Li C Tags: Cochrane Database Syst Rev Source Type: research

Modifying the consistency of food and fluids for swallowing difficulties in dementia.
CONCLUSIONS: We are uncertain about the immediate and long-term effects of modifying the consistency of fluid for swallowing difficulties in dementia as too few studies have been completed. There may be differences in outcomes depending on the grade of thickness of fluids and the sequence of interventions trialled in videofluoroscopy for people with dementia. Clinicians should be aware that while thickening fluids may have an immediate positive effect on swallowing, the long-term impact of thickened fluids on the health of the person with dementia should be considered. Further high-quality clinical trials are required. ...
Source: Cochrane Database of Systematic Reviews - September 24, 2018 Category: General Medicine Authors: Flynn E, Smith CH, Walsh CD, Walshe M Tags: Cochrane Database Syst Rev Source Type: research

Vitamin D for the management of multiple sclerosis.
CONCLUSIONS: To date, very low-quality evidence suggests no benefit of vitamin D for patient-important outcomes among people with MS. Vitamin D appears to have no effect on recurrence of relapse, worsening of disability measured by the Expanded Disability Status Scale (EDSS), and MRI lesions. Effects on health-related quality of life and fatigue are unclear. Vitamin D₃ at the doses and treatment durations used in the included trials appears to be safe, although available data are limited. Seven ongoing studies will likely provide further evidence that can be included in a future update of this review. PMID: 30246874...
Source: Cochrane Database of Systematic Reviews - September 24, 2018 Category: General Medicine Authors: Jagannath VA, Filippini G, Di Pietrantonj C, Asokan GV, Robak EW, Whamond L, Robinson SA Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for treating scrub typhus.
CONCLUSIONS: Tetracycline, doxycycline, azithromycin, and rifampicin are effective treatment options for scrub typhus and have resulted in few treatment failures. Chloramphenicol also remains a treatment option, but we could not include this among direct comparisons in this review.Most available evidence is of low or very low certainty. For specific outcomes, some low-certainty evidence suggests there may be little or no difference between tetracycline, doxycycline, and azithromycin as treatment options. Given very low-certainty evidence for rifampicin and the risk of inducing resistance in undiagnosed tuberculosis, clinic...
Source: Cochrane Database of Systematic Reviews - September 24, 2018 Category: General Medicine Authors: El Sayed I, Liu Q, Wee I, Hine P Tags: Cochrane Database Syst Rev Source Type: research

Insulin and glucose-lowering agents for treating people with diabetes and chronic kidney disease.
Abstract BACKGROUND: Diabetes is the commonest cause of chronic kidney disease (CKD). Both conditions commonly co-exist. Glucometabolic changes and concurrent dialysis in diabetes and CKD make glucose-lowering challenging, increasing the risk of hypoglycaemia. Glucose-lowering agents have been mainly studied in people with near-normal kidney function. It is important to characterise existing knowledge of glucose-lowering agents in CKD to guide treatment. OBJECTIVES: To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose levels in people with diabetes and CKD...
Source: Cochrane Database of Systematic Reviews - September 24, 2018 Category: General Medicine Authors: Lo C, Toyama T, Wang Y, Lin J, Hirakawa Y, Jun M, Cass A, Hawley CM, Pilmore H, Badve SV, Perkovic V, Zoungas S Tags: Cochrane Database Syst Rev Source Type: research

Intramuscular versus intravenous prophylactic oxytocin for the third stage of labour.
CONCLUSIONS: Very low-quality evidence indicates no clear difference between the comparative benefits and risks of intramuscular and intravenous oxytocin when given to prevent excessive blood loss after vaginal birth. Appropriately designed randomised trials with adequate sample sizes are needed to assess whether the route of prophylactic oxytocin after vaginal birth affects maternal or infant outcomes. Such studies could be large enough to detect clinically important differences in major side effects that have been reported in observational studies and should also consider the acceptability of the intervention to mothers ...
Source: Cochrane Database of Systematic Reviews - September 22, 2018 Category: General Medicine Authors: Oladapo OT, Okusanya BO, Abalos E Tags: Cochrane Database Syst Rev Source Type: research

Olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults.
CONCLUSIONS: There is moderate-quality evidence that oral olanzapine probably increases the likelihood of not being nauseous or vomiting during chemotherapy from 25% to 50% in adults with solid tumours, in addition to standard therapy, compared to placebo or no treatment. There is uncertainty whether it increases serious adverse events. It may increase the likelihood of other adverse events, probably increasing somnolence and fatigue. There is uncertainty about relative benefits and harms of 5 mg versus 10 mg.We identified only RCTs describing oral administration. The findings of this review cannot be extrapolated to provi...
Source: Cochrane Database of Systematic Reviews - September 21, 2018 Category: General Medicine Authors: Sutherland A, Naessens K, Plugge E, Ware L, Head K, Burton MJ, Wee B Tags: Cochrane Database Syst Rev Source Type: research

Interventions for promoting habitual exercise in people living with and beyond cancer.
CONCLUSIONS: Since the last version of this review, none of the new relevant studies have provided additional information to change the conclusions. We have found some improved understanding of how to encourage previously inactive cancer survivors to achieve international physical activity guidelines. Goal setting, setting of graded tasks and instruction of how to perform behaviour, feature in interventions that meet recommendations targets and report adherence of 75% or more. However, long-term follow-up data are still limited, and the majority of studies are in white women with breast cancer. There are still a considerab...
Source: Cochrane Database of Systematic Reviews - September 18, 2018 Category: General Medicine Authors: Turner RR, Steed L, Quirk H, Greasley RU, Saxton JM, Taylor SJ, Rosario DJ, Thaha MA, Bourke L Tags: Cochrane Database Syst Rev Source Type: research

Bronchoscopy-guided antimicrobial therapy for cystic fibrosis.
CONCLUSIONS: This review, limited to a single, well-designed randomized controlled study, shows no clear evidence to support the routine use of bronchoalveolar lavage for the diagnosis and management of pulmonary infection in pre-school children with cystic fibrosis compared to the standard practice of providing treatment based on results of oropharyngeal culture and clinical symptoms. No evidence was available for adult and adolescent populations. PMID: 30221745 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 17, 2018 Category: General Medicine Authors: Jain K, Wainwright C, Smyth AR Tags: Cochrane Database Syst Rev Source Type: research

Prophylactic platelet transfusions prior to surgery for people with a low platelet count.
CONCLUSIONS: Findings of this review were based on three small trials involving minor surgery in adults with thrombocytopenia. We found insufficient evidence to recommend the administration of preprocedure prophylactic platelet transfusions in this situation with a lack of evidence that transfusion resulted in a reduction in postoperative bleeding or all-cause mortality. The small number of trials meeting the inclusion criteria and the limitation in reported outcomes across the trials precluded meta-analysis for most outcomes. Further adequately powered trials, in people of all ages, of prophylactic platelet transfusions c...
Source: Cochrane Database of Systematic Reviews - September 17, 2018 Category: General Medicine Authors: Estcourt LJ, Malouf R, Doree C, Trivella M, Hopewell S, Birchall J Tags: Cochrane Database Syst Rev Source Type: research

Doug Altman's legacy to Cochrane and evidence synthesis.
PMID: 30221350 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 14, 2018 Category: General Medicine Authors: Deeks JJ, Hopewell S, Moher D, Higgins JP, Moons KG, Chandler J, Antes G Tags: Cochrane Database Syst Rev Source Type: research

Mesh versus non-mesh for inguinal and femoral hernia repair.
CONCLUSIONS: Mesh and non-mesh repairs are effective surgical approaches in treating hernias, each demonstrating benefits in different areas. Compared to non-mesh repairs, mesh repairs probably reduce the rate of hernia recurrence, and reduce visceral or neurovascular injuries, making mesh repair a common repair approach. Mesh repairs may result in a reduced length of hospital stay and time to return to activities of daily living, but these results are uncertain due to variation in the results of the studies. Non-mesh repair is less likely to cause seroma formation and has been favoured in low-income countries due to low c...
Source: Cochrane Database of Systematic Reviews - September 13, 2018 Category: General Medicine Authors: Lockhart K, Dunn D, Teo S, Ng JY, Dhillon M, Teo E, van Driel ML Tags: Cochrane Database Syst Rev Source Type: research

Methods for blood loss estimation after vaginal birth.
CONCLUSIONS: Overall, the evidence in this review is insufficient to support the use of one method over another for blood loss estimation after vaginal birth. In general, the quality of evidence for our predefined outcomes ranged from low to high quality, with downgrading decisions due to imprecision. The included trials did not report on many of our primary and secondary outcomes.In trials that evaluate methods for estimating blood loss during vaginal birth, we believe it is important to measure their impact on clinical maternal and neonatal outcomes, along with their diagnostic accuracy. This body of knowledge needs furt...
Source: Cochrane Database of Systematic Reviews - September 13, 2018 Category: General Medicine Authors: Diaz V, Abalos E, Carroli G Tags: Cochrane Database Syst Rev Source Type: research

Ensuring quality as the basis of evidence synthesis: leveraging information specialists' knowledge, skills, and expertise.
PMID: 30215846 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 13, 2018 Category: General Medicine Authors: Metzendorf MI, Featherstone RM Tags: Cochrane Database Syst Rev Source Type: research

Art therapy for people with dementia.
CONCLUSIONS: There is insufficient evidence about the efficacy of art therapy for people with dementia. More adequately-powered and high-quality studies using relevant outcome measures are needed. PMID: 30215847 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 13, 2018 Category: General Medicine Authors: Deshmukh SR, Holmes J, Cardno A Tags: Cochrane Database Syst Rev Source Type: research

Patient-mediated interventions to improve professional practice.
CONCLUSIONS: We found that two types of patient-mediated interventions, patient-reported health information and patient education, probably improve professional practice by increasing healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We consider the effect to be small to moderate. Other patient-mediated interventions, such as patient information may also improve professional practice (low-certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals' adhering to recommended clinical practice (low-certainty evidence).Th...
Source: Cochrane Database of Systematic Reviews - September 11, 2018 Category: General Medicine Authors: Fønhus MS, Dalsbø TK, Johansen M, Fretheim A, Skirbekk H, Flottorp SA Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for acute rhinosinusitis in adults.
CONCLUSIONS: The potential benefit of antibiotics to treat acute rhinosinusitis diagnosed either clinically (low risk of bias, high-quality evidence) or confirmed by imaging (low to unclear risk of bias, moderate-quality evidence) is marginal and needs to be seen in the context of the risk of adverse effects. Considering antibiotic resistance, and the very low incidence of serious complications, we conclude there is no place for antibiotics for people with uncomplicated acute rhinosinusitis. We could not draw conclusions about children, people with suppressed immune systems, and those with severe sinusitis, because these p...
Source: Cochrane Database of Systematic Reviews - September 10, 2018 Category: General Medicine Authors: Lemiengre MB, van Driel ML, Merenstein D, Liira H, Mäkelä M, De Sutter AI Tags: Cochrane Database Syst Rev Source Type: research

Antigen-specific active immunotherapy for ovarian cancer.
CONCLUSIONS: We conclude that despite promising immunological responses, no clinically effective antigen-specific active immunotherapy is yet available for ovarian cancer. Results should be interpreted cautiously, as review authors found a significant dearth of relevant information for assessment of risk of bias in both RCTs and NRSs. PMID: 30199097 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 10, 2018 Category: General Medicine Authors: Paijens ST, Leffers N, Daemen T, Helfrich W, Boezen HM, Cohlen BJ, Melief CJ, de Bruyn M, Nijman HW Tags: Cochrane Database Syst Rev Source Type: research

Topical and systemic antifungal therapy for chronic rhinosinusitis.
CONCLUSIONS: Due to the very low quality of the evidence, it is uncertain whether or not the use of topical or systemic antifungals has an impact on patient outcomes in adults with chronic rhinosinusitis compared with placebo or no treatment. Studies including specific subgroups (i.e. AFRS) are lacking. PMID: 30199594 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 10, 2018 Category: General Medicine Authors: Head K, Sharp S, Chong LY, Hopkins C, Philpott C Tags: Cochrane Database Syst Rev Source Type: research

Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children.
CONCLUSIONS: Pooling of two prevention and two treatment studies did not show any benefit of homeopathic medicinal products compared to placebo on ARTI recurrence or cure rates in children. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, so conclusions about safety could not be drawn. PMID: 30196554 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 9, 2018 Category: General Medicine Authors: Hawke K, van Driel ML, Buffington BJ, McGuire TM, King D Tags: Cochrane Database Syst Rev Source Type: research

Interventions for preventing falls in older people in care facilities and hospitals.
CONCLUSIONS: In care facilities: we are uncertain of the effect of exercise on rate of falls and it may make little or no difference to the risk of falling. General medication review may make little or no difference to the rate of falls or risk of falling. Vitamin D supplementation probably reduces the rate of falls but not risk of falling. We are uncertain of the effect of multifactorial interventions on the rate of falls; they may make little or no difference to the risk of falling.In hospitals: we are uncertain of the effect of additional physiotherapy on the rate of falls or whether it reduces the risk of falling. We a...
Source: Cochrane Database of Systematic Reviews - September 7, 2018 Category: General Medicine Authors: Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, Kerse N Tags: Cochrane Database Syst Rev Source Type: research

Oropharyngeal colostrum in preventing mortality and morbidity in preterm infants.
Abstract BACKGROUND: Placing a small volume of colostrum directly onto the buccal mucosa of preterm infants during the early neonatal period may provide immunological and growth factors that stimulate the immune system and enhance intestinal growth. These benefits could potentially reduce the risk of infection and necrotising enterocolitis (NEC) and improve survival and long-term outcome. OBJECTIVES: To determine if early (within the first 48 hours of life) oropharyngeal administration of mother's own fresh or frozen/thawed colostrum can reduce rates of NEC, late-onset invasive infection, and/or mortality in ...
Source: Cochrane Database of Systematic Reviews - September 7, 2018 Category: General Medicine Authors: Nasuf AWA, Ojha S, Dorling J Tags: Cochrane Database Syst Rev Source Type: research

Dornase alfa for cystic fibrosis.
CONCLUSIONS: There is evidence to show that, compared with placebo, therapy with dornase alfa improves lung function in people with cystic fibrosis in trials lasting from one month to two years. There was a decrease in pulmonary exacerbations in trials of six months or longer. Voice alteration and rash appear to be the only adverse events reported with increased frequency in randomised controlled trials. There is not enough evidence to firmly conclude if dornase alfa is superior to other hyperosmolar agents in improving lung function. PMID: 30187450 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 6, 2018 Category: General Medicine Authors: Yang C, Montgomery M Tags: Cochrane Database Syst Rev Source Type: research

Short-course versus long-course therapy of the same antibiotic for community-acquired pneumonia in adolescent and adult outpatients.
CONCLUSIONS: We found no eligible RCTs that studied a short-course of antibiotic compared to a longer-course (with the same antibiotic at the same daily dosage) for CAP in adolescent and adult outpatients. The effects of antibiotic therapy duration for CAP in adolescent and adult outpatients remains unclear. PMID: 30188565 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 6, 2018 Category: General Medicine Authors: López-Alcalde J, Rodriguez-Barrientos R, Redondo-Sánchez J, Muñoz-Gutiérrez J, Molero García JM, Rodríguez-Fernández C, Heras-Mosteiro J, Marin-Cañada J, Casanova-Colominas J, Azcoaga-Lorenzo A, Hernandez Santiago V, Gómez-García M Tags: Cochrane Database Syst Rev Source Type: research

Impact of public release of performance data on the behaviour of healthcare consumers and providers.
CONCLUSIONS: The existing evidence base is inadequate to directly inform policy and practice. Further studies should consider whether public release of performance data can improve patient outcomes, as well as healthcare processes. PMID: 30188566 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 6, 2018 Category: General Medicine Authors: Metcalfe D, Rios Diaz AJ, Olufajo OA, Massa MS, Ketelaar NA, Flottorp SA, Perry DC Tags: Cochrane Database Syst Rev Source Type: research

Head-to-head trials of antibiotics for bronchiectasis.
CONCLUSIONS: Limited low-quality evidence favours short-term oral fluoroquinolones over beta-lactam antibiotics for patients hospitalised with exacerbations. Very low-quality evidence suggests no benefit from inhaled aminoglycosides verus polymyxins. RCTs have presented no evidence comparing other modes of delivery for each of these comparisons, and no RCTs have included children. Overall, current evidence from a limited number of head-to-head trials in adults or children with bronchiectasis is insufficient to guide the selection of antibiotics for short-term or long-term therapy. More research on this topic is needed. ...
Source: Cochrane Database of Systematic Reviews - September 5, 2018 Category: General Medicine Authors: Kaehne A, Milan SJ, Felix LM, Sheridan E, Marsden PA, Spencer S Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Topical and systemic antifungal therapy for the symptomatic treatment of chronic rhinosinusitis.
CONCLUSIONS: On the basis of this meta-analysis, there is no evidence to support the use of either topical or systemic antifungal treatment in the management of CRS. PMID: 30184244 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 5, 2018 Category: General Medicine Authors: Sacks PL, Harvey RJ, Rimmer J, Gallagher RM, Sacks R Tags: Cochrane Database Syst Rev Source Type: research

Pharmacist services for non-hospitalised patients.
CONCLUSIONS: The results demonstrate that pharmacist services have varying effects on patient outcomes compared with usual care. We found no studies comparing services delivered by pharmacists with other healthcare professionals that evaluated the impact of the intervention on the six main outcome measures. The results need to be interpreted cautiously because there was major heterogeneity in study populations, types of interventions delivered and reported outcomes.There was considerable heterogeneity within many of the meta-analyses, as well as considerable variation in the risks of bias. PMID: 30178872 [PubMed - as ...
Source: Cochrane Database of Systematic Reviews - September 4, 2018 Category: General Medicine Authors: de Barra M, Scott CL, Scott NW, Johnston M, de Bruin M, Nkansah N, Bond CM, Matheson CI, Rackow P, Williams AJ, Watson MC Tags: Cochrane Database Syst Rev Source Type: research

Interventions to improve the appropriate use of polypharmacy for older people.
CONCLUSIONS: It is unclear whether interventions to improve appropriate polypharmacy, such as reviews of patients' prescriptions, resulted in clinically significant improvement; however, they may be slightly beneficial in terms of reducing potential prescribing omissions (PPOs); but this effect estimate is based on only two studies, which had serious limitations in terms of risk bias. PMID: 30175841 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 3, 2018 Category: General Medicine Authors: Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, Ryan C, Hughes C Tags: Cochrane Database Syst Rev Source Type: research

Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke.
Abstract BACKGROUND: Electromechanical and robot-assisted arm training devices are used in rehabilitation, and may help to improve arm function after stroke. OBJECTIVES: To assess the effectiveness of electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength in people after stroke. We also assessed the acceptability and safety of the therapy. SEARCH METHODS: We searched the Cochrane Stroke Group's Trials Register (last searched January 2018), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2018, Iss...
Source: Cochrane Database of Systematic Reviews - September 3, 2018 Category: General Medicine Authors: Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B Tags: Cochrane Database Syst Rev Source Type: research

Protease activity as a prognostic factor for wound healing in venous leg ulcers.
CONCLUSIONS: This review identified very low validity evidence regarding any association between protease activity and VLU healing and there is complete uncertainty regarding the relationship. The review offers information for both future research and systematic review methodology. PMID: 30171767 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 1, 2018 Category: General Medicine Authors: Westby MJ, Dumville JC, Stubbs N, Norman G, Wong JK, Cullum N, Riley RD Tags: Cochrane Database Syst Rev Source Type: research