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Total 16393 results found since Jan 2013.
Synbiotics, prebiotics and probiotics for solid organ transplant recipients
CONCLUSIONS: This review highlights the severe lack of high-quality RCTs testing the efficacy of synbiotics, prebiotics or probiotics in solid organ transplant recipients. We have identified significant gaps in the evidence. Despite GI symptoms and postoperative infection being the most common reasons for high antibiotic use in this patient population, along with increased morbidity and the growing antimicrobial resistance, we found very few studies that adequately tested these as alternative treatments. There is currently no evidence to support or refute the use of synbiotics, prebiotics, or probiotics in solid organ tran...
Source: Cochrane Database of Systematic Reviews - September 20, 2022 Category: General Medicine Authors: Tess E Cooper Nicole Scholes-Robertson Jonathan C Craig Carmel M Hawley Martin Howell David W Johnson Armando Teixeira-Pinto Allison Jaure Germaine Wong Source Type: research
Protein restriction for diabetic kidney disease
CONCLUSIONS: Dietary protein restriction has uncertain effects on changes in kidney function over time. However, it may make little difference to the risk of death and kidney failure. Questions remain about protein intake levels and compliance with protein-restricted diets. There are limited data on HRQoL and adverse effects such as nutritional measures and hyperglycaemic events. Large-scale pragmatic RCTs with sufficient follow-up are required for different stages of CKD.PMID:36594428 | PMC:PMC9809923 | DOI:10.1002/14651858.CD014906.pub2
Source: Cochrane Database of Systematic Reviews - January 3, 2023 Category: General Medicine Authors: Shimin Jiang Jinying Fang Wenge Li Source Type: research
Altered dietary salt intake for preventing diabetic kidney disease and its progression
CONCLUSIONS: This systematic review shows an important reduction in SBP and DBP in people with diabetes with normal GFR during short periods of salt restriction, similar to that obtained with single drug therapy for hypertension. These data support the international recommendations that people with diabetes with or without hypertension or evidence of kidney disease should reduce salt intake to less than 5 g/day (2 g sodium).PMID:36645291 | PMC:PMC9841968 | DOI:10.1002/14651858.CD006763.pub3
Source: Cochrane Database of Systematic Reviews - January 16, 2023 Category: General Medicine Authors: Elisabeth M Hodson Tess E Cooper Source Type: research
Digital technology for monitoring adherence to inhaled therapies in people with cystic fibrosis
CONCLUSIONS: Digital monitoring plus tailored support via an online platform probably improves adherence to inhaled therapies and reduces treatment burden (but without a corresponding change in QoL) in the medium term (low- and moderate-certainty evidence). In a shorter time frame, technological enhancement of inhaling antibiotics may improve adherence to treatment (low-certainty evidence). There may be little or no effect on lung function with either intervention, and online monitoring probably makes no difference to pulmonary exacerbations. Future research should assess the effect of digital technology on adherence in bo...
Source: Cochrane Database of Systematic Reviews - February 3, 2023 Category: General Medicine Authors: Sherie Smith Rebecca Calthorpe Sophie Herbert Alan R Smyth Source Type: research
Active cycle of breathing technique for cystic fibrosis
CONCLUSIONS: There is little evidence to support or reject the use of the ACBT over any other airway clearance therapy and ACBT is comparable with other therapies in outcomes such as participant preference, quality of life, exercise tolerance, lung function, sputum weight, oxygen saturation, and number of pulmonary exacerbations. Longer-term studies are needed to more adequately assess the effects of ACBT on outcomes important for people with cystic fibrosis such as quality of life and preference.PMID:36727723 | PMC:PMC9893420 | DOI:10.1002/14651858.CD007862.pub5
Source: Cochrane Database of Systematic Reviews - February 2, 2023 Category: General Medicine Authors: Lisa M Wilson Ian J Saldanha Karen A Robinson Source Type: research
Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis
CONCLUSIONS: The comparative effects of different ESAs on blood transfusions, death (any cause and cardiovascular), major cardiovascular events, myocardial infarction, stroke, vascular access thrombosis, kidney failure, fatigue and breathlessness were uncertain.PMID:36791280 | DOI:10.1002/14651858.CD010590.pub3
Source: Cochrane Database of Systematic Reviews - February 15, 2023 Category: General Medicine Authors: Edmund Ym Chung Suetonia C Palmer Valeria M Saglimbene Jonathan C Craig Marcello Tonelli Giovanni Fm Strippoli Source Type: research
Interventions for preventing and treating kidney disease in IgA vasculitis
CONCLUSIONS: There are no substantial changes in conclusions from this update compared with the initial review or the previous update despite the addition of five studies. From generally low to moderate certainty evidence, we found that there may be little or no benefit in the use of corticosteroids or antiplatelet agents to prevent persistent kidney disease in children with IgAV in participants with no or minimal kidney involvement at presentation. We did not find any studies which evaluated corticosteroids in children presenting with IgAV and nephritic and/or nephrotic syndrome, although corticosteroids are recommended i...
Source: Cochrane Database of Systematic Reviews - February 28, 2023 Category: General Medicine Authors: Deirdre Hahn Elisabeth M Hodson Jonathan C Craig Source Type: research
Ataluren and similar compounds (specific therapies for premature termination codon class I mutations) for cystic fibrosis
CONCLUSIONS: There is currently insufficient evidence to determine the effect of ataluren as a therapy for people with CF with class I mutations. One trial reported favourable results for ataluren in a post hoc subgroup analysis of participants not receiving chronic inhaled aminoglycosides, but these were not reproduced in the later trial, suggesting that the earlier results may have occurred by chance. Future trials should carefully assess for adverse events, notably renal impairment, and consider the possibility of drug interactions. Cross-over trials should be avoided, given the potential for the treatment to change the...
Source: Cochrane Database of Systematic Reviews - March 3, 2023 Category: General Medicine Authors: Aisha A Aslam Ian P Sinha Kevin W Southern Source Type: research
Device-modified trabeculectomy for glaucoma
CONCLUSIONS: Use of an Ex-PRESS plus trabeculectomy may produce greater IOP reduction at one-year follow-up than standard trabeculectomy; however, due to potential biases and imprecision in effect estimates, the certainty of evidence is low. PreserFlo MicroShunt may be inferior to standard trabeculectomy in lowering IOP. However, PreserFlo MicroShunt may prevent postoperative hypotony and bleb leakage. Overall, device-modified trabeculectomy appears associated with a lower risk of cataract surgery within five years compared with standard trabeculectomy. Due to various limitations in the design and conduct of the included s...
Source: Cochrane Database of Systematic Reviews - March 13, 2023 Category: General Medicine Authors: Junghyun Park Thanitsara Rittiphairoj Xue Wang Jian-Yu E Amanda K Bicket Source Type: research
Cranberries for preventing urinary tract infections
CONCLUSIONS: This update adds a further 26 studies taking the total number of studies to 50 with 8857 participants. These data support the use of cranberry products to reduce the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions. The evidence currently available does not support its use in the elderly, patients with bladder emptying problems, or pregnant women.PMID:37068952 | PMC:PMC10108827 | DOI:10.1002/14651858.CD001321.pub6
Source: Cochrane Database of Systematic Reviews - April 17, 2023 Category: General Medicine Authors: Gabrielle Williams Deirdre Hahn Jacqueline H Stephens Jonathan C Craig Elisabeth M Hodson Source Type: research
Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis
CONCLUSIONS: We found that nebulised antibiotics, alone or with oral antibiotics, were better than no treatment for early infection with P aeruginosa. Eradication may be sustained in the short term. There is insufficient evidence to determine whether these antibiotic strategies decrease mortality or morbidity, improve quality of life, or are associated with adverse effects compared to placebo or standard treatment. Four trials comparing two active treatments have failed to show differences in rates of eradication of P aeruginosa. One large trial showed that intravenous ceftazidime with tobramycin is not superior to oral ci...
Source: Cochrane Database of Systematic Reviews - June 2, 2023 Category: General Medicine Authors: Simon C Langton Hewer Sherie Smith Nicola J Rowbotham Alexander Yule Alan R Smyth Source Type: research
Early versus late removal of urinary catheter after kidney transplantation
CONCLUSIONS: A high-quality, well-designed RCT is required to compare the effectiveness of early catheter removal versus late catheter removal in patients following a kidney transplant. At the present time, there is insufficient evidence to suggest any difference between early and late catheter removal post-transplant, and the studies investigating this were generally of poor quality.PMID:37449968 | DOI:10.1002/14651858.CD013788.pub2
Source: Cochrane Database of Systematic Reviews - July 14, 2023 Category: General Medicine Authors: Michael Goodfellow Emily R Thompson Samuel J Tingle Colin Wilson Source Type: research
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease
CONCLUSIONS: There is currently insufficient evidence to determine the effectiveness of ACEi or ARB in patients with stage 1 to 3 CKD who do not have DM. The available evidence is overall of very low certainty and high risk of bias. We have identified an area of large uncertainty for a group of patients who account for most of those diagnosed as having CKD.PMID:37466151 | PMC:PMC10355090 | DOI:10.1002/14651858.CD007751.pub3
Source: Cochrane Database of Systematic Reviews - July 19, 2023 Category: General Medicine Authors: Tess E Cooper Claris Teng David J Tunnicliffe Brydee A Cashmore Giovanni Fm Strippoli Source Type: research
