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Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery
CONCLUSIONS: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.PMID:37681564 | PMC:PMC10486190 | DOI:10.1002/14651858.CD001888.pub5
Source: Cochrane Database of Systematic Reviews - September 8, 2023 Category: General Medicine Authors: Thomas D Lloyd Louise J Geneen Keeley Bernhardt William McClune Scott J Fernquest Tamara Brown Carolyn Dor ée Susan J Brunskill Michael F Murphy Antony Jr Palmer Source Type: research

Transfusion thresholds for guiding red blood cell transfusion
CONCLUSIONS: Transfusion at a restrictive haemoglobin concentration decreased the proportion of people exposed to RBC transfusion by 41% across a broad range of clinical contexts. Across all trials, no evidence suggests that a restrictive transfusion strategy impacted 30-day mortality, mortality at other time points, or morbidity (i.e. cardiac events, myocardial infarction, stroke, pneumonia, thromboembolism, infection) compared with a liberal transfusion strategy. Despite including 17 more randomised trials (and 8846 participants), data remain insufficient to inform the safety of transfusion policies in important and sele...
Source: Cochrane Database of Systematic Reviews - December 21, 2021 Category: General Medicine Authors: Jeffrey L Carson Simon J Stanworth Jane A Dennis Marialena Trivella Nareg Roubinian Dean A Fergusson Darrell Triulzi Carolyn Dor ée Paul C H ébert Source Type: research

Long-term hormone therapy for perimenopausal and postmenopausal women.
CONCLUSIONS: Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT, provided they do not have specific contraindications. HT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer (such as breast cancer, in women with a uterus). The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well docu...
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Marjoribanks J, Farquhar C, Roberts H, Lethaby A, Lee J Tags: Cochrane Database Syst Rev Source Type: research

Parenteral anticoagulation in ambulatory patients with cancer.
CONCLUSIONS: Heparin may have a small effect on mortality at 12 months and 24 months. It is associated with a reduction in venous thromboembolism and a likely increase in minor bleeding. Future research should further investigate the survival benefit of different types of anticoagulants in patients with different types and stages of cancer. The decision for a patient with cancer to start heparin therapy for survival benefit should balance the benefits and downsides, and should integrate the patient's values and preferences. PMID: 25491949 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 10, 2014 Category: Journals (General) Authors: Akl EA, Kahale LA, Ballout RA, Barba M, Yosuico VE, van Doormaal FF, Middeldorp S, Bryant A, Schünemann H Tags: Cochrane Database Syst Rev Source Type: research

Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters.
CONCLUSIONS: We found no significant effects of systemic treatments compared with no intervention in preventing (a)symptomatic VTE in paediatric oncology patients with CVCs. However, this could be a result of the low number of included participants, which resulted in low power. In one CCT, which compared one systemic treatment with another systemic treatment, we identified a significant reduction in symptomatic VTE with the addition of LMWH to AT supplementation.All studies investigated the prevalence of major and/or minor bleeding episodes, and none found a significant difference between study groups. None of the studies ...
Source: Cochrane Database of Systematic Reviews - September 11, 2013 Category: Journals (General) Authors: Schoot RA, Kremer LC, van de Wetering MD, van Ommen CH Tags: Cochrane Database Syst Rev Source Type: research