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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

Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease
CONCLUSIONS: HIF stabiliser management of anaemia had uncertain effects on CV death, fatigue, death (any cause), CV outcomes, and kidney failure compared to placebo or ESAs. Compared to placebo or ESAs, HIF stabiliser management of anaemia probably decreased the proportion of patients requiring blood transfusions, and probably increased the proportion of patients reaching the target Hb when compared to placebo.PMID:36005278 | DOI:10.1002/14651858.CD013751.pub2
Source: Cochrane Database of Systematic Reviews - August 25, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Allison Jaure Elisabeth M Hodson Marinella Ruospo Tess E Cooper Deirdre Hahn Valeria M Saglimbene Jonathan C Craig Giovanni Fm Strippoli 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

Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years
CONCLUSIONS: Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have a small increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. There was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there w...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Rosa Virgara Anna Phillips Lucy K Lewis Katherine Baldock Luke Wolfenden Ty Ferguson Mandy Richardson Anthony Okely Michael Beets Carol Maher Source Type: research

Prevention of depression in adults with long-term physical conditions
CONCLUSIONS: Based on evidence of very low certainty, our results may indicate the benefit of pharmacological interventions, during or directly after preventive treatment. Few trials examined short-term outcomes up to six months, nor the follow-up effects at six to 12 months, with studies suffering from great numbers of drop-outs and inconclusive results. Generalisation of results is limited as study populations and treatment regimes were very heterogeneous. Based on the results of this review, we conclude that for adults with long-term physical conditions, there is only very uncertain evidence regarding the implementation...
Source: Cochrane Database of Systematic Reviews - March 5, 2021 Category: General Medicine Authors: Hanna Kampling Harald Baumeister J ürgen Bengel Oskar Mittag Source Type: research

PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease.
CONCLUSIONS: The evidence for the clinical endpoint effects of  evolocumab and alirocumab were graded as high. There is a strong evidence base to prescribe PCSK9 monoclonal antibodies to people who might not be eligible for other lipid-lowering drugs, or to people who cannot meet their lipid goals on more traditional therapies, which was the main patient population of the available trials.  The evidence base of PCSK9 inhibitors compared with active treatment is much weaker (low very- to low-certainty evidence) and it is unclear whether evolocumab or alirocumab might be effectively used as replacement therapies. Related...
Source: Cochrane Database of Systematic Reviews - October 20, 2020 Category: General Medicine Authors: Schmidt AF, Carter JL, Pearce LS, Wilkins JT, Overington JP, Hingorani AD, Casas JP Tags: Cochrane Database Syst Rev Source Type: research

Reduction in saturated fat intake for cardiovascular disease.
CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events. ...
Source: Cochrane Database of Systematic Reviews - May 18, 2020 Category: General Medicine Authors: Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS Tags: Cochrane Database Syst Rev Source Type: research

Anticoagulant treatment for subsegmental pulmonary embolism.
CONCLUSIONS: There is no evidence from randomised controlled trials to assess the effectiveness and safety of anticoagulation therapy versus control in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE. Well-conducted research is required before informed practice decisions can be made. PMID: 32030721 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - February 6, 2020 Category: General Medicine Authors: Yoo HH, Nunes-Nogueira VS, Fortes Villas Boas PJ Tags: Cochrane Database Syst Rev Source Type: research

General health checks in adults for reducing morbidity and mortality from disease.
CONCLUSIONS: General health checks are unlikely to be beneficial. PMID: 30699470 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 31, 2019 Category: General Medicine Authors: Krogsbøll LT, Jørgensen KJ, Gøtzsche PC Tags: Cochrane Database Syst Rev Source Type: research

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