Which is more effective in reducing postoperative complications after pancreatic surgery – use of a drain tube or no drain tube? Key messages It is unclear if use of a drain (tube) affects postoperative complications after pancreaticoduodenectomy (Whipple's procedure, a major surgical operation involving the pancreas, duodenum, and other organs) or distal pancreatectomy (surgical removal of the body and tail of the pancreas). We do not know if an active (suction) drain after pancreaticoduodenectomy is better, worse, or the same as a passive (no suction) drain. Early drain removal is probably...

Lower-limb neuromuscular electrical stimulation (NMES) for people with chronic kidney disease undergoing dialysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of neuromuscular electrical stimulation (NMES) on muscle structure and function in people undergoing dialysis. This is a protocol....

Effects of clinical pathways in hospitals on patient outcomes, length of hospital stay, hospital costs and charges, and adherence to recommended practice. What is the aim of this review? Clinical pathways (CPW) are document-based tools that provide a link between the best available evidence and clinical practice. They provide recommendations, processes and time frames for the management of specific medical conditions or interventions. This review update aimed to summarize the evidence and assess the effect of clinical pathways on patient outcomes (inhospital mortality, mortality (up to 6...

Total neoadjuvant therapy for locally advanced rectal cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of total neoadjuvant therapy versus standard therapy in individuals with locally advanced rectal cancer. This is a protocol....

Do electronic or robotic gait-training devices help people walk better after a stroke? Key messages • Electronic and robotic devices plus physiotherapy probably help people walk independently again after a stroke. They may particularly benefit people in the first three months after a stroke. • We need more research to find out how often, and for how long, these devices should be used. What is a stroke? A stroke happens when the flow of blood to part of the brain is cut off, blocking the supply of oxygen and nutrients to brain cells. This causes a sudden attack of weakness that usually...

Early mobilization after skin graft for burn injury in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of early mobilization after skin graft for burn injury in adults. This is a protocol....

What are the benefits and risks of early discharge with home support of tube feeding for stable preterm babies who have not established full breast or bottle (all suck) feeds? Key messages For stable preterm babies (born before 37 weeks of pregnancy) who are not yet having all feeds at the breast or bottle (all suck or oral feeds), we found very uncertain evidence that early discharge with home support of gavage (tube) feeding versus later discharge when they are fully suck feeding: may result in little to no difference in weight gain, breastfeeding at discharge from home support/hospital...

What are the benefits and risks of ustekinumab for the treatment of Crohn's disease? Key messages • Ustekinumab is more effective than placebo (dummy treatment) in treating Crohn's disease (an inflammatory disorder of the large bowel) when used in the short term. • Ustekinumab probably does not cause increased severe unwanted effects when compared to placebo. • There is not enough evidence to draw any conclusions on the effect of ustekinumab compared to other medications. What is Crohn's disease? Crohn's disease is a long-term (chronic) inflammatory bowel disease that can affect any...

What are the benefits and risks of sustained-release (long-acting) naltrexone for the treatment of dependence on opioid drugs (addiction)? Key messages • It is unclear whether people treated with sustained-release naltrexone use illicit opioids, such as heroin, less frequently than people treated with opioid agonists, such as buprenorphine or methadone. • People treated with sustained-release naltrexone may use illicit opioids less frequently than people treated with oral naltrexone, placebo or treatment as usual. • Treatment with sustained-release naltrexone may be less safe than opioid...

Short versus long drug regimens for Chagas disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of short versus long drug regimens (trypanocidal schemes) for Chagas disease in chronic asymptomatic stages. This is a protocol....

Do proton pump inhibitors prevent ulcers and stomach discomfort caused by non-steroidal anti-inflammatory drugs? Key messages Compared to a placebo (dummy or inactive treatment), proton pump inhibitors probably reduce the development of new ulcers. They also slightly decrease symptoms of dyspepsia (indigestion). They may reduce ulcer complications and probably slightly improve quality of life. They may have little to no harmful effects, but the evidence is very uncertain. Compared to histamine 2-receptor antagonists (also known as H2-blockers; medications that help reduce stomach acid),...

What treatments help children with steroid-resistant nephrotic syndrome? Key messages • For children with steroid-resistant nephrotic syndrome (a condition where treatment with steroids does not stop the leaking of protein from the blood into the urine), calcineurin inhibitors (immunosuppressive medicines that decrease the body's immune response) may increase the likelihood of complete or partial remission (a decrease in or disappearance of signs and symptoms of nephrotic syndrome) compared with placebo (an inactive or 'dummy' medicine), no treatment or cyclophosphamide (another type of...

Pain and sedation management for screening or treatment of retinopathy of prematurity This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of pain and sedation management for screening or treatment of retinopathy of prematurity in preterm infants compared to placebo, no intervention, or other interventions. This is a protocol....

Which factors are related to return to work in breast cancer survivors? Key messages Breast cancer survivors who are older and who receive chemotherapy may be at higher risk of not returning to work. Results regarding educational level were inconclusive. Further research is warranted to identify those breast cancer survivors who are at higher risk of not returning to work, so that they can receive timely support. What is breast cancer? What is return to work, and why is it important? Breast cancer is the most common type of cancer in women around the world and many people diagnosed with...

Motor interventions initiated prior hospital discharge to prevent neurodevelopmental impairment in preterm infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of motor interventions initiated prior hospital discharge to prevent neurodevelopmental and motor impairment in preterm infants compared to standard care, post-discharge motor interventions, and different modalities of the same motor intervention. This is a protocol....

Socio-economic equity in the impact of population-based interventions to reduce alcohol consumption This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the differential effects of public health interventions aimed at reducing alcohol consumption in the general population across SEP as defined by education, occupation, or income. Outcomes will be evaluated using the RE-AIM framework, considering dimensions of reach, effectiveness, adoption, implementation, and maintenance. This is a protocol....

Which type of sleep study is better for diagnosing people with suspected obstructive sleep apnoea? Key messages – The diagnosis of obstructive sleep apnoea using limited channel sleep studies is less cumbersome than polysomnography and can be performed at the person's home rather than in a hospital laboratory. – Using limited channel sleep studies results in little to no difference in sleepiness. – However, much of the evidence is uncertain, in particular for Level IV studies. What is obstructive sleep apnoea? Obstructive sleep apnoea is a condition where the walls of the throat relax and...

Weight-neutral interventions for people with obesity and the perspective of patients, carers and healthcare professionals: a mixed methods review This is a protocol for a Cochrane Review (prototype). The objectives are as follows: To assess the effects of weight-neutral interventions for managing obesity in children and adults (quantitative data). To explore the views, perspectives and experiences of children and adults receiving the intervention, their close family members or, if appropriate, carers, and healthcare personnel who recommend or deliver weight-neutral interventions to determine...

Sedation for moderate-to-severe traumatic brain injury in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of sedative, analgesic, and anaesthetic drugs on neurological outcomes in adults with moderate-to-severe traumatic brain injury. This is a protocol....

Does the DASH diet help people with or at risk of cardiovascular diseases? Key messages - We do not have enough evidence to say that the DASH diet prevents heart attacks, strokes, or deaths from heart disease. - The DASH diet may produce little to no harmful effects, but we are unsure about this due to the limited evidence. - We need bigger and longer studies to find out if the DASH diet can truly prevent serious heart problems and to check if it’s safe in the long run. What is cardiovascular disease? Cardiovascular disease is a term for conditions affecting the heart and blood vessels. It...