Do intravenous antibiotics improve pulmonary exacerbations (flare-ups) in people with cystic fibrosis? Key messages – Intravenous (given into a vein) antibiotics are commonly used to treat flare-ups in symptoms of cystic fibrosis, but the assumption that exacerbations are due to more bacteria in the lungs has been questioned. – We assessed many different antibiotics as single medicines or combinations of medicines as well as how they were given (intravenous, inhaled (breathed in) or oral (by mouth)). We found no difference in any clinical outcomes such as how well the lungs work or the time...

Lurasidone or typical antipsychotics: which works better to treat schizophrenia? Key messages • We compared lurasidone, a newer antipsychotic, with traditional antipsychotics like haloperidol to treat schizophrenia. • Based on two studies, we are uncertain whether lurasidone improves schizophrenia symptoms or causes fewer unwanted effects compared to traditional medications. • More research is needed to determine the benefits and potential harms of lurasidone in managing schizophrenia. What is schizophrenia? Schizophrenia is a condition that affects how a person perceives reality, leading to...

How accurate are tests that diagnose excessive bleeding (postpartum haemorrhage) after women give birth vaginally? Key messages • Our study found that using visual estimation to diagnose postpartum haemorrhage (PPH) was inaccurate. Using a plastic drape to collect and measure the volume of blood loss – alongside observations including heart rate, blood pressure, tone of the womb, and flow of blood – showed high accuracy. • Other tests, including blood tests and measurements such as heart rate and blood pressure alone, showed varying levels of accuracy. What is postpartum haemorrhage (PPH)?...

Thrombolysis (giving a drug that dissolves blood clots) for aneurysmal subarachnoid haemorrhage (a type of brain bleed) Key messages - Thrombolysis (giving a drug that dissolves blood clots) may improve some outcomes following aneurysmal subarachnoid haemorrhage (a type of brain bleed). For example, it probably reduces the risk of a poor functional outcome (severe disability), probably reduces the risk of cerebral artery vasospasm (a condition where brain arteries constrict, often causing brain damage by reducing blood flow), and may reduce the risk of delayed cerebral ischaemia (a clinical...

Can calorie (energy) labelling change people's selection and consumption of food or alcohol? Key messages – Current evidence suggests that calorie (energy) labelling on menus, and on or next to products, leads to reductions in calories selected and bought from food and non-alcoholic drinks. The evidence for consumption (eating) suggests a similar effect, but there is less evidence and it is of lower quality. – There is insufficient evidence to estimate the effect of calorie labelling for alcoholic drinks. – Calorie labelling of food could lead to potentially meaningful impacts on...

Transtracheal ultrasound for identifying endotracheal intubation in adults This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of transtracheal ultrasound for detecting endotracheal intubation in adult patients. Secondary objectives Secondary objectives include assessing the diagnostic accuracy of transtracheal ultrasound amongst the following subgroups: setting (e.g. prehospital, emergency department, intensive care unit, operating room) operator specialty (e.g. emergency medicine, non-emergency medicine) operator...

Ankle-foot orthoses to improve walking in people with weakness of the calf muscles due to neuromuscular disorders Key messages Ankle-foot orthoses (AFOs) may reduce the effort required to walk, and increase walking speed and satisfaction with walking in people with calf muscle weakness due to neuromuscular disorders, but we are uncertain about these results. We are unable to draw any conclusions about the effect of AFOs on perceived walking effort, balance, AFO use, and adverse effects. The evidence suggests effects on walking improvement may vary depending on the material from which the AFO...

What are the benefits and risks of tranexamic acid for preventing heavy bleeding after vaginal birth? Key messages Tranexamic acid given as a preventive treatment makes little to no difference to heavy bleeding after vaginal birth. We are uncertain about whether there are any harmful effects from tranexamic acid. What is the issue? Postpartum haemorrhage, which is heavy bleeding after giving birth, is a common and potentially life-threatening complication of birthing a child. Most women receive drugs (called uterotonics) that stimulate the womb to contract after a normal (vaginal) delivery...

Does pre-emptive treatment with antiviral agents help to reduce the risk of cytomegalovirus disease in transplant recipients? Key messages • Cytomegalovirus (CMV, herpes virus related to chickenpox) is a common virus, with the majority of people being exposed by adulthood. CMV is a major cause of illness and death during the first year after transplantation. Prevention strategies include 1) giving daily low doses of an antiviral agent to all organ transplant recipients (prophylaxis) or 2) prescribing an antiviral agent when an organ transplant recipient develops laboratory-confirmed evidence...

Can rewards help people quit smoking, and do they work in the long term? Key messages • Smoking is the leading preventable cause of ill health and early death worldwide. Quitting smoking is vitally important to help people live in good health for longer. • Rewards help people to quit smoking for at least six months. • This effect continues after rewards have ended, suggesting long-term benefits. • Rewards also help pregnant people who smoke to quit smoking. This effect continues after the baby has been born. What are rewards? Incentives, such as money, vouchers or deposits, can be used to...

Do programmes offered through sporting organisations promote healthy behaviour and improve people's health? Key messages • Sporting organisation programmes probably lead to people being slightly more physically active. • Sporting organisation programmes may make little or no difference to the amount of time people are inactive (sedentary). They may increase the amount of fruits and vegetables people eat. • We do not know if sporting organisation programmes make any difference to how many sugary drinks and alcoholic drinks people have, or their tobacco use, as the evidence is very...

Is keeping the azygos vein intact during surgery for newborns with esophageal atresia beneficial? Key messages - Current evidence suggests that preserving the azygos vein during surgical repair for esophageal atresia may result in a reduction in the risk of death, serious complications, leakage from the esophageal repair site (anastomosis leakage), and severe infections or chest infections, when using the open chest surgery (thoracotomy) approach. - Further research is still needed as the results of this review may not be applicable to all newborns with congenital esophageal atresia. What is...

Which hormone (GnRHa) medications work best with ovarian stimulation hormones in assisted conception cycles? Key messages • When comparing long versus short gonadotropin-releasing hormone agonists (GnRHa) treatment, there was little to no difference between groups for live birth and ongoing pregnancy rates, but the long treatment may result in a higher clinical pregnancy rate (where the foetus can be seen or heard). • We are uncertain if there is any difference in live birth and clinical pregnancy rates for the other comparisons studied, except for the comparison 100 µg dose versus 25 µg...

Psychological interventions for depression in people with diabetes mellitus This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of psychological interventions for depression in people with diabetes mellitus. This is a protocol....

What are the benefits and risks of different immunotherapy drugs for treating glioblastoma (a cancerous brain tumour)? Key messages • A form of immunotherapy known as immune checkpoint inhibitors (ICIs), which uses the body's immune system to fight disease, has shown encouraging results in the treatment of some cancers. • Seven studies looked at the ICI anti-programmed cell death 1 (anti-PD-1) for the treatment of adults with glioblastoma. Six of them showed no benefit. One small trial showed an improvement in overall survival and progression-free survival, but the evidence is very...

Early versus delayed anticoagulation treatment for people with non-valvular atrial fibrillation-related acute ischaemic stroke This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and risks of early versus late initiation of oral anticoagulation (vitamin K antagonists or NOACs) in people with non-valvular atrial fibrillation-related ischaemic stroke. This is a protocol....

What are the best ways to help people to stop vaping nicotine and do they have any unwanted effects? Key messages Text message-based interventions compared to no or minimal support may help young people stop vaping, and varenicline compared to no or minimal support may help people stop vaping; however, more evidence is needed. We need more information on whether other interventions can help people to stop vaping. We need more information on potential harms of interventions and whether they affect the number of people smoking tobacco. What are nicotine-containing vapes? Vapes (also known as...

Yoga as an adjunctive therapy for rheumatoid arthritis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effect and safety of yoga as an adjunctive therapy for rheumatoid arthritis. This is a protocol....

Are virtual reality interventions more effective than an alternative or no intervention for the rehabilitation of people with multiple sclerosis? Key messages - Virtual reality might improve balance and postural control, upper limb function, and participation and quality of life, but the overall quality of the evidence is limited. - Since these results are based on few studies of lower quality, they should be interpreted with caution. What is multiple sclerosis? Multiple sclerosis is the most common neurological disease in young adults. People with multiple sclerosis can have a variety of...

Is a procedure to induce tolerance for aspirin an effective treatment for adults with a hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs)? Key messages • Due to a lack of robust evidence, the benefits and harms of aspirin after desensitisation (ATAD) (a procedure to induce tolerance to aspirin by exposing an individual to the drug gradually) as a treatment option for people with a hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) remain unclear. • Treatment with ATAD may lead to a better quality of life, although the evidence comes from small studies. •...