For cancer patients, what are the benefits and risks of taking the hormone melatonin? Key messages Due to a lack of robust evidence, the effects of melatonin on quality of life and sleep quality in people receiving treatment for cancer are unclear. Melatonin might not increase the risk of adverse events, but the available evidence is not strong enough for us to be certain. Well designed studies using melatonin over a period of up to three months are needed to give better estimates of the benefits and risks. What is melatonin? Melatonin is a hormone produced in the body to regulate the daily...

What are the effects of treatments for ulnar neuropathy at the elbow (UNE)? Key message • People had similar results in symptom scores and surgical complications whether the nerve was simply released (simple decompression) or released and moved to a new position under the skin or muscle (subcutaneous or submuscular transposition). We also found no major differences in terms of symptom scores and surgical complications between surgery done with a larger cut (open decompression) and surgery done using a small camera (endoscopic decompression). • It is unclear if only giving written...

Multi-level factors affecting adolescent and youth engagement in HIV-research in low- and middle-income countries: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: To explore the views and experiences of adolescents and youth who engaged with (i.e. were approached for participation) or participated in HIV research in low-and middle-income countries. To develop a logic model or visual representation that depicts the variety of factors affecting adolescent and youth engagement in HIV-related research, and how these factors...

Higher initial doses of surfactant for the prevention or treatment of respiratory distress syndrome in preterm infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of higher − compared with standard − initial doses of surfactant in high‐risk preterm infants and preterm infants with respiratory distress syndrome. This is a protocol....

Perioperative enhanced recovery after surgery (ERAS) for non-malignant gynaecological conditions This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of perioperative ERAS protocols compared to traditional perioperative care for women undergoing surgery due to non-malignant gynaecological conditions and to review the availability and key findings of health economic evaluations of ERAS, summarising their principal conclusions. This is a protocol....

Tyrosine kinase inhibitor maintenance therapy after stem cell transplantation for FLT3-mutated acute myeloid leukemia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of FLT3 TKIs as maintenance therapy compared to no maintenance therapy or alternative strategies for participants with FLT3-mutated AML after allo-HSCT. This is a protocol....

Do supplements (like lutein and zeaxanthin) reduce illnesses and death in preterm infants? Key messages • Lutein and zeaxanthin supplementation probably reduces severe eye disease in preterm infants. • We found no evidence of any other clear beneficial or harmful effects of the interventions in reducing gut (stomach/digestive system) or brain problems in preterm babies. However, all five studies were conducted in Italy and the USA. • Future studies should be conducted in a variety of countries and settings. These studies should evaluate major outcomes such as death, gut or brain problems,...

Exercise interventions for treating work-related complaints of the arm, neck or shoulder in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of exercise interventions for work-related complaints of the arm, neck or shoulder (CANS) in adults. The outcomes of interest are pain, function, work outcomes, adverse events, quality of life, healthcare use and injury recurrence. This is a protocol....

Are there any treatments that can prevent haemolytic uraemic syndrome in individuals already infected with high-risk bacteria? Key messages • There is not enough evidence to determine the best method for preventing haemolytic uraemic syndrome (HUS) in patients with Shiga toxin-producing Escherichia coli (STEC)-associated diarrhoea. • More studies with a larger group of patients are required before any recommendation can be made. What is haemolytic uraemic syndrome? Haemolytic uraemic syndrome (HUS) is a serious illness that primarily affects children and can have severe side effects such as...

Do different ways of giving blood or blood products to treat bleeding affect the risk of death or the risk of developing a blood clot in people who are bleeding heavily after a traumatic injury? Key messages - No particular transfusion strategy (method of giving blood products) seems to change the overall chance of a patient dying or getting a blood clot. - We found 18 studies that tested different ways of giving blood transfusions. This variety made it difficult to combine the results and means we do not have clear answers to our questions. What is traumatic injury? A traumatic injury is a...

For those receiving a procedure to open up vessels after an ischaemic stroke, is clot-busting medicine better than no clot-busting medicine? Key messages For people who received a procedure to open up blood vessels after a stroke, adding a clot-busting medicine: did not make a difference, on average, in their ability to perform daily activities on their own with slight or moderate disability, in the number of deaths, or in bleeding inside the brain with or without symptoms. resulted in a higher flow of blood that could be seen going through the previously blocked blood vessels. What is acute...

Is entecavir better than no treatment or placebo for treating people with chronic hepatitis B? Key messages We could not estimate the effects of entecavir (a medicine used to treat infections caused by viruses) on death due to any cause in people with chronic hepatitis B (a common liver disease) as there were no deaths. No studies looked at health-related quality of life (a measure of a person's satisfaction with their life and health). We do not know whether entecavir is better than no treatment or placebo (a pretend treatment) regarding the proportion of people with serious harmful...

Are there risks in providing anti-cancer treatment in people's homes and is it cost-effective? Key messages 1. Compared to receiving intravenous (directly into a vein (IV)) anti-cancer therapy in hospital outpatient clinics, we are uncertain whether receiving the same therapy at home affects the management of unwanted effects, admission to hospital or visits to the emergency department after therapy, and IV line complications. 2. People receiving treatment at home may be more likely to prefer future treatments at home after receiving treatment there, compared to participants' preference...

What steps can be taken to prevent infections after surgeries to fix the aortic or the aortoiliac segment (the largest arteries in the body)? Key messages • Antibiotics seem to reduce surgical site infections in people undergoing aortic or aortoiliac surgery. • Other interventions assessed appear to make little or no difference in reducing the incidence of surgical site infections. • Other outcomes evaluated were minimally or not affected by the interventions studied. What are peripheral arterial disease and aortic aneurysms? Peripheral arterial disease happens when arteries narrow, and...

What are the effects of acupuncture in managing pain in babies undergoing painful procedures? Key messages • Due to a lack of evidence, the benefits and harms of acupuncture for babies undergoing painful procedures are unclear. • Well-designed and thoroughly reported studies are needed to shed light on the benefits and harms of acupuncture, also compared to medicines, or different ways of using acupuncture. Pain in babies and acupuncture Newborns in intensive care units experience many invasive and painful procedures (like blood tests). Newborns who undergo repetitive episodes of untreated...

Psychological interventions in inflammatory bowel disease Will persons with inflammatory bowel disease IBD) feel better when they get psychological therapy as well as their normal medication? Key messages 1. Psychological treatments probably have small beneficial effects on quality of life and symptoms of depression and anxiety in grown-up persons with IBD. 2. There may be no effect on inflammation and bodily symptoms, but we are very uncertain about these results. 3. In adolescents, psychotherapy is probably effective in improving quality of life. We are uncertain about the effects on...

Blood pressure lowering efficacy of dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonists compared to glucagon-like peptide-1 (GLP-1) receptor agonists This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the blood pressure effects of dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonists with the blood pressure effects of glucagon-like peptide-1 (GLP-1) receptor agonists. This is a protocol....

What are the benefits and risks of vaccines for the prevention of infectious diseases in adults with cancer (solid tumours)? Key messages - In adults with cancer (solid tumours), vaccines to prevent herpes zoster reduce the occurrence of herpes zoster but increase unwanted effects such as pain or redness at the injection site. - We are uncertain about the effects of influenza vaccines on death from any cause, unwanted effects of any severity, and serious unwanted effects. The occurrence of influenza was not measured. - Vaccines to prevent COVID-19 probably reduce the occurrence of COVID-19...

Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors combination therapy for adults with type 2 diabetes mellitus: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To evaluate the relative benefits and harms of therapy with glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose co-transporter-2 inhibitors (SGLT2i), and their combination in adults with type 2 diabetes mellitus. Secondary objectives To determine the relative rankings of GLP-1RA, SGLT2i, and their...

Which medication is best for reducing excessive blood loss after childbirth and has the fewest unwanted effects? Key messages Most medications (uterotonics) to prevent excessive blood loss after childbirth (postpartum haemorrhage (PPH)) are more effective than no treatment. Ergometrine plus oxytocin, and misoprostol plus oxytocin are most effective compared with oxytocin (standard treatment). All uterotonics, except for carbetocin, are associated with an increased risk of unwanted effects compared with oxytocin. What is postpartum haemorrhage, and how is it treated? Postpartum haemorrhage...