What are the effects of combined psychosocial interventions and medications for helping people who consume an excessive amount of alcohol? Key messages • Compared to psychosocial interventions alone, adding medications is probably safe and helpful for people with alcohol use disorder (AUD) in reducing alcohol use. • Due to the limited number of available studies, we do not know if combined psychosocial interventions and medications, when compared to medications alone or no treatment or usual care, is helpful for people with AUD. • More studies are needed looking at the effects of combined...

What influences people to fund, provide, and attend general health checks? Key messages • People decide to get general health checks based on several things, such as being aware of general health checks and getting reminders from family, friends, or healthcare providers. In places where general health checks and treatment are not free, resources like time and money also play a role. Some people avoid general health checks because they are afraid of bad results. • We found less information about healthcare funders and providers, so we do not fully understand what drives their decisions about...

Does the risk of death differ between female and male adult patients with pulmonary embolism (a blood clot in the lungs)? Key messages - We concluded that it is uncertain if sex (whether a patient is male or female) is an independent predictor of the risk of death in people with pulmonary embolism (a blood clot in the lungs), as our review found contradictory results. - We found a small but important reduction in death from any cause by 30 days after pulmonary embolism in female compared to male patients. However, in female patients, there may be a small but important increase in death...

Blood transfusions in people born with heart problems who require surgery on their heart Key message We found 19 studies that compared different ways of doing red blood cell transfusion in newborns and children requiring heart surgery for congenital heart disease (heart problems they were born with). However, we are unable to reach any reliable conclusions based on this evidence. More studies are required. What is congenital heart disease? Congenital heart disease is any problem with the heart's development that a person is born with. It means the heart has not formed properly. It affects...

Prognosis of surgically resected clinical stage 1A non-small cell lung cancers manifesting as a subsolid nodule on computed tomography including pure ground glass nodules This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To quantify the risk of tumour relapse/recurrence after a surgical resection of stage 1A non-small cell lung cancer (NSCLC) as manifested on computed tomography (CT) imaging as a subsolid nodule. This is a protocol....

Are molecular tests better than blood cultures for detecting infections in the blood of newborn babies? Key messages – The studies included in this review suggest that molecular tests (based on a molecule that carries the genetic instructions used in growth, development, functioning and reproduction from bacteria) may be very helpful additional tests in detecting blood infection (sepsis) in babies because they provide rapid results. – Using molecular tests may help us stop using antibiotics in babies without a blood infection quicker because the results are faster than blood cultures (a test...

Statins for preventing preeclampsia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the relative benefits and harms of statins for preeclampsia prevention in pregnant women. This is a protocol....

What are the benefits and harms of nonsteroidal anti-inflammatory drugs (NSAIDs) for treating acute renal colic? Key messages - Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain in adults with renal colic. - Some NSAIDs may work better than others in adults with renal colic. - The risks of NSAIDs in the treatment of renal colic are not clear. What is renal colic? Kidney (urinary) stones may cause sudden ('acute') and severe abdominal pain when they block urinary flow. This pain is known as 'renal colic'. How is renal colic treated? Different drugs are used to treat this severe...

Do different methods of nutritional support affect recovery and complications in adults after pancreaticoduodenectomy? Key messages - Enteral nutrition may not increase the risk of complications but is probably linked to a shorter hospital stay compared to parenteral nutrition. - When comparing jejunostomy feeding to oral nutrition, there may be no clear difference in complications or length of hospital stay, but the evidence is uncertain. - More evidence is needed to say with higher levels of confidence how these different types of feeding affect patients after a pancreaticoduodenectomy....

Is rituximab better for people with multiple sclerosis than other disease-modifying medicines? Key messages • We are uncertain whether rituximab prevents disability worsening in people with any form of multiple sclerosis (MS). • Rituximab may offer moderate-to-large benefit against a range of other medicines in preventing relapses in relapsing MS, both in people treated with rituximab for the first time and in those given rituximab after other medicines failed to work or became unsuitable. • Very few people given rituximab in the studies had serious unwanted/harmful events, developed cancer,...

Safety and usefulness of proton pump inhibitors for preterm infants with reflux disease Key Messages - Reflux is common in preterm infants - The current evidence neither supports nor refutes the safety and efficacy (usefulness) of proton pump inhibitors (PPIs) for the treatment of reflux in preterm infants. What is gastroesophageal reflux, and how does it differ from gastroesophageal reflux disease? Gastroesophageal reflux happens when the stomach contents flow back into the esophagus (canal joining throat to stomach). It is common in a newborn. Premature infants are more likely to...

Can a class of antidiabetic medicine help protect the brain after a severe ischemic (caused by a blocked blood vessel) stroke? Key messages 1. There is limited evidence that glyburide (a sulfonylurea, or type of medicine used for type 2 diabetes) may have little to no effect on a person's function 90 days after a stroke, or the number of deaths after 90 days. It may have little to no effect on neurological deterioration within three days, such as consciousness, speech, or weakness, and probably has little to no effect on unwanted side effects, such as heart-related problems, or pneumonia. 2....

Is exercise of the pelvic floor muscles more effective for treating unintentional passing of urine (incontinence) in women when feedback or biofeedback are added? Key messages • In women with urinary incontinence (involuntary loss of urine), using a biofeedback device (a device with a sensor that measures muscle contractions and gives audio or visual feedback) with pelvic floor muscle training makes little or no difference to incontinence-related quality of life, how often leakage happens, or how often women feel their symptoms are cured or improved. Most evidence comes from women with...

Do antidepressants help people with non-specific low-back pain and spine-related leg pain? Key messages • Compared with a placebo (inactive or 'dummy' pill), serotonin and norepinephrine reuptake inhibitors (a class of antidepressant) probably provide small reductions in pain intensity and trivial improvements in function in people with low back pain. Some people will probably experience unwanted effects when taking these medicines. • Compared with a dummy pill, tricyclic antidepressants (a class of antidepressant) probably provide small improvements in function in people with low back pain,...

Does music-based therapy help people with dementia? Key messages · Compared to usual care (i.e. without specific activities), providing people with dementia with music-based therapy sessions probably improves depression, and may improve overall behavioural problems. · Compared to other activities, music-based therapy may improve social behaviour, but we are unsure if it improves anxiety. · These effects may not last beyond the end of treatment. · There is no evidence that music-based therapy makes a difference to the emotional well-being, agitation or cognition (e.g. thinking and...

What are the benefits and risks of alternative models of delivering care for people with low back pain? Key messages - Compared to usual care, alternative care models probably do not appreciably improve the quality of care for people with low back pain in terms of referrals to or use of any lumbar spine imaging and prescription or use of opioids. - Alternative care models do not make an important difference to the level of pain or back-related function. - We are less certain of the effects on lumbar spine surgery, hospitalisation, and total adverse (unwanted or harmful) events. What is...

Can vasodilators (medicines that widen blood vessels) help women with infertility have children? Key messages 1. Vasodilators (medicines that widen blood vessels) compared with dummy treatment or no treatment probably help women become pregnant, but probably have side effects. In addition, vasodilators compared with dummy treatment or no treatment, and compared with oestrogens (female sex hormones), may have little or no effect on the chance of women carrying the pregnancy to term and having the baby. 2. To draw more solid conclusions, we need larger, well-designed studies on this treatment....

Blood pressure management in reperfused ischemic stroke This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of intensive systolic blood pressure management (target less than 160 mmHg) versus conventional management (target less than 180 mmHg) in people undergoing ischemic stroke reperfusion via systemic thrombolysis or endovascular thrombectomy. This is a protocol....

Epley maneuver, performed by family doctors or emergency physicians, for benign paroxysmal positional vertigo in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of the Epley maneuver, performed by family doctors or emergency physicians, for adults with benign paroxysmal positional vertigo. This is a protocol....

What are the benefits and risks of different cervical preparation methods for surgical abortion in the second trimester of pregnancy? Key messages • Prostaglandin and osmotic dilators are likely safe and effective methods of cervical priming agents before second trimester surgical abortion. • Misoprostol plus osmotic dilators probably increases pre-procedure cervical dilation and reduces procedure time and need for additional dilation compared to placebo (dummy treatment) plus osmotic dilators. • Overnight laminaria may improve procedure time, pre-procedure dilation, and need for additional...