Are mobile health technologies useful for improving walking distance in people with intermittent claudication? Key messages Large, well-designed studies of mobile health (mhealth) technologies are needed to measure the distance a person with intermittent claudication can walk pain-free and the maximum distance they can walk. What is the condition? In peripheral arterial disease (PAD), the large blood vessels of the legs are narrowed or blocked, which makes it more difficult for oxygen from the blood to get to the muscles when needed. PAD may have no symptoms or may cause a muscle pain called...

What is the best method for rescuing clotted haemodialysis access? Key messages • There was insufficient evidence to suggest that a specific intervention was better than another for the outcomes of failure, function at 30 days, technical success and adverse events (both major and minor). • Function at 30 days may improve with surgical compared to mechanical thrombectomy; however, the evidence is very uncertain. • Death, access dysfunction, successful dialysis, and SONG (Standardised Outcomes in Nephrology) outcomes were rarely reported. Why is it important to treat thrombosed (clotted)...

Endovascular thrombectomy with versus without intravascular thrombolysis for acute ischaemic stroke This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of receiving endovascular thrombectomy with intravascular thrombolysis versus without intravascular thrombolysis on functional independence (defined as a modified Rankin Scale score (mRS) of < 3) at up to 90 days in people with acute ischaemic stroke. This is a protocol....

What are the benefits and risks of nonsurgical and surgical treatments for Morton's neuroma (pain in the forefoot on walking)? Key messages • The benefits and risks of nonsurgical and surgical treatments for Morton's neuroma (nerve enlargement in the foot that causes pain on walking) are unclear. • Well-designed studies are required to determine the benefits and risks of treatments for Morton's neuroma. What is Morton's neuroma? Morton's neuroma occurs when a nerve in the ball of the foot (the forefoot, i.e. the area connected to the toes) enlarges and causes pain. Its cause is unknown....

Physical exercise training to increase cardiorespiratory fitness in people with spinal cord injury This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to determine the effects (benefits and harms) of physical exercise training for increasing cardiorespiratory fitness compared with control (i.e. no intervention or placebo intervention) in people with spinal cord injury. This is a protocol....

Positions adopted by mothers in late pregnancy to improve the position of the baby Key messages We found no evidence for guiding practice with respect to the best positions for the mother to adopt in late pregnancy to change the position of the baby. What is the issue? The ideal position for the baby during labour and birth is with the baby's well-flexed head downwards, and the back of the head facing forwards (occipito-anterior). When the back of the baby's head faces backwards or to the side, labour may be more difficult. Various positions adopted by the mother, such as hands-knees or...

Antipsychotics for antipsychotic-naïve people with psychosis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate the efficacy and side effects of antipsychotics for antipsychotic-naïve people with psychosis. This is a protocol....

Cognitive behavioural therapy without antipsychotics for people with schizophrenia Key messages • There is not enough information to allow any strong conclusions about cognitive behavioural therapy (CBT) without medication for people with schizophrenia. • Additional studies are needed to look at the effectiveness and safety of CBT without medication for people with schizophrenia. Introduction Schizophrenia is a severe mental disorder. People with the illness struggle to differentiate between their own thoughts, beliefs, and ideas versus reality. For example, they may hear voices in their...

How useful is ultrasound for diagnosing giant cell arteritis? Key messages • Whether ultrasound (US) can replace biopsy for the diagnosis of giant cell arteritis (GCA) is uncertain. • We suggest that future studies use a different set of criteria to determine whether patients have GCA to allow US and biopsy to be compared more reliably. What is giant cell arteritis? Giant cell arteritis (GCA) is an inflammatory disease that affects blood vessels. It causes swelling and blockage of the arteries, particularly around the eye and at the side of the head, which can lead to sudden and permanent...

Is changing dietary fat intake beneficial or harmful for people with gallstones? Key message – Evidence about the effects of dietary fat intake on the wellbeing of people with gallstones is uncertain. What are gallstones? Gallstones, also known as cholelithiasis, are deposits from digestive fluid which consist of solidified substances such as cholesterol and bile pigments that are found in bile (a fluid that breaks down fats and is made and released by the liver and stored in the gallbladder). Cholesterol (a fat-like substance) circulates in the blood and all the body's cells contain...

Surgical and non-surgical procedures for management of pituitary tumours that secrete growth hormones in adults Key messages - The evidence on the effects of surgical and non-surgical (for example, medication) approaches for the management of pituitary tumours that secrete growth hormone is very limited. - Outcomes that are particularly important for people with the disease, such as disease-related complications, side effects and disease recurrence, were not, or only sparsely, reported. - When reported, we found that surgery may have little or no effect on the outcomes compared to...

Is LipiFlow more effective than other dry eye disease treatments? Key messages • LipiFlow performs similarly to other commonly used DED treatments with regard to DED signs and symptoms, but the evidence is very uncertain. • LipiFlow did not appear to cause any adverse events. What is dry eye disease? Dry eye disease is a common condition with several risk factors, including patient age, sex, race, hormonal imbalances, digital device use, and meibomian gland dysfunction. Meibomian gland dysfunction is the primary cause of dry eye disease. Meibomian glands in the eyelids, when functioning...

Is favipiravir useful in treating people with COVID‐19? Key messages Due to a lack of robust evidence, we are unclear if favipiravir provides any benefit in the treatment of people with coronavirus disease 2019 (COVID-19) infections who do not require hospital admission, as well as those admitted to hospital. Favipiravir might lead to mild side effects, but doesn't seem to cause major or severe side effects. What is favipiravir? Favipiravir is a medicine that can fight viruses. It is usually taken by mouth. Originally used for treating other viral infections, favipiravir has been suggested...

Multidisciplinary rehabilitation for Parkinson’s disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of multidisciplinary rehabilitation for people with Parkinson's disease on their functioning and quality of life. This is a protocol....

Bariatric surgery in adults with obesity and diabetes mellitus: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate comparative medium- and long-term effects and safety, and to obtain a clinically meaningful ranking of different metabolic bariatric surgery procedures (adjustable gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, one-anastomosis gastric bypass, gastric plication, biliopancreatic diversion with duodenal switch, and their variations) compared to each other and to non-surgical treatment (e.g....

Does deep muscle relaxation during laparoscopic surgery improve outcomes? Key messages – Deep muscle relaxation during laparoscopic surgery may not affect mortality (death) and morbidity (ill heath), but we are very uncertain about the results. – Deep muscle relaxation probably makes little to no difference in health-related quality of life (well-being) up to four days after the surgery. What is deep muscle relaxation in laparoscopic surgery? Surgery of the abdomen is increasingly performed by laparoscopy. Laparoscopy is an operation using a camera inserted through one or several small cuts...

Prehabilitation for people undergoing cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The overarching aim of this review is to determine the benefits and harms of prehabilitation on postoperative outcomes in people undergoing cardiac surgery. The specific objectives are: to identify and describe all prehabilitation interventions that have been administered prior to cardiac surgery (urgent and elective pathways); to compare the effectiveness of the different interventions against no intervention or usual care on postoperative and...

Pharmacological interventions for vasoplegic syndrome after cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of pharmacological interventions targeting vasoplegic syndrome in cardiothoracic surgery patients, compared to placebo or an active pharmacological control intervention. This is a protocol....

Rehabilitation interventions for oropharyngeal dysphagia in people with Parkinson's disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of rehabilitation interventions for oropharyngeal dysphagia in improving swallowing safety and efficiency in people with Parkinson's disease. This is a protocol....

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (which help to prevent blood clot formation) after a heart attack Key messages • Compared with placebo (dummy treatment), rivaroxaban reduces death from any cause (all-cause death) and probably reduces death from diseases of the heart and blood vessels (cardiovascular death) after a heart attack. Dabigatran may reduce all-cause death but may have little or no effect on cardiovascular death. Apixaban is probably no more effective than placebo for reducing all-cause death or cardiovascular death after a heart...