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...

Hilft Musiktherapie Menschen mit Demenz? Kernaussagen - Verglichen mit der Standardbehandlung (d. h. ohne spezifische Aktivitäten) verbessert eine Musiktherapie für Demenzkranke wahrscheinlich Depressionen und möglicherweise allgemeine Verhaltensprobleme. - Im Vergleich zu anderen Aktivitäten verbessert die Musiktherapie möglicherweise das Sozialverhalten, aber wir sind uns nicht sicher, ob sie Angstsymptome verbessert. - Diese Wirkungen halten möglicherweise nicht über das Ende der Behandlung hinaus an. - Eine Musiktherapie hat möglicherweise keinen Einfluss auf das emotionale Wohlbefinden,...

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....

Welches Medikament ist besser zur Behandlung von Bluthochdruck: Renin-Hemmer oder Angiotensin-Rezeptorblocker? Kernaussagen - Kurzzeitstudien legen nahe, dass zwischen Renin-Hemmern und Angiotensin-Rezeptorblockern wahrscheinlich nur geringe oder keine Unterschiede hinsichtlich des Therapieabbruchs aufgrund unerwünschter Wirkungen, schwerwiegender oder allgemeiner Nebenwirkungen sowie der Blutdruckkontrolle bei Menschen mit leichter primärer Hypertonie bestehen. Möglicherweise gilt das auch für die Sterblichkeitsrate. - Aufgrund fehlender aussagekräftiger Langzeitstudien ist über mögliche...

Grippeschutzimpfung für Gesundheitsfachpersonal, das Personen ab 60 Jahren in Langzeitpflegeeinrichtungen betreut Kernaussagen Das Angebot einer Grippeschutzimpfung für Menschen, die in Pflegeeinrichtungen arbeiten, hat möglicherweise einen geringen oder gar keinen Einfluss auf die Zahl der Bewohner*innen, die an Grippe erkranken oder mit einer Infektion der unteren Atemwege ins Krankenhaus kommen, verglichen mit Bewohner*innen von Pflegeeinrichtungen, in denen keine Impfung angeboten wird. Wir stellten fest, dass die Impfprogramme für das Gesundheitsfachpersonal wahrscheinlich zu weniger...

Renin inhibitors or angiotensin receptor blockers: which work better to treat hypertension? Key messages - The available evidence from short-term studies suggests there is probably little to no difference between renin inhibitors and angiotensin receptor blockers in terms of death rates, withdrawal due to unwanted effects, serious unwanted events, unwanted events, and blood pressure control for people with mild primary hypertension. - Due to a lack of strong evidence from long-term studies, any potential differences between these two drugs for measures of heart and blood vessel health are...

What are the best strategies to implement World Health Organization (WHO) recommendations to prevent, detect, and treat postpartum hemorrhage? Key messages Multicomponent implementation strategies may improve adherence to World Health Organization (WHO) postpartum hemorrhage (PPH) prevention recommendations and probably do not make a difference to intensive care unit (ICU) admissions, need for additional surgeries, or death of the mother. We do not know if multicomponent implementation strategies affect blood loss or blood transfusion. We do not know if single-component implementation...

Efficacy and safety of SARS-CoV-2 vaccination in pregnancy to prevent COVID-19 in mothers and early infancy This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of SARS-CoV-2 vaccination during pregnancy, versus placebo or no vaccination during pregnancy, for preventing COVID-19 disease in mothers and infants. This is a protocol....

What are the benefits and risks of balloon dilatation of the Eustachian tube for obstructive Eustachian tube dysfunction? Key messages Balloon dilatation of the Eustachian tube (BET) probably improves Eustachian tube dysfunction compared to nasal medications up to three months after the procedure. How certain we are about this evidence depends on the length of follow-up and the type of treatment this is compared with. What is Eustachian tube dysfunction? The Eustachian tube is a tube which connects the middle ear (part of the ear behind the ear drum) with the back of the nose. People can...

Quels sont les bénéfices et risques des anticoagulants oraux directs (AOD), les anticoagulants de nouvelle génération, après le remplacement de la valve aortique par cathéter (RVAC) ? Principaux messages Chez les personnes qui n'ont pas de raison médicale de prendre des anticoagulants, les nouveaux anticoagulants oraux (AOD), en particulier le rivaroxaban et l'apixaban, pourraient augmenter le risque de décès quelle qu'en soit la raison lorsqu'on les compare aux médicaments antiplaquettaires, tandis que l'edoxaban semble avoir peu ou pas d'effet. Toutes les différences entre le rivaroxaban,...

Welchen Nutzen und Schaden haben orale Antikoagulanzien ohne Vitamin-K-Antagonisten (NOAKs), die Blutverdünner der nächsten Generation, nach einem Transkatheter-Aortenklappenersatz (TAVR)? Kernaussagen - Bei Menschen, die keinen medizinischen Grund für die Einnahme von Blutverdünnern haben, erhöhen orale Antikoagulanzien ohne Vitamin-K-Antagonisten (NOAKs), insbesondere Rivaroxaban und Apixaban, im Vergleich zu Thrombozytenaggregationshemmern möglicherweise das Sterberisiko aus irgendeinem Grund. Edoxaban hat möglicherweise nur geringe oder keine Wirkungen. Rivaroxaban, Apixaban oder...

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (NOACs), the next-generation blood thinners, after transcatheter aortic valve replacement (TAVR)? Key messages • In people who do not have a medical reason to take blood thinners, non-vitamin K antagonist oral anticoagulants (NOACs), specifically rivaroxaban and apixaban, may increase the risk of death for any reason when compared with antiplatelet drugs, while edoxaban appears to have little or no effect. Any differences between rivaroxaban, apixaban, or edoxaban, and antiplatelet therapy in death caused by...

Effectiveness of SARS-CoV-2 testing strategies This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of different SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths among suspected cases and asymptomatic individuals. This is a protocol....

Acupuncture for babies with neonatal abstinence syndrome after exposure to drugs while in the womb Key messages • Due to a lack of evidence, we are unable to draw any conclusions about the benefits and risks of acupuncture for babies with neonatal abstinence syndrome caused by being exposed to drugs while in the womb. • Large studies that are well-designed and reported are needed to find out more about the benefits and risks of acupuncture, including studies that make comparisons of acupuncture techniques, sites, timing and application. What is neonatal abstinence syndrome? Neonatal...

Quels sont les bénéfices et les risques des inhibiteurs du facteur de nécrose tumorale pour l'arthrite juvénile idiopathique ? Principaux messages - Comparés au placebo, les inhibiteurs du facteur de nécrose tumorale (TNFi) pourraient globalement améliorer la santé des jeunes atteints d'arthrite juvénile idiopathique (AJI), mais les effets des médicaments sur la fonction articulaire, la douleur, le contrôle de la maladie et les risques sont incertains. - Nous ne sommes pas certains des bénéfices et risques des TNFi par rapport à un autre médicament appelé méthotrexate. - D'autres études...

Lindert Herz-Kreislauf-Training die krebsbedingte Erschöpfung vor, während oder nach einer Krebstherapie? Kernaussagen Ein Herz-Kreislauf-Training während einer Krebstherapie reduziert wahrscheinlich geringfügig die krebsbedingte Erschöpfung über den Zeitraum bis 12 Wochen. Die längerfristigen Wirkungen eines Herz-Kreislauf-Trainings auf die krebsbedingte Erschöpfung und auf die Lebensqualität sind unsicher. Es gibt keine Evidenz zu den Wirkungen eines Herz-Kreislauf-Trainings vor einer Krebstherapie. Wir fanden fast 50 laufende Studien zu Herz-Kreislauf-Training vor, während und nach einer...

Does cardiovascular training relieve cancer-related fatigue before, during, or after anticancer therapy? Key messages Cardiovascular training during anticancer therapy probably reduces cancer-related fatigue slightly for up to 12 weeks. The longer-term effects of cardiovascular training on cancer-related fatigue and quality of life are uncertain and there is no evidence about the effects of cardiovascular training before anticancer therapy. We found nearly 50 studies of cardiovascular training before, during, and after cancer treatment that are underway and these will add to the evidence...

What are the benefits and risks of tumor necrosis factor inhibitors for juvenile idiopathic arthritis? Key messages • When compared to placebo, tumor necrosis factor inhibitors (TNFi) may make young people with juvenile idiopathic arthritis (JIA) feel better overall, but the effects of the medicines on joint function, pain, disease control, and harm are uncertain. • We are uncertain about the benefits and harms of TNFi when compared to another medicine called methotrexate. • More high-quality studies are needed to understand the benefits and harms of TNFi in JIA. What is juvenile idiopathic...

What are the effects of angioplasty or stenting in people with deep vein thrombosis? Key messages ⦁ The effects of angioplasty or stenting for people with deep vein thrombosis (DVT) are unclear. ⦁ Further larger studies are needed to determine whether angioplasty and stenting are safe and effective treatments for people with DVT. What is deep vein thrombosis (DVT)? DVT is a blood clot that forms in a deep vein, usually in the leg. It can cause pain, swelling, and redness in the affected leg. DVT can also lead to serious complications, such as post-thrombotic syndrome (PTS) (a chronic...