What are the benefits and harms of diuretics given as a first treatment compared to other drug classes for hypertension (high blood pressure)? Key messages: - Thiazides and thiazide-like drugs (diuretics) probably decrease some adverse cardiovascular events compared to beta-blockers, calcium channel blockers, ACE inhibitors, and alpha-blockers when used as the first-line drug for the treatment of hypertension. - Total mortality is probably not different between diuretics and the other drug classes. - First-line diuretics likely reduce total cardiovascular events and heart failure compared to...

How effective are physical activity and education for chronic musculoskeletal pain in children and adolescents? Key messages - We are uncertain whether physical activity reduces pain or improves disability compared with usual care. We did not find studies that compared physical activities with medical care intervention (e.g. education). - We did not find studies that evaluated education about physical activity, with or without physical activity, in children and adolescents. - Due to the small number of included studies, and the ways in which the studies were conducted, which could introduce...

Interventions for people with type 2 diabetes mellitus fasting during Ramadan Review question What are the effects of interventions for adults with type 2 diabetes who fast during Ramadan? Background Fasting during Ramadan is one of the pillars of Islam's core beliefs and practices. During this period, all healthy Muslim adults will fast from dawn to dusk (sunset) and take meals after sunset or Iftar. People who are ill or have medical conditions such as type 2 diabetes are exempted from fasting. However, many individuals with type 2 diabetes choose to fast during Ramadan, which can have a...

Does oestrogen therapy help to treat pelvic organ prolapse in postmenopausal women? Key messages • Although 14 studies met the inclusion criteria for this review, no studies addressed our comparisons of greatest interest, so we are uncertain about the effects of oestrogen therapy on pelvic organ prolapse in postmenopausal women. • Further research is needed to assess the effects of oestrogen therapy, alone or in combination with other treatments, on pelvic organ prolapse in postmenopausal women. What is pelvic organ prolapse? Pelvic organ prolapse is when a woman's uterus (womb), bladder, or...

Emergency department or acute assessment unit: which is able to see and treat patients faster? Key messages • Emergency departments see and treat people with urgent illnesses or injuries. Worldwide, emergency departments are experiencing challenges in delivering care to patients because of increasing numbers of people needing to use them. • Acute assessment services are an alternative place for some patients to be seen and treated instead of the emergency departments and may help to ease long waiting times in the emergency departments. • It is unclear how safe and effective acute assessment...

Electronic symptom monitoring for patients with advanced cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of electronic symptom monitoring (ESM) on patient survival, hospital admission, emergency visit, changes in treatment protocol, adverse events, patient-reported outcomes (PROs), and cost-effectiveness for patients with advanced cancer. This is a protocol....

Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence What is primary healthcare integration? Primary healthcare integration is a way of combining different primary healthcare services that have previously been delivered separately. The aim of this integration is usually to give people better access to healthcare and to make more efficient use of limited health resources. Why is it important to know about healthcare workers' views and experiences? Primary healthcare integration has been implemented in many different...

Extensive intraoperative peritoneal lavage for resectable advanced gastric cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of extensive intraoperative peritoneal lavage for resectable advanced gastric cancer. This is a protocol....

Drugs to improve placental function in pregnant women carrying babies with poor growth What is the issue? In approximately 0.4% of pregnancies, the unborn baby suffers from poor growth because the placenta is unable to provide adequate nutrition. These babies are at high risk of dying in the womb due to the poor supply of nutrition and oxygen. Because of this, doctors often deliver these babies before full term, in order to feed them outside the womb. But such early births mean the babies are premature and of very low birthweight. Because of this, these babies are at risk of severe health...

Best therapy for people with advanced non-small cell lung cancer who have not been treated without a targetable mutation and moderately impaired performance status Key messages – The preferred chemotherapy for people with moderately impaired performance status (PS) with advanced non-small cell lung cancer (NSCLC) and that have never received any treatment before should contain two medicines, one of which is a platinum-based medicine. – Although the risk for bone marrow damage is higher with a platinum-based medicine, these events are often relatively mild and easy to treat. – We were unable...

Omega-3 fatty acid supplementation for distal symmetrical peripheral neuropathy in adults with diabetes mellitus This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of omega-3 polyunsaturated fatty acid (PUFA) supplements as a treatment for DSPN in people with diabetes mellitus compared to placebo or no treatment. This is a protocol....

Fenestrated endovascular repair for abdominal aortic aneurysms This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of complex stent-graft fenestrated endovascular aneurysm repair (FEVAR) versus open surgical repair or conservative (non-operative) management for people with complex abdominal aortic aneurysms. This is a protocol....

Psychological and educational interventions for childhood constipation This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the efficacy of psychological and educational intervention programmes used for functional constipation in children. This is a protocol....

Prophylactic treatment with monoclonal antibodies targeting the CGRP pathway for migraine prevention This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of monoclonal antibodies targeting the CGRP pathway compared with placebo or active treatments in preventing or reducing the symptoms of migraine attacks in adult and paediatric patients. This is a protocol....

Prognostic accuracy of imaging findings for predicting morbidity and mortality in patients with COVID-19 This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To evaluate the accuracy of imaging findings (on chest CT, chest X-ray, and ultrasound of the lungs) to predict the following medical outcomes in people with COVID-19. Morbidity, including: complications (e.g. development of hypoxia, severe AKI, delirium); escalation of care (e.g. hospital admission, ICU admission, non-invasive ventilation, intubation, mechanical ventilation, ECMO, need for renal...

What are the benefits and risks of cognitive rehabilitation for people with mild-to-moderate dementia? Key messages Cognitive rehabilitation helps people living with dementia to manage everyday activities that are important to them. Future studies could explore how to use cognitive rehabilitation to also improve overall functioning and wellbeing. What is dementia? Dementia is a group of symptoms caused by changes in the brain that get worse over time. People with some types of dementia have difficulties with memory, planning, concentrating, and communicating. These and other thinking...

Do social support interventions help people with heart disease? Key messages There is no clear evidence to suggest that social support or social network programmes help people with heart disease. These programmes may produce some improvement in quality of life and blood pressure. Our review suggests that, while social support or social network interventions may have potential to help people with heart disease, more high-quality, clearly reported trials are needed to prove any effectiveness. What is heart disease? The term 'heart disease' refers to a range of disorders affecting the heart,...

Multimodal interventions for cachexia management This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess: the effects of multimodal interventions which aim to alleviate and/or stabilise cachexia (disease-related wasting) in people with a chronic illness; and the safety of multimodal interventions when given to people with cachexia. This is a protocol....

Social and economic policy interventions to address household food insecurity in high-income countries (HIC) and the developing nations of Brazil, Russia, India, China and South Africa (BRICS) This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the effects of social and economic policy interventions for reducing the prevalence or severity, or both, of household food insecurity in high-income countries (HIC) and the developing nations of Brazil, Russia, India, China, and South Africa (BRICS). Secondary objective To characterise...

Does the separation or grouping, or both of newborn infants in the newborn unit decrease spread of infections? Key messages We did not find any published or ongoing medical studies to answer our question. Future studies are needed to assess the usefulness of separating or grouping newborn babies in decreasing the spread of infections as well as the financial costs of doing so. What are healthcare-associated infections? Healthcare-associated infections (HAIs) are infections that patients develop during their stay in the hospital, which were not present before hospital admission. They commonly...