Pain relief and side effects of a new regional anaesthetic technique (ESPB) Key messages Erector spinae plane block (ESPB) probably does not improve postoperative pain intensity 24 hours after surgery, but it may be performed without serious adverse events and may decrease requirements for oral pain relief as well as side effects associated with oral pain relief. What is regional anaesthesia? Acute postoperative pain is commonly treated with a combination of medications like opioids and regional anaesthesia. Regional anaesthesia is a way of specifically numbing nerves that carry pain signals...

Bladder training for treating overactive bladder in adults What did we want to find out? We wanted to compare the effectiveness of bladder training to other treatments for adults with overactive bladder (OAB). Background OAB is a common chronic condition involving daytime frequent urination, urination during sleep, and sudden urge to urinate with or without urinary incontinence (unintentional passing of urine). The disorder reduces quality of life and results in a significant economic burden on society. Bladder training is a behavioral therapy that establishes treatment goals and uses...

Superoxide dismutase in preterm newborns at risk of lung disease Key messages • We did not find enough good‐quality evidence about the use of superoxide dismutase in newborns born too early: only three studies for the prevention of lung disease. • The evidence is very uncertain about the effect of superoxide dismutase on bronchopulmonary dysplasia, also known as chronic lung disease, death, retinopathy of prematurity (eye damage which might cause blindness) compared to a placebo or no treatment. • No studies reported bronchopulmonary dysplasia or death at 36 weeks' postmenstrual age, need...

Immunotherapy versus chemotherapy for treating inoperable or metastatic bladder cancer Review question How does immunotherapy (a newer medicine that works through the body's immune system) compare to chemotherapy (a medicine that kills cancer cells) in people with cancer of the bladder or upper urinary system that has spread throughout the body or a surgical procedure is not feasible due to an advanced stage. Background Until a few years ago, the treatment of bladder cancer that has spread to other organs outside the urinary tract (metastatic bladder cancer) consisted of one of only a few...

Undernutrition as a risk factor for tuberculosis disease This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To determine the prognostic value of undernutrition in the general population of adults and children for predicting tuberculosis disease. Population Adults and children from the general population Index prognostic factors Undernutrition (wasting, stunting, underweight) Outcomes Incidence of tuberculosis (adjusted risk) Timing Short- and long-term follow-up Setting General population/outpatients Study design Cohort studies This is a protocol....

Diabetes as a risk factor for tuberculosis disease This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To determine the prognostic value of diabetes in the general population of adults and children for predicting tuberculosis disease. Population Adults and children from the general population Index prognostic factors Diabetes (type 1 and 2) Outcomes Incidence of tuberculosis (adjusted risk) Timing Short- and long-term follow-up Setting General population/outpatients Study design Cohort studies This is a protocol....

Children with chronic non-cancer pain and their families’ experiences and understanding of their condition, pain services and treatments: a meta-ethnography What is the aim of this synthesis? The aim of this Cochrane qualitative evidence synthesis was to find out how children and young people who have chronic pain and their families: 1) think about chronic pain; 2) live with chronic pain; 3) think of how health and social care services treated their pain; and 4) what they want from services and treatments. To answer these questions, we searched for, analysed and brought together the findings...

How helpful to recovery and healing are support and psychological interventions after exposure to sexual violence and abuse? Key messages • We found evidence that psychological or social (collectively known as ‘psychosocial’) interventions may reduce symptoms of post-traumatic stress disorder (PTSD) and depression in survivors of rape, sexual assault and abuse experienced during adulthood. • Our review suggests that interventions did not worsen symptoms or lead to unwanted effects. However, as large numbers of participants dropped out of treatments or did not complete studies’ assessments,...

Heliox for prevention of morbidity and mortality in ventilated newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effect of heliox on the rates of mortality, neurodevelopmental outcome, and chronic lung disease in invasively ventilated infants. This is a protocol....

Which common stimulant medicine is best for premature babies whose breathing pauses during sleep (apnea)? Key messages • Caffeine and other similar substances belong to a group of stimulants called methylxanthines. They are often used to prevent and treat apnea – when breathing repeatedly stops and starts – in newborn babies. • Caffeine may result in little to no difference in the frequency of death in babies born too early compared to other methylxanthines. • More studies are needed, especially in babies born extremely early, since these babies tend to be the most poorly. What is apnea of...

Is giving breathing support through the nose effective in babies that need help breathing at birth? Key message 1. In newborn babies who need help to breathe right after birth, in the delivery room, some studies have suggested that giving breathing support through the nose (nasal interface) is more effective than through a face mask (covers the nose and mouth) or laryngeal mask airway (LMA; a breathing tube, inserted through the mouth). 2. Giving babies breathing support through the nose compared with a face mask in the delivery room, may have little to no effect on the number of babies who...

Acupuncture for procedural pain in newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of acupuncture in newborn infants undergoing painful procedures. This is a protocol....

Vitamin D for the treatment of inflammatory bowel disease Key messages The data we presently have for the use of vitamin D for the treatment of inflammatory bowel disease are of very low quality, and we do not know whether it works or if it is safe. What is inflammatory bowel disease? Inflammatory bowel disease is a life-long disease that affects the gut. Its two main types are ulcerative colitis and Crohn's disease. Ulcerative colitis only affects the large intestine. Crohn's disease can affect any part of the gut, from mouth to bottom. Common symptoms include bloody poo, diarrhoea, stomach...

Bisphosphonates for postmenopausal osteoporosis: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The aim of this systematic review is to investigate the direct and indirect evidence regarding the benefits and harms of bisphosphonates in the primary and secondary prevention of osteoporotic fractures for postmenopausal women. We will perform a network meta-analysis, which will estimate the relative effects and relative ranking of the competing interventions for the outcomes of interest. This is a protocol....

Medicines to reduce pain and discomfort during spinal tap in newborns Key messages • Spinal tap is a painful procedure, but the best management for pain and discomfort in newborns in unclear. • We identified studies using creams containing painkillers, applied directly on the skin where spinal tap is performed. • These creams may reduce pain during spinal tap, but it is unclear whether they have an effect on the number of successful spinal taps on the first try, the number of attempts per successful spinal tap, episodes of bradycardia (slowing of the heartbeat), episodes of desaturation...

Hormonal contraception for women at risk of HIV infection. This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of hormonal contraception on HIV acquisition in women who live in settings with high HIV prevalence. This is a protocol....

Prebiotics for people with cystic fibrosis Key messages Growth and nutritional status can impact lung function and overall survival in people with cystic fibrosis (CF), and prebiotics, a source of food for healthy bacteria in the gut, might be of benefit. We did not find any trials that looked at how prebiotics affect people with CF, and such trials are needed. How can prebiotics be used to treat people with CF? We know that growth and nutritional status are important in CF as they affect lung function and overall survival. People with CF have an imbalance of bacteria and also inflammation...

Autoinflation for otitis media with effusion (OME or 'glue ear') in children Key messages Due to a lack of robust evidence, we are uncertain whether autoinflation has any effect on hearing. Using autoinflation two to three times per day may slightly reduce the number of children with OME after three months follow-up. Scores on a questionnaire that looked at quality of life for people with OME were also better for children who carried out autoinflation. However, some children may experience pain when using autoinflation. What is OME? Otitis media with effusion (OME, sometimes called...

Intraperitoneal chemotherapy for primary gastric cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of intraperitoneal chemotherapy (IPC) in people with primary gastric cancer, with or without peritoneal metastasis. This is a protocol....

What are the benefits and harms of silicon hydrogel versus hydrogel soft contact lenses for eye discomfort? Key messages 1) Silicone hydrogel and hydrogel soft contact lens (SCL) wearers may experience similar eye comfort, but we are very uncertain about the results. 2) In the long term, the risk of experiencing an adverse eye event may be more likely with extended wear silicone hydrogel SCLs than hydrogel SCLs. As above, the small number of studies and limitations in the evidence mean we are very uncertain about the results. What are silicone hydrogel and hydrogel soft contact lenses?...