Is measuring bilirubin levels through the skin a reliable alternative to measuring bilirubin levels in the blood of newborns? Key messages The studies included in this review suggest that measuring bilirubin levels through the skin without a needle can identify high bilirubin levels in newborns. Why is it important to diagnose high bilirubin levels in newborns? Bilirubin is a substance produced through the breakdown of red blood cells. Jaundice is a very common problem in the newborn period and results from high levels of bilirubin in the blood (hyperbilirubinaemia). It is important to...

Hepatitis B immunisation for adults with end-stage kidney disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objectives We aim to evaluate the beneficial and harmful effects of: hepatitis B immunisation in people with end-stage kidney disease. Secondary objectives We aim to evaluate the beneficial and harmful effects of: reinforced vaccination series (three doses plus one additional booster) versus traditional triple inoculations; and intradermal versus intramuscular hepatitis B vaccination, in people with end-stage kidney disease. This is...

Chlorhexidine or other antiseptic solutions: which works better to prevent infection in newborns with central lines? Key messages: • Due to a lack of robust evidence, the benefits and risks of chlorhexidine in alcohol compared to povidone-iodine (PI) as antiseptic solution for central line insertion in newborns are unclear. • The use of povidone in premature infants may reduce the level of thyroid hormone, which is an essential hormone for growth and development. • The limited number of studies and the lack of studies from low- and middle-income countries reduce our confidence in the...

Initial treatment for adults with advanced kidney cancer (renal cell carcinoma) Abbreviations • renal cell carcinoma (RCC) • avelumab (AVE) • axitinib (AXI) • cabozantinib (CAB) • ipilimumab (IPI) • lenvatinib (LEN)) • nivolumab (NIV) • pazopanib (PAZ) • pembrolizumab (PEM) • sunitinib (SUN) Key messages • When making treatment decisions, it is important to think about whether drugs lengthen life, and whether they decrease or increase harmful side effects. • The findings in this review apply mostly to advanced renal cell carcinoma (RCC) with a clear cell component. What is advanced RCC, and...

Interventions from pregnancy to two years after birth for parents experiencing complex post-traumatic stress disorder and/or with childhood experience of maltreatment Do supports during pregnancy or in the two years after birth improve parenting capacity or wellbeing for parents experiencing trauma-related symptoms, or who experienced maltreatment in their childhood? Key messages Most evidence either suggested that parenting and psychological interventions made little or no difference in parental psychological wellbeing and parenting capacity, or it was of low quality so that confidence in...

The use of technology for remote care in inflammatory bowel disease Key messages • Remote care is probably the same as usual care (e.g. face-to-face care in clinics and hospitals) for improving inflammatory bowel disease symptoms in adults; there is limited evidence for children. • Remote care is probably the same as usual care for avoiding relapses and flare-ups; the same may be true for children. • Remote care is probably the same as usual care for improving quality of life in adults; there is limited evidence for children. What is inflammatory bowel disease? Inflammatory bowel disease...

Education programmes for patients with inflammatory bowel disease (IBD) Key messages It is likely that patient education programmes have no additional benefits when compared to usual medications and care for: • improving inflammatory bowel disease (IBD); • avoiding relapses and flare-ups of the disease; or • improving quality of life for patients with IBD. What is inflammatory bowel disease? Inflammatory bowel disease refers mainly to two conditions that cause inflammation of the gut. These are ulcerative colitis and Crohn's disease. Ulcerative colitis only affects the large intestine....

Occupational therapy in multiple sclerosis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Main objective To assess the benefits and harms of occupational therapy interventions for improving daily functioning, participation, and quality of life in people with multiple sclerosis. Secondary objectives To assess whether the effects of occupational therapy interventions differ according to the format of intervention delivery (individually versus group) and to the location of service delivery (outpatient, inpatient, or home-based therapy). This is a...

Personalised interventions for children with conduct problems Key messages There is currently little evidence to support personalising or tailoring interventions for children with conduct problems. What little evidence exists is of low quality. Therefore, it is unclear whether personalising interventions can improve outcomes for children with conduct problems. Further high-quality research is needed. What are conduct problems? Conduct problems are a range of disruptive behaviours in childhood that can have a negative impact on an individual's life. Conduct problems may lead to difficulties...

Iodine supplementation for preventing iodine deficiency disorders in children and adolescents This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of iodine supplementation for preventing iodine deficiency in children and adolescents. This is a protocol....

Stool transplantation for treatment of repeated Clostridioides difficile infection Review question We reviewed the evidence about the effect of stool transplant compared to currently used treatments such as antibiotics for the treatment of recurrent C difficile diarrhea in adults and children. What is Clostridioides difficile infection and how is it treated? Clostridioides difficile (C difficile) infection is a common bacterial illness that can cause life-threatening diarrhea (runny stools). Evidence suggests that an unhealthy mixture of gut bacteria called dysbiosis may increase the risk of...

What are the benefits and risks of exercise for people with systemic lupus erythematosus? Key messages Exercise in addition to 'usual care' may have little benefit on fatigue, functional capacity, and pain in people with systemic lupus erythematosus (SLE). No studies reported side effects during exercise. However, we have low confidence in the overall evidence. What is systemic lupus erythematosus? SLE (or 'lupus') is a disease in which the body's immune (defence) system mistakenly attacks healthy tissue in many parts of the body. It is a long-term disease (one that lasts longer than six...

Procalcitonin for the diagnosis of sepsis in neonates: a diagnostic test accuracy review This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To evaluate the diagnostic accuracy of procalcitonin in culture proven early- or late-onset neonatal sepsis. Secondary objectives To evaluate the diagnostic accuracy of procalcitonin in all sepsis (including both culture-proven and culture-negative early- or late-onset neonatal sepsis). To evaluate the diagnostic accuracy of procalcitonin in all sepsis at the most common threshold ranges used (0.5 to 1 ng/mL and ≥ 2...

Training health workers in breast examination for early detection of breast cancer in low- and middle-income countries What is the issue? Limited screening services and inadequate health systems in low- and middle-income countries (LMICs) leads to late diagnosis of breast cancer among women living in LMICs. Advanced screening for breast cancer (using mammography) is mostly unavailable in many health facilities and, if available, is too expensive for most women. This Cochrane Review examines whether training health workers based in LMICs in clinical breast examination (CBE) would have any...

Conservative interventions for managing urinary incontinence after prostate surgery Key messages - In men who have urinary incontinence following prostate surgery, combined non-pharmacological and non-surgical treatments may make little difference to continence, quality of life or the number of men experiencing adverse events as a result of the interventions. - The evidence is uncertain as to whether pelvic floor muscle training combined with biofeedback has any effect on incontinence or quality of life, while no evidence was identified assessing electrical stimulation for our key outcomes...

Glucagon-like peptide 1 (GLP-1) receptor agonists for people with chronic kidney disease and diabetes This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to assess the benefits and harms of GLP-1 receptor agonists to treat diabetes in people with CKD. This is a protocol....

Perampanel add-on for drug-resistant focal epilepsy Key messages Add-on perampanel is effective at reducing seizure frequency and may maintain seizure freedom for people with drug-resistant focal epilepsy. Perampanel is well-tolerated at doses of 8 mg/day or less. What is epilepsy? Epilepsy is one of the most common brain disorders. Approximately 30% of people with epilepsy continue to have seizures (sudden bursts of electrical activity in the brain that change how it works for a short time) despite adequate therapy with antiepileptic medicines. These people are regarded as having...

Post-incident debriefing for people with schizophrenia after coercive measures This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate the effects of post-incident debriefing after coercive measures for people with schizophrenia or schizophrenia-type psychosis. This is a protocol....

Digital technology for early identification of chest infections in people with cystic fibrosis Review question Can digital technology identify chest infections in people with cystic fibrosis (CF) earlier than with standard care and how does this affect clinical outcomes? What is cystic fibrosis? CF is a life-limiting condition affecting several body organs, especially the lungs. Chest infections can worsen the damage in the lungs of people with CF. Identifying chest infections early and treating them quickly is very important. Digital technology, such as smartphone applications (apps) and...

Is general anesthesia or loco-regional anesthesia better for people needing an endovascular repair of an aortic aneurysm? Key messages - we did not find any randomized controlled trials to help answer our question - there is a need for high-quality evidence to compare the benefits and harms of general anesthesia compared to loco-regional anesthesia in people undergoing endovascular repair of an aortic aneurysm What is an aortic aneurysm? When the diameter of arteries or veins grows beyond a certain size, they are known as aneurysms. Aneurysms that continue to grow beyond a certain size are...