How effective are hydrogel dressings for helping donor site wounds to heal after split-thickness skin grafts? Key messages - We do not know if hydrogel dressings (designed to keep wounds moist) are better than other dressings for helping donor site wounds to heal after split-thickness skin grafts (skin taken from another part of the body). - We did not find any studies comparing hydrogel dressings with creams, ointments, or other solutions applied directly to the wound. - More and better designed studies are needed to answer this question. What are donor site wounds and split-thickness skin...

Prophylactic blood thinners for the prevention of death and venous thromboembolism in COVID-19 outpatients Key messages ‐ When used in the outpatient setting, anticoagulants (blood thinners) probably reduce venous thromboembolism (VTE) and pulmonary embolism (PE) when compared with placebo or no treatment in people with COVID-19. However, these drugs seem to have little or no effect in reducing death, major bleeding, need for hospitalisation, or adverse events. What is VTE? Venous thromboembolism, which includes both deep vein thrombosis (DVT) and PE, is a condition where a blood clot forms...

Consolidative thoracic radiotherapy for extensive disease small cell lung cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of consolidative thoracic radiotherapy after chemotherapy in comparison with chemotherapy alone for ED SCLC. This is a protocol....

Medicines to manage pain and discomfort in premature babies assisted with breathing machines and at risk of brain bleeding Overview question Do pain medicines reduce brain bleeding and death and improve long-term development in babies born too early ('preterm' babies) who need mechanical breathing assistance? Background Preterm babies, especially babies born before 28 weeks of pregnancy are completed, sometimes develop brain bleeding. Babies with less severe bleeding may make a full recovery or have only mild problems later in life. Babies with more serious bleeding may die or have problems...

Interventions for the uptake of evidence-based recommendations in acute stroke settings Do implementation interventions improve the delivery of evidence-based care in acute stroke units? Key messages Implementation interventions are designed to improve the delivery of 'evidence-based' care, which is care that has been proven in research studies to help people with a particular health condition. We do not know if implementation interventions delivered in acute stroke units lead to better delivery of evidence-based care. More research is needed to investigate how to successfully implement...

What are the benefits and unwanted effects of topical anesthetics for corneal abrasions? Key message(s) 1. We are very uncertain about the effectiveness of anesthetic eye drops for control of pain due to corneal abrasions (scratches). 2. We are very uncertain about the safety of anesthetic eye drops regarding speed of healing and complications. 3. To ensure trustworthy evidence, researchers should follow best-practice guidance. Future research studies should include more people followed over a longer period of time after treatment ends. What is a corneal abrasion? A corneal abrasion is a...

Use of fibrin-based agents to reduce blood loss in adults undergoing liver surgery Key messages • The studies investigating fibrin-based agents for reducing blood loss in adult liver surgery have many design flaws, so their results are very uncertain. • Based on the available evidence, we cannot recommend or advise against the routine use of fibrin-based agents. What is topic of this review? People who undergo liver surgery for tumours are at risk of significant blood loss, complications after surgery, and even death. Several techniques have been developed to reduce blood loss in liver...

Is there a difference between pars plana vitrectomy with internal limiting membrane flap and pars plana vitrectomy with internal limiting membrane peeling for large macular holes? Key messages 1. Pars plana vitrectomy with internal limiting membrane flap technique compared to pars plana vitrectomy with internal limiting membrane peeling for treating macular holes may result in better vision after three or more months. 2. Pars plana vitrectomy with internal limiting membrane flap technique compared to pars plana vitrectomy with internal limiting membrane peeling for treating macular holes...

High flow nasal cannula oxygen therapy for respiratory support in term infants Review question Does high flow nasal cannula oxygen therapy improve the health outcomes of critically ill newborn infants requiring support for their breathing? Background When newborn infants have difficulty breathing, they may need external support to help move air in and out of their lungs (ventilation). There are various methods used to provide this breathing support. Invasive ventilation delivers air via a breathing tube placed in the baby's windpipe. Non-invasive ventilation delivers air via a mask that can...

Anti-vascular endothelial growth factor biosimilars for macular degeneration This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of the anti-VEGF biosimilars compared with their reference product in people with neovascular AMD. This is a protocol....

What medicines are best for people with narrowing of the carotid arteries (blood vessels that deliver oxygen-rich blood from the heart to the brain)? Key messages Compared to placebo (an inactive medicine): - warfarin, an anticoagulant (blood-thinning medicine), may reduce the risk of side effects by 11%; - chlorthalidone, an antihypertensive (medicine for lowering high blood pressure), may slow the progression of carotid stenosis (narrowing of the carotid arteries) by 55%. Studies with more participants and with long-term follow-up are needed to define the best medical treatment for...

Combination treatment of pegylated interferon and tenofovir versus tenofovir for people with chronic hepatitis B This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of pegylated interferon combined with tenofovir versus tenofovir monotherapy in adults with chronic hepatitis B. This is a protocol....

De novo mTOR inhibitor immunosuppression versus calcineurin inhibitor immunosuppression for liver transplant recipients This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of de novo mTOR inhibitor-based versus calcineurin inhibitor-based immunosuppression for liver transplant recipients. This is a protocol....

The effects of different abortion policy environments on women's health This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To investigate the effects of different abortion policies on country level maternal mortality, and abortion-related health outcomes, including abortion-related mortality, physical and mental morbidity, and social and economic well-being. Secondary objective To assess possible differences in the effects of different policies on specific vulnerable populations, including minors, refugees, immigrants, sex workers,...

Interventions for improving adherence to amblyopia treatments in children This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and harms of various behavioral interventions, such as educational and reward systems, for improving children's objective adherence to amblyopia treatments. Secondary objective: to assess the subsequent treatment effects of improved adherence to amblyopia treatments and qualitatively explore equity and social determinants of health as factors affecting adherence. This is a protocol....

What are the benefits and risks of covered stents compared with conventional bare stents for transjugular intrahepatic portosystemic shunt in people with liver cirrhosis? Key messages – Expanded polytetrafluoroethylene (ePTFE)-covered stents may be more likely to reduce mortality (deaths), upper gastrointestinal bleeding, recurrence of ascites (a condition where fluid collects in spaces within your abdomen), and shunt dysfunction compared with bare stents of the same diameter. – Beneficial effects of ePTFE-covered stents remain unclear when comparing with bare stents of different diameters....

In adults, does oxygen therapy during the non-breathing period before intubation prevent complications? What is intubation? Intubation is a medical procedure that involves insertion of a tube into the breathing passage during the course of anaesthesia before surgery or in life-saving emergency situations such as road-side trauma or in times of critical illness. The breathing tube serves as a portal for assisted ventilation. Why might oxygen therapy help? During the time when a person stops breathing after going to sleep ready for an operation before an oral breathing tube is inserted low...

Vocabulary interventions for second language learners up to six years of age Key messages – Studies included in this review suggest that vocabulary interventions for L2 learners may benefit children's L2 vocabulary learning but have little to no effect on their listening comprehension skills, though the evidence is very uncertain. Vocabulary interventions probably improve their storytelling skills. – There is a need for more high-quality research that follows L2 learners over a longer time to investigate longer-term effects. This should include learners outside the USA. Why is this review...

What are the benefits and harms of brexpiprazole, a new antipsychotic medication, for the treatment of depression when compared to dummy tablets or antidepressants? Key messages – Brexpiprazole added to an antidepressant is better at reducing the symptoms of depression than placebo (dummy tablet) added to an antidepressant. – Brexpiprazole might be more commonly associated with weight gain and akathisia (a feeling of restlessness that causes a compelling need to move all the time). What is depression? Depression is a common mental health condition which leads to low mood, inability to...

Auxiliary procedures following percutaneous treatment to remove kidney stones Review question We wanted to know how important it is to leave a nephrostomy tube (which connects the inside of the kidney to the skin) or a ureteral stent (a small tube that goes from the inside of the kidney through the ureter to the bladder) in people after a percutaneous kidney stone removal operation (percutaneous nephrolithotomy [PNL]). Background Kidney stones is a common disease worldwide. PNL is a method to remove stones from the kidney by creating a connection between the skin and the inside of the kidney...