How effective are medicines used to prevent attacks of vestibular migraine Key messages It is not clear whether any medications are effective at preventing attacks of vestibular migraine. There are very few studies that have assessed the possible benefits and harms of taking medication to prevent attacks. The available studies are small and the results are inconclusive. Further work is needed in this area to help establish whether there are any treatments that may improve this condition. What is vestibular migraine? Migraine (sometimes known as 'headache migraine') is a common condition that...

How effective are medicines used to treat attacks of vestibular migraine? Key messages It is not clear whether any medications are effective at treating attacks of vestibular migraine. There are few studies that have assessed the possible benefits and harms of taking medication at the time of an attack. The available studies are small and the results are inconclusive. Further work is needed in this area to help establish whether there are any treatments that may be used to help relieve the symptoms of a vestibular migraine attack. What is vestibular migraine? Migraine (sometimes known as...

Treatments to manage patent ductus arteriosus in premature babies Review question What treatments are effective and safe in preventing or treating a common heart condition, called patent ductus arteriosus (PDA) in premature babies? Background PDA is a common complication among premature and low birthweight babies. PDA is an open blood vessel channel between the lungs and the heart, which usually closes shortly after birth. In premature and low birthweight babies, the PDA may remain open, and may contribute to life-threatening complications. We wanted to see what treatments can safely and...

High-dose caffeine compared to standard-dose caffeine in preterm newborns at risk of lung disease Key messages • Although caffeine is commonly given to babies born too early, its most effective dose is unclear. • Higher doses of caffeine might improve breathing and long-term development, but it potentially has unwanted effects. Why give caffeine to babies born too early? Newborns born too early (preterm), especially before 28 weeks of pregnancy, have a higher risk of death, lung disease, and brain impairment than those born at or near term. For instance, some of these babies develop...

Rituximab for myasthenia gravis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess: the safety and efficacy, as assessed by the effect on disease severity or functional ability and the burden of alternative treatment, of rituximab (including biosimilar variants) for the treatment of myasthenia gravis in adults; and outcomes and adverse effects between different patient subgroups, and treatment strategies, in order to aid treatment choice for individuals, and to inform policymakers about those most likely to benefit. This is a protocol....

Is the McKenzie method effective for the treatment of (sub)acute non-specific low back pain? Key messages The McKenzie method may result in little to no benefit in pain and disability in people with (sub)acute non-specific low back pain in the short term (closest to two weeks) and in the intermediate term (closest to three months). The McKenzie method is not an effective treatment for (sub)acute non-specific low back pain. We do not know whether the McKenzie method leads to any side effects as none of the trials included in this review measured any side effects. What is (sub)acute...

Silymarin for treatment of adults with nonalcoholic fatty liver disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of silymarin in adults with nonalcoholic fatty liver disease (NAFLD). This is a protocol....

Opioids for managing pain in babies exposed to painful procedures Key messages • Due to a lack of strong evidence, the benefits and risks of opioids for managing pain in babies exposed to painful procedures are unclear. • Compared to placebo (a 'dummy' treatment, or sham treatment, that does not contain any medicine but looks identical to the medicine being tested), opioids may reduce pain assessed with certain scales during the procedure, but may not make a difference with other scales one to two hours after the procedure. • The evidence is very uncertain about the effect of opioids on:...

Painkillers other than opioids to treat pain in babies undergoing painful procedures Key messages • We did not find enough evidence on painkillers that are not opioids to manage pain in babies undergoing painful procedures. We found only two small studies that compared a painkiller (ketamine) with either another painkiller (an opioid) or sweet solution to manage different procedures. • Larger studies on a variety of painkillers are needed to provide a better understanding of the benefits and harms of the different painkillers and the best way to give them. What did we want to find out?...

Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews Key messages For acute low back pain • NSAIDs and muscle relaxants may provide small benefits on pain, however muscle relaxants may be associated with unwanted effects. Paracetamol had no effect on pain or unwanted effects. For chronic low back pain • Opioids may reduce pain but may be associated with unwanted effects. NSAIDs may reduce pain without unwanted effects and antidepressants may make little or no difference on pain. • Physicians should discuss the possibility for a small effect on pain and...

Pressure sources for nasal continuous positive airway pressure (CPAP) in preterm infants Key messages Bubble continuous positive airway pressure (CPAP) may reduce the risk of CPAP treatment failure when compared with CPAP delivered by mechanical ventilators or Infant Flow Driver. Bubble CPAP probably has little or no impact on the risk of death or other complications associated with premature birth but likely increases the risk of moderate-severe nasal injury. What is CPAP? CPAP is a form of breathing support that can be used to support breathing in a preterm (premature) baby with lung...

Experiences and perceptions of cash transfers for health What is the aim of this synthesis? The aim of this Cochrane qualitative evidence synthesis was to explore how people receiving health-related conditional or unconditional cash transfers experienced them. We analysed 41 qualitative studies to answer this question. Key messages People appreciate cash transfers and see them as necessary for their basic needs. However, cash transfers can influence people’s relationships in positive and negative ways. Not all people want to receive cash and some recipients do not perceive that cash alone...

Disease-modifying pharmacological treatments for amyotrophic lateral sclerosis/motor neuron disease: an overview of intervention reviews This is a protocol for a Cochrane Review (overview). The objectives are as follows: To summarise the evidence from Cochrane and non-Cochrane systematic reviews of pharmacological disease-modifying treatments for amyotrophic lateral sclerosis/motor neuron disease. This is a protocol....

Interventions for orthostatic hypotension in Parkinson's disease: a systematic review and network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness and safety of interventions for orthostatic hypotension in Parkinson's disease. To obtain an estimate of the relative ranking of interventions for orthostatic hypotension in Parkinson's disease by a network meta-analysis. This is a protocol....

Psychological interventions to help people with cystic fibrosis take their inhaled treatments Key messages Psychological interventions are designed to help people modify their thoughts, feelings and behaviours. We think that psychological interventions are probably better than usual care at helping people with CF to take their inhaled treatments, and may cause little or no harm (e.g. anxiety or depression) when measured six to 12 months after treatment. We are uncertain whether motivational interviewing (MI) was better or worse than education plus problem-solving (EPS) at helping people with...

Incremental versus standard dialysis for people with kidney failure This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the benefits and harms of incremental versus full-dose dialysis in patients with kidney failure at commencement of KRT. This is a protocol....

Lovastatin for lowering lipids This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To evaluate the benefits and harms of different doses of lovastatin on lipid parameters and withdrawals due to adverse effects (WDAEs) in people of any age compared to placebo. This is a protocol....

Interventions for improving walking after stroke: an overview of Cochrane Reviews This is a protocol for a Cochrane Review (overview). The objectives are as follows: To summarise and appraise the evidence from Cochrane Reviews assessing the effects of interventions for the recovery and/or the improvement of walking in people after stroke. We will conduct an overview of Cochrane Reviews involving stakeholders to: provide accessible high-quality evidence on the effects of interventions aiming to recover and/or improve walking in people after stroke; summarise the evidence of the effects of...

Is skin-sparing mastectomy an effective and safe surgical procedure for the treatment of breast cancer? What is the aim of this review? We reviewed the evidence about the surgery technique called skin-sparing mastectomy (SSM) (that is, removing the breast tissue including the breast and areola (skin surrounding the nipple) but preserving all the skin that overlies the breast) compared to conventional mastectomy (that is, removing the skin that overlies the breast including nipple and areola). Key messages We found that SSM may not be different from conventional mastectomy for the risk of...

Surgical interventions for presbyopia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The primary objective is to evaluate the effectiveness and safety of surgical interventions for people with presbyopia. The secondary objective is to produce a brief economic commentary, summarizing relevant economic evaluations that compare different surgical interventions. This is a protocol....