Blood pressure targets for people undergoing heart surgery Review question What effect does a high blood pressure target compared with a low blood pressure target have in people undergoing heart surgery while on cardiopulmonary bypass (CPB). Key messages A high blood pressure target compared with a lower target may result in little to no difference in kidney injury, cognition (ability to learn and understand) damage, or survival. A high blood pressure target may increase the length of hospital stay slightly. What is heart surgery? Heart surgery is a common type of surgery throughout the...

Coriolus versicolor mushroom in colorectal cancer Review question Does adding Coriolus to colorectal (bowel) cancer treatment reduce side effects and improve survival? Background Radiotherapy and chemotherapy are used to treat colorectal cancer but side effects can be a problem. Coriolus versicolor mushroom (also known as Trametes versicolor or 'Turkey Tail') and its extracts have been used by cancer patients to help with side effects. Search date We searched medical databases for trials comparing Coriolus plus chemotherapy or radiotherapy to chemotherapy or radiotherapy alone in adults...

Food-based calcium or vitamin D or both for osteoporosis in postmenopausal women This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of calcium- or vitamin D-rich foods, or both, for preventing osteoporosis in postmenopausal women. This is a protocol....

Interventions to prevent or cease electronic cigarette use in children and adolescents This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The co-primary objectives of the review are to: 1. Evaluate the effectiveness of interventions to prevent e-cigarette use in children and adolescents (aged 19 years and younger), relative to usual practice or no intervention. 2. Evaluate the effectiveness of interventions to cease e-cigarette use in children and adolescents (aged 19 years and younger), relative to usual practice or no intervention. Secondary objectives...

Exercise training for adult kidney transplant recipients This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims: To assess the benefits and harms of regular physical activity interventions in adult kidney transplant recipients when compared with any other or no intervention. To determine whether benefits and harms vary in absolute or relative terms dependent on specific characteristics of the physical activity intervention (i.e. frequency, intensity, type, time, volume, progression and pattern of the intervention). To determine whether...

Pre-emptive versus empirical antifungal therapy in people with cancer who have febrile neutropenia Intensive chemotherapy for people with cancer can cause severe and prolonged cytopenia (lower-than-normal number of blood cells), especially neutropenia (lower-than-normal white blood cells, which help to fight infection), a critical condition that is potentially life-threatening. When a person has both fever and neutropenia, it is called febrile neutropenia (FN). Invasive fungal disease (IFD; an infection caused by a fungus) is one of the serious causes of chemotherapy-induced FN. There are...

Day 5 versus day 3 embryo biopsy for genetic testing for single gene disorders before embryo implantation Background Couples who have a personal or family history of a single-gene genetic disease, such as cystic fibrosis, can now undergo assisted reproductive technology (ART) to reduce the chance of them having a child with that same genetic disorder. This is known as preimplantation genetic testing for single gene disorders (PGT-M). During PGT-M, cells from a fertilised embryo are removed (biopsied) and analysed for the genetic disorder before those embryos that do not have the disorder are...

Reduction in the dose of antipsychotics for people with schizophrenia Key messages Reducing the dose of antipsychotics may be associated with a higher number of study participants relapsing and leaving the study early. Very little information was available on quality of life, functioning, and side effects. Introduction to the review topic Schizophrenia is a severe disease that needs treatment with medication (antipsychotics). Use of antipsychotics is connected with side effects, and it appears that these side effects may be worse with higher doses. On the other hand, the dose needs to be...

Cephalosporin antibiotics for the treatment of enteric fever (typhoid fever) Key messages • There may be no difference in the performance of ceftriaxone (a type of cephalosporin) compared with azithromycin, fluoroquinolones, or chloramphenicol (other antimicrobial medicines) for adults and children with enteric fever (typhoid fever). • Cefixime (another type of cephalosporin) can also be used for treatment of enteric fever in adults and children but may not be as effective as fluoroquinolones. • Policymakers and clinicians need to consider local antibiotic resistance patterns when...

Interventions for preventing and treating acute kidney injury in children This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to look at the benefits and harms of all pharmacological interventions except dialysis for the prevention and treatment of AKI. This is a protocol....

Liver support systems for adults with acute-on-chronic liver failure This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of liver support systems for adults with acute-on-chronic liver failure. This is a protocol....

Can medicines prevent venous thromboembolism after weight-loss surgery? What is venous thromboembolism? Venous thromboembolism (VTE) is a clinical condition that usually starts when a blood clot forms inside a vein. The condition includes both deep vein thrombosis (when the clot forms in a deep vein, usually in the legs) and pulmonary embolism (when the clot forms in or reaches a blood vessel in the lungs). Both situations can substantially reduce quality of life and can be life-threatening. People with obesity or who undergo surgery are more likely to experience VTE. Therefore, people...

Psychedelic/entactogen-assisted therapy for treatment of anxiety, depression and existential distress in adult palliative care This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of psychedelic/entactogen-assisted therapy compared to placebo or active comparators (e.g. antidepressants) for treatment of anxiety, depression, and existential distress in adult palliative care. This is a protocol....

Transversus abdominis plane (TAP) blocks for prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of TAP blocks for the prevention of postoperative pain in women undergoing laparoscopic and robotic gynaecological surgery compared to no block, sham block, or injection of local anaesthetic. This is a protocol....

Blood pressure lowering effect of hydrochlorothiazide compared to other diuretics for hypertension This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to assess the short-term (3 to 12 weeks) blood pressure lowering efficacy of hydrochlorothiazide in comparison with other diuretics for primary hypertension in adults, and will build upon the other Cochrane Reviews studying the blood pressure lowering effect of diuretics (Chen 2009; Musini 2009; Musini 2014). The main outcomes of this review will be change in blood pressure, heart rate, and...

Prothrombin complex concentrate in the treatment of bleeding that occurs with heart surgery This purpose of this review was to assess the current evidence on whether prothrombin complex concentrates are safe to use to prevent bleeding following heart surgery. We also assessed its ability to reduce death and other serious complications when compared to other therapies. Background Bleeding following complex heart surgery can be challenging to manage. The blood clotting pathway is complex, and when the patient is placed on the heart bypass machine, there is a reduction of certain components...

Is the outcome of severe postoperative eye infection improved by early surgery to remove the vitreous gel? What is exogenous endophthalmitis? The eye is a relatively self-contained organ that is lined by light-sensitive cells that make up the retina. The retina lines the back of the eyeball and the centre is filled with a clear gel, known as the vitreous. Like all organs, the eye can become infected. Infection inside the eye (endophthalmitis) is rare but sight-threatening. Exogenous endophthalmitis is defined as an infection which enters the eye from the surrounding environment, usually...

Interventions to prevent obesity in children under 2 years old This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The overall aim of the review is to determine the effectiveness of interventions to prevent obesity in children under two years old. This includes to assess obesity prevention interventions that are conducted during this age bracket (in children under two years old only) and to measure any impacts of these interventions during this age bracket and at any follow-up periods. The four objectives are: 1. to evaluate the effects of interventions...

Surgical decompression for people with severe brain swelling after stroke Review question What is the effect of surgical decompression on death or disability in people who have developed brain swelling after a stroke? Background Most strokes are caused by blockage of a blood vessel to the brain (ischaemic stroke), which is a major cause of death and disability worldwide. This blockage prevents the oxygen-carrying blood from supplying the brain, and part of the brain being supplied by this vessel begins to die (infarct). Over the following 24 to 48 hours, the damaged brain begins to swell....

Delayed initiation or reduced initial dose of calcineurin-inhibitors for kidney transplant recipients This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to look at the benefits and harms of delayed initiation of CNI or reduced initial CNI dose as initial immunosuppression therapy for KT recipients. This is a protocol....