Local steroid injection for carpal tunnel syndrome Key messages Corticosteroid injection into the wrist probably improves symptoms of carpal tunnel syndrome (compression of a nerve in the wrist) and function of the hand for up to six months. Quality of life assessments, and tests of nerve conduction measured up to three months after injection, may also improve. Corticosteroid injection may reduce the need for surgery, assessed at one-year follow-up. Side effects appear to be rare. However, spontaneous improvement without treatment can occur in up to a third of people. What is carpal tunnel...

Liver and spleen stiffness for the diagnosis of oesophageal varices in adults with chronic liver disease This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of liver stiffness and spleen stiffness, separately or in combination, as measured by vibration-controlled transient elastography (VCTE) in detection of any oesophageal varices in adults with chronic liver disease. We will regard a combination of tests as positive when at least one is positive. To compare the diagnostic accuracy of individual tests (liver stiffness and...

Immunosuppressive and immunomodulatory therapies for idiopathic inflammatory myopathies This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This protocol is for two separate reviews to assess the effects (benefits and harms) of immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies. Targeted treatments To assess the effects (benefits and harms) of targeted immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies: dermatomyositis (DM, including juvenile dermatomyositis, jDM), immune...

Endovascular treatment for thromboangiitis obliterans (Buerger’s disease) This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of endovascular treatment for thromboangiitis obliterans (Buerger’s disease). This is a protocol....

Calcium and vitamin D for improving bone health in healthy premenopausal women Key messages The evidence suggests that calcium, vitamin D, or calcium plus vitamin D supplementation has no effect on bone mineral density at any site (hip or spine) in healthy premenopausal women. What is osteoporosis? Osteoporosis is characterised by low levels of calcium and other types of minerals in the bones (called bone mineral density). This causes holes to form inside the bones and the outer walls of the bone to become thin making the bones more fragile, which may lead to increased fractures and breaks....

Therapeutic donor hypothermia following brain death to improve the quality of transplanted organs This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to examine the benefits and harms of therapeutic donor hypothermia in recipients or organs donated after brain death. This is a protocol....

Are concentrated antibodies from people who have recovered from COVID-19 or animals an effective treatment for people with COVID-19? Key messages • We do not know whether hyperimmune immunoglobulin (a preparation made with antibodies from people who have recovered from COVID-19) reduces deaths or serious unwanted effects in people with moderate to severe COVID-19. But a similar preparation made by injecting animals with certain antibodies may reduce deaths, and serious unwanted effects and may stop people’s condition getting worse. • We found no studies that investigated people with COVID-19...

Interventions to improve sanitation for preventing diarrhoea What is the aim of this review? The aim of this Cochrane Review was to assess if diarrhoea is reduced by sanitation interventions to provide, upgrade, or encourage people to use toilets or latrines. We collected and analysed all relevant studies of certain prespecified rigorous study design types and found 51 studies involving 238,535 people. Key messages We found evidence that sanitation interventions may be protective against diarrhoea. However, the effects varied by the type of intervention and setting, and the certainty of the...

Immunoglobulin treatment for Kawasaki disease Key message In children with Kawasaki disease, high-dose intravenous immunoglobulin (IVIG) regimens: • probably reduce the risk of coronary artery abnormalities formation compared to aspirin or medium- or low-dose IVIG regimens; • show no clear safety concerns; • probably reduce the duration of fever, but there was little or no difference detected in the need for additional treatment compared to aspirin; • may reduce the duration of fever and need for additional treatment compared to medium- or low-dose IVIG. Why is this question important?...

Prognostic models for colorectal cancer incidence and mortality in patients with inflammatory bowel disease This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objectives The primary objectives are to identify, describe, and appraise all prognostic models developed to predict colorectal cancer incidence or mortality in patients with IBD, at any time point after the clinical diagnosis of IBD, and if possible meta-analyse their predictive performances. Investigation of sources of heterogeneity between studies Sources of heterogeneity to be investigated...

What are the benefits and risks of using corticosteroid medicines in the treatment of fatigue related to advanced cancer? Key messages We did not find any good-quality evidence about the benefits and risks of corticosteroids in treating adults with advanced cancer and cancer-related fatigue (CRF). Future larger, well-designed studies are needed to determine if corticosteroids are of benefit or harmful in treating CRF. Why is this review important? Fatigue is a very common and troublesome symptom in people with advanced cancer, which greatly impacts their quality of life. Corticosteroid...

Predicting a second seizure after a single unprovoked seizure Why was this review performed? A single unprovoked seizure is fairly common, with estimates that up to 3% to 4% of the population will have one by age 85. This translates to approximately one in 25 people having an epileptic seizure during their lifetime. It is therefore of the utmost importance that accurate prognostic data are available so that clinicians can reliably counsel people on the risk of further seizures, and factors that predict the recurrence of seizures and therefore the development of epilepsy. What is the aim of...

Long-term prognosis of childhood language disorders and difficulties This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objectives Population Children between four and eight years of age, diagnosed with a language disorder, or determined to have low language proficiency before age eight. Intervention Not applicable, this is a review of observational studies and will not include active interventions. Comparator The comparison group will be peers or siblings with typically developing language skills, that is, no identified language disorder or low...

Positioning for lumbar puncture in newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the success rate of the lateral decubitus, sitting and prone positions for lumbar puncture in newborn infants. This is a protocol....

What are the benefits and risks of neoadjuvant treatment (drug treatment prior to surgery to remove a tumour) for melanoma, a type of skin cancer? What did we want to find out? Cutaneous melanoma is a very aggressive form of skin cancer. It is generally fatal if detected at an advanced stage. Earlier treatment may allow for surgical removal of the tumour and an improved chance of long-term survival. Neoadjuvant treatment is drug treatment administered before surgery, to reduce the tumour size so that it is easier to remove, to reduce complications of surgery, and to reduce the risk of spread...

How effective and safe are systemic opioids for postoperative pain control and management in neonates? Review Question How effective and safe are systemic opioids for reducing newborn babies' pain after surgery? Background Neonates (babies in the first four weeks after birth) may undergo surgery (operations) or surgical procedures. Like adults, babies experience pain, and this pain must be managed (reduced) after surgery. Opioids are pain-relieving medications. Examples of opioids are codeine and morphine. Opioids work by interacting with opioid receptors in the body and reducing feelings of...

Medicines to increase foetal haemoglobin levels and reduce the need for blood transfusion in people with non-transfusion-dependent thalassaemia Review question Do medicines that increase foetal haemoglobin (HbF) levels in people with non-transfusion-dependent β-thalassaemia (NTDβT) reduce their need for blood transfusion? What is thalassaemia? Thalassaemia is a genetic (inherited) blood disorder that causes defects in adult haemoglobin (the oxygen carrying component of red blood cells) leading to destruction of the red blood cells and anaemia with different degrees of severity. Persistent...

Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) for detecting pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Secondary objectives To compare the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) with that of Xpert MTB/RIF Ultra for the detection of pulmonary tuberculosis and rifampicin resistance in adults with...

Placebo versus no treatment for people with schizophrenia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the effects of placebo versus no treatment in people with schizophrenia. This is a protocol....

Stimulating the baby's scalp as a test of the baby's well-being in labour We set out to look for evidence from randomised controlled trials on the effectiveness and safety of stimulating the baby's scalp as a second-line test of well-being when there are concerns about the baby's heart rate monitoring. What is the issue? Women with complicated pregnancies are recommended continuous monitoring of the baby's heart rate using an electronic recorder called a CTG. Babies commonly demonstrate abnormal features on the CTG during labour. In some cases the abnormal features are of...