Prehabilitation for people undergoing cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The overarching aim of this review is to determine the benefits and harms of prehabilitation on postoperative outcomes in people undergoing cardiac surgery. The specific objectives are: to identify and describe all prehabilitation interventions that have been administered prior to cardiac surgery (urgent and elective pathways); to compare the effectiveness of the different interventions against no intervention or usual care on postoperative and...

Pharmacological interventions for vasoplegic syndrome after cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of pharmacological interventions targeting vasoplegic syndrome in cardiothoracic surgery patients, compared to placebo or an active pharmacological control intervention. This is a protocol....

Rehabilitation interventions for oropharyngeal dysphagia in people with Parkinson's disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of rehabilitation interventions for oropharyngeal dysphagia in improving swallowing safety and efficiency in people with Parkinson's disease. This is a protocol....

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (which help to prevent blood clot formation) after a heart attack Key messages • Compared with placebo (dummy treatment), rivaroxaban reduces death from any cause (all-cause death) and probably reduces death from diseases of the heart and blood vessels (cardiovascular death) after a heart attack. Dabigatran may reduce all-cause death but may have little or no effect on cardiovascular death. Apixaban is probably no more effective than placebo for reducing all-cause death or cardiovascular death after a heart...

Benefits and harms of giving probiotics to newborns after digestive tract surgery Key message • Probiotics may have little or no effect on the risk of blood infection in infants born from 35 weeks of pregnancy who have undergone surgery of the digestive tract (food pipe, stomach, or bowel). • Probiotics may increase the proportion of 'good' bacteria in the bowel, but we do not know if this has any real benefit for the infant. What are probiotics? Probiotics are live bacteria that may offer health benefits when consumed. There is evidence that probiotics can prevent an inflammatory disease of...

Phosphodiesterase type 5 inhibitor plus endothelin receptor antagonist compared to either alone for group 1 pulmonary arterial hypertension This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of combination therapy involving a PDE5 inhibitor and an ERA in adults and adolescents with group 1 PAH (as defined by WHO) compared to either agent alone. This is a protocol....

Intrahepatic shunts in adults with kidney failure due to liver disease Review question Intrahepatic shunts compared with conventional treatment: which is best for improving the clinical conditions of adults with hepatorenal syndrome? Keys messages – We did not find enough good-quality evidence on the benefits and harms of intrahepatic shunts to improve clinical conditions in adults with hepatorenal syndrome. – Larger randomised clinical trials (trials where people are randomly put into one of two or more treatment groups) with more reliable data are needed to better assess the benefits and...

Medicine-free management of neonates' pain during endotracheal suctioning Key messages — Gently holding the infant in a flexed posture (facilitated tucking, which is the gentle positioning of an infant's arms and legs in a bent, midline position close to the infant's body while the infant is lying on their side, lying on their back with their face upwards (supine), or lying on their tummy with their head to one side (prone)) is probably effective in reducing pain during endotracheal suctioning in ventilated newborn infants What is endotracheal suctioning? An endotracheal tube is a...

Platelet transfusion thresholds for thrombocytopenic infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety and efficacy of more restrictive platelet transfusion thresholds compared to more liberal thresholds in thrombocytopenic neonates. This is a protocol....

Midline or off-midline wound closure techniques: which works better to treat pilonidal sinus disease? Key messages • Closing wounds from one side of the butt crack (off-midline closure) may lead to faster healing, lower chances of the disease returning, fewer infections, less chance of the wound breaking open again, shorter hospital stays, quicker return to work, and less pain compared to closing wounds directly from the middle of the butt crack (conventional midline closure). • We could not find enough good-quality evidence to show that off-midline closure is better than closing wounds from...

What is the best medication to stop bleeding in those having non-emergency hip or knee surgery? Key messages • Tranexamic acid may be an effective medicine to help blood to clot during hip or knee replacement surgery, which reduces bleeding and the need for a blood transfusion (replacing lost blood with donated blood). • A high dose of this medicine and administering it in more than one way (for example, as a tablet and injected into the joint at the end of surgery) appears to work best. • Tranexamic acid is potentially as effective when given as a tablet as when injected into a vein. •...

Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of solid tumors This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy of prophylactic granulopoiesis-stimulating factors compared with placebo or no prophylaxis for improving survival and preventing adverse effects of cancer treatment in people with solid tumors. This is a protocol....

Does testosterone work in men who have problems with erections? Background Testosterone is a crucial male hormone. It is commonly used in men with low testosterone levels who experience erection difficulties. However, it is unclear how effective this treatment is and if it has unwanted harmful effects (adverse effects), especially on heart health. Key messages In the short term, testosterone replacement therapy has a minimal impact on erectile function, sexual quality of life, and cardiovascular mortality, with few side effects. The long-term effects of this therapy on erectile function...

Psychological treatment to help children and adolescents with asthma Key messages 1. The available evidence suggests that psychological interventions could be beneficial for children and adolescents with asthma. 2. Due to the differences between studies, it was very hard to compare the data, so the results of this review are very uncertain and difficult to interpret. Background Children and adolescents with asthma are more likely to experience symptoms of psychological distress (e.g. anxiety, depression, or both) than those without asthma. Psychological treatment might help reduce this...

Is alpha-lipoic acid (a natural antioxidant) better than no treatment or dummy treatment for nerve damage in people with diabetes? Key messages • We found that alpha-lipoic acid treatment compared with placebo (dummy treatment) probably has little or no effect on the symptoms of nerve damage and may have little or no effect on impairment after six months of treatment. • There is probably little or no difference between alpha-lipoic acid and placebo in the occurrence of unwanted effects that cause people to stop using treatment. • We found no studies to help us answer whether alpha-lipoic...

Oral killed cholera vaccines for preventing cholera Key messages Two doses of the whole-cell plus recombinant vaccine (WC-rBS vaccine (Dukoral)), with or without a booster dose, reduces cases of cholera for two years. Two doses of the bivalent whole-cell vaccine (BivWC vaccine (Shanchol)) reduces cases of cholera for five years. A single dose of Shanchol reduces cases of cholera and cases of severe dehydrating cholera for two years. The vaccines are considered safe, with similar side effects reported by all groups. Further studies are required to assess the effectiveness of a single-dose of...

Mindfulness-enhanced parenting programs for improving outcomes for children and their parents Key messages • Mindfulness-enhanced parent training programmes may improve some child and parent outcomes, including child emotional and behavioural adjustment, parenting skills, parental depression or anxiety, parenting stress, and parent mindfulness. • When mindfulness parent training is combined with a skills-based parent training programme, this may decrease parenting stress. • The current body of evidence is limited, with more research needed to be confident in our findings. Children's...

Interventions to encourage use of seat belts Key messages – We found some evidence to suggest education-based (behavioural and health risk appraisal (HRA)) and engineering-based interventions may promote seat belt use in early and late adolescents and adults; however, we are not confident in the current evidence. – More research is needed to better understand the effectiveness of education- and engineering-based interventions on seat belt use. – High-quality research is also needed to investigate the benefit of incentives (alone or combined with other interventions) as well as other types of...

Nutritional interventions for early psychosis: a systematic review and network meta-analysis This is a protocol for a Cochrane Review (prototype). The objectives are as follows: To compare the efficacy of different kinds of nutritional supplements in individuals with early psychosis. This is a protocol....

Pharmacological interventions for bone health in people with epilepsy This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of various pharmacological interventions (for treatment and for prevention) for bone health in people with epilepsy. This is a protocol....