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....

Ginkgo biloba herbal supplement for tinnitus What is tinnitus? Tinnitus is a symptom where people have a perception of sound without there being an external source. It is often described as a ringing, hissing, buzzing or whooshing sound. It is common, affecting between 5% and 43% of the general population, and its prevalence increases with age. For some people tinnitus is persistent and troublesome, and it may lead to sleep problems (insomnia), difficulty concentrating, difficulties in communication and social interaction, and anxiety and depression. Management can include education and...

Cannabidiol for people with schizophrenia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of CBD in the treatment of people with schizophrenia. This is a protocol....

What are the benefits and risks of medication for people with borderline personality disorder? Key messages This review is an update of a previous review on the same topic published in 2010. Although this review includes an additional 18 studies, the conclusions remain the same: there are probably no benefits and risks of medications for borderline personality disorder (BDP), but the evidence is unclear. Better and larger studies comparing the effects of medication with placebo are needed. Such studies should focus on men, adolescents and those with additional psychiatric diagnoses. What is...

Statins for Smith-Lemli-Opitz syndrome Review question Is statin therapy, either alone or combined with cholesterol therapy, linked to better outcomes (e.g. survival, quality of life, severity or frequency of neurobehavioral abnormalities, changes in growth parameters or biomarker levels) compared to cholesterol therapy alone for people with Smith-Lemli-Opitz syndrome (SLOS), and what are the risks of harmful effects for either option? Background Smith-Lemli-Opitz syndrome is a genetic malformation syndrome, which occurs when cholesterol is not able to be produced by the body and there is a...

Nasal masks versus nasal prongs for continuous positive airway pressure in preterm infants Key messages Masks rather than nasal prongs may reduce the risk of continuous positive airway pressure (CPAP) treatment failure and nasal injury but may have little or no impact on the risk of death or other complications associated with premature birth. What is continuous positive airway pressure treatment? Nasal CPAP is a form of breathing support that is less invasive than mechanical ventilation (where a breathing tube is placed into a baby's windpipe). Nasal CPAP delivers oxygen to a baby through...

Gastrostomy plus fundoplication or gastro-jejunal tube versus gastrostomy alone for gastro-esophageal reflux in children with neurological impairment This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of the two most common enteral feeding tubes and associated antireflux procedures. We aim to compare: (1) gastrostomy plus fundoplication and (2) gastrostomy plus insertion of a GJ tube, versus gastrostomy alone for children with NI. This is a protocol....