Surgery and minimally invasive treatments for uterine fibroids This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of surgery and minimally invasive treatments for uterine fibroids. This is a protocol....

Gene therapy for people with hepatocellular carcinoma What are the benefits and risks of gene therapy (treatment) (replacing abnormal or defective genes with normal genes) for treating people with resectable (operable) or unresectable (unable to be removed surgically/inoperable) hepatocellular carcinoma? Key messages — We found six small trials. Overall, there were problems with trial design, low numbers of trials and participants, and variability in results. The trials included 364 people with unresectable hepatocellular carcinoma (primary liver cancer). We found no trials with people with...

Factors that influence physical activity in bipolar disorder Key messages We found few studies that explored factors that influence participation in physical activity for people with bipolar disorder. The studies we found suggested that regular physical activity can be beneficial for people with bipolar disorder, but there are some obstacles and challenges to as well as effective ways of promoting being active. What was the aim of this synthesis? The aim of this qualitative evidence synthesis was to explore the factors that promote physical activity for people with bipolar disorder. We...

What are the benefits and risks of using metformin in the treatment of chronic kidney disease? Key messages - This study did not find enough evidence to show that metformin had any effect on kidney function. Our findings may have been limited by the fact that most of the studies we looked at were conducted in two specific patient populations (those with cystic kidney disease or diabetes) and often did not fully report effects on kidney function. - Further evidence in the form of large, well-designed randomised trials is needed to more robustly assess whether metformin can be a long-term...

Do imitations of anti-VEGF medicines (biosimilars) work as well as the original anti-VEGF medicines for people with neovascular age-related macular degeneration (nAMD)? Key messages Imitations (biosimilars) of anti-vascular endothelial growth factors (anti-VEGFs) work as well as the original anti-VEGF medicines when used to treat neovascular age-related macular degeneration (nAMD) for up to a year. Anti-VEGF biosimilars cause similar unwanted effects to the original anti-VEGF medicines for up to a year. Future research should take place over more than one year to understand the desired and...

Aerobic exercise therapy for chronic low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of aerobic exercise on pain, function, quality of life, psychological functioning, and adverse events, compared with placebo, sham treatment, attention control, or no treatment. This is a protocol....

Electrical shocks (electrical cardioversion) and drugs (pharmacological cardioversion) for restoring normal rhythm in patients with atrial fibrillation or atrial flutter Key Messages - Electrical cardioversion and some drugs can be used to restore the normal rhythm in patients with atrial fibrillation (AF) and atrial flutter. While electrical cardioversion is highly effective in dealing with all arrhythmias, the efficacy of drugs varies, with some being only moderately effective or not working at all in persistent AF and atrial flutter. - Electrical cardioversion seems to be a very safe...

What do we know about the impact of comprehensive care programmes for children with medical complexity? What is the aim of this review? The aim of this Cochrane review was to find out if comprehensive care programmes that provide care coordination and other services for children with medical complexity improve outcomes for this group of children and their families, and whether they have an impact on the use and cost of healthcare services. Key messages The research relating to comprehensive care programmes for children with medical complexity is limited, and the findings should be treated...

Does non-invasive brain stimulation or language training help people with primary progressive aphasia? Key messages • We do not know if non-invasive brain stimulation or various types of language training, or both of these treatments combined, help people with primary progressive aphasia as the evidence available is limited and generally of poor quality. • No severe side effects were reported in brain stimulation studies. What is primary progressive aphasia? Primary progressive aphasia (PPA) is a rare condition that slowly damages the parts of the brain that control speech and language....

Parenteral medication for the management of acute severe behavioural disturbance (ASBD) in the emergency department This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety profiles of different parenteral medications for the management of acute severe behavioural disturbance in the emergency department setting. These medications are required following the failure of less restrictive means of controlling the patient’s behavioural disturbance. This is a protocol....

What are the different ways eye tests are carried out and spectacles provided in the community and in health clinics worldwide? Key messages 1. Outreach (a community-based approach to provide eye care in various settings, which are often not permanent locations), and school-based service delivery approaches were mainly used to provide eye care in the community, while vision centres were mainly used in primary care (first-line health care). 2. In the World Health Organization (WHO) South-East Asia region, eye care was most often delivered using outreach and vision centres, whereas in the...

Manual therapy and exercise for treating lateral elbow pain Key messages Compared with placebo (sham) manual therapy, manual therapy may reduce pain and disability at the end of treatment. Longer-term effects are unknown. Compared with minimal or no treatment, manual therapy, prescribed exercises or both may slightly reduce pain and disability, and result in little to no improvement in quality of life and treatment success. We are uncertain if more people have adverse effects from the treatments. What is lateral elbow pain? Lateral elbow pain, known as 'tennis elbow', may arise spontaneously...

Transcutaneous bilirubin screening for jaundice in newborns Key messages – Jaundice is a common newborn condition. If left undetected and untreated, it can lead to brain injury. – Screening newborn babies by measuring jaundice levels through the skin (called transcutaneous bilirubin screening) may lead to a reduction in readmission for light therapy. It does lead to more babies having light therapy before discharge from the hospital and has little or no effect on the number of babies who require an exchange blood transfusion to treat their jaundice. It has little or no effect on the number...

Low-carbohydrate diet for people with type 2 diabetes mellitus This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of a low-carbohydrate diet in adults with type 2 diabetes mellitus. This is a protocol....

Do dressings and securement devices prevent complications for people with peripheral arterial catheters? Key messages – We are very uncertain whether different dressings and securement devices reduce the risk of peripheral arterial catheter complications or failure. – We found five studies that investigated this, but we are not very confident in their results due to small sample sizes and few outcome events. – Future research should compare products currently used to secure and dress arterial catheters in hospitals, with high-quality methods and large numbers of people receiving catheters. –...

Interventions for preventing dialysis dysequilibrium in dialysis patients Key messages - In haemodialysis patients, sodium modelling compared to slow dialysis may result in little to no difference in dialysis disequilibrium syndrome and death. The evidence is very uncertain about the effect of these interventions on adverse events. - The evidence is very uncertain about the effect of high-sodium dialysate and standard sodium dialysate on dialysis disequilibrium syndrome, death and adverse events. What did we want to find out? Haemodialysis is a medical treatment that helps remove waste and...

Do antioxidant supplements help people with sickle cell disease (unusually shaped red blood cells)? Key messages • Compared to a dummy pill (placebo), zinc and N-acetylcysteine (NAC; 1200 mg) may not reduce the frequency of painful episodes (crises) that people with sickle cell disease (SCD) experience. • Zinc may improve haemoglobin status (number of red blood cells) slightly, but L-arginine may not. L-arginine also probably reduces the severity of pain, but may not reduce the frequency of hospitalization. • Larger studies to assess the effects of vitamin C plus vitamin E, zinc, NAC,...

Is the use of continuous infusion of loop diuretics better than bolus injections for acute heart failure? Key messages – The use of continuous infusion over bolus injection of loop diuretics may result in little to no difference in all the outcomes we measured. – The use of continuous infusion over bolus injection of loop diuretics may result in little to no difference in harmful side effects. – Our research suggests there may be little to no difference between how loop diuretics are delivered. Future studies should focus less on how they are given and more on how they work for patients...

Interventions for quitting vaping This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To conduct a living systematic review to assess the benefits and harms of interventions to help people quit vaping compared to each other or to placebo or no intervention. We will also assess how these interventions affect the use of combustible tobacco, and whether effects vary based on participant characteristics. This is a protocol....

Do psychological and social interventions promote improved mental health in people living in low- and middle-income countries affected by humanitarian crises? Key message – We did not find enough evidence in favour of interventions for promoting positive aspects of mental health in humanitarian settings. Larger, well-conducted randomised studies are needed. Mental health during a humanitarian crisis A humanitarian crisis is an event, or series of events, that threatens the health, safety, security, and well-being of a community or large group of people, usually over a wide area. Examples...