Is ultrasound guidance a good option for peripheral intravenous cannulation in adults? What is peripheral intravenous cannulation? Placing a peripheral intravenous line is one of the most essential procedures in medicine. It involves putting a thin, flexible tube (known as a catheter or cannula) into a vein using a needle. This process is known as 'cannulation'. It is necessary when administering fluids, drugs, and drawing blood samples. Peripheral intravenous cannulation is usually carried out by seeing and touching a target vein in the hand or arm. This is known as the landmark method....

Surgery for spontaneous supratentorial intracerebral haemorrhage This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of surgery plus standard medical management, compared to standard medical management alone, in people with spontaneous supratentorial ICH, and to assess whether the effect of surgery differs according to the surgical technique. This is a protocol....

Umbilical cord management strategies for improving outcomes in preterm infants: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the efficacy and safety of different umbilical cord management strategies in preterm infants (before 37 weeks’ gestation), and to provide rankings of the available methods according to their effectiveness and safety profile using a network meta-analysis. This is a protocol....

Interventions for unresectable intrahepatic cholangiocarcinoma: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To establish the existence of differences in effectiveness and safety of intra-arterial therapies (IATs) such as bland embolisation, conventional transarterial chemoembolisation (cTACE), drug-eluting bead transarterial chemoembolisation (DEBTACE), yttrium-90 (Y90), hepatic artery infusion (HAI), external beam radiotherapies (EBRTs), and immunotherapy versus systemic chemotherapy for unresectable intrahepatic...

Addition of a stomach wrap (fundoplication) around the food pipe (oesophagus) in keyhole (laparoscopic) surgery to treat achalasia Review questions 1) Does the addition of a stomach wrap around the food pipe (oesophagus) reduce the backflow of food and acid from the stomach to the food pipe (regurgitation) when used with keyhole surgery to treat achalasia? 2) Which type of stomach wrap (partial or total) around the food pipe is better at controlling regurgitation without causing difficulty in swallowing (dysphagia) when used with keyhole surgery to treat achalasia? Background Achalasia is a...

Anticholinergic deprescribing interventions for reducing risk of cognitive decline or dementia in older adults with and without prior cognitive impairment This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the efficacy and safety of anticholinergic medication reduction interventions to improve cognitive outcomes in both cognitively healthy older adults and older adults with pre-existing cognitive issues. Secondary objectives To compare the effectiveness of different types of reduction interventions (e.g. pharmacist-led versus...

In preterm infants, how accurate are the blood tests BNP and NT-proBNP in identifying PDAs (patent ductus arteriosus) that require further treatment? A number of preterm infants have a heart condition called patent ductus arteriosus (PDA). A PDA is a blood vessel that usually closes spontaneously in term and most preterm infants, but in some the PDA tends to remain open longer. Preterm infants who have an open PDA often remain stable; but in some, the large blood flow through the PDA can cause breathing and blood pressure problems and may need treatment. Usually, a large PDA is identified by...

Use of nerve repair devices in the arm, forearm, and hand What is nerve injury and how is it repaired? Injuries to the nerves of the arm, forearm, and hand are common and have a lasting effect on a person's ability to move and their sensation. Usually surgeons stitch injured nerves together (we call this standard repair). Sometimes they also use a nerve graft, which means taking a nerve from another area of the body to bridge a gap between the ends of a damaged nerve. Standard methods of repair are not always successful and even when successful, the healing process can be incomplete and...

What are the benefits and risks of vaccines for preventing COVID-19? Key messages – Most vaccines reduce, or probably reduce, the number of people who get COVID-19 disease and severe COVID-19 disease. – Many vaccines likely increase number of people experiencing events such as fever or headache compared to placebo (sham vaccine that contains no medicine but looks identical to the vaccine being tested). This is expected because these events are mainly due to the body's response to the vaccine; they are usually mild and short-term. – Many vaccines have little or no difference in the incidence...

Topical antibiotics for treating bacterial keratitis: a network meta-analysis This is a protocol for a Cochrane Review (prototype). The objectives are as follows: To compare the effectiveness and safety of topical antibiotics for treating BK and to rank different interventions through a systematic review and NMA. This is a protocol....

Carnitine supplements for people with chronic kidney disease requiring dialysis What is the issue? Carnitine deficiency is an important problem in chronic kidney disease (CKD) patients requiring dialysis. Dialysis-related carnitine deficiency can exacerbate intradialytic symptoms (e.g. muscle symptoms including muscle cramps and weakness, and hypotension) and chronic complications of kidney failure (e.g. anaemia). However, it is unknown whether carnitine supplementation can improve the symptoms of dialysis-related carnitine deficiency. What did we do? We searched the medical literature for...

What is triple inhaled therapy, when is it used, and what does it do in asthma? How are inhalers used for the management of asthma? Management of asthma involves a series of stepwise therapies depending on the severity of the disease. Initial therapy typically starts with as needed short-acting inhaler therapy (step 1), and a daily low- to medium-dose inhaled steroids is added for better asthma control when needed (step 2). Subsequently, a bronchodilator known as long-acting beta2-agonist (LABA), which causes the passages of the airways to expand and relax so that breathing difficulty is...

Health literacy interventions in people with chronic kidney disease What is the issue? The long-term management of chronic kidney disease (CKD) requires people with the disease to be involved in their own care because it is a complex chronic disease. Many people who have CKD may not understand how to use health information to best support their decisions about treatment and management. This ability or skill is referred to as health literacy. Improving the health literacy of people with CKD may improve their health outcomes and help them to manage their disease and avoid complications. What...

Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin for preventing colorectal adenomas and cancers in the general population This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, or both, for preventing colorectal adenomas and cancers in the general population. This is a protocol....

Interventions for treatment of herpes labialis (cold sores on the lips) This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of interventions for treating herpes labialis among immunocompetent people. This is a protocol....

Face-down positioning or posturing after vitrectomy for macula-involving rhegmatogenous retinal detachments This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The primary objective of this review is to determine whether face-down positioning reduces the risk of retinal displacement following pars plana vitrectomy (PPV) and gas tamponade for macula-involving rhegmatogenous retinal detachment (RRD). This is a protocol....

Physical activity for the management of cancer-related fatigue in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the effects of physical activity interventions for cancer-related fatigue (CRF) in adults. Secondary objective To assess whether the effects of CRF interventions differ according to: type of comparator: no intervention, usual care, or another CRF intervention: phase or type of cancer treatments: when receiving disease-modifying oncological treatment with curative intent; after receiving disease-modifying...

Vaginal cervical support device to prevent delivery of a single baby before 37 weeks What is preterm birth? Preterm birth means birth before 37 weeks of pregnancy. It is the leading cause of death in newborn babies. Often, preterm birth is caused by weakness of the cervix (the lower, narrow end of the womb). How can cervical weakness be treated to prevent preterm birth? Methods used to treat cervical weakness include cervical cerclage (tightening the cervix with a stitch to prevent its premature opening), expectant management (monitoring without intervention until problems arise), medical...

Surgery for long-term joint disease in people with haemophilia How does surgery compare to non-surgical treatment in terms of safety and efficacy for people with chronic (long-term) joint disease from a rare condition that affects the ability of the blood to form clots (haemophilia)? Key messages We did not find any relevant studies. More research is needed in this field. Future studies should compare surgical and non-surgical treatments for chronic arthropathy in people with haemophilia. Background Haemophilia is a disease that affects the ability of blood to clot. People with severe...

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...