Accuracy of a first- and second-trimester ultrasound scan for identifying fetal anomalies in low-risk and unselected pregnancies Key messages Prenatal ultrasound is commonly used in the first and second trimesters of pregnancy to identify potential issues with a developing baby (fetus). In this study, we analysed 87 studies covering over 7 million fetuses. While both first- and second-trimester scans confirm normal development well (high specificity), their ability to detect issues (sensitivity) varied. Women with both scans seemed to have more anomalies detected before 24 weeks compared to...

Do calcium supplements help people with overweight or obesity lose weight? Key messages - Calcium supplements may make little to no difference in reducing overall body weight in people with overweight, or obesity, compared to sham calcium supplements (i.e. placebo). - Calcium supplements probably lead to a small reduction in body mass index (BMI) and waist circumference. - More high-quality research is needed to provide clearer insights into the connection between calcium supplements and body weight. What is obesity? Overweight and obesity are defined as excessive fat accumulation that...

Risk assessment for aggressive behaviour in schizophrenia Review question Are structured aggression or violence risk assessment methods effective for people with schizophrenia or schizophrenia-like illnesses for decreasing aggressive incidents in psychiatric settings? Background Aggressive or violent behaviour is often associated with people with schizophrenia in common perceptions of the disease. Although many different interventions have been developed to decrease aggressive or violent occurrences in inpatient care, staff working in inpatient settings seek easy-to-use methods to decrease...

What are the benefits and harms of daratumumab in addition to antimyeloma medicines compared to antimyeloma medicines only for adults with newly diagnosed multiple myeloma who aren't suited for stem cell transplant? Key messages • Research shows that in adults with multiple myeloma, adding a newer medicine called daratumumab to standard antimyeloma treatments probably helps people live longer than treatment with standard antimyeloma treatments alone. • Adding daratumumab probably increases the chance of serious adverse events, but probably not the chance of overall adverse events...

Are sealants better than more traditional methods at stopping bleeding in connections created between blood vessels during vascular surgery? Key messages Using sealants for bleeding anastomoses in vascular surgery may result in faster time to no bleeding and fewer failures in stopping the bleeding, but did not provide better results for other outcomes such as the amount of bleeding during surgery, the length of the operation, death, bleeding after surgery, or having to return to the operating room after surgery because of bleeding. The certainty of our findings was low or very low, because...

Non-invasive high-frequency ventilation (nHFV) in newborn infants with respiratory distress Key messages What is respiratory distress? Respiratory distress is a breathing problem that frequently affects newborn babies. The causes vary depending on the baby's gestation (the length of time that a baby spends in the womb before delivery). The most common cause in babies born before their due date (preterm) is a lack of the lung's natural compound (surfactant) that prevents the air sacs (alveoli) from opening and closing easily. The commonest cause in babies born after 37 weeks gestation (term)...

Does exercise after surgery to restore or improve blood circulation to the legs help people with peripheral arterial disease? Key messages: - People who find walking difficult due to pain caused by a lack of blood flow in the legs can be treated with an operation to improve blood flow. Adding an exercise programme to this treatment may help them walk further distances compared to just having an operation, but we are very uncertain due to poor-quality evidence. - We cannot tell if adding exercise helps improve lower limb blood flow, the distance people can walk without pain, quality of life,...

Personal protective equipment in asbestos demolition workplaces Key messages • Asbestos concentrations inside respiratory protection should be below the occupational exposure limit. • Only air masks with a supply of clean breathing air can reduce workers' exposure to asbestos to below the proposed occupational exposure limit (0.01 fibres/cm3 of air) regardless of the asbestos concentration in the environment. Why is it important to reduce exposure to asbestos? Asbestos is a mineral with good isolation properties and high fire resistance. However, when inhaled, asbestos can cause several...

Does respiratory syncytial virus (RSV) vaccination during pregnancy reduce RSV-related hospitalisations in infants? Key messages • The studies in this review suggest that respiratory syncytial virus (RSV) vaccination during pregnancy reduces RSV-related hospitalisations in infants. • The results suggest that RSV vaccination during pregnancy has little or no effect on the risk of birth defects in infants and probably has little or no effect on the risk of fetal growth restriction. • Future research in this area should focus on the effect of RSV vaccination during pregnancy on the risk of...

Use of dexmedetomidine to reduce pain and induce sleep in newborn babies who need life support ventilation Key messages 1. Dexmedetomidine is a medicine that is used to relieve pain and induce sleep. It is used in newborn babies who need mechanical ventilation (a machine to assist breathing). We found no evidence to support using or not using dexmedetomidine in newborn babies on mechanical ventilation. 2. Well-designed studies are needed to determine the benefits and harms of dexmedetomidine in newborn babies, particularly in very preterm babies, as they are the sickest. What is...

Medicine that kills bacteria (antibiotics) or surgery: which works better to treat appendicitis? Key messages – Medicine that kills bacteria (antibiotics) may result in unsuccessful treatment of symptoms for a few people. – Antibiotics may reduce wound infection but increase time spent at the hospital slightly. – One third of people with appendicitis initially treated with antibiotics underwent surgery for appendicitis within one year. Put another way, two-thirds of people avoided surgery within one year. What is appendicitis? Appendicitis (painful swelling in the finger-shaped pouch that...

Treatments to reduce alcohol use during pregnancy Key messages We found that among pregnant women who report alcohol use during pregnancy, brief psychosocial interventions (BIs) may increase the number of continuously abstinent women when compared to treatment as usual (TAU). There may be no difference between groups in the number of drinks per day, but the evidence is very uncertain. Receiving a BI compared to TAU probably results in little to no difference in the number of women who completed treatment. What are the consequences of alcohol use during pregnancy? Alcohol use during pregnancy...

Can injection of platelet-rich plasma in the womb or ovaries of infertile women undergoing assisted reproduction help them to become pregnant? Key messages • We do not know if platelet-rich plasma (PRP) injection in the womb is better than no treatment or dummy treatment in terms of live birth (or ongoing pregnancy), miscarriage, clinical pregnancy, multiple pregnancy, or ectopic pregnancy. PRP injection in the womb may increase the risk of preterm birth. We have insufficient information about other potential unwanted effects of PRP. • We have insufficient information about the use of PRP...

Prognostic factors for return to work following knee arthroplasty This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: We will examine four prognostic factors for return to work that can be used to manage patient expectations, enhance shared decision-making, and improve timely, multidisciplinary, work-directed care. The research question Which of the following four prognostic factors, categorised according to the International Classification of Functioning, Disability and Health (ICF) framework, are associated with return to work after primary knee...

Botulinum toxins for sleep bruxism This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effectiveness and safety of botulinum toxins as an intervention to reduce the negative consequences of sleep bruxism in adults. This is a protocol....

Pharmacological treatments for adults with overweight and obesity without diabetes This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the comparative efficacy and safety of weight-loss drugs, provided in addition to lifestyle modification, for weight management in adults with overweight or obesity without diabetes. To obtain a ranking of pharmacological interventions for weight loss amongst the various available options through a network meta-analysis. This is a protocol....

Antibiotics for relapses of protracted bacterial bronchitis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of antibiotics for protracted bacterial bronchitis in children who have suffered a relapse. This is a protocol....

Serious adverse events associated with systemic treatments for psoriasis: a network meta-analysis of observational studies and randomized controlled trials This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety of current systemic treatments for moderate-to-severe psoriasis in adults, using a network meta-analysis that includes both randomised and non-randomised trials. This is a protocol....

What are the benefits and risks of treating preterm infants at risk of developing bronchopulmonary dysplasia with corticosteroids? Key messages Treatment with dexamethasone after the first week of life is, at present, the only effective treatment in babies at high risk of bronchopulmonary dysplasia. Giving corticosteroids directly into the windpipe, together with surfactant, might be a promising treatment in the future. Treatment with dexamethasone in the first week of life and treatment with hydrocortisone at any time after birth are ineffective or possibly unsafe. What is bronchopulmonary...

Does releasing Wolbachia-carrying mosquitoes prevent dengue infection? Key messages – People living in areas where Wolbachia-carrying Aedes mosquitoes have been released are less likely to contract dengue than people living in areas with no release. – People living in areas where Wolbachia-carrying Aedes mosquitoes have been released are less likely to be admitted to hospital due to dengue than people living in areas with no release. What is dengue? Dengue is a viral disease transmitted by certain mosquitoes that is found in over 100 countries, with 3.9 billion people at risk of infection....