Medicines to reduce pain and discomfort during spinal tap in newborns Key messages • Spinal tap is a painful procedure, but the best management for pain and discomfort in newborns in unclear. • We identified studies using creams containing painkillers, applied directly on the skin where spinal tap is performed. • These creams may reduce pain during spinal tap, but it is unclear whether they have an effect on the number of successful spinal taps on the first try, the number of attempts per successful spinal tap, episodes of bradycardia (slowing of the heartbeat), episodes of desaturation...

Hormonal contraception for women at risk of HIV infection. This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of hormonal contraception on HIV acquisition in women who live in settings with high HIV prevalence. This is a protocol....

Prebiotics for people with cystic fibrosis Key messages Growth and nutritional status can impact lung function and overall survival in people with cystic fibrosis (CF), and prebiotics, a source of food for healthy bacteria in the gut, might be of benefit. We did not find any trials that looked at how prebiotics affect people with CF, and such trials are needed. How can prebiotics be used to treat people with CF? We know that growth and nutritional status are important in CF as they affect lung function and overall survival. People with CF have an imbalance of bacteria and also inflammation...

Autoinflation for otitis media with effusion (OME or 'glue ear') in children Key messages Due to a lack of robust evidence, we are uncertain whether autoinflation has any effect on hearing. Using autoinflation two to three times per day may slightly reduce the number of children with OME after three months follow-up. Scores on a questionnaire that looked at quality of life for people with OME were also better for children who carried out autoinflation. However, some children may experience pain when using autoinflation. What is OME? Otitis media with effusion (OME, sometimes called...

Intraperitoneal chemotherapy for primary gastric cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of intraperitoneal chemotherapy (IPC) in people with primary gastric cancer, with or without peritoneal metastasis. This is a protocol....

What are the benefits and harms of silicon hydrogel versus hydrogel soft contact lenses for eye discomfort? Key messages 1) Silicone hydrogel and hydrogel soft contact lens (SCL) wearers may experience similar eye comfort, but we are very uncertain about the results. 2) In the long term, the risk of experiencing an adverse eye event may be more likely with extended wear silicone hydrogel SCLs than hydrogel SCLs. As above, the small number of studies and limitations in the evidence mean we are very uncertain about the results. What are silicone hydrogel and hydrogel soft contact lenses?...

Pravastatin for lowering lipids Key messages • Pravastatin decreases low-density lipoprotein cholesterol and the effect is dependent on the dose over the range of 5 mg to 160 mg. • Pravastatin at 80 mg/day is the maximal licensed dose. • From other systematic reviews we conducted, pravastatin has a similar effect on cholesterol to fluvastatin and has a lesser effect on cholesterol than the other statins. What are cholesterol and blood fats? Cholesterol is required to build and maintain all animal cell membranes and is critical to human life. Main components of cholesterol are low-density...

Self-management interventions for quality of life in adults with visual impairment This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The objective of this review is to assess the impact of self-management interventions on quality of life in adults with visual impairment compared with inactive or active (usual care) control interventions. This is a protocol....

Sucrose analgesia for venepuncture in neonates This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of orally administered sucrose for pain relief from venepuncture in preterm and term neonates compared to no intervention, standard care, and other types of analgesic interventions. This is a protocol....

Group-based self-management education 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 group-based self-management education for adults diagnosed with T2DM on clinical, lifestyle, and psychosocial outcomes in the short (six months to 10 months), medium (> 10 months up to 18 months), and long (> 18 months) term. To explore the intervention characteristics and processes that are aligned with effective group-based self-management education for people with T2DM. This is a protocol....

Can 'perfusion' machines improve the quality of livers donated for transplantation? Key messages – Cold machine perfusion improves liver transplantation when compared with the standard ice-box technique. – Warm machine perfusion does not seem to have these benefits, but might allow the transplant of donated livers that would otherwise not be used. What is the issue? Liver transplantation is the only chance of cure for thousands of people with liver failure or advanced liver cancers. Both of these conditions are becoming more common worldwide. This has caused an imbalance between...

How effective are medications and e-cigarettes for quitting smoking, and what works best? Key messages Some medicines and e-cigarettes (handheld devices that work by heating liquid that usually contains nicotine and flavourings) can help people to quit smoking for six months or longer. E-cigarettes, and the medicines cytisine (otherwise known as Tabex) and varenicline (otherwise known as Chantix and Champix), appear to help the most people to quit smoking, followed by using two types of nicotine replacement therapy at once (nicotine patch and another type, such as gum or lozenge). We need...

Lymphadenectomy or sentinel node biopsy for the management of endometrial cancer: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness and safety of lymphadenectomy and sentinel node biopsy for the management of women with endometrial cancer, comparing different head-to-head comparisons in a network meta-analysis, thereby allowing ranking of alternative treatment strategies. This is a protocol....

Early intervention for high risk smoldering multiple myeloma (SMM) This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of different early interventions for people with high-risk smoldering multiple myeloma compared to placebo/observation alone. This is a protocol....

Changing shift worker's schedules to improve sleep quality and duration and reduce sleepiness Key messages • There is limited evidence that changes in shift schedules improve sleep quality, increase sleep duration, or reduce sleepiness. • More studies are needed to draw stronger conclusions about shift schedule changes on sleep and sleepiness. What can be done to improve shift workers' sleep? Shift work often leads to insufficient sleep that can compromise worker alertness, with ultimate effects on health and work safety. Changing shift work schedules is one method that may reduce the...

Tenofovir versus entecavir for children and adults with chronic hepatitis B This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of tenofovir versus entecavir in children and adults with chronic hepatitis B. This is a protocol....

Tenofovir for children and adults with chronic hepatitis B This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of tenofovir versus no intervention or placebo for children and adults with chronic hepatitis B. This is a protocol....

How can we best filter systematic reviews in MEDLINE and Embase? Key Messages A wide range of search filters to retrieve systematic reviews were evaluated. Although many had acceptable sensitivity (missed few relevant studies) and specificity (omitted irrelevant studies), no single filter can be recommended since most were derived from older sets of reviews that may not reflect current reporting characteristics and standards. What are search filters for systematic reviews? Search filters combine words and phrases to retrieve records with a common feature (e.g. study design, clinical topic)...

Which models exist for prediction of future disease outcomes in people with multiple sclerosis? Why is it important to study multiple sclerosis? Multiple sclerosis (MS) is a chronic disease of the brain, spine, and nerves. Millions of people worldwide suffer from this disease, but the disease and how it progresses can be very different from person to person. Although MS cannot be cured, different treatments are available that can help reduce symptoms and slow the worsening of the disease. These treatments work differently, with some having more severe side effects than others. Understanding...

Intermittent fasting for adults with overweight or obesity This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of intermittent fasting for adults with overweight or obesity. This is a protocol....