Do different ways of giving blood or blood products to treat bleeding affect the risk of death or the risk of developing a blood clot in people who are bleeding heavily after a traumatic injury? Key messages - No particular transfusion strategy (method of giving blood products) seems to change the overall chance of a patient dying or getting a blood clot. - We found 18 studies that tested different ways of giving blood transfusions. This variety made it difficult to combine the results and means we do not have clear answers to our questions. What is traumatic injury? A traumatic injury is a...

For those receiving a procedure to open up vessels after an ischaemic stroke, is clot-busting medicine better than no clot-busting medicine? Key messages For people who received a procedure to open up blood vessels after a stroke, adding a clot-busting medicine: did not make a difference, on average, in their ability to perform daily activities on their own with slight or moderate disability, in the number of deaths, or in bleeding inside the brain with or without symptoms. resulted in a higher flow of blood that could be seen going through the previously blocked blood vessels. What is acute...

Is entecavir better than no treatment or placebo for treating people with chronic hepatitis B? Key messages We could not estimate the effects of entecavir (a medicine used to treat infections caused by viruses) on death due to any cause in people with chronic hepatitis B (a common liver disease) as there were no deaths. No studies looked at health-related quality of life (a measure of a person's satisfaction with their life and health). We do not know whether entecavir is better than no treatment or placebo (a pretend treatment) regarding the proportion of people with serious harmful...

Are there risks in providing anti-cancer treatment in people's homes and is it cost-effective? Key messages 1. Compared to receiving intravenous (directly into a vein (IV)) anti-cancer therapy in hospital outpatient clinics, we are uncertain whether receiving the same therapy at home affects the management of unwanted effects, admission to hospital or visits to the emergency department after therapy, and IV line complications. 2. People receiving treatment at home may be more likely to prefer future treatments at home after receiving treatment there, compared to participants' preference...

What steps can be taken to prevent infections after surgeries to fix the aortic or the aortoiliac segment (the largest arteries in the body)? Key messages • Antibiotics seem to reduce surgical site infections in people undergoing aortic or aortoiliac surgery. • Other interventions assessed appear to make little or no difference in reducing the incidence of surgical site infections. • Other outcomes evaluated were minimally or not affected by the interventions studied. What are peripheral arterial disease and aortic aneurysms? Peripheral arterial disease happens when arteries narrow, and...

What are the effects of acupuncture in managing pain in babies undergoing painful procedures? Key messages • Due to a lack of evidence, the benefits and harms of acupuncture for babies undergoing painful procedures are unclear. • Well-designed and thoroughly reported studies are needed to shed light on the benefits and harms of acupuncture, also compared to medicines, or different ways of using acupuncture. Pain in babies and acupuncture Newborns in intensive care units experience many invasive and painful procedures (like blood tests). Newborns who undergo repetitive episodes of untreated...

Psychologische Maßnahmen bei chronisch-entzündlichen Darmerkrankungen Geht es Menschen mit einer chronisch-entzündlichen Darmerkrankung (CED) besser, wenn sie zusätzlich zu ihrer medikamentösen Behandlung eine psychologische Therapie erhalten? Kernaussagen 1. Psychologische Behandlungen haben wahrscheinlich einen leicht positiven Einfluss auf die Lebensqualität sowie auf Symptome von Depressionen und Angstzuständen bei Erwachsenen mit chronisch-entzündlicher Darmerkrankung (CED). 2. Möglicherweise haben sie keine Wirkungen auf die Entzündung und auf körperliche Symptome. Dieses Ergebnis ist...

Quels sont les bénéfices et risques des vaccins pour la prévention des maladies infectieuses chez les adultes atteints de cancer (tumeurs solides) ? Principaux messages Chez les adultes atteints de cancer (tumeurs solides), les vaccins destinés à prévenir le zona réduisent la fréquence du zona mais augmentent les effets indésirables tels que la douleur ou la rougeur au point d'injection. Nous ne sommes pas certains des effets des vaccins antigrippaux sur les décès, quelle qu'en soit la cause, sur les effets indésirables, quelle qu'en soit la gravité, et sur les effets indésirables graves....

Quel est le médicament le plus efficace pour réduire la perte de sang excessive après l'accouchement et qui a le moins d'effets indésirables ? Principaux messages La plupart des médicaments (utérotoniques) destinés à prévenir la perte de sang excessive après l'accouchement (hémorragie du post-partum (HPP)) sont plus efficaces que l'absence de traitement. L'ergométrine associée à l'oxytocine et le misoprostol associé à l'oxytocine sont plus efficaces que l'oxytocine (traitement standard). Tous les utérotoniques, à l'exception de la carbétocine, sont associés à un risque accru...

Blood pressure lowering efficacy of dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonists compared to glucagon-like peptide-1 (GLP-1) receptor agonists This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the blood pressure effects of dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonists with the blood pressure effects of glucagon-like peptide-1 (GLP-1) receptor agonists. This is a protocol....

What are the benefits and risks of vaccines for the prevention of infectious diseases in adults with cancer (solid tumours)? Key messages - In adults with cancer (solid tumours), vaccines to prevent herpes zoster reduce the occurrence of herpes zoster but increase unwanted effects such as pain or redness at the injection site. - We are uncertain about the effects of influenza vaccines on death from any cause, unwanted effects of any severity, and serious unwanted effects. The occurrence of influenza was not measured. - Vaccines to prevent COVID-19 probably reduce the occurrence of COVID-19...

Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors combination therapy for adults with type 2 diabetes mellitus: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To evaluate the relative benefits and harms of therapy with glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose co-transporter-2 inhibitors (SGLT2i), and their combination in adults with type 2 diabetes mellitus. Secondary objectives To determine the relative rankings of GLP-1RA, SGLT2i, and their...

Welche Faktoren beeinflussen die Ansichten und Praktiken von Betreuungspersonen und Jugendlichen in Bezug auf die Impfung von Jugendlichen gegen humane Papillomviren (HPV)? Kernaussagen - Viele komplexe Faktoren können die Ansichten und Handlungen von Betreuungspersonen und Jugendlichen in Bezug auf die Impfung von Jugendlichen gegen humane Papillomviren (HPV) beeinflussen. Wir unterteilten sie in 8 Themen mit Bezug auf individuelles Wissen und Wahrnehmungen, familiäre und soziale Beziehungen und den größeren Kontext, in dem Betreuungspersonen und Jugendliche leben. - Planende im...

Wie kann man Menschen am besten dabei unterstützen, mit dem Konsum von rauch- und dampflosem Tabak aufzuhören? Kernaussagen Beratung, kurze Ratschläge, Vareniclin und eine Nikotinersatztherapie sind möglicherweise wirksame Maßnahmen, um Menschen dabei zu unterstützen, mit dem Konsum von rauch- und dampflosen Tabakprodukten aufzuhören. Es bedarf verstärkter Forschung aus (süd-)ostasiatischen Ländern, in denen diese Tabakprodukte am weitesten verbreitet sind und zugleich die größte Vielfalt dieser Produkte besteht. Was sind rauch- und dampflose Tabakprodukte? Rauch- und dampflose Tabakprodukte...

What are the best ways to help people to stop using smokeless tobacco? Key messages Counselling, brief advice, varenicline and nicotine replacement therapy may all be effective ways to help people quit using smokeless tobacco. We need more research from countries in South and Southeast Asia, where smokeless tobacco is most commonly used and where there are the most different kinds of smokeless tobacco. What is smokeless tobacco? Smokeless tobacco is tobacco that, instead of being smoked in a cigarette or pipe, is used by chewing, sniffing or holding in the mouth. Over 300 million people...

Training to increase parental participation in the care of infants in neonatal units This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of training to increase parental participation in the care of infants in neonatal units, compared to no training or a different type of training. This is a protocol....

What factors influence caregivers’ and adolescents’ views and practices around human papillomavirus (HPV) vaccination for adolescents? Key messages • Many complex factors may influence caregivers’ and adolescents’ views and actions about human papillomavirus (HPV) vaccination for adolescents. We divided them into 8 themes relating to individual knowledge and perceptions, family and social relationships, and the wider contexts in which caregivers and adolescents live. • Healthcare planners and policy-makers could use the themes to help them understand specific contexts in which people are...

Antibiotics to prevent infection after surgery to manage miscarriage Key messages We are uncertain whether routine antibiotics have any effect on the risk of getting a uterine infection (infection in the womb) after surgery to manage a miscarriage, based on the combined results from all six trials. However, based on the results from only the well-done trials (85% of the total number of women in the studies), we are confident that routine antibiotics reduce the risk of getting a uterine infection after surgery to manage a miscarriage. We are uncertain whether routine antibiotics have any...

Échelles d'évaluation de la douleur chez les nouveau-nés Principaux messages Le personnel clinique doit savoir que les échelles d’évaluation disponibles pour la douleur chez les nouveau-nés sont de très faible qualité. Il est nécessaire de développer davantage ces échelles. Que sont les échelles d'évaluation clinique ? Comme les nouveau-nés ne peuvent pas exprimer leur douleur par des mots, le personnel doit à la place évaluer leur douleur en observant leur comportement et leurs signes vitaux. De nombreuses échelles d'évaluation différentes peuvent être utilisées à cette fin, en...

Skalen zur Beurteilung von Schmerzen bei Neugeborenen Kernaussagen Pflege- und ärztliches Personal sollte sich bewusst sein, dass die verfügbaren Skalen zur Schmerzbeurteilung bei Neugeborenen nur eine sehr geringe Aussagekraft besitzen. Es besteht die Notwendigkeit, diese Skalen weiterzuentwickeln. Was sind klinische Bewertungsskalen? Da Neugeborene ihre Schmerzen nicht mit Worten ausdrücken können, muss das Pflege- und ärztliche Personal bei ihnen Schmerzen durch ihr Verhalten und körperliche Anzeichen wie zum Beispiel die Atmung oder den Herzschlag erkennen. Zur Beurteilung des Schmerzes...