Safety and usefulness of proton pump inhibitors for preterm infants with reflux disease Key Messages - Reflux is common in preterm infants - The current evidence neither supports nor refutes the safety and efficacy (usefulness) of proton pump inhibitors (PPIs) for the treatment of reflux in preterm infants. What is gastroesophageal reflux, and how does it differ from gastroesophageal reflux disease? Gastroesophageal reflux happens when the stomach contents flow back into the esophagus (canal joining throat to stomach). It is common in a newborn. Premature infants are more likely to...

Can a class of antidiabetic medicine help protect the brain after a severe ischemic (caused by a blocked blood vessel) stroke? Key messages 1. There is limited evidence that glyburide (a sulfonylurea, or type of medicine used for type 2 diabetes) may have little to no effect on a person's function 90 days after a stroke, or the number of deaths after 90 days. It may have little to no effect on neurological deterioration within three days, such as consciousness, speech, or weakness, and probably has little to no effect on unwanted side effects, such as heart-related problems, or pneumonia. 2....

What are the benefits and risks of alternative models of delivering care for people with low back pain? Key messages - Compared to usual care, alternative care models probably do not appreciably improve the quality of care for people with low back pain in terms of referrals to or use of any lumbar spine imaging and prescription or use of opioids. - Alternative care models do not make an important difference to the level of pain or back-related function. - We are less certain of the effects on lumbar spine surgery, hospitalisation, and total adverse (unwanted or harmful) events. What is...

Blood pressure management in reperfused ischemic stroke This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of intensive systolic blood pressure management (target less than 160 mmHg) versus conventional management (target less than 180 mmHg) in people undergoing ischemic stroke reperfusion via systemic thrombolysis or endovascular thrombectomy. This is a protocol....

Epley maneuver, performed by family doctors or emergency physicians, for benign paroxysmal positional vertigo in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of the Epley maneuver, performed by family doctors or emergency physicians, for adults with benign paroxysmal positional vertigo. This is a protocol....

Renin inhibitors or angiotensin receptor blockers: which work better to treat hypertension? Key messages - The available evidence from short-term studies suggests there is probably little to no difference between renin inhibitors and angiotensin receptor blockers in terms of death rates, withdrawal due to unwanted effects, serious unwanted events, unwanted events, and blood pressure control for people with mild primary hypertension. - Due to a lack of strong evidence from long-term studies, any potential differences between these two drugs for measures of heart and blood vessel health are...

What are the best strategies to implement World Health Organization (WHO) recommendations to prevent, detect, and treat postpartum hemorrhage? Key messages Multicomponent implementation strategies may improve adherence to World Health Organization (WHO) postpartum hemorrhage (PPH) prevention recommendations and probably do not make a difference to intensive care unit (ICU) admissions, need for additional surgeries, or death of the mother. We do not know if multicomponent implementation strategies affect blood loss or blood transfusion. We do not know if single-component implementation...

Efficacy and safety of SARS-CoV-2 vaccination in pregnancy to prevent COVID-19 in mothers and early infancy This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of SARS-CoV-2 vaccination during pregnancy, versus placebo or no vaccination during pregnancy, for preventing COVID-19 disease in mothers and infants. This is a protocol....

What are the benefits and risks of balloon dilatation of the Eustachian tube for obstructive Eustachian tube dysfunction? Key messages Balloon dilatation of the Eustachian tube (BET) probably improves Eustachian tube dysfunction compared to nasal medications up to three months after the procedure. How certain we are about this evidence depends on the length of follow-up and the type of treatment this is compared with. What is Eustachian tube dysfunction? The Eustachian tube is a tube which connects the middle ear (part of the ear behind the ear drum) with the back of the nose. People can...

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (NOACs), the next-generation blood thinners, after transcatheter aortic valve replacement (TAVR)? Key messages • In people who do not have a medical reason to take blood thinners, non-vitamin K antagonist oral anticoagulants (NOACs), specifically rivaroxaban and apixaban, may increase the risk of death for any reason when compared with antiplatelet drugs, while edoxaban appears to have little or no effect. Any differences between rivaroxaban, apixaban, or edoxaban, and antiplatelet therapy in death caused by...

Effectiveness of SARS-CoV-2 testing strategies This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of different SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths among suspected cases and asymptomatic individuals. This is a protocol....

Acupuncture for babies with neonatal abstinence syndrome after exposure to drugs while in the womb Key messages • Due to a lack of evidence, we are unable to draw any conclusions about the benefits and risks of acupuncture for babies with neonatal abstinence syndrome caused by being exposed to drugs while in the womb. • Large studies that are well-designed and reported are needed to find out more about the benefits and risks of acupuncture, including studies that make comparisons of acupuncture techniques, sites, timing and application. What is neonatal abstinence syndrome? Neonatal...

Does cardiovascular training relieve cancer-related fatigue before, during, or after anticancer therapy? Key messages Cardiovascular training during anticancer therapy probably reduces cancer-related fatigue slightly for up to 12 weeks. The longer-term effects of cardiovascular training on cancer-related fatigue and quality of life are uncertain and there is no evidence about the effects of cardiovascular training before anticancer therapy. We found nearly 50 studies of cardiovascular training before, during, and after cancer treatment that are underway and these will add to the evidence...

What are the benefits and risks of tumor necrosis factor inhibitors for juvenile idiopathic arthritis? Key messages • When compared to placebo, tumor necrosis factor inhibitors (TNFi) may make young people with juvenile idiopathic arthritis (JIA) feel better overall, but the effects of the medicines on joint function, pain, disease control, and harm are uncertain. • We are uncertain about the benefits and harms of TNFi when compared to another medicine called methotrexate. • More high-quality studies are needed to understand the benefits and harms of TNFi in JIA. What is juvenile idiopathic...

What are the effects of angioplasty or stenting in people with deep vein thrombosis? Key messages ⦁ The effects of angioplasty or stenting for people with deep vein thrombosis (DVT) are unclear. ⦁ Further larger studies are needed to determine whether angioplasty and stenting are safe and effective treatments for people with DVT. What is deep vein thrombosis (DVT)? DVT is a blood clot that forms in a deep vein, usually in the leg. It can cause pain, swelling, and redness in the affected leg. DVT can also lead to serious complications, such as post-thrombotic syndrome (PTS) (a chronic...

How accurate is carbon dioxide detection in establishing if a tube inserted through the nose or mouth has been accidentally placed in the airway instead of the stomach in children? Key message • There is not enough evidence to suggest that carbon dioxide (CO₂) testing should be added to current checking procedures. • More studies are needed to determine if CO₂ testing is beneficial for children undergoing insertion of an enterogastric tube. Why is it important to know if the tube is accidentally placed in the airway? The insertion of a thin, flexible plastic tube through the nose or mouth...

Does treatment with GLP-1 receptor agonists prevent complications for people with chronic kidney disease and diabetes? Key messages • For people with chronic kidney disease (CKD) (a long-term condition where the kidneys do not work effectively) also having diabetes (a lifelong condition that causes a person's blood sugar level to become too high) increases the chances of early death, heart attack, stroke and reduces a person's quality of life. • Glucagon-like peptide 1 receptor agonists (GLP-1) (medicines used to lower blood glucose) probably reduce the risk of death due to any cause but may...

Can breastfeeding support interventions that target depression prevent the development of depression after childbirth? Key messages - Psychosocial breastfeeding support interventions may prevent some cases of postpartum (postnatal) depression in mothers one to three months after the support has been received and increase the duration of breastfeeding seven to 12 months after the support has been received. The evidence is very uncertain about the effect on other mental health and breastfeeding outcomes. - The evidence is very uncertain about the impact of alternative breastfeeding...

What are the benefits and harms of TNF inhibitors for people with psoriatic arthritis? Key messages Tumour necrosis factor inhibitors (TNFi) – a group of medicines that help reduce inflammation – are probably more effective than placebo (an inactive or 'dummy' medicine) in treating people with psoriatic arthritis who did not benefit from treatment with first-line immunosuppressants (medicines that prevent the activity of the immune system, such as methotrexate). High-quality studies comparing TNF inhibitors with second-line immunosuppressants, and studies that evaluate the effects of TNFi in...

Oral nicotine pouches for cessation or reduction of use of other tobacco or nicotine products This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objectives To evaluate the benefits and harms of oral nicotine pouches when used to help people transition away from combustible tobacco use (smoking) To evaluate the impact of oral nicotine products on the prevalence of combustible tobacco use Secondary objectives To evaluate the benefits and harms of oral nicotine pouches when used to help people transition away from other non-combustible...