How useful is ultrasound for diagnosing giant cell arteritis? Key messages • Whether ultrasound (US) can replace biopsy for the diagnosis of giant cell arteritis (GCA) is uncertain. • We suggest that future studies use a different set of criteria to determine whether patients have GCA to allow US and biopsy to be compared more reliably. What is giant cell arteritis? Giant cell arteritis (GCA) is an inflammatory disease that affects blood vessels. It causes swelling and blockage of the arteries, particularly around the eye and at the side of the head, which can lead to sudden and permanent...

Is changing dietary fat intake beneficial or harmful for people with gallstones? Key message – Evidence about the effects of dietary fat intake on the wellbeing of people with gallstones is uncertain. What are gallstones? Gallstones, also known as cholelithiasis, are deposits from digestive fluid which consist of solidified substances such as cholesterol and bile pigments that are found in bile (a fluid that breaks down fats and is made and released by the liver and stored in the gallbladder). Cholesterol (a fat-like substance) circulates in the blood and all the body's cells contain...

Surgical and non-surgical procedures for management of pituitary tumours that secrete growth hormones in adults Key messages - The evidence on the effects of surgical and non-surgical (for example, medication) approaches for the management of pituitary tumours that secrete growth hormone is very limited. - Outcomes that are particularly important for people with the disease, such as disease-related complications, side effects and disease recurrence, were not, or only sparsely, reported. - When reported, we found that surgery may have little or no effect on the outcomes compared to...

Is LipiFlow more effective than other dry eye disease treatments? Key messages • LipiFlow performs similarly to other commonly used DED treatments with regard to DED signs and symptoms, but the evidence is very uncertain. • LipiFlow did not appear to cause any adverse events. What is dry eye disease? Dry eye disease is a common condition with several risk factors, including patient age, sex, race, hormonal imbalances, digital device use, and meibomian gland dysfunction. Meibomian gland dysfunction is the primary cause of dry eye disease. Meibomian glands in the eyelids, when functioning...

Is favipiravir useful in treating people with COVID‐19? Key messages Due to a lack of robust evidence, we are unclear if favipiravir provides any benefit in the treatment of people with coronavirus disease 2019 (COVID-19) infections who do not require hospital admission, as well as those admitted to hospital. Favipiravir might lead to mild side effects, but doesn't seem to cause major or severe side effects. What is favipiravir? Favipiravir is a medicine that can fight viruses. It is usually taken by mouth. Originally used for treating other viral infections, favipiravir has been suggested...

Multidisciplinary rehabilitation for Parkinson’s disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of multidisciplinary rehabilitation for people with Parkinson's disease on their functioning and quality of life. This is a protocol....

Bariatric surgery in adults with obesity and diabetes mellitus: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate comparative medium- and long-term effects and safety, and to obtain a clinically meaningful ranking of different metabolic bariatric surgery procedures (adjustable gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, one-anastomosis gastric bypass, gastric plication, biliopancreatic diversion with duodenal switch, and their variations) compared to each other and to non-surgical treatment (e.g....

Does deep muscle relaxation during laparoscopic surgery improve outcomes? Key messages – Deep muscle relaxation during laparoscopic surgery may not affect mortality (death) and morbidity (ill heath), but we are very uncertain about the results. – Deep muscle relaxation probably makes little to no difference in health-related quality of life (well-being) up to four days after the surgery. What is deep muscle relaxation in laparoscopic surgery? Surgery of the abdomen is increasingly performed by laparoscopy. Laparoscopy is an operation using a camera inserted through one or several small cuts...

Prehabilitation for people undergoing cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The overarching aim of this review is to determine the benefits and harms of prehabilitation on postoperative outcomes in people undergoing cardiac surgery. The specific objectives are: to identify and describe all prehabilitation interventions that have been administered prior to cardiac surgery (urgent and elective pathways); to compare the effectiveness of the different interventions against no intervention or usual care on postoperative and...

Pharmacological interventions for vasoplegic syndrome after cardiac surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of pharmacological interventions targeting vasoplegic syndrome in cardiothoracic surgery patients, compared to placebo or an active pharmacological control intervention. This is a protocol....

Rehabilitation interventions for oropharyngeal dysphagia in people with Parkinson's disease This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of rehabilitation interventions for oropharyngeal dysphagia in improving swallowing safety and efficiency in people with Parkinson's disease. This is a protocol....

What are the benefits and harms of non-vitamin K antagonist oral anticoagulants (which help to prevent blood clot formation) after a heart attack Key messages • Compared with placebo (dummy treatment), rivaroxaban reduces death from any cause (all-cause death) and probably reduces death from diseases of the heart and blood vessels (cardiovascular death) after a heart attack. Dabigatran may reduce all-cause death but may have little or no effect on cardiovascular death. Apixaban is probably no more effective than placebo for reducing all-cause death or cardiovascular death after a heart...

Benefits and harms of giving probiotics to newborns after digestive tract surgery Key message • Probiotics may have little or no effect on the risk of blood infection in infants born from 35 weeks of pregnancy who have undergone surgery of the digestive tract (food pipe, stomach, or bowel). • Probiotics may increase the proportion of 'good' bacteria in the bowel, but we do not know if this has any real benefit for the infant. What are probiotics? Probiotics are live bacteria that may offer health benefits when consumed. There is evidence that probiotics can prevent an inflammatory disease of...

Phosphodiesterase type 5 inhibitor plus endothelin receptor antagonist compared to either alone for group 1 pulmonary arterial hypertension This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of combination therapy involving a PDE5 inhibitor and an ERA in adults and adolescents with group 1 PAH (as defined by WHO) compared to either agent alone. This is a protocol....

Intrahepatic shunts in adults with kidney failure due to liver disease Review question Intrahepatic shunts compared with conventional treatment: which is best for improving the clinical conditions of adults with hepatorenal syndrome? Keys messages – We did not find enough good-quality evidence on the benefits and harms of intrahepatic shunts to improve clinical conditions in adults with hepatorenal syndrome. – Larger randomised clinical trials (trials where people are randomly put into one of two or more treatment groups) with more reliable data are needed to better assess the benefits and...

Medicine-free management of neonates' pain during endotracheal suctioning Key messages — Gently holding the infant in a flexed posture (facilitated tucking, which is the gentle positioning of an infant's arms and legs in a bent, midline position close to the infant's body while the infant is lying on their side, lying on their back with their face upwards (supine), or lying on their tummy with their head to one side (prone)) is probably effective in reducing pain during endotracheal suctioning in ventilated newborn infants What is endotracheal suctioning? An endotracheal tube is a...

Platelet transfusion thresholds for thrombocytopenic infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety and efficacy of more restrictive platelet transfusion thresholds compared to more liberal thresholds in thrombocytopenic neonates. This is a protocol....

Midline or off-midline wound closure techniques: which works better to treat pilonidal sinus disease? Key messages • Closing wounds from one side of the butt crack (off-midline closure) may lead to faster healing, lower chances of the disease returning, fewer infections, less chance of the wound breaking open again, shorter hospital stays, quicker return to work, and less pain compared to closing wounds directly from the middle of the butt crack (conventional midline closure). • We could not find enough good-quality evidence to show that off-midline closure is better than closing wounds from...

What is the best medication to stop bleeding in those having non-emergency hip or knee surgery? Key messages • Tranexamic acid may be an effective medicine to help blood to clot during hip or knee replacement surgery, which reduces bleeding and the need for a blood transfusion (replacing lost blood with donated blood). • A high dose of this medicine and administering it in more than one way (for example, as a tablet and injected into the joint at the end of surgery) appears to work best. • Tranexamic acid is potentially as effective when given as a tablet as when injected into a vein. •...

Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of solid tumors This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy of prophylactic granulopoiesis-stimulating factors compared with placebo or no prophylaxis for improving survival and preventing adverse effects of cancer treatment in people with solid tumors. This is a protocol....