Does testosterone work in men who have problems with erections? Background Testosterone is a crucial male hormone. It is commonly used in men with low testosterone levels who experience erection difficulties. However, it is unclear how effective this treatment is and if it has unwanted harmful effects (adverse effects), especially on heart health. Key messages In the short term, testosterone replacement therapy has a minimal impact on erectile function, sexual quality of life, and cardiovascular mortality, with few side effects. The long-term effects of this therapy on erectile function...

Psychological treatment to help children and adolescents with asthma Key messages 1. The available evidence suggests that psychological interventions could be beneficial for children and adolescents with asthma. 2. Due to the differences between studies, it was very hard to compare the data, so the results of this review are very uncertain and difficult to interpret. Background Children and adolescents with asthma are more likely to experience symptoms of psychological distress (e.g. anxiety, depression, or both) than those without asthma. Psychological treatment might help reduce this...

Is alpha-lipoic acid (a natural antioxidant) better than no treatment or dummy treatment for nerve damage in people with diabetes? Key messages • We found that alpha-lipoic acid treatment compared with placebo (dummy treatment) probably has little or no effect on the symptoms of nerve damage and may have little or no effect on impairment after six months of treatment. • There is probably little or no difference between alpha-lipoic acid and placebo in the occurrence of unwanted effects that cause people to stop using treatment. • We found no studies to help us answer whether alpha-lipoic...

Oral killed cholera vaccines for preventing cholera Key messages Two doses of the whole-cell plus recombinant vaccine (WC-rBS vaccine (Dukoral)), with or without a booster dose, reduces cases of cholera for two years. Two doses of the bivalent whole-cell vaccine (BivWC vaccine (Shanchol)) reduces cases of cholera for five years. A single dose of Shanchol reduces cases of cholera and cases of severe dehydrating cholera for two years. The vaccines are considered safe, with similar side effects reported by all groups. Further studies are required to assess the effectiveness of a single-dose of...

Mindfulness-enhanced parenting programs for improving outcomes for children and their parents Key messages • Mindfulness-enhanced parent training programmes may improve some child and parent outcomes, including child emotional and behavioural adjustment, parenting skills, parental depression or anxiety, parenting stress, and parent mindfulness. • When mindfulness parent training is combined with a skills-based parent training programme, this may decrease parenting stress. • The current body of evidence is limited, with more research needed to be confident in our findings. Children's...

Interventions to encourage use of seat belts Key messages – We found some evidence to suggest education-based (behavioural and health risk appraisal (HRA)) and engineering-based interventions may promote seat belt use in early and late adolescents and adults; however, we are not confident in the current evidence. – More research is needed to better understand the effectiveness of education- and engineering-based interventions on seat belt use. – High-quality research is also needed to investigate the benefit of incentives (alone or combined with other interventions) as well as other types of...

Nutritional interventions for early psychosis: a systematic review and network meta-analysis This is a protocol for a Cochrane Review (prototype). The objectives are as follows: To compare the efficacy of different kinds of nutritional supplements in individuals with early psychosis. This is a protocol....

Pharmacological interventions for bone health in people with epilepsy This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of various pharmacological interventions (for treatment and for prevention) for bone health in people with epilepsy. This is a protocol....

Retrograde distal vascular access versus femoral artery access for below the knee arterial angioplasty Key messages – The choice of vascular access can influence the outcome of below the knee angioplasty. – We identified no trials that compared retrograde distal access with femoral access for below the knee angioplasty for inclusion; there is a need for high-quality trials on this topic. What is peripheral artery disease? Peripheral artery disease is a stenosis (narrowing) or occlusion (blocking) of the limb arteries usually caused by the build-up of fatty deposits in the arteries (known as...

Vitamin B12 supplementation for women during pregnancy Key messages – Women who took vitamin B12 supplements during pregnancy may have improved vitamin B12 status during pregnancy or postpartum, including less vitamin B12 deficiency and higher vitamin B12 levels, compared to women who did not take vitamin B12 supplements, but the evidence is uncertain. – The effects of taking vitamin B12 supplements during pregnancy on other health outcomes in pregnant women or their children are not known. Public health implications Vitamin B12 is an important nutrient that helps keep your body's blood and...

Treatments to thin the blood during haemodialysis: which treatments reduce clotting problems without causing bleeding? What is the issue? When people have dialysis using a machine to clean their blood (called haemodialysis (HD)), blood-thinning treatment helps prevent blood clots in the dialysis tubing. However, thinning the blood too much with treatment can lead to bleeding problems. There are several different medications to thin the blood, but it is not clear which is the best or the safest choice. What did we do? We searched for all the research trials that assessed the blood thinning...

Pressure garments for preventing hypertrophic scarring after burn injury Key messages – We do not know if pressure garment therapy is more effective than other scar treatment options (e.g. silicone gel/sheets, massage with lanolin) for preventing an abnormally thick and raised scar (hypertrophic scarring). – Future studies should include more participants who are monitored for longer; should clearly report on any other treatments that are offered alongside or as an alternative to pressure garment therapy; and measure outcomes that are most important to people with burn injuries. What are...

Are population-based interventions (those aimed at entire communities rather than individuals) helpful in preventing falls and fall-related injuries in older people? Key messages: • We are unsure whether approaches to falls prevention that target the whole community reduce falls and fall-related injuries. • Future studies should be well-designed and use up-to-date descriptions of their interventions. Ideally, studies should be carried out in several communities (rather than just two study communities), each with large populations, and types of older people living in the study communities...

What are the benefits and harms of ibuprofen for managing pain after an operation in children? Key messages • Ibuprofen probably reduces pain intensity just after an operation up to two hours compared to a placebo (dummy) and compared to paracetamol. The evidence compared to other medicines and in the longer term is unclear or lacking. • Overall, we are uncertain about unwanted effects of ibuprofen, especially serious unwanted effects, since the studies in the review rarely measured them. • Future studies should examine ibuprofen compared to commonly used medications and measure benefits and...

Community views on mass drug administration for soil-transmitted helminths: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: To synthesize qualitative research evidence about community experience with, and perception of, mass drug administration (MDA) programmes for soil-transmitted helminths (STHs). To assess how findings confirm, extend, enrich, or conflict with those previously identified for MDA programmes for lymphatic filariasis. This is a protocol....

Is maintenance therapy following previous treatment better than observation or placebo for treating chronic lymphocytic leukaemia in adults? What is the aim of this review? We aimed to determine whether the currently available maintenance treatments for disease control in adults with chronic lymphocytic leukaemia (CLL) have an acceptable balance between benefits and harms following previous treatment. Key messages We found that maintenance therapy in adults with CLL after previous therapy probably has little to no effect on long-term survival. We also found that maintenance therapy probably...

Methylxanthine for preventing morbidity and mortality in preterm infants: a network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of methylxanthines (caffeine; theophylline or aminophylline) and 'no methylxanthine administration' on morbidity and mortality in preterm infants, using network meta-analysis. This is a protocol....

Oral or nasal steroids for otitis media with effusion (OME or 'glue ear') in children Key messages Taking steroids in tablet or syrup form (by mouth) may have little or no impact on hearing and quality of life for children with glue ear. Steroids may reduce the number of children who have glue ear after 6 to 12 months, but we are uncertain how large this reduction might be. Using a steroid nasal spray may also make little or no difference to hearing or quality of life, although the evidence is not as robust. It is also unclear whether nasal steroids affect the number of children...

Riboflavin supplements for blood pressure lowering in adults This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of riboflavin supplements compared to placebo or no additional treatment for lowering systolic and diastolic blood pressure. This is a protocol....

Non-surgical treatment for lower limb apophyseal injuries This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of non-surgical treatment versus placebo or no treatment for lower limb apophyseal injuries in children and adolescents on pain, function, participation in physical activity, and participant-reported treatment success. This is a protocol....