Do bone-modifying medicines help reduce bone loss in women with early or locally advanced breast cancer? Key messages • Giving medicines that slow down bone breakdown (bone-modifying medicines) likely helps make bones stronger and lowers the chance of fractures, but it might also lead to more unwanted effects. • Because each treatment has its own benefits and drawbacks, it is difficult to determine which medicine is the best option. • We need more studies where these medicines are compared directly to each other. What is bone loss and why do people with cancer develop it? Bone loss means...

Lumbar braces and other assistive devices for treatment of chronic low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of assistive technologies (i.e. non-rigid and rigid lumbar braces, belts, supports, and devices to assist mobility and gait) for improving pain and function (and consequently reducing disability) in adults with chronic low back pain. This is a protocol....

Cognitive behavioural therapy and third-wave approaches for anxiety and related disorders in older people Does cognitive behavioural therapy (CBT) work better than minimal management or other psychological therapies for older adults with anxiety disorders? Key messages • Evidence suggests that cognitive behavioural therapy (CBT) may reduce anxiety severity right after treatment compared to minimal management. However, the lessening in anxiety severity may not be sustained and, at six months, there may be no difference between treatments. • Due to a lack of evidence, we do not know if CBT is...

Carotid revascularisation versus medical treatment for asymptomatic carotid artery stenosis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the safety and efficacy of carotid revascularisation plus best medical treatment with best medical treatment alone in people with asymptomatic carotid artery stenosis. This is a protocol....

Does treating the coronary arteries of the heart help prevent heart attacks during major blood vessels surgeries? Key messages - We do not know if treating the coronary arteries (blood vessels of the heart) prior to major vascular surgery (surgery to the blood vessels) has an effect on preventing acute myocardial infarction (heart attack) and death (mortality) during surgery. Acute myocardial infarction may be reduced in the long term, but the evidence is very uncertain, and length of hospital stay may be reduced slightly. - In order to determine the effect of treating the coronary arteries...

Haloperidol compared to olanzapine for people with schizophrenia Key messages We are very uncertain whether there is a difference between the two medications in terms of benefits. Olanzapine may have slight advantages in terms of improving general state of mind (behaviour, mood, thoughts, perceptions, etc.) and may have some advantages in terms of quality of life. People are more likely to gain weight with olanzapine and more likely to develop movement problems with haloperidol. People on haloperidol are more likely to stop taking their medication. When choosing between haloperidol and...

What are the benefits and risks of catheter material and design innovations (thin plastic tubes that deliver blood and medicine to the veins) to reduce complications and infections that lead to premature catheter failure? Key messages Peripherally inserted central catheters (PICCs) are associated with serious complications, a high failure rate, and negative aftereffects for patients and healthcare systems. There is a lack of strong evidence to evaluate the benefits and risks of PICC design and material (e.g. silicone versus polyurethane) to prevent catheter complications, infection, and...

Cytoreductive surgery plus chemotherapy versus chemotherapy alone for recurrent epithelial ovarian cancer This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of secondary CRS and chemotherapy in comparison to chemotherapy alone for women with platinum-sensitive recurrent epithelial ovarian cancer. This is a protocol....

Peritoneal dialysis versus haemodialysis for people starting long-term dialysis Key messages - The existing research does not provide sufficient evidence to draw confident conclusions regarding the relative effects of peritoneal dialysis and haemodialysis on health outcomes for people with kidney failure. - As most results came from observational rather than randomised studies, it remains uncertain what are the relative benefits and harms of peritoneal dialysis and haemodialysis. - The results are limited in generalisability due to very diverse clinical practice patterns, eligibility...

Using evidence from civil society in national and subnational health policy processes: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: To explore the use of evidence from civil society in national and subnational health policy processes. The specific research questions will include the following. How is evidence from civil society incorporated into health policy processes and what types of evidence are (or are not) incorporated? How do civil society actors perceive and experience the use of their evidence in health...

Ultrasound and blind endometrial sampling for detection of endometrial cancer in women with postmenopausal bleeding This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of endometrial sampling with histology in the diagnosis of endometrial cancer in women with postmenopausal bleeding and thickened endometrium on ultrasound. Diagnosis will be verified by the reference standards, hysteroscopy with histology, obtained by targeted (such as grasp biopsy of the endometrium or resection of focal pathology) or global sampling (with...

Management of intractable constipation in children Key messages • There may be little to no difference between lubiprostone and placebo (dummy treatment) in achieving treatment success in children with intractable constipation. We also found that lubiprostone is probably as safe as placebo. • There is probably little or no difference between prucalopride, also a laxative, and placebo in frequency of defecation per day, treatment success, and safety. • It is unclear whether any of the other treatments we looked at are helpful. The evidence is uncertain because of the very low number of study...

Ultra-early versus early surgery for hip fracture This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects (benefits and harms) of ultra-early versus early surgery for hip fracture in adults. This is a protocol....

What are the benefits and risks of interventions to increase time spent outdoors for preventing the incidence and progression of myopia (nearsightedness) in children? Key message An intervention of spending more time outdoors may potentially reduce the onset of myopia. However, we are uncertain if the intervention might reduce the progression of myopia. What is myopia? Myopia, or nearsightedness, is a disease in which individuals see near objects clearly, but distant objects appear blurred. In recent years, myopia has become a major public health problem all over the world. Myopia is the...

Immunosuppressive therapy for treating of IgA nephropathy in children Key messages - It is unclear if corticosteroid (steroid) therapy or any other immunosuppressive therapy prevents kidney damage in children with IgA nephropathy. - The included studies do not provide information on the risks of steroid therapy in children with IgA nephropathy. What is IgA nephropathy? IgA nephropathy is a kidney disease that can cause a decrease in kidney function and kidney failure. The cause of the disease is unknown, but we know that the immune system is involved, and treatment targets the immune system....

Does undernutrition increase the risk of tuberculosis? Key messages Having undernutrition doubles the risk of getting tuberculosis. These results apply to the general adult population; the risk for other groups, such as adolescents and children, is uncertain. What is tuberculosis? Tuberculosis (TB) is an infection caused by a bacteria (Mycobacterium tuberculosis). It primarily affects the lungs but can also affect other sites in the body. TB spreads through the air when an infected person coughs or sneezes. Some people do not develop symptoms after infection, while others progress with the...

Anticoagulation during extracorporeal membrane oxygenation This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the efficacy and safety of anticoagulation for maintaining extracorporeal membrane oxygenation in people of all ages with cardiac or respiratory failure, or both. This is a protocol....

Effects of kidney removal in combination with medicine in people with kidney cancer that has spread to other parts of the body Key messages • People who have kidney removal surgery after receiving interferon immunotherapy (medicine that helps the immune system fight cancer) probably live longer than those who receive interferon immunotherapy without kidney removal surgery. • People who have immediate kidney removal surgery then receive tyrosine kinase inhibitor therapy (medicine that identifies and attacks specific types of cancer cells) may live shorter than those who receive tyrosine...

What are the benefits and risks of using sympathetic nerve blocks for treating pain caused by cancer in the belly and/or pelvis? Key messages We did not find enough evidence to say if sympathetic nerve blocks provide more pain relief than 'usual care'. The risk of harm with sympathetic nerve blocks is unclear. We did not find enough evidence to say if sympathetic nerve blocks improve or reduce quality of life. Future research should focus on the different types of sympathetic nerve blocks not well represented in the current studies. What is persistent pain due to inoperable abdominopelvic...

What are the treatments for postburn itch and how effective are they? Key messages Neuromodulatory agents, such as gabapentin and pregabalin, are drugs that can help manage how the body senses and responds to itch. These drugs may reduce postburn itch compared with oral antihistamines. Physical modalities showed variance in their effectiveness at reducing postburn itch. Massage therapy and extracorporeal shock wave therapy probably reduce postburn itch compared with relevant controls, while therapeutic touch may increase postburn itch compared with nursing presence. Topical interventions...