What are the effects of precision nutrition-based interventions for managing obesity in children and adolescents? Key messages • It is unclear if precision nutrition (diets or foods tailored to people based on characteristics related to individual biology and environment) has an effect on weight change measured as body weight or body mass index (BMI) (a percentile measure of someone's weight relative to the average for a given age) in children and adolescents with obesity. • Further research, including large studies, is needed to understand the effects of precision nutrition-based...

Antidepressants for generalised anxiety disorder Key messages – Antidepressants are more effective than placebo (pretend tablet) at improving treatment response and have similar acceptability to placebo. Fewer participants dropped out due to a lack of effectiveness in the antidepressant group compared to the placebo group and more participants dropped out due to unwanted effects in the antidepressant group compared to placebo. – Future studies may be more transparent with their methods and outcome reporting. Future reviews may also include people with co-occurring medical conditions...

What are the benefits and risks of diuretics for preventing and treating acute kidney injury? Key messages • For prevention of acute kidney injury (AKI; a condition where the kidneys suddenly lose their ability to filter waste from the blood), compared to control, diuretics probably reduce the need for any dialysis and may reduce the risk of developing AKI and death. Diuretics may result in little or no difference in the need for permanent dialysis, hypotension (low blood pressure), low blood potassium, or serum creatinine (a measure of kidney function). The effect of diuretics on irregular...

What are the effects of interventions on sales of antimicrobial drugs without prescription in community pharmacies? Key messages • There is no clear evidence that the single-component interventions targeted at pharmacists and non-pharmacists in community pharmacies and drugstores are effective. • When multicomponent interventions are used, the sale of antimicrobial drugs without a prescription may not be reduced, but we are very uncertain about the results. • Better-quality studies are needed to fully look at this topic. What is antimicrobial resistance? Antimicrobial drugs kill...

Is continuing chronic blood thinners better than stopping them near or during surgical heart rhythm device implantation? Key message Stopping blood thinners before or during surgery for a CIED may result in little to no difference in undesirable outcomes such as blood clots or bleeding events when compared to taking them continuously. What are cardiac implantable electronic devices? Sometimes, people's hearts do not beat at a normal rhythm. This can make it hard for the heart to pump blood to the rest of the body. It can also increase the chance of getting blood clots. To fix this problem,...

Home visiting for postpartum depression This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits of home visiting models for postpartum depression amongst mothers of young children, where either the mothers or the children are enrolled in early childhood home visiting programs or interventions. To identify core components essential for a home visiting program to effectively address postpartum depression in mothers of young children. The hypothesized core components of such a program include the priority level given to PPD intervention,...

Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of dexmedetomidine compared with opioids, non-opioids and placebo in providing sedation and analgesia for procedural pain in newborn infants. This is a protocol....

What are the benefits and risks of using caesarean myomectomy in pregnant women with fibroids in the womb? Key messages The evidence is very uncertain about the effect of caesarean myomectomy (surgery to remove uterine fibroids, which are non-cancerous growths) on the requirement for blood transfusion, risk of bleeding, length of hospitalisation, length of operation, risk of major surgery, and risk of postpartum fever (high temperature in the days following delivery), so it is not possible to generate any meaningful conclusions. The authors do not know the effect of caesarean myomectomy on...

Individualized developmental care interventions for promoting development and preventing morbidity in preterm infants This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of individualized developmental care interventions for promoting development and preventing morbidity in preterm infants. This is a protocol....

Graded activity for acute and subacute low back pain This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of graded activity compared to placebo, sham, or no treatment, on pain and function in adults with acute and subacute non-specific low back pain. This is a protocol....

Do interventions to help adults stop smoking cigarettes work differently depending on people’s socioeconomic background? Key messages • We have little or no confidence in the evidence for all treatments. This means there is no clear evidence to support using different stop-smoking interventions for people from lower versus higher socioeconomic groups, or that any one intervention would have an effect on health inequalities. However, this conclusion may change as more research becomes available. • More studies that report quit rates by socioeconomic status for each study group are needed....

Direct factor Xa inhibitors or classic 'blood thinners': which leads to better outcomes for people undergoing major hip or knee surgery? Key messages • We do not know if classic anticoagulant medicines (commonly known as 'blood thinners') or newer blood-thinning medicines called 'direct factor Xa inhibitors' (DFXa inhibitors) are better at preventing death or the development of blood clots in the deep veins of the legs or in the lungs of people who have had hip or knee replacement surgery. • Compared to classic anticoagulants, DFXa inhibitors may slightly reduce the number of...

Lurasidone or typical antipsychotics: which works better to treat schizophrenia? Key messages • We compared lurasidone, a newer antipsychotic, with traditional antipsychotics like haloperidol to treat schizophrenia. • Based on two studies, we are uncertain whether lurasidone improves schizophrenia symptoms or causes fewer unwanted effects compared to traditional medications. • More research is needed to determine the benefits and potential harms of lurasidone in managing schizophrenia. What is schizophrenia? Schizophrenia is a condition that affects how a person perceives reality, leading to...

Thrombolysis (giving a drug that dissolves blood clots) for aneurysmal subarachnoid haemorrhage (a type of brain bleed) Key messages - Thrombolysis (giving a drug that dissolves blood clots) may improve some outcomes following aneurysmal subarachnoid haemorrhage (a type of brain bleed). For example, it probably reduces the risk of a poor functional outcome (severe disability), probably reduces the risk of cerebral artery vasospasm (a condition where brain arteries constrict, often causing brain damage by reducing blood flow), and may reduce the risk of delayed cerebral ischaemia (a clinical...

How accurate are tests that diagnose excessive bleeding (postpartum haemorrhage) after women give birth vaginally? Key messages • Our study found that using visual estimation to diagnose postpartum haemorrhage (PPH) was inaccurate. Using a plastic drape to collect and measure the volume of blood loss – alongside observations including heart rate, blood pressure, tone of the womb, and flow of blood – showed high accuracy. • Other tests, including blood tests and measurements such as heart rate and blood pressure alone, showed varying levels of accuracy. What is postpartum haemorrhage (PPH)?...

Can calorie (energy) labelling change people's selection and consumption of food or alcohol? Key messages – Current evidence suggests that calorie (energy) labelling on menus, and on or next to products, leads to reductions in calories selected and bought from food and non-alcoholic drinks. The evidence for consumption (eating) suggests a similar effect, but there is less evidence and it is of lower quality. – There is insufficient evidence to estimate the effect of calorie labelling for alcoholic drinks. – Calorie labelling of food could lead to potentially meaningful impacts on...

Transtracheal ultrasound for identifying endotracheal intubation in adults This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of transtracheal ultrasound for detecting endotracheal intubation in adult patients. Secondary objectives Secondary objectives include assessing the diagnostic accuracy of transtracheal ultrasound amongst the following subgroups: setting (e.g. prehospital, emergency department, intensive care unit, operating room) operator specialty (e.g. emergency medicine, non-emergency medicine) operator...

Ankle-foot orthoses to improve walking in people with weakness of the calf muscles due to neuromuscular disorders Key messages Ankle-foot orthoses (AFOs) may reduce the effort required to walk, and increase walking speed and satisfaction with walking in people with calf muscle weakness due to neuromuscular disorders, but we are uncertain about these results. We are unable to draw any conclusions about the effect of AFOs on perceived walking effort, balance, AFO use, and adverse effects. The evidence suggests effects on walking improvement may vary depending on the material from which the AFO...

Do programmes offered through sporting organisations promote healthy behaviour and improve people's health? Key messages • Sporting organisation programmes probably lead to people being slightly more physically active. • Sporting organisation programmes may make little or no difference to the amount of time people are inactive (sedentary). They may increase the amount of fruits and vegetables people eat. • We do not know if sporting organisation programmes make any difference to how many sugary drinks and alcoholic drinks people have, or their tobacco use, as the evidence is very...

Is keeping the azygos vein intact during surgery for newborns with esophageal atresia beneficial? Key messages - Current evidence suggests that preserving the azygos vein during surgical repair for esophageal atresia may result in a reduction in the risk of death, serious complications, leakage from the esophageal repair site (anastomosis leakage), and severe infections or chest infections, when using the open chest surgery (thoracotomy) approach. - Further research is still needed as the results of this review may not be applicable to all newborns with congenital esophageal atresia. What is...