Does treatment with SGLT2 inhibitors prevent complications for people with chronic kidney disease and diabetes? Key messages - Treatment with sodium-glucose co-transporter protein 2 (SGLT2) inhibitors decreases the risk of death and kidney problems for people with chronic kidney disease and diabetes. - We are not sure whether SGLT2 inhibitors are better than other diabetes drugs as not enough clinical research has been done directly comparing them in clinical studies. Chronic kidney disease and diabetes Diabetes is a common disease caused by reduced insulin activity (the hormone that...

Do dietary and activity strategies help prevent obesity in children aged 5 to 11 years? Key messages - Strategies for changing activity levels, or both activity levels and diet, of children to help prevent them developing overweight or obesity might be effective in making small reductions in body mass index (BMI) in children aged 5 to 11 years. - There is very little information about whether the strategies resulted in serious adverse events (e.g. injuries), but from what we found there appears to be little or no effect. - This change in BMI, when provided to many children across a whole...

Medicines to prevent post-traumatic stress disorder for people with acute traumatic stress symptoms Key messages - Acute stress symptoms are common after a traumatic experience. They are usually time-limited. However, for some people, they may persist or progress to a condition known as post-traumatic stress disorder (PTSD). Medicines have been proposed to prevent later PTSD. - We found data for four medicines: escitalopram, an antidepressant; hydrocortisone, a hormone that reduces the immune response and is involved in the body's response to stress; oxytocin, a hormone that could lessen the...

Do dietary and activity strategies help prevent obesity in children and young people aged 12 to 18 years? Key messages - Strategies to encourage adolescents to change their diet or activity levels (or both), to prevent them becoming overweight or developing obesity make no or very little difference to their body mass index (BMI; an estimate of the amount of body fat according to height and weight). - Based on the very little information available about serious adverse events, there appears to be little or no effect of dietary or activity strategies, or both, to results in serious harms (e.g....

Do earplug fit tests plus training on how to fit earplugs help people who work in noisy environments? Key messages • Earplug fit testing paired with simple instructions for properly fitting earplugs probably does not improve noise reduction. • Earplug fit testing paired with extensive instructions probably improves protection against noise compared to receiving no instructions or simple instructions. Why are noisy work environments a problem? Noise exposure at work is associated with serious health conditions, from hearing loss and tinnitus (ringing or buzzing sounds in the ears without an...

Endovascular rectal artery embolisation (RAE) for symptomatic haemorrhoids This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety and clinical effectiveness of endovascular rectal artery embolisation (RAE) for symptomatic haemorrhoids. This is a protocol....

Weight reduction interventions for the management of atrial fibrillation in overweight and obese people This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the efficacy of weight loss interventions as adjunctive treatment for reducing atrial fibrillation burden. This is a protocol....

Early versus late tracheostomy in people with multiple trauma This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of early tracheostomy compared to late tracheostomy in people with multiple trauma in the intensive care unit. This is a protocol....

Herbal medicines to prevent dental caries This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of herbs/herbal extracts to prevent or minimise tooth decay in children and adults. This is a protocol....

Parallel use of low-complexity automated nucleic acid amplification tests on respiratory samples and stool with or without lateral flow lipoarabinomannan assays to detect pulmonary tuberculosis disease in children This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To compare the diagnostic accuracy of the parallel use of low-complexity automated nucleic acid amplification tests on respiratory and stool specimens in children and lateral flow urine lipoarabinomannan amongst children with HIV versus each assay alone for detecting pulmonary tuberculosis....

Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To compare the diagnostic accuracy of parallel use of lateral flow urine lipoarabinomannan on urine and low-complexity automated nucleic acid amplification tests on respiratory samples versus each test alone for detection of tuberculosis disease in adults and adolescents living with HIV who present with presumptive...

Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age Background Acute upper respiratory tract infections (URTIs) are the most common acute infectious diseases in children, especially in preschool children. Vitamin A has a positive role in the immune system and may improve the host's defences against infections. Studies show that children with vitamin deficiency are more likely to suffer from respiratory tract infections. Therefore, we assessed the role of vitamin A supplementation in the prevention of acute upper respiratory...

Does shared decision-making help women when making decisions about whether or not to participate in breast cancer screening? Key messages Shared decision-making could help women feel less unsure or regretful and assist with learning during the decision-making process for breast cancer screening. However, it is important to note that our understanding of how exactly it may affect women's screening decisions is incomplete. What is shared decision-making? Shared decision-making is when a doctor and a patient work together to choose the best care. They talk about different options, the pros and...

Zinc for the prevention and treatment of the common cold Key messages - There may be little or no reduction in the risk of developing a cold with zinc supplements compared to placebo. - For people who already have a cold, there may be a reduction in how long the cold lasts with zinc supplements compared to placebo. - There is probably an increase in the risk of non-serious adverse events when zinc is used for cold treatment. What is the common cold? The common cold is primarily a viral infection of the upper respiratory tract. There is no specific combination of symptoms that defines a cold,...

Accuracy of a first- and second-trimester ultrasound scan for identifying fetal anomalies in low-risk and unselected pregnancies Key messages Prenatal ultrasound is commonly used in the first and second trimesters of pregnancy to identify potential issues with a developing baby (fetus). In this study, we analysed 87 studies covering over 7 million fetuses. While both first- and second-trimester scans confirm normal development well (high specificity), their ability to detect issues (sensitivity) varied. Women with both scans seemed to have more anomalies detected before 24 weeks compared to...

Do calcium supplements help people with overweight or obesity lose weight? Key messages - Calcium supplements may make little to no difference in reducing overall body weight in people with overweight, or obesity, compared to sham calcium supplements (i.e. placebo). - Calcium supplements probably lead to a small reduction in body mass index (BMI) and waist circumference. - More high-quality research is needed to provide clearer insights into the connection between calcium supplements and body weight. What is obesity? Overweight and obesity are defined as excessive fat accumulation that...

Risk assessment for aggressive behaviour in schizophrenia Review question Are structured aggression or violence risk assessment methods effective for people with schizophrenia or schizophrenia-like illnesses for decreasing aggressive incidents in psychiatric settings? Background Aggressive or violent behaviour is often associated with people with schizophrenia in common perceptions of the disease. Although many different interventions have been developed to decrease aggressive or violent occurrences in inpatient care, staff working in inpatient settings seek easy-to-use methods to decrease...

What are the benefits and harms of daratumumab in addition to antimyeloma medicines compared to antimyeloma medicines only for adults with newly diagnosed multiple myeloma who aren't suited for stem cell transplant? Key messages • Research shows that in adults with multiple myeloma, adding a newer medicine called daratumumab to standard antimyeloma treatments probably helps people live longer than treatment with standard antimyeloma treatments alone. • Adding daratumumab probably increases the chance of serious adverse events, but probably not the chance of overall adverse events...

Are sealants better than more traditional methods at stopping bleeding in connections created between blood vessels during vascular surgery? Key messages Using sealants for bleeding anastomoses in vascular surgery may result in faster time to no bleeding and fewer failures in stopping the bleeding, but did not provide better results for other outcomes such as the amount of bleeding during surgery, the length of the operation, death, bleeding after surgery, or having to return to the operating room after surgery because of bleeding. The certainty of our findings was low or very low, because...

Non-invasive high-frequency ventilation (nHFV) in newborn infants with respiratory distress Key messages What is respiratory distress? Respiratory distress is a breathing problem that frequently affects newborn babies. The causes vary depending on the baby's gestation (the length of time that a baby spends in the womb before delivery). The most common cause in babies born before their due date (preterm) is a lack of the lung's natural compound (surfactant) that prevents the air sacs (alveoli) from opening and closing easily. The commonest cause in babies born after 37 weeks gestation (term)...