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(Cochrane Database Syst Rev[TA])
13,768 results
  • Prophylactic platelet transfusions prior to surgery for people with a low platelet count. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 17; 9:CD012779
  • Estcourt LJ, Malouf R, … Birchall J
  • CONCLUSIONS: Findings of this review were based on three small trials involving minor surgery in adults with thrombocytopenia. We found insufficient evidence to recommend the administration of preprocedure prophylactic platelet transfusions in this situation with a lack of evidence that transfusion resulted in a reduction in postoperative bleeding or all-cause mortality. The small number of trials meeting the inclusion criteria and the limitation in reported outcomes across the trials precluded meta-analysis for most outcomes. Further adequately powered trials, in people of all ages, of prophylactic platelet transfusions compared with no transfusion, other alternative treatments, and considering different platelet thresholds prior to planned and emergency surgical procedures are required. Future trials should include major surgery and report on bleeding, adverse effects, mortality (as a long-term outcome) after surgery, duration of hospital stay and quality of life measures.
  • Bronchoscopy-guided antimicrobial therapy for cystic fibrosis. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 17; 9:CD009530
  • Jain K, Wainwright C, Smyth AR
  • CONCLUSIONS: This review, limited to a single, well-designed randomized controlled study, shows no clear evidence to support the routine use of bronchoalveolar lavage for the diagnosis and management of pulmonary infection in pre-school children with cystic fibrosis compared to the standard practice of providing treatment based on results of oropharyngeal culture and clinical symptoms. No evidence was available for adult and adolescent populations.
  • Art therapy for people with dementia. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 13; 9:CD011073
  • Deshmukh SR, Holmes J, Cardno A
  • CONCLUSIONS: There is insufficient evidence about the efficacy of art therapy for people with dementia. More adequately-powered and high-quality studies using relevant outcome measures are needed.
  • Methods for blood loss estimation after vaginal birth. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 13; 9:CD010980
  • Diaz V, Abalos E, Carroli G
  • CONCLUSIONS: Overall, the evidence in this review is insufficient to support the use of one method over another for blood loss estimation after vaginal birth. In general, the quality of evidence for our predefined outcomes ranged from low to high quality, with downgrading decisions due to imprecision. The included trials did not report on many of our primary and secondary outcomes.In trials that evaluate methods for estimating blood loss during vaginal birth, we believe it is important to measure their impact on clinical maternal and neonatal outcomes, along with their diagnostic accuracy. This body of knowledge needs further, well designed, appropriately powered, randomised controlled trials that correlate blood loss with relevant clinical outcomes, such as those listed in this review.
  • Mesh versus non-mesh for inguinal and femoral hernia repair. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 13; 9:CD011517
  • Lockhart K, Dunn D, … van Driel ML
  • CONCLUSIONS: Mesh and non-mesh repairs are effective surgical approaches in treating hernias, each demonstrating benefits in different areas. Compared to non-mesh repairs, mesh repairs probably reduce the rate of hernia recurrence, and reduce visceral or neurovascular injuries, making mesh repair a common repair approach. Mesh repairs may result in a reduced length of hospital stay and time to return to activities of daily living, but these results are uncertain due to variation in the results of the studies. Non-mesh repair is less likely to cause seroma formation and has been favoured in low-income countries due to low cost and reduced availability of mesh materials. Risk of bias in the included studies was low to moderate and generally handled well by study authors, with attention to details of allocation, blinding, attrition and reporting.
  • Patient-mediated interventions to improve professional practice. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 11; 9:CD012472
  • Fønhus MS, Dalsbø TK, … Flottorp SA
  • CONCLUSIONS: We found that two types of patient-mediated interventions, patient-reported health information and patient education, probably improve professional practice by increasing healthcare professionals' adherence to recommended clinical practice (moderate-certainty evidence). We consider the effect to be small to moderate. Other patient-mediated interventions, such as patient information may also improve professional practice (low-certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals' adhering to recommended clinical practice (low-certainty evidence).The impact of these interventions on patient health and satisfaction, adverse events and resource use, is more uncertain mostly due to very low certainty evidence or lack of evidence.
  • Topical and systemic antifungal therapy for chronic rhinosinusitis. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 10; 9:CD012453
  • Head K, Sharp S, … Philpott C
  • CONCLUSIONS: Due to the very low quality of the evidence, it is uncertain whether or not the use of topical or systemic antifungals has an impact on patient outcomes in adults with chronic rhinosinusitis compared with placebo or no treatment. Studies including specific subgroups (i.e. AFRS) are lacking.
  • Antigen-specific active immunotherapy for ovarian cancer. [Review]
  • CDCochrane Database Syst Rev 2018 Sep 10; 9:CD007287
  • Paijens ST, Leffers N, … Nijman HW
  • CONCLUSIONS: We conclude that despite promising immunological responses, no clinically effective antigen-specific active immunotherapy is yet available for ovarian cancer. Results should be interpreted cautiously, as review authors found a significant dearth of relevant information for assessment of risk of bias in both RCTs and NRSs.
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