Cochrane Database of Systematic Reviews最新文献

{"title":"Clarithromycin for treating sepsis in adults.","authors":"Xin Lu, Yanxia Gao, Chao Gong, Qin Zhou, Mubing Qin, Zengrui Song, Yi Li","doi":"10.1002/14651858.CD016328","DOIUrl":"https://doi.org/10.1002/14651858.CD016328","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of clarithromycin for treating sepsis in adults versus standard care with or without placebo or with an alternative active intervention, or clarithromycin in combination with antibiotic therapy versus standard care.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016328"},"PeriodicalIF":8.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for childhood apraxia of speech.","authors":"Miya St John, Elizabeth Murray, Frederique J Liégeois, Angela T Morgan","doi":"10.1002/14651858.CD016149","DOIUrl":"https://doi.org/10.1002/14651858.CD016149","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To examine the effectiveness of speech and language interventions for children and adolescents with Childhood Apraxia of Speech (CAS) as delivered by speech and language pathologists/therapists or by other personnel under the direction of a speech and language pathologist/therapist.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016149"},"PeriodicalIF":8.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrolides for the prevention of bronchopulmonary dysplasia in preterm neonates.","authors":"Kristin L O'Connor, Jane Cracknell, Chris Cooper, Mark W Davies","doi":"10.1002/14651858.CD015063.pub2","DOIUrl":"https://doi.org/10.1002/14651858.CD015063.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Bronchopulmonary dysplasia (BPD) continues to be the most frequent complication of prematurity despite advances in neonatal care. It occurs from interactions between antenatal exposures, postnatal oxygen, ventilation-mediated injury as well as other postnatal injuries that induce a proinflammatory state in an immature developing lung. Macrolides, particularly azithromycin, have anti-inflammatory actions that may play a role in preventing BPD. A current review is required to investigate whether macrolide use in the highest-risk patient population, intubated and ventilated very preterm and very low-birthweight infants, have benefits that outweigh any harms when used for the prevention of BPD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of: 1. macrolide antibiotics in the prevention of BPD in preterm neonates compared to no intervention; and 2. different subtypes of macrolides in preventing BPD in preterm neonates compared to other macrolides.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, and trial registries. We conducted reference checking. The latest search date was June 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised and quasi-randomised trials in very and extremely preterm infants (less than 32 weeks' gestational age) or very and extremely low-birthweight infants (less than 1500 g), or both, requiring mechanical ventilation, and at risk of developing BPD, who received either a macrolide or placebo/no intervention. This included studies comparing macrolide versus macrolide. We excluded trials that enrolled: 1. only infants with Ureaplasma colonisation (and not all 'at risk' ventilated infants); 2. a broader group of infants, most of whom were not ventilated, who were only at risk because of their size and birthweight, and where specific outcome data for ventilated preterm infants were unobtainable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our outcomes were BPD at 36 weeks' postmenstrual age (PMA); death before discharge; adverse effects including gastrointestinal upset, hepatic dysfunction, prolonged corrected QT interval (QTc) and cardiac arrhythmias, pyloric stenosis; and use of postnatal steroids to prevent or treat BPD prior to discharge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 1 tool to assess risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using meta-analysis where possible, calculating risk ratios (RR) and risk difference with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous outcomes. Where MD was not calculable, we summarised the results using the Synthesis Without Meta-analysis (SWiM) method. We used GRADE to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included six studies involving a total of 1108 infants providing macrolide or placebo (saline)/no intervention from 72 hour","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015063"},"PeriodicalIF":8.8,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for women with pelvic organ prolapse with or without stress urinary incontinence.","authors":"Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Alex Mowat, Zhuoran Chen, Sheila A Wallace, Ellen Yeung, Christopher Maher","doi":"10.1002/14651858.CD013108.pub2","DOIUrl":"10.1002/14651858.CD013108.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pelvic organ prolapse (POP) is common in women and frequently associated with stress urinary incontinence (SUI). SUI may be present following prolapse reduction (occult SUI) and may develop after surgery for POP (new-onset SUI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine the impact of surgery for symptomatic POP, with or without concomitant or delayed two-stage continence procedures, to treat or prevent SUI, on postoperative bladder function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Incontinence Specialised Register, two trials registries, journals and conference proceedings (searched 29 April 2024, updated 23 July 2025), and reference lists of articles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Randomised controlled trials (RCTs) including surgical interventions for POP with or without continence procedures in continent or incontinent women. Our primary outcome was subjective postoperative SUI. Secondary outcomes included POP on examination, overactive bladder, further continence surgery, and voiding dysfunction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We used standard Cochrane methodological procedures. We assessed evidence certainty using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 22 RCTs with 3095 women. Evidence certainty ranged from low to moderate. Limitations were risk of bias (especially blinding of outcome assessors), indirectness, and imprecision associated with low event rates and small samples. POP surgery in women with SUI Vaginal POP surgery with versus without midurethral sling: a concomitant midurethral sling may decrease SUI, (risk ratio (RR) 0.30, 95% confidence interval (CI) 0.19 to 0.48; 2 studies, 319 women), and rates of further continence surgery (RR 0.04, 95% CI 0.00 to 0.74; 1 study, 134 women), both low-certainty evidence. This suggests that if the risk of SUI with POP surgery alone is 39%, the risk with midurethral sling is between 8% and 19%. Vaginal POP surgery with concomitant versus delayed midurethral sling: low-certainty evidence suggested little or no difference in SUI (RR 0.41, 95% CI 0.12 to 1.37; 1 study, 140 women). Vaginal transobturator mesh versus vaginal POP surgery with midurethral sling: evidence from one study with 84 women suggested little or no difference in SUI (RR 1.47, 95% CI 0.51 to 4.26); POP (RR 6.29, 95% CI 0.79 to 50.03); new-onset overactive bladder (RR not estimable); and voiding dysfunction (RR 3.14, 95% CI 0.13 to 75.02), low-certainty evidence. Abdominal sacrocolpopexy with versus without Burch colposuspension: an additional Burch colposuspension may have little or no effect on SUI after five years (RR 1.17, 95% CI 0.60 to 2.26; 45 women), or on overactive bladder (RR 0.85, 95%CI 0.61 to 1.18), new-onset overactive bladder (RR 1.92, 95% CI 0.19 to 19.73) or voiding dysfunction (RR 0.96, 95%CI 0.06 to 14.43) all after one year (1 study, 47 women, all low-certainty evidence). Abdominal sacrocolpopexy wi","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD013108"},"PeriodicalIF":8.8,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12879284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ginkgo biloba for cognitive impairment and dementia.","authors":"Lisa S Wieland, Emilie Ludeman, Yuan Chi, Termeh M Feinberg, I-Hui Chen, Kee-Hsin Chen, Yanan Zhu, Emma Wolverson, Hakima Amri","doi":"10.1002/14651858.CD013661.pub2","DOIUrl":"10.1002/14651858.CD013661.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dementia is a neurocognitive disorder that interferes with cognition and independent functioning. Common dementia subtypes include Alzheimer's disease, vascular dementia, and mixed type. Mild cognitive impairment (MCI) is a risk factor for dementia, and subjective cognitive complaints may be the earliest manifestation. Although cholinesterase inhibitors may help reduce some cognitive and behavioral symptoms, there is no established treatment that cures or slows dementia progression. Ginkgo biloba (ginkgo) is a popular herbal preparation that is used to improve brain and circulatory health, and neuroprotective effects are biologically plausible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of Ginkgo biloba for the treatment of people with cognitive impairment or dementia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE, Embase, four other databases, and two trials registries on 8 December 2022. The search was updated in MEDLINE, Embase, CENTRAL, and the trials registers on 18 November 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) comparing ginkgo with placebo, usual treatment, or other treatments for cognitive problems in people with cognitive complaints or diagnoses of MCI or dementia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently selected trials, extracted data, and assessed studies for risk of bias. Key outcomes were global clinical status, global cognitive function, activities of daily living (ADLs), adverse events (AEs), and serious adverse events (SAEs) at six months. When clinically appropriate, we pooled data using a random-effects model and expressed treatment effects as mean differences (MDs), standardized mean differences (SMDs), or risk ratios (RRs), each with its 95% confidence interval (CI). We used GRADE methods to assess the certainty of the evidence for each estimate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 82 studies with 10,613 participants; 72 studies with 9783 participants provided extractable data. Four studies were at low risk of bias in all domains. Below we present data for the comparison of ginkgo versus placebo in people with different clinical conditions. Subjective cognitive impairment Three studies (597 participants) compared ginkgo with placebo for people with subjective cognitive complaints. Based on one study that lasted six months, it is uncertain whether ginkgo has any effect on global clinical status measured on a five-point Likert scale (MD 0.00, 95% CI -0.33 to 0.33; P = 1.00; 1 study, 197 participants; very low-certainty evidence). There were no data on cognition or ADLs. One study reported no difference in minor side effects between treatment groups and did not mention SAEs. A larger study lasting three months found that the risk of AEs may be higher with ginkgo versus placebo. It","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD013661"},"PeriodicalIF":8.8,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Face-to-face psychoeducation for the parents of people with severe mental illness.","authors":"Elena Jimenez Tejero, Jesús Lopez-Alcalde, Ana Carralero-Montero, Noelia Álvarez-Díaz, Montserrat García Sastre, Ángel Luis Asenjo-Esteve, Francisco Javier Castro-Molina, Alfonso Muriel, Paulina Maravilla Herrera, Diana Monge Martín, Daniel Cuesta-Lozano","doi":"10.1002/14651858.CD014532.pub2","DOIUrl":"10.1002/14651858.CD014532.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Parents who are the primary caregivers of people with severe mental illness are at high risk of mental health problems, including stress, depression and anxiety. While growing evidence suggests that psychoeducation may be beneficial, no systematic review has assessed its specific effects on parents. Clarifying this impact is essential to guide mental health services and improve outcomes for both caregivers and patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of face-to-face psychoeducational interventions for parents of people with severe mental illness compared to inactive or active (pharmacological or non-pharmacological) interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL and ProQuest databases, and two trial registries, up to 11 November 2024. We contacted experts in the field, checked references and used forward 'snowballing' to identify additional studies. There were no restrictions on language or date of publication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) in parents of people with severe mental illness that compared a face-to-face psychoeducational intervention versus either an inactive intervention (i.e. no intervention, placebo, sham intervention, waiting list, or usual or standard care), a pharmacological intervention or another non-pharmacological intervention. We excluded studies that compared different psychoeducational interventions or the same intervention delivered in different modes (e.g. face-to-face versus online).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our outcomes were psychosocial well-being, quality of life, adverse events, anxiety, and satisfaction with care (i.e. caregivers' subjective appraisal of their caregiving experience), assessed as clinically important change, any change or average endpoint score. Where possible, we stratified effect estimates into short term (≤ 3 months), medium term (&gt; 3 to ≤ 6 months) and long term (&gt; 6 months).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool RoB 2 to assess possible bias in the RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised outcome data using random-effects meta-analyses with an inverse-variance approach and the restricted-maximum-likelihood method to estimate between-study variance. For continuous outcomes, we reported the mean difference (MD) or standardised mean difference (SMD), along with the 95% confidence interval (CI) and 95% prediction interval (PI). We assessed the certainty of the evidence for each key outcome using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included five RCTs with 304 participants. The studies were conducted in Asia (Iran, Indonesia, Japan and China) and published between 2006 and 2020. Sample sizes ranged from 40 to 84 parents. Most parents were women over the age of 45 years, and their children with severe mental illness primarily ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD014532"},"PeriodicalIF":8.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12871467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation strategies for rehabilitation services in health systems: an overview of systematic reviews.","authors":"Dima Touhami, Rebecca Ryan, Eshetu Haileselassie Engeda, Chiara Arienti, Melissa Atkinson-Graham, Nora Bakaa, Irene Battel, Paolo Capodaglio, Claudio Cordani, Pierre Côté, Simon Décary, Wouter De Groote, Matteo Johann Del Furia, Antony Duttine, Walter R Frontera, Francesca Gimigliano, Carlotte Kiekens, Theodore Konstantinidis, Sara Liguori, Silvia Minozzi, Qhayiya Mudau, Marco Paoletta, Stefano Negrini, Carla Sabariego","doi":"10.1002/14651858.CD016324","DOIUrl":"10.1002/14651858.CD016324","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews that synthesize current available evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four pillars of HPSR as identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. This overview examined implementation strategies, defined by EPOC as interventions designed to bring about changes in healthcare organizations, the behavior of healthcare professionals, or the use of health services by healthcare recipients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This overview aimed to synthesize current evidence on implementation strategies in rehabilitation from a health policy and systems research (HPSR) perspective. Our series of four overviews have the following overarching objectives. • To offer a broad synthesis of the existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint the needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched the Epistemonikos database, the Health Systems Evidence database, and EPOC Group systematic reviews to identify reviews published between 1 January 2015 and 17 November 2024. We applied no language limitations. We included Cochrane and non-Cochrane systematic reviews of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) that evaluated the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to implementation strategies as defined in the EPOC taxonomy. All four overview teams collaborated to screen reviews and extract data. We used AMSTAR 2 to critically appraise the quality of the reviews. Results were analyzed descriptively and are based on reviews with ratings of high-to-moderate confidence, with low-confidence reviews reported separately.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We identified 7882 systematic reviews, of which 15 met our inclusion criteria. Three reviews overlapped substantially with other reviews, and eight received low- or critically low-confidence ratings. Ultimately, four moderate- to high-confidence reviews contributed to the synthesis; two were Cochrane systematic reviews. Most primary studies were from high-income countries; none were from low-income countries. Most strategies targeting healthcare professionals (e.g. guideline dissemination, interactive workshops, opinion leaders, audit and feedback) or hea","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016324"},"PeriodicalIF":8.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12871471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aminoglycosides, vancomycin, and metronidazole for people with cirrhosis and hepatic encephalopathy.","authors":"Rebecca Jeyaraj, Harry D Zacharias, Sonam Vadera, Zhi Yang Low, Lise Lotte Gluud, Marsha Y Morgan","doi":"10.1002/14651858.CD012734.pub2","DOIUrl":"10.1002/14651858.CD012734.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Hepatic encephalopathy is a common complication of cirrhosis. Its development is associated with increased morbidity and mortality. Its exact pathogenesis is unknown, but ammonia, produced by bacterial action in the intestine, plays a key role. Antibiotics modulate the gut flora and may reduce intestinal ammonia production. Aminoglycosides such as neomycin, paromomycin, and ribostamycin have been used to treat hepatic encephalopathy, as have other antibiotics such as vancomycin and metronidazole.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the beneficial and harmful effects of aminoglycosides, vancomycin, and metronidazole versus placebo, no intervention, other antibiotics, or other active pharmacological interventions, for the prevention and treatment of hepatic encephalopathy in people with cirrhosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, and three other databases to 15 April 2025. We also searched online trials registries for ongoing and unpublished trials, undertook manual searches of meeting and conference proceedings, checked bibliographies of relevant articles, and corresponded with investigators and pharmaceutical companies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised clinical trials (RCTs) involving participants with cirrhosis and hepatic encephalopathy, or who were at risk of developing hepatic encephalopathy, comparing aminoglycosides, vancomycin, or metronidazole to (1) placebo or no intervention; or (2) other pharmacological agents, including non-absorbable disaccharides, other antibiotics, or other potentially beneficial agents (e.g. branched-chain amino acids, L-ornithine L-aspartate, nitazoxanide (a broad-spectrum antiparasitic/antiviral agent), and nicotinohydroxamic acid (a potent urease inhibitor). We included trials irrespective of publication status, outcomes reported, language, or blinding. We excluded trials involving people with hepatic encephalopathy associated with acute liver failure or with non-cirrhotic portal hypertension.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcomes were all-cause mortality, hepatic encephalopathy, and serious adverse events. The important outcomes were non-serious adverse events and health-related quality of life (HRQoL). Our primary time point was the maximum length of follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used Cochrane's original risk of bias tool (RoB 1) to assess the risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We used standard Cochrane methods. We undertook random-effects meta-analyses to calculate risk ratios (RRs) or standardised mean differences (SMDs), with 95% confidence intervals (CIs). We assessed heterogeneity with the I&lt;sup&gt;2&lt;/sup&gt; statistic, and the certainty of evidence with the GRADE framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 24 RCTs, involving 1405 participants experiencin","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD012734"},"PeriodicalIF":8.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin for asthma exacerbations.","authors":"Nurul Syafiqah Othman, Amy Hy Chan, Jeff Harrison, Kebede A Beyene, Adam Wright-St Clair, Nataly Martini, Jiayi Gong","doi":"10.1002/14651858.CD016177","DOIUrl":"10.1002/14651858.CD016177","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of metformin for exacerbations in people with asthma.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016177"},"PeriodicalIF":8.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-flow nasal cannula use for respiratory support in children for indications other than acute bronchiolitis.","authors":"Mohamad El-Khatib, Nizar El Bcherawi, Frida Atallah, Marc Moukarzel, Thuraya HajAli, Joanne Khabsa, Hassan Moukalled, Lynn Sibai, Patrick Maroun, Christian Raphael","doi":"10.1002/14651858.CD016323","DOIUrl":"10.1002/14651858.CD016323","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of high-flow nasal cannula (HFNC) use, versus conventional oxygen therapy or other non-invasive ventilation, for respiratory support in children for indications other than acute bronchiolitis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016323"},"PeriodicalIF":8.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}