Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016168
Caitlin R Williams, Hanna E Huffstetler, Angelo S Nyamtema, Eva Larkai, Magdalena Lyimo, Afroditi Kanellopoulou, Lindsay Robertson, Leslie Choi, Fadhlun M Alwy Al-Beity
<p><strong>Rationale: </strong>Postpartum haemorrhage (PPH) is commonly defined as blood loss of 500 mL or greater within 24 hours after birth. Intravenous transfusions of whole blood, red blood cells (RBC), or other blood components collected from a donor may be administered to manage PPH. Key questions remain regarding optimal timing for initiating blood and blood product transfusion in managing PPH and whether the use of fractionated blood products, either as replacement for or in addition to whole blood transfusion, could improve maternal outcomes. No systematic review has examined appropriate transfusion strategies for managing PPH.</p><p><strong>Objectives: </strong>To assess the benefits and harms of transfusion of whole blood or other blood products for preventing morbidity and mortality among women with PPH.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and two trials registers, together with reference checking, citation searching, and contact with study authors to identify studies for inclusion in the review. The latest search was 18 July 2024.</p><p><strong>Eligibility criteria: </strong>We considered randomised controlled trials (RCTs), cluster-randomised trials, or controlled non-randomised studies of interventions (NRSI) evaluating the efficacy and safety of blood transfusion for managing PPH, regardless of the mode of birth.</p><p><strong>Outcomes: </strong>Our critical outcomes were maternal death, severe maternal morbidity, and adverse effects.</p><p><strong>Risk of bias: </strong>We assessed risk of bias in included studies using the Cochrane RoB 2 tool and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.</p><p><strong>Synthesis methods: </strong>We synthesised results for each outcome within each comparison using meta-analysis where possible, and used GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Included studies: </strong>We included 12 studies with 17,868 participants. We excluded five NRSIs from outcome analyses due to critical risk of bias related to confounding.</p><p><strong>Synthesis of results: </strong>One threshold for initiating transfusion versus another threshold for initiating transfusion None of the studies assessed this comparison. One- to two-unit RBCs versus no transfusion Among women with moderate blood loss, low-certainty evidence from one NRSI found that transfusing 1 to 2 units of RBCs to treat PPH may increase severe maternal morbidity - composite excluding intensive care unit (ICU) admission (risk ratio (RR) 7.00, 95% confidence interval (CI) 2.75 to 17.80; 2130 women) and severe maternal morbidity - ICU admission (RR 2.12, 95% CI 1.20 to 3.75; 2130 women), though we have substantial concerns about the potential bias due to confounding as the volume of blood lost was not controlled for in the analysis. The study did not report maternal death or adverse effects. Packed RBCs versus whole blood versus combination of blood
{"title":"Transfusion of blood and blood products for the management of postpartum haemorrhage.","authors":"Caitlin R Williams, Hanna E Huffstetler, Angelo S Nyamtema, Eva Larkai, Magdalena Lyimo, Afroditi Kanellopoulou, Lindsay Robertson, Leslie Choi, Fadhlun M Alwy Al-Beity","doi":"10.1002/14651858.CD016168","DOIUrl":"10.1002/14651858.CD016168","url":null,"abstract":"<p><strong>Rationale: </strong>Postpartum haemorrhage (PPH) is commonly defined as blood loss of 500 mL or greater within 24 hours after birth. Intravenous transfusions of whole blood, red blood cells (RBC), or other blood components collected from a donor may be administered to manage PPH. Key questions remain regarding optimal timing for initiating blood and blood product transfusion in managing PPH and whether the use of fractionated blood products, either as replacement for or in addition to whole blood transfusion, could improve maternal outcomes. No systematic review has examined appropriate transfusion strategies for managing PPH.</p><p><strong>Objectives: </strong>To assess the benefits and harms of transfusion of whole blood or other blood products for preventing morbidity and mortality among women with PPH.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and two trials registers, together with reference checking, citation searching, and contact with study authors to identify studies for inclusion in the review. The latest search was 18 July 2024.</p><p><strong>Eligibility criteria: </strong>We considered randomised controlled trials (RCTs), cluster-randomised trials, or controlled non-randomised studies of interventions (NRSI) evaluating the efficacy and safety of blood transfusion for managing PPH, regardless of the mode of birth.</p><p><strong>Outcomes: </strong>Our critical outcomes were maternal death, severe maternal morbidity, and adverse effects.</p><p><strong>Risk of bias: </strong>We assessed risk of bias in included studies using the Cochrane RoB 2 tool and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.</p><p><strong>Synthesis methods: </strong>We synthesised results for each outcome within each comparison using meta-analysis where possible, and used GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Included studies: </strong>We included 12 studies with 17,868 participants. We excluded five NRSIs from outcome analyses due to critical risk of bias related to confounding.</p><p><strong>Synthesis of results: </strong>One threshold for initiating transfusion versus another threshold for initiating transfusion None of the studies assessed this comparison. One- to two-unit RBCs versus no transfusion Among women with moderate blood loss, low-certainty evidence from one NRSI found that transfusing 1 to 2 units of RBCs to treat PPH may increase severe maternal morbidity - composite excluding intensive care unit (ICU) admission (risk ratio (RR) 7.00, 95% confidence interval (CI) 2.75 to 17.80; 2130 women) and severe maternal morbidity - ICU admission (RR 2.12, 95% CI 1.20 to 3.75; 2130 women), though we have substantial concerns about the potential bias due to confounding as the volume of blood lost was not controlled for in the analysis. The study did not report maternal death or adverse effects. Packed RBCs versus whole blood versus combination of blood","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016168"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255024","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}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD006606.pub5
Charalampos S Siristatidis, Michail Papapanou, Abha Maheshwari, Dennis Vaidakis
<p><strong>Background: </strong>Polycystic ovarian syndrome (PCOS) occurs in 8% to 13% of all women of reproductive age and 50% of women presenting with infertility (i.e. inability to reach a pregnancy after 12 months or more of regular unprotected sexual intercourse). A proportion of these women ultimately need assisted reproductive technology. In vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) are assisted reproduction techniques used to raise the chances of a pregnancy. In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome (OHSS). A potentially effective intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes at the germinal-vesicle stage followed by in vitro maturation (IVM). This is the third update of this Cochrane review on the subject (after the last update on 27 June 2018).</p><p><strong>Objectives: </strong>To assess the benefits and harms of IVM followed by IVF or ICSI versus conventional IVF or ICSI among women with PCOS.</p><p><strong>Search methods: </strong>On 27 February 2023, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, and the Open Grey database. We further searched the National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We also searched reference lists of relevant papers and Google Scholar for any additional trials.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) comparing IVM before IVF or ICSI with conventional IVF or ICSI for infertile women with PCOS, irrespective of language and country of origin.</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected studies, assessed the risk of bias, extracted data from studies, and, where needed, attempted to contact the authors for missing data. Our primary outcomes were live birth per woman randomised and miscarriage. We performed statistical analysis using Review Manager. We assessed the certainty of the evidence using GRADE and the risk of bias using the Cochrane RoB 2 tool.</p><p><strong>Main results: </strong>We found four published trials suitable for inclusion in this update. The studies involved 810 subfertile women undergoing assisted reproductive technology. Two of four were already included in the previous version of the review, were published as abstracts in international conferences, and were at high risk of bias. The two new studies were at low risk of bias in all domains and in terms of all outcomes. We implemented the random-effects model for the quantitative analyses and restricted the primary analysis to studies at l
{"title":"In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction.","authors":"Charalampos S Siristatidis, Michail Papapanou, Abha Maheshwari, Dennis Vaidakis","doi":"10.1002/14651858.CD006606.pub5","DOIUrl":"10.1002/14651858.CD006606.pub5","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovarian syndrome (PCOS) occurs in 8% to 13% of all women of reproductive age and 50% of women presenting with infertility (i.e. inability to reach a pregnancy after 12 months or more of regular unprotected sexual intercourse). A proportion of these women ultimately need assisted reproductive technology. In vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) are assisted reproduction techniques used to raise the chances of a pregnancy. In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome (OHSS). A potentially effective intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes at the germinal-vesicle stage followed by in vitro maturation (IVM). This is the third update of this Cochrane review on the subject (after the last update on 27 June 2018).</p><p><strong>Objectives: </strong>To assess the benefits and harms of IVM followed by IVF or ICSI versus conventional IVF or ICSI among women with PCOS.</p><p><strong>Search methods: </strong>On 27 February 2023, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, and the Open Grey database. We further searched the National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We also searched reference lists of relevant papers and Google Scholar for any additional trials.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) comparing IVM before IVF or ICSI with conventional IVF or ICSI for infertile women with PCOS, irrespective of language and country of origin.</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected studies, assessed the risk of bias, extracted data from studies, and, where needed, attempted to contact the authors for missing data. Our primary outcomes were live birth per woman randomised and miscarriage. We performed statistical analysis using Review Manager. We assessed the certainty of the evidence using GRADE and the risk of bias using the Cochrane RoB 2 tool.</p><p><strong>Main results: </strong>We found four published trials suitable for inclusion in this update. The studies involved 810 subfertile women undergoing assisted reproductive technology. Two of four were already included in the previous version of the review, were published as abstracts in international conferences, and were at high risk of bias. The two new studies were at low risk of bias in all domains and in terms of all outcomes. We implemented the random-effects model for the quantitative analyses and restricted the primary analysis to studies at l","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD006606"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255056","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}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016096
Therese K Dalsbø, Rakel Aasheim Greve, Ingrid L Jørgensen, Marita S Fønhus
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.
{"title":"Education and training interventions for healthcare workers to prevent sexual harassment.","authors":"Therese K Dalsbø, Rakel Aasheim Greve, Ingrid L Jørgensen, Marita S Fønhus","doi":"10.1002/14651858.CD016096","DOIUrl":"10.1002/14651858.CD016096","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016096"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255042","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}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016093
Lorenzo Righi, Jürgen Barth, Cristian Baicus, Julia A Critchley, Ioana Daha, Martha McCarey, Erik von Elm
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To examine the benefits and harms of different types of psychosocial interventions for smoking cessation in people with CHD. Secondary objectives To examine the benefits and harms of psychosocial interventions aimed solely at smoking cessation compared with multi-risk factor interventions for smoking cessation in people with CHD. To examine the benefits and harms of brief (duration of < one month) compared to extended (duration of ≥ one month) psychosocial interventions for smoking cessation in people with CHD. To explore whether using a validated biochemical assessment versus a self-report of abstinence moderates the effectiveness of smoking cessation interventions in people with CHD. To assess the equity of psychosocial interventions for smoking cessation in people with CHD.
{"title":"Psychosocial interventions for smoking cessation in people with coronary heart disease.","authors":"Lorenzo Righi, Jürgen Barth, Cristian Baicus, Julia A Critchley, Ioana Daha, Martha McCarey, Erik von Elm","doi":"10.1002/14651858.CD016093","DOIUrl":"10.1002/14651858.CD016093","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To examine the benefits and harms of different types of psychosocial interventions for smoking cessation in people with CHD. Secondary objectives To examine the benefits and harms of psychosocial interventions aimed solely at smoking cessation compared with multi-risk factor interventions for smoking cessation in people with CHD. To examine the benefits and harms of brief (duration of < one month) compared to extended (duration of ≥ one month) psychosocial interventions for smoking cessation in people with CHD. To explore whether using a validated biochemical assessment versus a self-report of abstinence moderates the effectiveness of smoking cessation interventions in people with CHD. To assess the equity of psychosocial interventions for smoking cessation in people with CHD.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016093"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255069","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}
Pub Date : 2025-01-30DOI: 10.1002/14651858.CD012942.pub2
Katarina Kopcalic, Justin Arcaro, Antonio Pinto, Shehzad Ali, Corrado Barbui, Chiara Curatoli, Janet Martin, Giuseppe Guaiana
<p><strong>Background: </strong>Generalised anxiety disorder (GAD) is a mental health condition characterised by excessive anxiety and worry about everyday events. GAD is a common disorder and generally affects women twice as often as men. Treatments include various psychological and pharmacological therapies. Among the pharmacological therapies, antidepressants, in particular, selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs), are commonly used for the treatment of GAD and many studies have shown their benefit over placebo. Only one systematic review and meta-analysis comparing all antidepressants to placebo has been done in the past. Since then, new data on existing antidepressants have emerged and new antidepressants have been introduced. An updated and more comprehensive review is needed to provide a stronger understanding of the efficacy, acceptability, tolerability, and impact on the quality of life of the various types of antidepressants compared to placebo.</p><p><strong>Objectives: </strong>To assess the effects of antidepressants in GAD in adults, specifically: to determine the efficacy of antidepressants in alleviating symptoms of GAD compared to placebo and to review the acceptability of antidepressants in GAD in terms of adverse effects, including the general prevalence of adverse effects compared to placebo.</p><p><strong>Search methods: </strong>We searched the Cochrane Common Mental Health Disorders (CCMD) register, CENTRAL, MEDLINE, Embase, PsycINFO, and two trials registers in October 2022.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCT) or cluster-RCTs that randomly assigned participants to receive either an antidepressant or placebo for the treatment of GAD. There were no restrictions on dose, frequency, intensity, or duration of treatment. The studies included adults of either sex with a primary diagnosis of GAD and without any serious medical comorbidities. Psychiatric comorbidities were allowed as long as GAD was the primary diagnosis. We excluded studies investigating psychotherapies and those that included participants who had regular use of benzodiazepines. There were no restrictions on setting, country, or language.</p><p><strong>Data collection and analysis: </strong>Two review authors independently checked eligibility and extracted data following standard Cochrane methodological procedures. We assessed risk of bias using the Cochrane RoB 1 tool. A third review author resolved disagreements between the two primary review authors. We extracted study characteristics, participant characteristics, intervention details, settings, and outcome measures regarding efficacy, acceptability, tolerability, and quality of life. We used GRADE to assess the certainty of the evidence.</p><p><strong>Main results: </strong>We included 37 unique RCTs with 12,226 participants in the review. The studies included adults with moderate-severe GAD an
{"title":"Antidepressants versus placebo for generalised anxiety disorder (GAD).","authors":"Katarina Kopcalic, Justin Arcaro, Antonio Pinto, Shehzad Ali, Corrado Barbui, Chiara Curatoli, Janet Martin, Giuseppe Guaiana","doi":"10.1002/14651858.CD012942.pub2","DOIUrl":"10.1002/14651858.CD012942.pub2","url":null,"abstract":"<p><strong>Background: </strong>Generalised anxiety disorder (GAD) is a mental health condition characterised by excessive anxiety and worry about everyday events. GAD is a common disorder and generally affects women twice as often as men. Treatments include various psychological and pharmacological therapies. Among the pharmacological therapies, antidepressants, in particular, selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs), are commonly used for the treatment of GAD and many studies have shown their benefit over placebo. Only one systematic review and meta-analysis comparing all antidepressants to placebo has been done in the past. Since then, new data on existing antidepressants have emerged and new antidepressants have been introduced. An updated and more comprehensive review is needed to provide a stronger understanding of the efficacy, acceptability, tolerability, and impact on the quality of life of the various types of antidepressants compared to placebo.</p><p><strong>Objectives: </strong>To assess the effects of antidepressants in GAD in adults, specifically: to determine the efficacy of antidepressants in alleviating symptoms of GAD compared to placebo and to review the acceptability of antidepressants in GAD in terms of adverse effects, including the general prevalence of adverse effects compared to placebo.</p><p><strong>Search methods: </strong>We searched the Cochrane Common Mental Health Disorders (CCMD) register, CENTRAL, MEDLINE, Embase, PsycINFO, and two trials registers in October 2022.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCT) or cluster-RCTs that randomly assigned participants to receive either an antidepressant or placebo for the treatment of GAD. There were no restrictions on dose, frequency, intensity, or duration of treatment. The studies included adults of either sex with a primary diagnosis of GAD and without any serious medical comorbidities. Psychiatric comorbidities were allowed as long as GAD was the primary diagnosis. We excluded studies investigating psychotherapies and those that included participants who had regular use of benzodiazepines. There were no restrictions on setting, country, or language.</p><p><strong>Data collection and analysis: </strong>Two review authors independently checked eligibility and extracted data following standard Cochrane methodological procedures. We assessed risk of bias using the Cochrane RoB 1 tool. A third review author resolved disagreements between the two primary review authors. We extracted study characteristics, participant characteristics, intervention details, settings, and outcome measures regarding efficacy, acceptability, tolerability, and quality of life. We used GRADE to assess the certainty of the evidence.</p><p><strong>Main results: </strong>We included 37 unique RCTs with 12,226 participants in the review. The studies included adults with moderate-severe GAD an","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD012942"},"PeriodicalIF":8.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064168","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}
Pub Date : 2025-01-30DOI: 10.1002/14651858.CD015877
Samantha L Huey, Neel H Mehta, Ruth S Steinhouse, Yue Jin, Matthew Kibbee, Rebecca Kuriyan, Julia L Finkelstein, Saurabh Mehta
<p><strong>Background: </strong>Precision nutrition-based methods develop tailored interventions and/or recommendations accounting for determinants of intra- and inter-individual variation in response to the same diet, compared to current 'one-size-fits-all' population-level approaches. Determinants may include genetics, current dietary habits and eating patterns, circadian rhythms, health status, gut microbiome, socioeconomic and psychosocial characteristics, and physical activity. In this systematic review, we examined the evidence base for the effect of interventions based on precision nutrition approaches on overweight and obesity in children and adolescents to help inform future research and global guidelines.</p><p><strong>Objectives: </strong>To examine the impact of precision nutrition-based interventions for the management of obesity in children and adolescents in all their diversity.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, CINAHL, Web of Science Core Collection, BIOSIS Previews, Global Index Medicus (all regions), IBECS, SciELO, PAHO, PAHO IRIS, WHO IRIS, WHOLIS, Bibliomap, and TRoPHI, as well as the WHO ICTRP and ClinicalTrials.gov. We last searched the databases on 23 July 2024. We did not apply any language restrictions.</p><p><strong>Selection criteria: </strong>We included randomised or quasi-randomised controlled trials that evaluated precision nutrition-based interventions (accounting for 'omics' such as phenotyping, genotyping, gut microbiome; clinical data, baseline dietary intake, postprandial glucose response, etc., and/or including artificial intelligence such as machine learning methods) compared to general or one-size-fits-all interventions or no intervention in children and adolescents aged 0 to 9 years or 10 to 19 years with overweight or obesity.</p><p><strong>Data collection and analysis: </strong>Two review authors independently conducted study screening, data extraction, and risk of bias and GRADE assessments. We used fixed-effect analyses. Our outcomes of interest were physical and mental well-being, physical activity, health-related quality of life, obesity-associated disability, and adverse events associated with the interventions as defined or measured by trialists, and weight change (reduction, stabilisation or maintenance).</p><p><strong>Main results: </strong>Two studies (3 references, 105 participants) conducted in Ukraine and Greece met our eligibility criteria. One study reported nonprofit funding sources, whilst the other did not report funding, and the certainty of evidence ranged from very low to low across outcomes (all measured at endpoint). Only one trial (65 participants) contributed data on our primary outcomes of interest. Precision nutrition-based intervention versus one-size-fits-all intervention or standard of care In children 0 to 9 years of age, evidence is very uncertain about the effect of a precision nutrition-based intervention (a computerised Decision Supp
{"title":"Precision nutrition-based interventions for the management of obesity in children and adolescents up to the age of 19 years.","authors":"Samantha L Huey, Neel H Mehta, Ruth S Steinhouse, Yue Jin, Matthew Kibbee, Rebecca Kuriyan, Julia L Finkelstein, Saurabh Mehta","doi":"10.1002/14651858.CD015877","DOIUrl":"10.1002/14651858.CD015877","url":null,"abstract":"<p><strong>Background: </strong>Precision nutrition-based methods develop tailored interventions and/or recommendations accounting for determinants of intra- and inter-individual variation in response to the same diet, compared to current 'one-size-fits-all' population-level approaches. Determinants may include genetics, current dietary habits and eating patterns, circadian rhythms, health status, gut microbiome, socioeconomic and psychosocial characteristics, and physical activity. In this systematic review, we examined the evidence base for the effect of interventions based on precision nutrition approaches on overweight and obesity in children and adolescents to help inform future research and global guidelines.</p><p><strong>Objectives: </strong>To examine the impact of precision nutrition-based interventions for the management of obesity in children and adolescents in all their diversity.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, CINAHL, Web of Science Core Collection, BIOSIS Previews, Global Index Medicus (all regions), IBECS, SciELO, PAHO, PAHO IRIS, WHO IRIS, WHOLIS, Bibliomap, and TRoPHI, as well as the WHO ICTRP and ClinicalTrials.gov. We last searched the databases on 23 July 2024. We did not apply any language restrictions.</p><p><strong>Selection criteria: </strong>We included randomised or quasi-randomised controlled trials that evaluated precision nutrition-based interventions (accounting for 'omics' such as phenotyping, genotyping, gut microbiome; clinical data, baseline dietary intake, postprandial glucose response, etc., and/or including artificial intelligence such as machine learning methods) compared to general or one-size-fits-all interventions or no intervention in children and adolescents aged 0 to 9 years or 10 to 19 years with overweight or obesity.</p><p><strong>Data collection and analysis: </strong>Two review authors independently conducted study screening, data extraction, and risk of bias and GRADE assessments. We used fixed-effect analyses. Our outcomes of interest were physical and mental well-being, physical activity, health-related quality of life, obesity-associated disability, and adverse events associated with the interventions as defined or measured by trialists, and weight change (reduction, stabilisation or maintenance).</p><p><strong>Main results: </strong>Two studies (3 references, 105 participants) conducted in Ukraine and Greece met our eligibility criteria. One study reported nonprofit funding sources, whilst the other did not report funding, and the certainty of evidence ranged from very low to low across outcomes (all measured at endpoint). Only one trial (65 participants) contributed data on our primary outcomes of interest. Precision nutrition-based intervention versus one-size-fits-all intervention or standard of care In children 0 to 9 years of age, evidence is very uncertain about the effect of a precision nutrition-based intervention (a computerised Decision Supp","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD015877"},"PeriodicalIF":8.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064185","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}
<p><strong>Background: </strong>Acute kidney injury (AKI) is a well-known complication of critical illnesses, significantly affecting morbidity and the risk of death. Diuretics are widely used to ameliorate excess fluid accumulation and oliguria associated with AKI. Their popularity stems from their ability to reduce the energy demands of renal tubular cells by inhibiting transporters and flushing out intratubular casts. Numerous studies have assessed the effects of diuretics in the context of AKI prevention and treatment. However, a comprehensive systematic review addressing this topic has yet to be conducted.</p><p><strong>Objectives: </strong>This review aimed to explore the benefits and harms of diuretics for both the prevention and treatment of AKI.</p><p><strong>Search methods: </strong>The Cochrane Kidney and Transplant Register of Studies was searched up to May 2024 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov.</p><p><strong>Selection criteria: </strong>We selected randomised controlled trials (RCTs) and quasi-RCTs in which diuretics were used to prevent or treat AKI.</p><p><strong>Data collection and analysis: </strong>Two authors independently extracted data using standardised data extraction forms. Dichotomous outcomes were expressed as risk ratios (RR) with 95% confidence intervals (CI). Where continuous scales of measurement were used to assess the effects of treatment, the standardised mean difference (SMD) was used. The primary review outcomes for AKI prevention studies were the incidence of AKI and any use of kidney replacement therapy (KRT). For treatment studies, the primary outcome was any use of KRT. The certainty of evidence was assessed per outcome using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Main results: </strong>We included 64 studies (83 reports, 9871 participants): 53 prevention studies (8078 participants) and 11 treatment studies (1793 participants). Studies were conducted in the following World Health Organization regions: the Americas (15), Eastern Mediterranean (9), Europe (25), South-East Asia (2), and the Western Pacific (13). Thirty-six studies were single-centre studies, 19 were multicentre, and the setting was unclear in nine studies. Diuretics were compared to placebo, no treatment or conventional therapy, saline solutions (isotonic or hypotonic), 5% dextrose, 5% glucose, Hartmann's solution, and Ringer's acetate. Overall, the risk of bias was low in one study, high in 19 studies, and of some concern in 41 studies. Three studies could not be assessed because they did not report any outcomes of interest. For AKI prevention, compared to control, diuretics may reduce the risk of AKI (38 studies, 5540 participants: RR 0.75, 95%, CI 0.61 to 0.92; I
{"title":"Diuretics for preventing and treating acute kidney injury.","authors":"Hiroyuki Hashimoto, Hiroyuki Yamada, Maki Murata, Norio Watanabe","doi":"10.1002/14651858.CD014937.pub2","DOIUrl":"10.1002/14651858.CD014937.pub2","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a well-known complication of critical illnesses, significantly affecting morbidity and the risk of death. Diuretics are widely used to ameliorate excess fluid accumulation and oliguria associated with AKI. Their popularity stems from their ability to reduce the energy demands of renal tubular cells by inhibiting transporters and flushing out intratubular casts. Numerous studies have assessed the effects of diuretics in the context of AKI prevention and treatment. However, a comprehensive systematic review addressing this topic has yet to be conducted.</p><p><strong>Objectives: </strong>This review aimed to explore the benefits and harms of diuretics for both the prevention and treatment of AKI.</p><p><strong>Search methods: </strong>The Cochrane Kidney and Transplant Register of Studies was searched up to May 2024 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov.</p><p><strong>Selection criteria: </strong>We selected randomised controlled trials (RCTs) and quasi-RCTs in which diuretics were used to prevent or treat AKI.</p><p><strong>Data collection and analysis: </strong>Two authors independently extracted data using standardised data extraction forms. Dichotomous outcomes were expressed as risk ratios (RR) with 95% confidence intervals (CI). Where continuous scales of measurement were used to assess the effects of treatment, the standardised mean difference (SMD) was used. The primary review outcomes for AKI prevention studies were the incidence of AKI and any use of kidney replacement therapy (KRT). For treatment studies, the primary outcome was any use of KRT. The certainty of evidence was assessed per outcome using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Main results: </strong>We included 64 studies (83 reports, 9871 participants): 53 prevention studies (8078 participants) and 11 treatment studies (1793 participants). Studies were conducted in the following World Health Organization regions: the Americas (15), Eastern Mediterranean (9), Europe (25), South-East Asia (2), and the Western Pacific (13). Thirty-six studies were single-centre studies, 19 were multicentre, and the setting was unclear in nine studies. Diuretics were compared to placebo, no treatment or conventional therapy, saline solutions (isotonic or hypotonic), 5% dextrose, 5% glucose, Hartmann's solution, and Ringer's acetate. Overall, the risk of bias was low in one study, high in 19 studies, and of some concern in 41 studies. Three studies could not be assessed because they did not report any outcomes of interest. For AKI prevention, compared to control, diuretics may reduce the risk of AKI (38 studies, 5540 participants: RR 0.75, 95%, CI 0.61 to 0.92; I","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD014937"},"PeriodicalIF":8.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058070","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}
Pub Date : 2025-01-29DOI: 10.1002/14651858.CD010216.pub9
Nicola Lindson, Ailsa R Butler, Hayden McRobbie, Chris Bullen, Peter Hajek, Angela Difeng Wu, Rachna Begh, Annika Theodoulou, Caitlin Notley, Nancy A Rigotti, Tari Turner, Jonathan Livingstone-Banks, Tom Morris, Jamie Hartmann-Boyce
<p><strong>Background: </strong>Electronic cigarettes (ECs) are handheld electronic vaping devices that produce an aerosol by heating an e-liquid. People who smoke, healthcare providers, and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review.</p><p><strong>Objectives: </strong>To examine the safety, tolerability, and effectiveness of using EC to help people who smoke tobacco achieve long-term smoking abstinence, in comparison to non-nicotine EC, other smoking cessation treatments, and no treatment.</p><p><strong>Search methods: </strong>We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 February 2024 and the Cochrane Tobacco Addiction Group's Specialized Register to 1 February 2023, reference-checked, and contacted study authors.</p><p><strong>Selection criteria: </strong>We included trials randomizing people who smoke to an EC or control condition. We included uncontrolled intervention studies in which all participants received an EC intervention. Studies had to report an eligible outcome.</p><p><strong>Data collection and analysis: </strong>We followed standard Cochrane methods for screening and data extraction. We used the risk of bias tool (RoB 1) and GRADE to assess the certainty of evidence. Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). Important outcomes were biomarkers, toxicants/carcinogens, and longer-term EC use. We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in pairwise and network meta-analyses (NMA).</p><p><strong>Main results: </strong>We included 90 completed studies (two new to this update), representing 29,044 participants, of which 49 were randomized controlled trials (RCTs). Of the included studies, we rated 10 (all but one contributing to our main comparisons) at low risk of bias overall, 61 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. Nicotine EC results in increased quit rates compared to nicotine replacement therapy (NRT) (high-certainty evidence) (RR 1.59, 95% CI 1.30 to 1.93; I<sup>2</sup> = 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more). The rate of occurrence of AEs is probably similar between groups (moderate-certainty evidence (limited by imprecision)) (RR 1.03, 95% CI 0.91 to 1.17; I<sup>2</sup> = 0%; 5 studies, 2052 participants). SAEs were rare, and there is insufficient evidence to determine whether rates differ between groups due to very serious imprecision (RR 1.20, 95% CI 0.90 to 1.60; I<sup>2</sup> = 32%; 6 studies, 2761 partici
{"title":"Electronic cigarettes for smoking cessation.","authors":"Nicola Lindson, Ailsa R Butler, Hayden McRobbie, Chris Bullen, Peter Hajek, Angela Difeng Wu, Rachna Begh, Annika Theodoulou, Caitlin Notley, Nancy A Rigotti, Tari Turner, Jonathan Livingstone-Banks, Tom Morris, Jamie Hartmann-Boyce","doi":"10.1002/14651858.CD010216.pub9","DOIUrl":"10.1002/14651858.CD010216.pub9","url":null,"abstract":"<p><strong>Background: </strong>Electronic cigarettes (ECs) are handheld electronic vaping devices that produce an aerosol by heating an e-liquid. People who smoke, healthcare providers, and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review.</p><p><strong>Objectives: </strong>To examine the safety, tolerability, and effectiveness of using EC to help people who smoke tobacco achieve long-term smoking abstinence, in comparison to non-nicotine EC, other smoking cessation treatments, and no treatment.</p><p><strong>Search methods: </strong>We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 February 2024 and the Cochrane Tobacco Addiction Group's Specialized Register to 1 February 2023, reference-checked, and contacted study authors.</p><p><strong>Selection criteria: </strong>We included trials randomizing people who smoke to an EC or control condition. We included uncontrolled intervention studies in which all participants received an EC intervention. Studies had to report an eligible outcome.</p><p><strong>Data collection and analysis: </strong>We followed standard Cochrane methods for screening and data extraction. We used the risk of bias tool (RoB 1) and GRADE to assess the certainty of evidence. Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). Important outcomes were biomarkers, toxicants/carcinogens, and longer-term EC use. We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in pairwise and network meta-analyses (NMA).</p><p><strong>Main results: </strong>We included 90 completed studies (two new to this update), representing 29,044 participants, of which 49 were randomized controlled trials (RCTs). Of the included studies, we rated 10 (all but one contributing to our main comparisons) at low risk of bias overall, 61 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. Nicotine EC results in increased quit rates compared to nicotine replacement therapy (NRT) (high-certainty evidence) (RR 1.59, 95% CI 1.30 to 1.93; I<sup>2</sup> = 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more). The rate of occurrence of AEs is probably similar between groups (moderate-certainty evidence (limited by imprecision)) (RR 1.03, 95% CI 0.91 to 1.17; I<sup>2</sup> = 0%; 5 studies, 2052 participants). SAEs were rare, and there is insufficient evidence to determine whether rates differ between groups due to very serious imprecision (RR 1.20, 95% CI 0.90 to 1.60; I<sup>2</sup> = 32%; 6 studies, 2761 partici","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD010216"},"PeriodicalIF":8.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058191","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}
Pub Date : 2025-01-29DOI: 10.1002/14651858.CD013722.pub2
Moe Moe Thandar, Toshiaki Baba, Sadatoshi Matsuoka, Erika Ota
<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a major global health concern. One of the most important causes of AMR is the excessive and inappropriate use of antimicrobial drugs in healthcare and community settings. Most countries have policies that require antimicrobial drugs to be obtained from a pharmacy by prescription. The term 'non-prescription antimicrobial sale' refers to the dispensing and selling of antimicrobial drugs without a prescription in countries where the pharmaceutical policy does not permit the sale of antimicrobial drugs without a prescription. Pharmacies, drugstores, and other medicine outlets are major sources of non-prescription antimicrobial sales in the community setting.</p><p><strong>Objectives: </strong>To assess the effects of interventions for reducing non-prescription antimicrobial sales by pharmacists and non-pharmacists in community pharmacies, drugstores, and other medicine outlets. To assess whether the effects of interventions differ according to types of interventions (single or multicomponent), community pharmacy personnel (pharmacists or non-pharmacists), and countries (low to lower-middle-income and upper-middle to high income).</p><p><strong>Search methods: </strong>We searched five databases, including CENTRAL, MEDLINE, and Embase, and two trial registers to 26 September 2022. We also conducted reference checking and citation searches.</p><p><strong>Selection criteria: </strong>We included randomized trials, cluster-randomized trials, and quasi-randomized trials evaluating interventions targeted at pharmacists and non-pharmacists in community pharmacies, drugstores, and other medicine outlets. Our primary outcomes were non-prescription antimicrobial sales, symptomatic or asymptomatic infections caused by antimicrobial-resistant pathogens among pharmacy clients or community residents, and adverse events associated with non-prescription antimicrobial drug use in pharmacy clients. Our secondary outcomes were history taking and provision of advice to pharmacy clients, and knowledge of pharmacists and non-pharmacists.</p><p><strong>Data collection and analysis: </strong>We followed standard Cochrane methods.</p><p><strong>Main results: </strong>We included four trials conducted in pharmacies and drugstores. Three studies were published between 2000 and 2010, and the fourth in 2016. In total, 942 community pharmacies and drugstores participated, including both pharmacists and non-pharmacists. One study conducted in Scotland was a four-arm trial that included educational outreach visits, continuing professional education, and a combination of both as interventions, in comparison to a control group supplied with guideline materials only. Two studies conducted in Portugal and Uganda compared the combination of training and distribution of written materials with a control of no intervention. One study conducted in Thailand and Vietnam compared a sequence of three interventions (regulatory enf
{"title":"Interventions to reduce non-prescription antimicrobial sales in community pharmacies.","authors":"Moe Moe Thandar, Toshiaki Baba, Sadatoshi Matsuoka, Erika Ota","doi":"10.1002/14651858.CD013722.pub2","DOIUrl":"10.1002/14651858.CD013722.pub2","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a major global health concern. One of the most important causes of AMR is the excessive and inappropriate use of antimicrobial drugs in healthcare and community settings. Most countries have policies that require antimicrobial drugs to be obtained from a pharmacy by prescription. The term 'non-prescription antimicrobial sale' refers to the dispensing and selling of antimicrobial drugs without a prescription in countries where the pharmaceutical policy does not permit the sale of antimicrobial drugs without a prescription. Pharmacies, drugstores, and other medicine outlets are major sources of non-prescription antimicrobial sales in the community setting.</p><p><strong>Objectives: </strong>To assess the effects of interventions for reducing non-prescription antimicrobial sales by pharmacists and non-pharmacists in community pharmacies, drugstores, and other medicine outlets. To assess whether the effects of interventions differ according to types of interventions (single or multicomponent), community pharmacy personnel (pharmacists or non-pharmacists), and countries (low to lower-middle-income and upper-middle to high income).</p><p><strong>Search methods: </strong>We searched five databases, including CENTRAL, MEDLINE, and Embase, and two trial registers to 26 September 2022. We also conducted reference checking and citation searches.</p><p><strong>Selection criteria: </strong>We included randomized trials, cluster-randomized trials, and quasi-randomized trials evaluating interventions targeted at pharmacists and non-pharmacists in community pharmacies, drugstores, and other medicine outlets. Our primary outcomes were non-prescription antimicrobial sales, symptomatic or asymptomatic infections caused by antimicrobial-resistant pathogens among pharmacy clients or community residents, and adverse events associated with non-prescription antimicrobial drug use in pharmacy clients. Our secondary outcomes were history taking and provision of advice to pharmacy clients, and knowledge of pharmacists and non-pharmacists.</p><p><strong>Data collection and analysis: </strong>We followed standard Cochrane methods.</p><p><strong>Main results: </strong>We included four trials conducted in pharmacies and drugstores. Three studies were published between 2000 and 2010, and the fourth in 2016. In total, 942 community pharmacies and drugstores participated, including both pharmacists and non-pharmacists. One study conducted in Scotland was a four-arm trial that included educational outreach visits, continuing professional education, and a combination of both as interventions, in comparison to a control group supplied with guideline materials only. Two studies conducted in Portugal and Uganda compared the combination of training and distribution of written materials with a control of no intervention. One study conducted in Thailand and Vietnam compared a sequence of three interventions (regulatory enf","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD013722"},"PeriodicalIF":8.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058226","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}
Pub Date : 2025-01-28DOI: 10.1002/14651858.CD014212
Nai Ming Lai, Michelle Fiander, Jane Cracknell, Kenneth Tan, Olga Romantsik
Objectives: 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.
{"title":"Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants.","authors":"Nai Ming Lai, Michelle Fiander, Jane Cracknell, Kenneth Tan, Olga Romantsik","doi":"10.1002/14651858.CD014212","DOIUrl":"10.1002/14651858.CD014212","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 dexmedetomidine compared with opioids, non-opioids and placebo in providing sedation and analgesia for procedural pain in newborn infants.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"1 ","pages":"CD014212"},"PeriodicalIF":8.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051945","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}
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