Cochrane Database of Systematic Reviews最新文献

{"title":"Lower-limb neuromuscular electrical stimulation (NMES) for people with chronic kidney disease undergoing dialysis.","authors":"Louise Beresford, Susan Dewhurst, Alastair Hutchison, Anand D Pandyan","doi":"10.1002/14651858.CD016155","DOIUrl":"10.1002/14651858.CD016155","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 neuromuscular electrical stimulation (NMES) on muscle structure and function in people undergoing dialysis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD016155"},"PeriodicalIF":8.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076542","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":"Prophylactic abdominal drainage for pancreatic surgery.","authors":"Chunmu Miao, Yali Hu, Guijuan Bai, Nansheng Cheng, Yao Cheng, Weimin Wang","doi":"10.1002/14651858.CD010583.pub6","DOIUrl":"10.1002/14651858.CD010583.pub6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;This is the fourth update of a Cochrane review first published in 2015 and last updated in 2021. The use of surgical drains is a very common practice after pancreatic surgery. The role of prophylactic abdominal drainage to reduce postoperative complications after pancreatic surgery is controversial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of routine abdominal drainage after pancreatic surgery; to compare the effects of different types of surgical drains; and to evaluate the optimal time for drain removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, three other databases, and five trials registers, together with reference checking and contact with study authors, to identify studies for inclusion in the review. The search dates were 20 April 2024 and 20 July 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) in participants undergoing pancreatic surgery comparing (1) drain use versus no drain use, (2) different types of drains, or (3) different schedules for drain removal. We excluded quasi-randomised and non-randomised studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were 30-day mortality, 90-day mortality, intra-abdominal infection, wound infection, and drain-related complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 1 tool to assess the risk of bias in RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised the results for each outcome using meta-analysis with the random-effects model where possible. We used GRADE to assess the certainty of evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 12 RCTs with a total of 2550 participants. The studies were conducted in North America, Europe, and Asia and were published between 2001 and 2024. All studies were at overall high risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;We considered the certainty of the evidence for intra-abdominal infection for the comparison of early versus late drain removal following pancreaticoduodenectomy to be moderate, downgraded due to indirectness. We considered the certainty of the evidence for the other outcomes to be low or very low, mainly downgraded due to high risk of bias, inconsistency, indirectness, and imprecision. Drain use versus no drain use following pancreaticoduodenectomy We included two RCTs with 532 participants randomised to the drainage group (N = 270) and the no drainage group (N = 262) after pancreaticoduodenectomy. The evidence is very uncertain about the effect of drain use on 30-day mortality (risk ratio (RR) 0.49, 95% confidence interval (CI) 0.07 to 3.66; 2 studies, 532 participants), 90-day mortality (RR 0.25, 95% CI 0.06 to 1.15; 1 study, 137 participants), intra-abdominal infection rate (RR 0.85, 95% CI 0.21 to 3.51; 2 studies, 532 participants), and wound infection rate (RR 0.85, 95% CI 0.55 to 1.31; 2 studies, 532 participants","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD010583"},"PeriodicalIF":8.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076543","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":"Clinical pathways for secondary care and the effects on professional practice, patient outcomes, length of stay and hospital costs.","authors":"Thomas Rotter, Leigh D Kinsman, Agnès Alsius, Shannon D Scott, Adegboyega Lawal, Ulrich Ronellenfitsch, Christopher Plishka, Gary Groot, Phil Woods, Chloe Coulson, Leigh Anne Bakel, Kim Sears, Amanda Ross-White, Andreas Machotta, Timothy J Schultz","doi":"10.1002/14651858.CD006632.pub3","DOIUrl":"10.1002/14651858.CD006632.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical pathways (CPWs) are structured multidisciplinary care plans. They aim to translate evidence into practice and optimize clinical outcomes. This is the first update of the previous systematic review (Rotter 2010).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the effect of CPWs on patient outcomes, length of stay, costs and charges, adherence to recommended practice, and to measure the impact of different approaches to implementation of CPWs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;For this update, CENTRAL, MEDLINE, and Embase were searched on 25 July 2024. Two trial registries were searched on 26 July 2024, along with reference checking, citation searching and contacting authors to identify additional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We considered two groups of participants: health professionals involved in CPW utilization, including (but not limited to) physicians, nurses, physiotherapists, pharmacists, occupational therapists and social workers; and patients managed using a CPW. We included randomized trials, non-randomized trials, controlled before-after (CBA) studies, and interrupted time-series (ITS) studies comparing (1) stand-alone clinical pathways with usual care, and (2) clinical pathways as part of a multifaceted intervention with usual care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two authors independently screened all titles, abstracts and full-text manuscripts to assess eligibility and the methodological quality of included studies using the Cochrane Effective Practice and Organization of Care 'Risk of Bias' tool. Certainty of evidence was assessed by two authors independently. Interventions were scored as 'high', 'moderate' or 'low' for the evidence-based implementation process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;The update provided 31 additional studies for a total of 58 included studies (24,841 patients and 2027 healthcare professionals). Forty-one (71%) were randomized trials, four (7%) non-randomized trials, four (7%) CBA studies and nine (16%) ITS studies. Forty-nine studies compared stand-alone CPWs to usual care and nine compared multifaceted interventions including a CPW to usual care. Collectively, the risk of bias was high due to potential contamination by healthcare professionals, lack of blinding of patients and personnel, lack of allocation concealment and selective reporting in ITS studies. Stand-alone clinical pathway interventions It is uncertain whether stand-alone CPWs reduce inhospital mortality (13% v 16%: OR 0.79, 95% CI 0.53 to 1.20; P = 0.27; I² = 65%; 7 randomized trials; n = 4603; low-certainty evidence due to serious imprecision and inconsistency) or mortality (up to 6 months) (4% v 3%: OR 1.37, 95% CI 0.72 to 2.60; P = 0.34; I² = 20%; 3 randomized trials, n = 805; low-certainty evidence due to serious risk of bias and imprecision). Stand-alone CPWs likely reduce inhospital complications (10% v 17%: OR 0.57, 95% CI 0.41 to 0.80; P","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD006632"},"PeriodicalIF":8.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971778","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":"Total neoadjuvant therapy for locally advanced rectal cancer.","authors":"Sophie Mueller, Yung-Shuo Kao, Carolin Kastner, Po-Huang Chen, Anne Hendricks, Gin Yi Lee, Franziska Koehler, Hong-Jie Jhou, Christoph-Thomas Germer, Enoch Yi-No Kang, Heidrun Janka, Ching-Liang Ho, Cho-Hao Lee, Armin Wiegering","doi":"10.1002/14651858.CD015590","DOIUrl":"10.1002/14651858.CD015590","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 and safety of total neoadjuvant therapy versus standard therapy in individuals with locally advanced rectal cancer.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD015590"},"PeriodicalIF":8.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986122","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":"Early mobilization after skin graft for burn injury in adults.","authors":"Tamara S Sousa, Roger Andrey Carvalho Jardim, Caroline Fr Silva, André S Sousa, Natalia Iosimuta, Virginia Fm Trevisani, Ana Carolina Pereira Nunes Pinto","doi":"10.1002/14651858.CD016109","DOIUrl":"10.1002/14651858.CD016109","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 early mobilization after skin graft for burn injury in adults.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD016109"},"PeriodicalIF":8.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989165","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":"Electromechanical-assisted training for walking after stroke.","authors":"Jan Mehrholz, Joachim Kugler, Marcus Pohl, Bernhard Elsner","doi":"10.1002/14651858.CD006185.pub6","DOIUrl":"10.1002/14651858.CD006185.pub6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Walking difficulties are common after a stroke. During rehabilitation, electromechanical and robotic gait-training devices can help improve walking. As the evidence and certainty of the evidence may have changed since our last update in 2020, we aimed to update the scientific evidence on the benefits and acceptability of these technologies to ensure they remain a viable option for stroke rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Primary • To determine whether electromechanical- and robot-assisted gait training versus physiotherapy (or usual care) improves walking in adults after stroke. Secondary • To determine whether electromechanical- and robot-assisted gait training versus physiotherapy (or usual care) after stroke improves walking velocity, walking capacity, acceptability, and death from all causes until the end of the intervention phase.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, and seven other databases. We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trial authors to identify further published, unpublished, and ongoing trials. The date of the latest search was December 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included all randomised controlled trials and randomised controlled cross-over trials in people over the age of 18 years diagnosed with stroke of any severity, at any stage, in any setting, evaluating electromechanical- and robot-assisted gait training versus physiotherapy (or usual care).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcome was the ability to walk independently, measured with the Functional Ambulation Category (FAC). An FAC score of 4 or 5 indicated independent walking over a 15-metre surface, irrespective of aids used, such as a cane. An FAC score less than 4 indicates dependency in walking (supervision or assistance, or both, must be given in performing walking). Important outcomes included walking velocity and capacity, as well as dropouts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used Cochrane's RoB 1 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Two review authors independently selected trials for inclusion, assessed methodological quality and risk of bias, and extracted data. We used random-effects models for the meta-analysis. We assessed the certainty of evidence using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 101 studies (39 new studies plus 62 studies from previous versions) with a total of 4224 participants after stroke in our review update.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Electromechanical-assisted gait training in combination with physiotherapy probably increases the odds of participants becoming independent in walking (odds ratio (OR) 1.65, 95% confidence interval (CI) 1.21 to 2.25; P = 0.001; I² = 31%; 51 studies, 2148 participants; moderate-certainty evidence); probably does not increase me","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD006185"},"PeriodicalIF":8.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957375","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":"Anti-IL-12/23p40 antibodies for induction of remission in Crohn's disease.","authors":"Johannes Hasskamp, Christian Meinhardt, Antje Timmer","doi":"10.1002/14651858.CD007572.pub4","DOIUrl":"10.1002/14651858.CD007572.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Crohn's disease (CD) is a chronic inflammatory bowel disease leading to symptoms such as abdominal pain, diarrhea, weight loss, fatigue, and complications such as strictures and fistulas. Ustekinumab (CNTO 1275) and briakinumab (ABT-874) are monoclonal antibodies that target the standard p40 subunit of the cytokines interleukin-12 and interleukin-23 (IL-12/23p40), which are involved in the pathogenesis of CD. Briakinumab has been withdrawn for the treatment of CD, making ustekinumab the only available antibody against the p40 subunit of interleukin-12 and interleukin-23 approved for this purpose.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of anti-IL-12/23p40 antibodies for induction of remission in CD, as compared to no treatment, placebo, other drug treatment, or varying dosing schedules.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and MEDLINE (from inception to 2 February 2024) and Embase (from inception until 12 August 2022). We also searched ClinicalTrials.gov, WHO ICTRP, references, and conference abstracts to identify additional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) of at least four weeks' duration in which monoclonal antibodies against IL-12/23p40 were compared to placebo, no treatment, or another active comparator in people with active CD. We also included trials examining different doses of antibodies against IL-12/23p40.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently screened studies for inclusion and extracted data. We assessed the methodological quality of the included studies using Cochrane's RoB 2 tool. The primary outcome was failure to induce clinical remission by week 8, or 6 to 12 as available. Secondary outcomes included failure to induce clinical improvement (clinical response), induction of endoscopic remission, quality of life, and adverse events, serious adverse events, and withdrawals due to adverse events. We calculated the risk ratio (RR) or risk difference (RD) and 95% confidence intervals (95% CI) for each outcome unless substantial heterogeneity was detected. We analyzed data on an intention-to-treat basis. We assessed the certainty of the evidence using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Eight RCTs involving a total of 3224 participants with CD met the inclusion criteria. All studies were double-blinded. We assessed the risk of bias for most outcomes as either low risk of bias or some concerns. Based on a pooled analysis of three trials, ustekinumab decreased the number of participants failing to achieve clinical remission at eight weeks when compared to placebo. Seventy-four per cent (693/938) of participants in the ustekinumab group and 87% (421/483) of those in the placebo group did not enter clinical remission (RR 0.85, 95% CI 0.81 to 0.89;","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD007572"},"PeriodicalIF":8.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985854","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":"Early discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds.","authors":"Alice R Rumbold, Amy Keir, Carmel T Collins, Chris Cooper, Emily S Shepherd","doi":"10.1002/14651858.CD003743.pub3","DOIUrl":"10.1002/14651858.CD003743.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Many preterm infants otherwise ready for discharge remain hospitalised while they transition from gavage to full sucking feeds. Early discharge of stable preterm infants still requiring gavage feeds may have some benefits: it could reduce separation of parents and infants and reduce costs to the healthcare system and families compared with discharge home when on full sucking feeds. Potential disadvantages of early discharge include increased care burden for the family and the risk of complications related to gavage feeding. This is an update of a review first published in 2003 and last updated in 2015.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness and safety of early discharge with home support of gavage feeding for stable preterm infants who have not established full oral feeds compared with later discharge when full sucking feeds have been established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, CINAHL, and trial registries up to May 2024. We checked the reference lists of included studies and relevant systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) and quasi-RCTs that enroled infants born before 37 weeks who required no intravenous nutrition at the time of discharge. The comparison of interest was early discharge home with gavage feeds and healthcare support versus later discharge home after attainment of full sucking feeds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were time to reach full sucking feeds, weight gain at latest time point measured, and breastfeeding on discharge from home support or hospital. Important outcomes included infection up to discharge (e.g. respiratory infections, use of intravenous antibiotics), breastfeeding at three months after discharge, rehospitalisation up to 12 months after discharge, and composite neurodevelopmental outcome at 12 months or later.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two review authors independently screened and selected trials, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool RoB 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We presented dichotomous data as summary risk ratios (RRs) with 95% confidence intervals (CIs), and continuous data as mean differences (MDs) with 95% CIs. We used the GRADE approach to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;There were no new studies available for inclusion in this update. As in the original review, we included one quasi-RCT (88 infants, 75 families) evaluating early discharge with home support of gavage feeding (early discharge with support) versus later discharge on full sucking feeds (later discharge) in physiologically stable preterm infants born before 37 weeks' gestation with an anticipated need for special care for at least one additional week. The study was conducted in Sweden in the 1990s.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of result","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD003743"},"PeriodicalIF":8.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989116","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":"Short versus long drug regimens for Chagas disease.","authors":"Samanta Díaz Menai, Lucia B Varela, Camila Micaela Escobar Liquitay, Marilina Santero, Javier Bracchiglione, Luis Garegnani","doi":"10.1002/14651858.CD016172","DOIUrl":"https://doi.org/10.1002/14651858.CD016172","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 short versus long drug regimens (trypanocidal schemes) for Chagas disease in chronic asymptomatic stages.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD016172"},"PeriodicalIF":8.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971508","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":"Sustained-release naltrexone for opioid dependence.","authors":"Hege Kornør, Philipp Paul K Lobmaier, Nikolaj Kunøe","doi":"10.1002/14651858.CD006140.pub3","DOIUrl":"https://doi.org/10.1002/14651858.CD006140.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Opioid dependence is a severe and often lifelong disorder with a high risk of overdose and premature death, as well as severe psychosocial difficulties. Sustained-release naltrexone is a treatment option that works by blocking the euphoric and overdose effects of opioids. When injected intramuscularly, naltrexone provides blockade for one month, while the blocking effects with implants can last for up to six months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of sustained-release naltrexone for the treatment of opioid dependence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;For this update, we searched the following databases from 2007 up to 20 December 2023: the Cochrane Drugs and Alcohol Specialised Register of Trials, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, ISI Web of Science, LILACS, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. We manually searched the reference lists of identified studies, published reviews and relevant websites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Randomised controlled trials comparing the effects of injectable or implantable naltrexone with other treatment, no treatment or placebo in adults with opioid dependence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Primary outcomes were illicit opioid use, retention in treatment, treatment acceptability and adverse events. Secondary outcomes were opioid craving, recreational use of substances other than opioids, mental health, quality of life and criminal activity. We assessed the risk of bias using the Cochrane risk of bias tool (RoB 1). We combined the results of individual trials through meta-analysis where possible using a random-effects model. Two review authors independently assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We identified 22 studies (3416 participants) that met our inclusion criteria. Three studies compared sustained-release naltrexone with opioid agonist treatment, five with oral naltrexone, six with placebo, nine with treatment as usual and one with psychosocial intervention. Sustained-release naltrexone compared with opioid agonist treatment We found moderate-certainty evidence that sustained-release naltrexone probably increases in-treatment illicit opioid use slightly (risk ratio (RR) 1.15, 95% confidence interval (CI) 1.01 to 1.31; 1 study, 570 participants). The evidence is very uncertain about the effect of sustained-release naltrexone on retention in treatment (RR 1.17, 95% CI 0.78 to 1.76; 3 studies, 773 participants) and treatment acceptability (RR 0.92, 95% CI 0.73 to 1.16; 3 studies, 773 participants). There was low-certainty evidence that sustained-release naltrexone may increase serious adverse events slightly in comparison with opioid agonist treatment for serious adverse events (RR 1.40,","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"5 ","pages":"CD006140"},"PeriodicalIF":8.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977421","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}