Cochrane Database of Systematic Reviews最新文献

{"title":"Interventions for improving adherence to exercise-based treatments in people with knee osteoarthritis.","authors":"Joaquin Gonzalez Aroca, Laura Vergara Merino, Nicolás Meza, Carlos Gonzalez, Priscila Ramirez Araya, Camila Micaela Escobar Liquitay, Sergio R Munoz, Eva Madrid","doi":"10.1002/14651858.CD016088","DOIUrl":"10.1002/14651858.CD016088","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 interventions aimed at improving adherence to land-based therapeutic exercise in adults with knee osteoarthritis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD016088"},"PeriodicalIF":8.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658516","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 manual rotation of the fetal head (manual rotation alone) to reduce operative delivery and complications for mother and babies.","authors":"Hala Phipps, David A Osborn, Rongming Zhang, Chris Cooper, Jon Hyett, Bradley S de Vries","doi":"10.1002/14651858.CD009298.pub3","DOIUrl":"10.1002/14651858.CD009298.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Manual rotation of the fetal head for women with fetal malpresentation (occipital posterior (OP) or occipital transverse (OT)) is commonly performed to increase the chances of normal vaginal delivery and is perceived to be safe. Prophylactic manual rotation has the potential to prevent operative delivery and caesarean section, and reduce obstetric and neonatal complications. This review updates a previous 2014 Cochrane review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effect of prophylactic manual rotation compared to no manual rotation for women with malposition in labour on mode of delivery, and maternal and neonatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, three other databases and three trial registries in March 2024. We reviewed the reference lists of retrieved studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Randomised controlled trials (RCTs), quasi-randomised or cluster-randomised clinical trials comparing prophylactic manual rotation in labour for fetal malposition versus expectant management, augmentation of labour or operative delivery were eligible. Participants included women at term or preterm, (&lt; 37 weeks' gestation) planning a vaginal birth with a cephalic singleton fetal malposition in labour. We defined prophylactic manual rotation as rotation performed without immediate instrumental vaginal delivery. We excluded non-randomised studies, and studies comparing manual rotation as part of a multi-component intervention without the ability to isolate the effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were operative delivery (forceps or vacuum delivery or caesarean section), maternal and perinatal mortality, caesarean section, instrumental delivery (forceps or vacuum delivery), third- or fourth-degree perineal trauma and postpartum haemorrhage of 500 mL or more.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two review authors independently assessed RCTs for inclusion and extracted data. Two review authors independently evaluated the risk of bias using the Cochrane risk of bias (RoB 1, version 5.2) tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We analysed dichotomous data using a random effects model and presented the results as summary risk ratios (RRs) with 95% confidence intervals (CIs). We also assessed the certainty of the evidence using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;The review included six RCTs in Australia, France and the USA, recruiting a total of 1002 participants. We judged the overall risk of bias to be low for three RCTs (444 participants). We assessed the other three RCTs (558 participants) to have a high risk of performance and detection bias as they did not blind the control group. All RCTs included pregnant women in labour ≥ 37 weeks gestation with a singleton pregnancy at full cervical dilatation. A single study enrolled only nulliparous women. The majority of women (&gt; 80%) had epidural analgesia. Four R","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD009298"},"PeriodicalIF":8.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658517","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 versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes.","authors":"Matteo Bruschettini, Tilda Moberg, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Maria Grazia Calevo","doi":"10.1002/14651858.CD004953.pub5","DOIUrl":"10.1002/14651858.CD004953.pub5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable gas exchange. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving a sustained lung inflation (SLI) at the start of PPV may help clear lung fluid and establish gas volume within the lungs. This is a review update; the last version was published in 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of an initial SLI (&gt; 1 second duration) versus standard inflations (≤ 1 second) in newborn infants receiving resuscitation with intermittent PPV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and two trial registries on 8 April 2024. We checked the reference lists of studies and other related papers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) and quasi-RCTs comparing initial SLI versus standard inflations given to infants receiving resuscitation with PPV at birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were: death in the delivery room; death during hospitalisation. Other clinically relevant outcomes were: rate of mechanical ventilation; chronic lung disease, any grade; chronic lung disease, moderate to severe; pneumothorax during hospitalisation; intraventricular haemorrhage grade 3 or 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool 1.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We conducted meta-analyses using fixed-effect models to calculate risk ratios (RR) and 95% confidence intervals (CI). We summarised the certainty of the evidence according to GRADE methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;Fourteen trials enrolling 1766 infants met our inclusion criteria. The studies were conducted on five continents, and published between 2005 and 2024. Investigators in 12 trials (1722 infants) administered SLI with no chest compressions; 10 studies reported that peak inspiratory pressure (PIP) was sustained for 15 seconds. Levels of PIP ranged from 20 to 30 cmH₂O. Investigators in seven studies provided additional SLIs in cases of poor response. We downgraded the overall certainty of evidence for all outcomes because of limitations in study design (e.g. selection bias due to lack of allocation concealment and performance bias due to unblinded intervention), and serious imprecision of results, with wide confidence intervals and few events. One trial is ongoing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;For each outcome, we downgraded the overall certainty of evidence because of limitations in study design and imprecision. Compared with intermittent ventilation, SLI with no chest compression may result in little to no difference in","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD004953"},"PeriodicalIF":8.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658518","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":"Surgery for spontaneous supratentorial intracerebral haemorrhage.","authors":"Floor Nh Wilting, Lotte Sondag, Floris Hbm Schreuder, Ruben Dammers, Catharina Jm Klijn, Hieronymus D Boogaarts","doi":"10.1002/14651858.CD015387.pub2","DOIUrl":"10.1002/14651858.CD015387.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;It is unknown whether surgery improves outcomes in people with spontaneous supratentorial intracerebral haemorrhage (ICH), and whether the effects of surgery differ according to the applied surgical technique. This review updated the methodology of a previous Cochrane review from 2008.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of surgery plus standard medical management, compared to standard medical management alone, in people with spontaneous supratentorial ICH, and to assess whether the effect of surgery differs according to the surgical technique used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, and five other databases to 11 March 2025. We handsearched reference lists of included studies and relevant systematic reviews, forward-tracked relevant references, and contacted trialists for additional information on unpublished or ongoing studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) of surgery (craniotomy with haematoma evacuation, minimally invasive surgery (MIS), or decompressive craniectomy) plus standard medical management in adults with a spontaneous supratentorial ICH, compared with standard medical management alone. We excluded studies of people with secondary causes of ICH (such as trauma, a macrovascular cause, or an intracranial tumour).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were: good functional outcome at end of scheduled follow-up, and all-cause mortality at end of scheduled follow-up. Important outcomes were: 30-day case fatality and health-related quality of life (HRQoL) at end of scheduled follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 1 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We conducted meta-analyses using random-effects models to calculate risk ratios (RR) with 95% confidence intervals (CI) for dichotomous data, and mean differences (MD) with 95% CI for continuous data. We summarised the certainty of the evidence using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 24 RCTs (4597 participants). The studies were conducted in Europe, North and South America, Asia, Africa, and Australia, and were published between 1989 and 2024. Twenty-three studies examined surgery aimed at clot removal plus standard medical management versus standard medical management, of which six were included in the separate comparison of craniotomy with haematoma evacuation plus standard medical management versus standard medical management, and 14 in the comparison of MIS plus standard medical management versus standard medical management. One study examined decompressive craniectomy without haematoma evacuation plus standard medical management versus standard medical management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Surgery aimed at clot removal plus standard medical management versus standard medical management alone","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD015387"},"PeriodicalIF":8.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648769","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":"Midazolam for sedation of infants in the neonatal intensive care unit.","authors":"Olga Romantsik, Amin Sharifan, Michelle Fiander, Eugene Ng, Matteo Bruschettini","doi":"10.1002/14651858.CD002052.pub4","DOIUrl":"10.1002/14651858.CD002052.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and prevent complications. Midazolam is a short-acting benzodiazepine that is used in neonatal intensive care units. This is an update of a Cochrane review first published in 2003.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of midazolam - compared with placebo, other pharmacological interventions, and non-pharmacological interventions - for sedation of newborn infants in neonatal intensive care units.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched MEDLINE, Embase, CINAHL, CENTRAL, trial registries, and conference abstracts up to January 2025. We also screened reference lists of relevant systematic reviews and included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We selected randomised controlled trials (RCTs) and quasi-RCTs of midazolam for sedation in newborn infants compared with placebo, other pharmacological interventions, and non-pharmacological interventions. We excluded studies that used midazolam in combination with an analgesic for painful procedures, as an anaesthetic or anticonvulsant, or in infants undergoing endotracheal suctioning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes included sedation and analgesia assessed at 30 minutes after administration, neurodevelopmental outcomes at 18 to 24 months, hypotension, and apnoea. Important outcomes included all-cause mortality until hospital discharge and days on mechanical ventilation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool RoB 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We conducted meta-analyses using fixed-effect models to calculate risk ratios (RRs) for categorical variables and mean differences (MDs) for continuous variables, each with its 95% confidence interval (CI). To assess statistical heterogeneity, we calculated the I&lt;sup&gt;2&lt;/sup&gt; statistic. We evaluated the certainty of evidence according to GRADE methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included six trials (three new) in 388 neonates. The indications for sedation with midazolam were ventilatory support (4 studies) and magnetic resonance imaging (MRI; 2 studies). The gestational age and bodyweight of infants in the trials varied substantially. The administration route of midazolam was intravenous in five studies and intranasal in one. In two studies, the control arm received placebo, and in one study each, the control arm received opioids, both placebo and opioids, an oral sweet solution, and phenobarbital. We downgraded the overall certainty of evidence for all outcomes because of limitations in study design (e.g. selection bias due to lack of allocation concealment) and serious imprecision of results (wide CIs and few events). We identified three ongoing trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;No studies reported sedation, analgesia, or neurodevelopmental outcomes at 18 to 24 months for any comparison. The e","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD002052"},"PeriodicalIF":8.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648768","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":"Soft tissue augmentation procedures for natural teeth and dental implants: an overview of systematic reviews.","authors":"Sandra Olivia Kuswandani, Jacopo Buti, Roberto Rotundo, Dimas Ilham Hutomo, Hong Jin Tan, Francesco D'Aiuto","doi":"10.1002/14651858.CD014993","DOIUrl":"10.1002/14651858.CD014993","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (overview). The objectives are as follows: To synthesise the evidence from Cochrane and non-Cochrane systematic reviews of randomised controlled trials on the comparative clinical effectiveness, aesthetic, and patient-reported outcomes of soft tissue augmentation procedures with or without the use of soft tissue substitutes around teeth, dental implants, or both.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD014993"},"PeriodicalIF":8.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636450","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":"Low-intensity shockwave therapy for erectile dysfunction.","authors":"Onuralp Ergun, Kwangmin Kim, Myung Ha Kim, Eu Chang Hwang, Yooni Blair, Ahmet Gudeloglu, Sijo Parekattil, Philipp Dahm","doi":"10.1002/14651858.CD013166.pub3","DOIUrl":"10.1002/14651858.CD013166.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Low-intensity shockwave therapy (LiSWT) is a new way of treating erectile dysfunction using sound waves to help improve blood flow to the penis. No existing systematic reviews comparing LiSWT to placebo or other therapies for treating erectile dysfunction have used rigorous Cochrane methodology. Many existing studies appear to be of poor methodological quality, and several trials are ongoing, reflecting an evolving evidence base. Therefore, it is unclear whether LiSWT truly helps men who have erectile dysfunction. Furthermore, there is very limited focus on patient-important outcomes in the existing systematic reviews. In this comprehensive Cochrane review, we compared LiSWT to sham therapy to evaluate its efficacy and safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of low-intensity shockwave therapy for erectile dysfunction in men compared to sham treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We performed a comprehensive search of the Cochrane Library, MEDLINE, Embase, Scopus, and two trial registries up to 7 July 2024. We applied no restrictions on publication status or language.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) that compared LiSWT to either sham or no treatment. We excluded trials involving people with prior kidney transplants or who had surgical procedures to remove the prostate gland (i.e. radical prostatectomy).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were erectile function, discontinuation from treatment, and treatment-related adverse events; important outcomes were patient/partner satisfaction, penile rigidity, and quality of sexual life. We assessed all outcomes in the short term (≤ 3 months) and long term (&gt; 3 months).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed the risk of bias using Cochrane's risk of bias assessment tool (RoB1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We performed statistical analyses following Cochrane Handbook of Systematic Reviews of Interventions guidance. We synthesized results for each outcome using meta-analysis using a random-effects model. We used GRADE to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We focused on RCTs that applied LiSWT treatment utilizing electrohydraulic, electromagnetic, or piezoelectric energy. We included 21 RCTs, including 1357 randomized participants (men aged 39 to 65 years old with erectile dysfunction between 3 and 68 months); 16 were published in full text, and the rest as abstract proceedings. The baseline International Index of Erectile Function-Erectile Function domain (IIEF-EF) scores of participants in these studies ranged from seven to 20. Based on this scale, most men had mild-to-moderate (12 to 16) and mild (17 to 21) erectile dysfunction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;We included 21 RCTs that randomized 1357 participants. The certainty of the evidence for reported outcomes was low, most","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD013166"},"PeriodicalIF":8.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625499","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":"Skin cleansers and leave-on product interventions for preventing incontinence-associated dermatitis in adults.","authors":"Tanya Graham, Dimitri Beeckman, Jan Kottner, Mandy Fader, Francesca Fiorentino, Joanne M Fitzpatrick, Mikel Gray, Ruth G Harris, Sangeeta Sooriah, Sheila A Wallace, Peter R Worsley, Sue Woodward","doi":"10.1002/14651858.CD011627.pub3","DOIUrl":"10.1002/14651858.CD011627.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Incontinence-associated dermatitis (IAD) is a common skin problem in adults with urinary incontinence, faecal incontinence, or both. Prevention involves skin care interventions such as skin cleansing and the application of skin protectants/barriers (leave-on products).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of skin care cleansers, leave-on products, and procedures for preventing incontinence-associated dermatitis in adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;On 29 April 2024, we searched the Cochrane Incontinence Specialised Register - which includes searches of CENTRAL, MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, ClinicalTrials.gov, and WHO ICTRP - and hand-searched journals and conference proceedings. We searched reference lists of included studies to identify additional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We selected randomised controlled trials (RCTs) and quasi-RCTs conducted in any healthcare setting and involving participants aged over 18 years without IAD at baseline. We included trials comparing the effectiveness of skin cleansing interventions and leave-on products or combinations of interventions/leave-on products.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Three review authors independently screened the titles, abstracts, and full-text articles. Four review authors independently extracted data and assessed risk of bias. Data from studies not published in English were translated and extracted by volunteers from Cochrane Engage and the review authors' networks. Primary outcomes were: number of participants with IAD and adverse effects related to the intervention (pain, skin rash, itching, and other serious adverse effects). Secondary outcomes were: number of participants satisfied with skin care products or procedures, adherence to the protocol throughout the intervention, and quality of life (condition-specific or generic). We used GRADE to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 15 trials with 1020 participants in a qualitative synthesis (41 participants from nursing homes; 65 from both care homes and hospital, and 914 from hospital settings). Participants had urinary incontinence, faecal incontinence, or both. Thirteen trials had small sample sizes and two trials had 180 and 174 participants. Six trials assessed outcomes in the short term (≤ 7 days), four in the medium term (8 days-1 month), and one in the long term (&gt; 1 month-3 months). In the remaining studies, the timing of assessment was unclear. The overall risk of bias in the included studies was high. Substantial heterogeneity (in study populations, skin care products, skin care procedures, outcomes, and measurement tools) precluded meta-analysis. Three trials compared skin cleansing interventions, and five trials compared leave-on products or a combination of leave-on products. Seven trials compared a combination of skin cleansers and lea","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD011627"},"PeriodicalIF":8.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607718","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":"Postextubation use of non-invasive respiratory support in preterm infants: a network meta-analysis.","authors":"Abdul Razak, Prakeshkumar S Shah, Madhura Kadam, Sayem Borhan, Amit Mukerji","doi":"10.1002/14651858.CD014509.pub2","DOIUrl":"10.1002/14651858.CD014509.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Several non-invasive respiratory support modes are available to reduce extubation failure in preterm infants. However, their relative efficacy is unclear.</p><p><strong>Objectives: </strong>To assess the benefits and harms of non-invasive respiratory support modes for postextubation support in preterm infants.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science to January 2024.</p><p><strong>Eligibility criteria: </strong>Randomised, quasi-randomised, and cluster-randomised controlled trials comparing non-invasive respiratory support modes for preterm infants postextubation.</p><p><strong>Outcomes: </strong>Critical outcomes included treatment failure, endotracheal ventilation, and moderate-severe chronic lung disease (CLD). Important outcomes included any CLD, death, death or moderate-severe CLD, pulmonary air leak syndrome, intestinal perforation, and moderate to severe neurodevelopmental impairment.</p><p><strong>Risk of bias: </strong>We assessed risk of bias using the Cochrane RoB 1 tool.</p><p><strong>Synthesis methods: </strong>We evaluated seven non-invasive respiratory support modes: nasal continuous positive airway pressure (CPAP); non-invasive positive pressure ventilation (NIPPV); biphasic positive airway pressure (BiPAP); high-flow nasal cannula (HFNC); non-invasive high-frequency oscillatory ventilation (NIHFV); non-invasive neurally adjusted ventilatory assist (NIV-NAVA); high nasal continuous positive airway pressure (H-CPAP). We used random-effects pairwise meta-analysis for direct comparisons and a Bayesian network meta-analysis to estimate network risk ratio (nRR) and 95% credible interval (95% CrI) for indirect and mixed comparisons across seven non-invasive respiratory support modes. We assessed the certainty of evidence using Confidence In Network Meta-Analysis specifically developed for network meta-analysis.</p><p><strong>Included studies: </strong>We included 54 studies involving 6995 preterm infants.</p><p><strong>Synthesis of results: </strong>Treatment failure (48 studies, 6652 infants). NIPPV may result in a large reduction in treatment failure compared to CPAP (nRR 0.48, 95% CrI 0.36 to 0.62; low-certainty evidence) and HFNC (nRR 0.39, 95% CrI 0.26 to 0.57; low-certainty evidence). NIHFV likely results in a large reduction in treatment failure compared to CPAP (nRR 0.39, 95% CrI 0.26 to 0.58; moderate-certainty evidence) and may result in a large reduction in treatment failure compared to HFNC (nRR 0.32, 95% CrI 0.19 to 0.52; low-certainty evidence). For other comparisons, the evidence was very uncertain or there may have been little to no difference. Endotracheal ventilation (47 studies, 6459 infants). NIPPV may result in a large reduction in endotracheal ventilation compared to CPAP (nRR 0.51, 95% CrI 0.38 to 0.65; low-certainty evidence). NIHFV likely results in a large reduction in endotracheal ventilation compared to CPAP (nRR 0.3","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD014509"},"PeriodicalIF":8.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607717","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":"Virtual reality for stroke rehabilitation: time to rethink? Lessons from a Cochrane review.","authors":"Derick T Wade","doi":"10.1002/14651858.ED000174","DOIUrl":"10.1002/14651858.ED000174","url":null,"abstract":"","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"ED000174"},"PeriodicalIF":8.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607719","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}