Cochrane Database of Systematic Reviews最新文献

{"title":"Vitamin D for preventing acute respiratory infections in children up to five years of age.","authors":"Marisa van Arragon, Cameron C Grant, Robert Kr Scragg, Vanessa Mb Jordan","doi":"10.1002/14651858.CD015111.pub2","DOIUrl":"https://doi.org/10.1002/14651858.CD015111.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Acute respiratory infections (ARIs) are a leading cause of morbidity and mortality in children under five years of age and contribute to healthcare visits and hospitalisations globally. Vitamin D deficiency is common amongst pregnant women and young children. Given that vitamin D supplementation is safe, affordable, and easy to administer, its potential to reduce ARI-related healthcare visits holds substantial public health relevance. This review evaluates the benefit and harm of vitamin D supplementation in preventing ARI-related healthcare visits in young children, aiming to inform supplementation policies during pregnancy and early childhood.</p><p><strong>Objectives: </strong>To determine the benefit and harm of vitamin D supplementation for preventing ARIs in children up to five years of age.</p><p><strong>Search methods: </strong>We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, Web of Science, WHO Global Index Medicus, and four clinical trial registries on 18 March 2025.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials (RCTs) comparing vitamin D to placebo, or a higher dose (≥ 1000 IU) versus a lower dose (≤ 1000 IU) administered from early pregnancy through to five years of age. We excluded studies involving children with chronic respiratory or systemic conditions.</p><p><strong>Outcomes: </strong>Critical outcomes: 1) healthcare visits made by children for an ARI: (a) the proportion of children with healthcare visits made for ARIs; (b) the mean number of healthcare visits made for ARIs per child; and 2) hypercalcaemia: the number of pregnant women and children with hypercalcaemia.</p><p><strong>Risk of bias: </strong>We assessed risk of bias using the Cochrane risk of bias (RoB) 1 tool for outcomes reported in the summary of findings tables.</p><p><strong>Synthesis methods: </strong>We synthesised outcome data using meta-analyses, calculating risk ratios (RR) for dichotomous, and mean differences (MD) for continuous outcomes, each with 95% confidence intervals (CI). Where meta-analysis was not feasible, we summarised the results narratively. We used GRADE to assess the certainty of the evidence for pre-specified outcomes.</p><p><strong>Included studies: </strong>We included 107 RCTs involving 31,521 participants. Vitamin D supplementation was administered during pregnancy, early childhood, or both, and in some cases to both infants and lactating mothers. Interventions used vitamin D<sub>2</sub>, D<sub>3</sub>, both, or unspecified forms, with dosages ranging from daily administration to large single or quarterly boluses. Most were delivered orally, typically on a daily schedule, but also weekly or quarterly, over durations ranging from a single dose to 18 months. Settings included hospitals, day-care centres, communities, and homes.</p><p><strong>Synthesis of results: </strong>Vitamin D supplementation may result in a slig","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD015111"},"PeriodicalIF":8.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764738","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 women with anterior compartment prolapse.","authors":"Corina Christmann-Schmid, Kaven Baessler, Ellen Yeung, Nir Haya, Alexandra Mowat, Zhuoran Chen, Sheila A Wallace, Christopher Maher","doi":"10.1002/14651858.CD004014.pub7","DOIUrl":"https://doi.org/10.1002/14651858.CD004014.pub7","url":null,"abstract":"<p><strong>Background: </strong>Anterior compartment prolapse is the most common pelvic organ prolapse. Clinicians have utilised various surgical techniques to minimise the rate of recurrent pelvic organ prolapse (POP).</p><p><strong>Objectives: </strong>To determine the benefits and harms of surgery for anterior compartment prolapse.</p><p><strong>Search methods: </strong>We searched the Cochrane Incontinence Specialised Register on 29 April 2024. This includes records indexed in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov and WHO ICTRP. We also handsearched journals, conference proceedings and the reference lists of included studies.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) that compared surgical operations in women with anterior compartment prolapse.</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected trials, assessed their risk of bias and extracted their data.</p><p><strong>Main results: </strong>We included 41 RCTs evaluating 4531 women. The certainty of evidence ranged from very low to moderate due to risk of bias and imprecision. Anterior native tissue repair versus biological graft at 1 to 2 years There is likely little to no difference between these two methods in terms of awareness of prolapse (RR 1.20, 95% CI 0.80 to 1.81; 5 RCTs, 515 women; moderate certainty). Native tissue repair likely increases the risk of recurrent anterior compartment prolapse (RR 1.53, 95% CI 1.19 to 1.97; 8 RCTs, 707 women; moderate certainty); the result suggests that if 21% of women had recurrent prolapse after biological graft, 24% to 40% would have recurrence after native tissue repair. There may be little to no difference between native tissue repair and biological graft repair groups for repeat surgery for prolapse (RR 0.99, 95% CI 0.45 to 2.17; 6 RCTs, 524 women; low certainty). Surgery for stress urinary incontinence was not reported. There is likely little to no difference between groups in dyspareunia (RR 0.87, 95% CI 0.39 to 1.93; 2 RCTs, 151 women; moderate certainty). De novo dyspareunia was not reported. Anterior native tissue repair versus transvaginal anterior permanent mesh at 1 to 2 years Native anterior tissue repair likely results in more awareness of prolapse than anterior mesh repair (RR 1.77, 95% CI 1.37 to 2.27; 10 RCTs, 1203 women; moderate certainty); the result suggests that if 13% of women were aware of prolapse after mesh repair, 17% to 29% would be aware after native tissue repair. Native tissue repair may result in slightly increased recurrent anterior compartment prolapse (RR 3.21, 95% CI 2.27 to 4.55; 20 RCTs, 2483 women; low certainty). There was moderate heterogeneity (I<sup>2</sup> = 73%). The result suggests that if 13% of women had recurrent prolapse after mesh repair, 29% to 58% would have recurrence after native tissue repair. Repeat surgery for prolapse is probably more likely after","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD004014"},"PeriodicalIF":8.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764562","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":"Cognitive behavioural therapeutics for insomnia symptoms in the perimenopause through to the early postmenopausal period.","authors":"Dani Breitinger-Blatt, Julinda Lee, Sofia Isabel Ribeiro Pereira, Carolyn Smith, Dimitri Gavriloff, Sumathi Sekaran","doi":"10.1002/14651858.CD016349","DOIUrl":"https://doi.org/10.1002/14651858.CD016349","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary Objective i) To assess the effects of cognitive behavioural therapy for insomnia (CBT-I) and cognitive behavioural therapy for menopausal symptoms (CBT-M) on sleep disturbances in women in perimenopause through to the early postmenopausal period. Secondary Objectives i) To assess the effects of CBT-I and CBT-M on vasomotor symptoms in women in perimenopause through to the early postmenopausal period. ii) To assess the impact of socioeconomic status on the effectiveness of CBT-I and CBT-M, in order to determine the interventions' impact on health equality.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD016349"},"PeriodicalIF":8.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764644","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":"Extended versus standard lymph node dissection for urothelial carcinoma of the bladder in people undergoing radical cystectomy.","authors":"Chan Ho Lee, Andrew Shepherd, Niranjan Sathianathen, Jun Eul Hwang, Eu Chang Hwang, Myung Ha Kim, Vikram Narayan, Jae Hung Jung, Philipp Dahm","doi":"10.1002/14651858.CD013336.pub2","DOIUrl":"https://doi.org/10.1002/14651858.CD013336.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;We are currently uncertain of the benefits and harms of standard pelvic lymph node dissection (PLND) compared to extended PLND in the treatment of urothelial carcinoma of the bladder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of extended versus standard PLND in people undergoing cystectomy to treat muscle-invasive (cT2 and cT4a) and treatment-refractory, non-muscle-invasive (cT1 with or without carcinoma in situ) urothelial carcinoma of the bladder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We conducted a comprehensive literature search using multiple databases (CENTRAL, PubMed, Embase, Web of Science, and LILACS), trial registries, and conference proceedings published up to 24 September 2025, with no restrictions on language or publication status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) in which participants underwent radical cystectomy for muscle-invasive or therapy-refractory non-muscle-invasive urothelial carcinoma of the bladder with either an extended PLND with an upper extent reaching as far as the inferior mesenteric artery, or a standard PLND up to the bifurcation of the internal and external iliac artery, with otherwise the same anatomical boundaries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were time to death from any cause (assessed at five years), time to death from bladder cancer (assessed at five years), and Clavien-Dindo classification of surgical complications grade III-V (assessed up to 90 days' postoperatively). Important outcomes were time to recurrence (assessed at five years), Clavien-Dindo I-II complications (assessed up to 90 days' postoperatively), and disease-specific quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 2 tool to assess the risk of bias in the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We conducted statistical analyses according to the guidance in the Cochrane Handbook for Systematic Reviews of Interventions. We combined the results for each outcome using a meta-analysis with a random-effects model. We employed GRADE to evaluate the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included two RCTs with 993 randomized participants (extended PLND 490, standard PLND 503). Both studies were published in full text. The median age of both groups was similar, ranging from 67 to 69 years for the extended group and 68 years for the standard group. All participants had locally completely resectable, invasive urothelial bladder cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Overall, the certainty of evidence for most outcomes was moderate to low, primarily downgraded due to imprecision. Time to death from any cause Extended PLND may result in little to no difference in time to death from any cause as compared to standard PLND (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.75 to 1.30; 2 studies, 993 participants; low-certainty evide","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD013336"},"PeriodicalIF":8.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764611","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":"Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children.","authors":"Francisco de Paula Delgado Moya, Alba Antequera, Alfonso Muriel, Ignacio Sáez, Laura Lopez Garcia, Mario Chico-Fernández, José M Estrada-Lorenzo, Maria Cruz Martin Delgado, Jesus A Barea Mendoza, Maria Nieves Plana","doi":"10.1002/14651858.CD012247.pub3","DOIUrl":"10.1002/14651858.CD012247.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Fluid therapy is one of the main interventions provided for critically ill patients, although there is no consensus regarding the type of solution that should be used. There are two main types: colloid and crystalloid. The most commonly administered crystalloid solution is 0.9% saline. Buffered solutions may offer some theoretical advantages (e.g. less metabolic acidosis, less electrolyte disturbance), but the clinical relevance of these remains unknown. This is an update of a review published in 2019.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of buffered solutions versus 0.9% saline for resuscitation or maintenance in critically ill adults and children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, CINAHL, and four trial registers in July 2023. We checked references, conducted backward and forward citation searches for relevant articles, and contacted study authors to identify additional studies. Although we updated our search in June 2025, the results have not yet been fully incorporated into the review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) with parallel or cross-over design that examined buffered solutions versus 0.9% saline in a critical care setting (resuscitation or maintenance). We included studies with participants who required intravenous fluid therapy due to critical illness (including trauma and burns) or undergoing emergency surgery during critical illness. We included studies of adults or children (or both). We excluded studies of people undergoing elective surgery and studies with multiple interventions in the same arm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were overall (in-hospital) mortality and acute renal injury. Our important outcomes were organ system dysfunction, need for renal replacement therapy, days without organ support, electrolyte disturbances, blood loss or transfusion, coagulation disorders, total resuscitation fluid volume, quality of life, and cost. To populate a table summarising the findings of our review, we selected key outcomes for decision-makers, which were our two critical outcomes and two of our important outcomes (organ system dysfunction and electrolyte disturbances).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two review authors independently assessed the risk of bias of each included study using the Cochrane risk of bias tool RoB 1. We considered pharmaceutical industry funding as a potential source of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Where possible, we synthesised results for each outcome using random-effects meta-analysis. We reported outcomes using the odds ratio (OR) and 95% confidence intervals (CIs). We used the GRADE approach to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 34 studies, with a total of 37,859 participants. Two RCTs with 26,854 participants contributed more than 70% of the total sample","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD012247"},"PeriodicalIF":8.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728831","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":"Delivery arrangements for rehabilitation services in health systems: an overview of systematic reviews.","authors":"Matteo Johann Del Furia, Silvia Minozzi, Irene Battel, Claudio Cordani, Chiara Arienti, Melissa Atkinson-Graham, Nora Bakaa, Paolo Capodaglio, Pierre Côté, Simon Décary, Wouter De Groote, Antony Duttine, Eshetu Haileselassie Engeda, Walter R Frontera, Francesca Gimigliano, Theodore Konstantinidis, Sara Liguori, Qhayiya Mudau, Marco Paoletta, Rebecca Ryan, Carla Sabariego, Dima Touhami, Carlotte Kiekens, Stefano Negrini","doi":"10.1002/14651858.CD016348","DOIUrl":"10.1002/14651858.CD016348","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews synthesizing evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four HPSR pillars identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery, financial, and governance arrangements; and implementation strategies. This overview addresses delivery arrangements, which Cochrane EPOC defines as how health services are organized and delivered, including who provides care, how care is coordinated and managed, and where services are provided.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This overview aimed to synthesize current evidence on delivery arrangements in rehabilitation from an HPSR perspective. Our series of four overviews has the following overarching objectives. • To offer a broad synthesis of existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched Epistemonikos Health Systems Evidence databases and EPOC Group systematic reviews with no language limitations to identify reviews published between 2015 and 17 November 2024. We included Cochrane systematic reviews (CSRs) and non-CSRs of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) evaluating the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to delivery arrangements as defined in the EPOC taxonomy. All four overview teams screened reviews and extracted data. We used AMSTAR 2 to critically appraise the reviews, and we analyzed the results descriptively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 25 systematic reviews. Three overlapped, and for 17 the AMSTAR 2 rating was low or critically low confidence. Five systematic reviews (2 CSRs and 3 non-CSRs) contributed to our synthesis. Most outcomes focused on patients, caregivers, or service use (e.g. access to rehabilitation). Equity-related outcomes were absent, and quality of care, adverse events, and our important outcomes were rarely reported. Below, we report the results of three of the five reviews judged to have moderate to high confidence for our outcomes of interest, in which authors conducted meta-analysis and assessed the certainty of the evidence. Who provides care One review analyzed advanced practice physiotherapy (APP) models, which may result in little to no difference in health-related outcomes measured by the Pain Disability Index and EuroQol 5-Dimension que","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD016348"},"PeriodicalIF":8.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728797","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":"Psychosocial interventions for supporting women to stop smoking in pregnancy.","authors":"Isabella Freijah, Kimberley A Jones, Tim Coleman, Susan M Perlen, Michelle Kennedy, Megan E Passey, Joanne E McKenzie, Catherine Chamberlain","doi":"10.1002/14651858.CD001055.pub6","DOIUrl":"10.1002/14651858.CD001055.pub6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Tobacco smoking is a leading preventable cause of pregnancy complications with serious long-term impacts on women and babies. This update is needed to incorporate new evidence and ensure that guidance on psychosocial interventions in pregnancy remains current for policy and practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of psychosocial interventions provided to support pregnant women who are currently smoking or have recently quit, on smoking abstinence, continued postpartum abstinence, and infant outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched Embase, MEDLINE, PsycINFO, four other databases and two trial registers, together with reference checking, citation searching, and contact with study authors to identify studies that are included in the review. The latest search date was November 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials, cluster-randomized trials, and quasi-randomized controlled trials in pregnant women who smoked cigarettes or have recently quit, comparing psychosocial interventions (counseling, health education, feedback, social support, incentives, exercise) with usual care, less intensive interventions, or alternative interventions. We excluded studies on other forms of tobacco (e-cigarettes, smokeless tobacco), environmental tobacco smoke exposure, and those aimed outside of pregnancy (e.g. postpartum interventions).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcome was self-reported and/or biochemically validated smoking abstinence in late pregnancy. The important outcomes included: smoking abstinence from zero to five months postpartum; mean birthweight; low birthweight (&lt; 2500 g); preterm births (&lt; 37 weeks); stillbirths; and neonatal intensive care unit (NICU) admissions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane Risk of Bias tool 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesized results for each outcome using random-effects meta-analysis where possible. Where this was not possible, we have presented narrative summaries. We used GRADE to assess the certainty of evidence for main outcomes, including smoking abstinence in late pregnancy, low birthweight, preterm birth, mean birthweight, stillbirth, and NICU admissions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 127 studies (including 145 study arms) with 47,361 participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Smoking abstinence during late pregnancy All psychosocial interventions, compared with all comparator types, probably result in an important increase in the likelihood of smoking abstinence during late pregnancy (RR 1.41, 95% CI 1.30 to 1.54; I² = 47%; 117 studies, 33,694 participants; moderate-certainty evidence) and in the early postpartum period (0 to five months) (RR 1.33, 95% CI 1.18 to 1.50; I² = 28%; 42 studies, 11,977 participants; moderate-certainty evidence). Similar effects were observed for counseling co","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD001055"},"PeriodicalIF":8.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728838","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":"Lung transplant in people with cystic fibrosis and nontuberculous mycobacteria infection.","authors":"Shahideh Safavi, Sherie Smith, Nikki Jahnke, Iain Stewart, Sethina A Watson, Andrew P Prayle, Alan R Smyth","doi":"10.1002/14651858.CD016200","DOIUrl":"10.1002/14651858.CD016200","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Cystic fibrosis (CF) is an inherited multi-organ disorder. People with CF (pwCF) experience recurrent and chronic lung infections and a progressive loss of lung function. PwCF with poor and rapidly declining lung function may be considered for lung transplantation (LTx), which may improve their quality of life and survival. Nontuberculous mycobacteria (NTM) can cause pulmonary disease in pwCF, and NTM infection is a poor prognostic factor in LTx. Guidelines recommend NTM infection should not automatically preclude LTx. It is important to evaluate the evidence base for LTx in pwCF and NTM pulmonary disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate clinical outcomes in pwCF and with NTM infection (NTM infection alone or with NTM pulmonary disease) who undergo LTx by comparing: 1. pwCF with current NTM lung infection who undergo LTx versus those with NTM infection who do not undergo LTX; 2. pwCF with current NTM lung infection who undergo LTx versus those without NTM undergoing LTx.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Cystic Fibrosis Trials Register, CENTRAL, MEDLINE, Embase, and PubMed as well as two ongoing trials registries. We checked references. The latest search date was 17 February 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We considered non-randomised studies of pwCF (any age) with or without NTM lung infection or disease being considered for LTx as well as studies of pwCF and NTM who either did or did not undergo LTx.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were mortality, disseminated NTM infection post-LTx, time to chronic lung allograft dysfunction (CLAD), and quality of life at any time points reported. We additionally planned to report lung function, hospitalisations for pulmonary exacerbations, and nutritional parameters in the review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed the risk of bias in three studies using ROBINS-I and in one study using the Joanna Briggs Institute checklist for case series.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We could only report results narratively. We used GRADE to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included four single-centre retrospective studies (388 adults). Sample sizes ranged from nine to 177 participants. Mycobacteria abscessus was the most common NTM species identified, and all studies reported infection with other pathogens. All studies compared pwCF and NTM infection to pwCF without NTM infection, all undergoing LTx. Each study reported mortality and disseminated NTM infection post-LTx; two studies recorded CLAD. No study reported quality of life, specific lung function measures (although one study commented briefly on lung function in general), hospitalisations for pulmonary exacerbations, or nutritional parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;We analysed all NTM infections together for practical reasons and were not able to underta","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD016200"},"PeriodicalIF":8.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728777","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":"Amyloid-beta-targeting monoclonal antibodies for people with mild cognitive impairment or mild dementia due to Alzheimer's disease.","authors":"Francesco Nonino, Silvia Minozzi, Luisa Sambati, Cinzia Del Giovane, Elisa Baldin, Maria Chiara Bassi, Claudia De Santis, Marien Gonzalez-Lorenzo, Luca Vignatelli, Graziella Filippini, Edo Richard","doi":"10.1002/14651858.CD016297","DOIUrl":"10.1002/14651858.CD016297","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Alzheimer's disease is a neurodegenerative disorder and the most common cause of dementia. Aggregated amyloid-beta protein deposits are implicated in its pathogenesis. Amyloid-beta-targeting monoclonal antibodies (sometimes represented as Aβ-mAbs) are potentially disease-modifying for Alzheimer's disease: through the clearance of amyloid in the brain, they may slow cognitive and functional decline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the clinical benefits and harms of amyloid-beta-targeting monoclonal antibodies aducanumab, bapineuzumab, crenezumab, donanemab, gantenerumab, lecanemab, ponezumab, remternetug, and solanezumab in people with mild cognitive impairment or mild dementia due to Alzheimer's disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE (PubMed), Embase, and two clinical trials registries (Clinicaltrials.gov and WHO International Clinical Trials Registry Platform), and we undertook reference checking and citation research. The most recent search date was 7 August 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that lasted at least 12 months and compared amyloid-beta-targeting monoclonal antibodies with placebo or no treatment in people with mild cognitive impairment or mild dementia due to Alzheimer's disease. We included both parallel-group and cluster designs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our outcomes of critical importance were: cognitive function; dementia severity; functional ability; any amyloid-related imaging abnormality (ARIA), which includes oedema (E) and haemorrhage (H); any symptomatic ARIA E and H; symptomatic brain haemorrhage; serious adverse events; and any-cause mortality. We analysed data at 12, 18, 24, and over 24 months of treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool RoB 2 to assess the risk of bias in outcomes of critical importance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We meta-analysed results for each outcome within each comparison using the inverse variance method and the random-effects model. We used GRADE to assess the certainty of evidence for each outcome as very low, low, moderate, or high.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;Overall, we included 17 studies with 20,342 participants. The mean age of participants in the studies ranged from 70 to 74 years. Seven studies enroled only participants with mild dementia, and one study enroled only participants with mild cognitive impairment. The remaining studies included a mixed population. The mean duration of participants' cognitive impairment ranged from 17 to 52 months. The 17 studies assessed seven different amyloid-beta-targeting monoclonal antibodies: aducanumab (n = 3), bapineuzumab (n = 4), crenezumab (n = 2), donanemab (n = 1), gantenerumab (n = 4), lecanemab (n = 1), and solanezumab (n = 2). All used placebo as a comparison. Eleven studies lasted 18 months, four lasted 24 months, a","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD016297"},"PeriodicalIF":8.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688816","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":"Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis.","authors":"Xiao Zhang, Shengyan Cui, Tao Wang, Xue Wang, Kun Yang, Adam A Dmytriw, Jiayao Li, Wenlong Xu, Tianhua Li, Yan Ma, Bin Yang, Liqun Jiao, Ran Xu","doi":"10.1002/14651858.CD013692.pub3","DOIUrl":"10.1002/14651858.CD013692.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Vertebral artery stenosis (VAS), which refers to the narrowing of the vertebral artery, is a significant cause of posterior circulation ischaemic stroke. Medical treatment involves managing risk factors and using medications, while endovascular treatment typically consists of percutaneous transluminal angioplasty, which may be performed with or without stenting. Despite these available options, optimal management of people with symptomatic vertebral artery stenosis has not yet been established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harm of percutaneous transluminal angioplasty, with or without stenting, plus medical treatment (MT), compared with MT alone, in people with episodes of vertebrobasilar ischaemia due to vertebral artery stenosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched MEDLINE, Embase, BIOSIS, and two other indexes on the Web of Science, China Biological Medicine Database, Chinese Science and Technique Journals Database, China National Knowledge Infrastructure and Wanfang Data, as well as ClinicalTrials.gov trials register and the World Health Organisation (WHO) International Clinical Trials Registry Platform to 9 Dec 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included all randomised controlled trials (RCTs) that compared endovascular therapy (ET) plus MT with MT alone in treating people aged 18 years or over with symptomatic VAS. We included all types of ET modalities, such as angioplasty alone, balloon-mounted stenting, and angioplasty followed by the placement of a self-expanding stent. The MT regimen encompassed risk-factor control, antiplatelet therapy, lipid-lowering therapy, and individualised management for patients with hypertension or diabetes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our outcomes were 30-day post-randomisation death or stroke; fatal or non-fatal stroke in the territory of the treated vertebral artery from 30 days after randomisation to the end of follow-up; stroke (ischaemic or haemorrhagic) during the entire follow-up period; death during the entire follow-up period; stroke or transient ischaemic attack (TIA) during the entire follow-up period; and ≥ 50% restenosis of the treated vertebral artery documented by conventional cerebral angiography. All strokes and TIAs were newly diagnosed events. We evaluated all important outcomes during the entire follow-up period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias in RCTs using version 1 of the Cochrane tool (RoB 1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Two review authors independently screened studies, extracted data, and assessed risk of bias. For dichotomous outcomes, we calculated risk ratios with 95% confidence intervals and pooled results using fixed-effect meta-analysis when studies were sufficiently similar; otherwise, we provided a narrative synthesis. We used GRADE methods to assess the certainty of evidence and summarised key outcomes in a summary of findings tab","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"4 ","pages":"CD013692"},"PeriodicalIF":8.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688776","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}