Cochrane Database of Systematic Reviews最新文献

{"title":"Effectiveness of SARS-CoV-2 testing strategies inreducing COVID-19 cases, hospitalisations, and deaths.","authors":"K M Saif-Ur-Rahman, Nadra Nurdin, Ani Movsisyan, Kavita Kothari, Ciara Gleeson, Thomas Conway, Marie Tierney, Eylul Taneri, Deirdre Mulholland, Andrea C Tricco, Jacqueline Dinnes, Declan Devane","doi":"10.1002/14651858.CD016192.pub2","DOIUrl":"10.1002/14651858.CD016192.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has substantially affected daily life. Sustainable testing practices are essential to balance the resource demands of widespread testing with the need to reduce the health impacts of COVID-19. However, the effectiveness of specific testing strategies for symptomatic and asymptomatic individuals in reducing COVID-19 cases, hospitalisations, and deaths remains uncertain.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of different SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths amongst suspected cases and asymptomatic individuals.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE (Ovid), Embase (Elsevier), Europe PMC, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also conducted reference checks, citation searches, and contacted study authors to identify eligible studies. The most recent search was conducted on 07 October 2024.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials (RCTs), non-randomised studies of interventions (NRSIs), controlled before-and-after studies (CBA), matched cohort studies, and observational studies with a comparison group involving suspected or asymptomatic individuals. Eligible studies compared testing strategy versus no testing or standard care or usual practice; one testing strategy with another, such as antigen-detecting rapid diagnostic tests (RDTs) versus nucleic acid amplification testing (NAAT), including reverse transcription polymerase chain reaction (RT-PCR); home-based versus provider-administered testing; one-time testing versus repeated testing at different frequencies; and targeted testing versus widespread testing. Combinations of these components were also considered. In this review, we define 'SARS-CoV-2 testing strategy' as a complex intervention comprising multiple varying components, including test type (e.g. NAAT, antigen-detecting RDT), sample type (e.g. nasopharyngeal swab, saliva), target population (e.g. symptomatic, contacts), setting (e.g. home, clinic, congregate), frequency of testing (e.g. one-time, weekly, daily), and response protocol (e.g. isolation, confirmatory testing, treatment). We excluded single-arm studies, reviews, theses, editorials, letters, commentaries, studies reported solely in abstract form, laboratory or animal studies, mathematical modelling studies, and diagnostic test accuracy studies.</p><p><strong>Outcomes: </strong>Our critical outcomes were: COVID-19 cases avoided (reduction in new cases); COVID-19-related hospitalisations avoided (reduction in hospital admissions); COVID-19-related deaths avoided (reduction in mortality); and serious adverse events related to testing, including unnecessary interventions, employment impacts, isolation effects, and psychological harms.</p><p><strong>Risk of bias: </strong","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016192"},"PeriodicalIF":8.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205758","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":"Interventions for preventing dengue: a mapping review.","authors":"Leslie Choi, Bruno Guedes Alcoforado Aguiar, Susi Wisniewski, Ana Carolina F Modesto, Luis Phillipe Lopes, Jose Salvador Carrillo, Mariana Del Grossi Moura, Anna Noel-Storr, Roses Parker, Luciane C Lopes","doi":"10.1002/14651858.CD016299","DOIUrl":"10.1002/14651858.CD016299","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (rapid). The objectives are as follows: To comprehensively identify the published literature on prevention strategies for dengue. To critically appraise secondary research. To present the findings of objectives 1 and 2 in a single evidence gap map. To identify critical knowledge gaps to inform future primary research and systematic reviews.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016299"},"PeriodicalIF":8.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205752","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":"Pharmacotherapies for cannabis use disorder.","authors":"Francesca Spiga, Thomas Parkhouse, Victor M Tang, Jelena Savović, Bernard Le Foll, Suzanne Nielsen","doi":"10.1002/14651858.CD008940.pub4","DOIUrl":"10.1002/14651858.CD008940.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Globally, cannabis use is prevalent and widespread. There are currently no pharmacotherapies approved for the treatment of cannabis use disorder (a problematic pattern of cannabis use that leads to clinically significant impairment or distress). This is the second update of a Cochrane Review first published in the Cochrane Library in Issue 12, 2014.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness and safety of pharmacotherapies as compared with each other, placebo or no pharmacotherapy (supportive care) for reducing symptoms of cannabis withdrawal and promoting cessation or reduction of cannabis use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO in May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Randomised controlled trials (RCTs) and quasi-RCTs of medications to treat cannabis withdrawal and/or to promote cessation or reduction of cannabis use, in comparison with other medications, placebo or no medication in people diagnosed as cannabis dependent or who are likely to be dependent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were: 1) abstinence at the end of treatment; 2) intensity of withdrawal including craving; 3) nature, incidence and frequency of adverse events (AE) and 4) severe AE (SAE); 5) withdrawal from treatment due to adverse effects and whether the planned medication regimen was modified in response to adverse effects; 6) completion of scheduled treatment. Important outcomes were: 1) cannabis use at the end of treatment; 2) number of participants engaged in further treatment; 3) economic outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed the risk of bias in results included in meta-analyses using the risk of bias 2 (RoB 2) tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using random-effect meta-analysis where possible. Where this was not possible due to the nature of the data, we reported results narratively. We used GRADE to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 37 RCTs (3201 participants). Most were undertaken in the USA (29), Australia (4), Israel (2), Canada (1) and the United Kingdom (1), mainly recruiting adults (mean age 22-41 years), with four studies only including young people (mean age 17-21 years). In 32 studies, most of the participants were male (56-92%). Five studies targeted participants with comorbidities (depression (2), bipolar disorder (1), and attention deficit hyperactivity disorder (1)). Eleven studies received study medicines from the manufacturing company and none were funded by pharmaceutical companies. Thirty-six studies compared active medications and placebo; one study compared four active medications. Medications were diverse, as were the outcomes reported, which limited the potential for synthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/str","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD008940"},"PeriodicalIF":8.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191071","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":"Dose reduction and discontinuation of conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) for people with rheumatoid arthritis or psoriatic arthritis in remission or low disease activity.","authors":"Huai Leng Pisaniello, Samuel L Whittle, Renea V Johnston, Vanessa Glennon, Liesl Grobler, Sheila Cyril, Anneliese D Arno, Rachelle Buchbinder","doi":"10.1002/14651858.CD015900","DOIUrl":"10.1002/14651858.CD015900","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate the benefits and harms of dose reduction and discontinuation of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in adults with rheumatoid arthritis or psoriatic arthritis, who have been in sustained remission or low disease activity. This is a common review protocol, outlining the approach for two separate Cochrane reviews for people with rheumatoid arthritis or psoriatic arthritis. Dose reduction or discontinuation of csDMARDs in adults with rheumatoid arthritis, who have been in sustained remission or low disease activity Dose reduction or discontinuation of csDMARDs in adults with psoriatic arthritis, who have been in sustained remission or low disease activity.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD015900"},"PeriodicalIF":8.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190997","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":"Antibiotic prophylaxis for corneal abrasion.","authors":"Sueko M Ng, Louis Leslie, Chih-Chen Tzang, Abdullah M Algarni, Irene C Kuo, Annali L Lawrenson","doi":"10.1002/14651858.CD014617.pub3","DOIUrl":"10.1002/14651858.CD014617.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Corneal abrasion is a condition frequently treated by eye care professionals, emergency physicians, and primary care physicians. Topical ophthalmic antibiotics are the most common therapy for corneal abrasion. However, there has been no comprehensive summary and synthesis of the evidence regarding antibiotic prophylaxis in traumatic corneal abrasion. In this review update, we evaluated the current evidence regarding the benefits and harms of antibiotic treatment for this relatively common emergency condition. This is an update of a review published in 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of topical antibiotic prophylaxis for corneal abrasion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase.com, two other databases, and two trials registries together with reference checking to identify studies that are included in the review. The latest search date was 28 March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) comparing an antibiotic with another antibiotic or with placebo in children and adults with corneal abrasion(s).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Outcomes included the following: risk of any ocular infection up to one month following corneal abrasion, proportion of eyes healed within 48 hours, participant-reported pain intensity reduction of 50% or more at 24 hours, loss of one or more lines of best-corrected visual acuity at one month, change in pain interference from baseline to 24 hours, complications of corneal abrasion, and treatment-related adverse events at the longest follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Using the Cochrane risk of bias (RoB) 2 tool, we assessed the RoB for the three reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesized results for each outcome using meta-analysis by calculating risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes where possible; otherwise, we summarized the results narratively. We used GRADE to assess the certainty of evidence for prespecified outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included four RCTs enrolling a total of 998 participants, ranging from 20 to 437 participants. The included studies were published from 1975 to 1998, and conducted in Denmark (1), the Republic of Korea (1), and the UK (2). The length of follow-up was 24 hours to four weeks, or unspecified in two studies. Two studies had industry support. Participants had a mean age of 35 years (range 5 to 80 years) in one study, while the other three studies reported age ranges from 15 to 64 years. Most participants had traumatic corneal abrasions, commonly following foreign body removal. Two studies compared topical antibiotics with placebo (vehicle ointment or sodium hyaluronic acid drops), while three studies compared chloramphenicol ointment with antibiotics from other classes. One study was a three-arm study that compared","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014617"},"PeriodicalIF":8.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184764","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":"Efficacy and safety of respiratory syncytial virus vaccines.","authors":"K M Saif-Ur-Rahman, Catherine King, Seán Olann Whelan, Matthew Blair, Seán Donohue, Caoimhe Madden, Kavita Kothari, Isolde Sommer, Thomas Harder, Nicolas Dauby, Ida Rask Moustsen-Helms, Simona Ruta, Julie Frère, Viktoria Schönfeld, Eero Poukka, Irja Lutsar, Kate Olsson, Angeliki Melidou, Karam Adel Ali, Kerry Dwan, Declan Devane","doi":"10.1002/14651858.CD016131","DOIUrl":"10.1002/14651858.CD016131","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Respiratory syncytial virus (RSV) is a highly transmissible pathogen that causes varying degrees of respiratory illness across all age groups. The safety and efficacy profiles of available RSV vaccines, a critical consideration for their integration into public health strategies and clinical practice, remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of RSV vaccines compared to placebo, no intervention, vaccines for other respiratory infections, other RSV vaccines, or monoclonal antibodies (mAbs) across all human populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We conducted a comprehensive literature search of CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and the WHO ICTRP following standard systematic review methodology from 2000 to April 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included both randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) involving all human populations comparing RSV vaccines with placebo, no intervention, vaccines for other respiratory infections, other RSV vaccines, or mAbs. We excluded studies focused on dose-finding schedules and immunogenicity assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Benefits included frequency of RSV illness (both lower and upper respiratory illness) confirmed by laboratory tests (RSV-associated lower respiratory tract illness and RSV-associated acute respiratory illness); hospitalisation due to RSV disease (both lower and upper respiratory illness) confirmed by laboratory tests; mortality from illness caused by RSV (confirmed by laboratory test); all-cause mortality; and admission to an intensive care unit. Harms included serious adverse events (SAEs) related to vaccination, including neurological disorders such as Guillain-Barré syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias in RCTs using Cochrane's RoB 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We used standard Cochrane methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We identified 14 RCTs: five trials (101,825 participants) on older adults; three trials (12,010 participants) on maternal vaccination and effects on infants; one trial (300 participants) on women of childbearing age; and five trials (192 participants) on infants and children. We identified no NRSIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;RSV prefusion vaccine versus placebo in older adults These vaccines reduced RSV-associated lower respiratory tract illness with vaccine efficacy (VE) of 77% (95% confidence interval (CI) 0.70 to 0.83; risk ratio (RR) 0.23, 95% CI 0.17 to 0.30; 4 RCTs, 99,931 participants; high-certainty evidence) and RSV-associated acute respiratory illness with VE of 67% (95% CI 0.60 to 0.73; RR 0.33, 95% CI 0.27 to 0.40; 3 RCTs, 94,339 participants; high-certainty evidence). There may be little to no difference in mortality from illness caused by RSV, all-cause mortality, and SAEs related to vaccination (lo","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016131"},"PeriodicalIF":8.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184796","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":"Conservative interventions for managing exercise-related musculoskeletal groin pain.","authors":"Anna Paula P Siqueira, Luiz Hespanhol, Anderson Js Oliveira, Brenda Andriolo, Regis B Andriolo, Álvaro N Atallah, Maria S Peccin, Matheus O Almeida","doi":"10.1002/14651858.CD016137","DOIUrl":"10.1002/14651858.CD016137","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of conservative interventions for managing exercise-related musculoskeletal groin pain.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016137"},"PeriodicalIF":8.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136615","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":"Once- or twice-daily thoracic radiation in limited-stage small-cell lung cancer treated with concurrent chemoradiotherapy.","authors":"Ken Harada, Kazuya Inoki, Takenori Ichimura, Kanae Taruno, Hidenori Shinjo, Noyuri Yamaji, Hisashi Noma, Erika Ota, Takeshi Hasegawa","doi":"10.1002/14651858.CD016084","DOIUrl":"10.1002/14651858.CD016084","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of once-daily radiotherapy versus twice-daily radiotherapy concurrently with chemotherapy for optimal survival outcomes in people with limited-stage small-cell lung cancer (LS-SCLC).</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016084"},"PeriodicalIF":8.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136620","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":"Combined cardiorespiratory and resistance training for people with stroke.","authors":"David H Saunders, Sharon A Carstairs, Joshua D Cheyne, Megan Fileman, Jacqui Morris, Sarah Morton, Gavin Wylie, Gillian E Mead","doi":"10.1002/14651858.CD016002","DOIUrl":"10.1002/14651858.CD016002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Levels of physical activity and physical fitness, including both cardiorespiratory fitness and muscle strength, are often low after stroke and are associated with post-stroke disability. Multicomponent exercise interventions that increase muscle strength and cardiorespiratory fitness could be effective for improving physical function and disability, and for secondary prevention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary objective of this review is to determine whether combined cardiorespiratory fitness and resistance training after stroke has any effects on death, disability, adverse events, risk factors, fitness, walking, and indices of physical function when compared to a non-exercise control.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;In January 2024, we searched nine databases (CENTRAL, MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO, WoS, PEDro, and DORIS) and two trial registers (ClinicalTrials.gov and ICTRP). We also undertook reference checking, citation tracking, and contact with experts in the field, in order to identify eligible studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that compared combined cardiorespiratory fitness and muscle strength training against usual care, no intervention, or a non-exercise intervention for people with stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcome domains were death, disability, adverse events, risk factors, fitness, walking, and indices of physical function. We assessed outcomes at the end of intervention and at the end of follow-up. Our other important outcome domains were indices of quality of life, mood, cognition, and fatigue.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane tool RoB 1 to assess bias in the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Where possible, we synthesised results for each outcome at the end of intervention and end of follow-up using random-effects meta-analyses on arm-level data. For dichotomous outcomes, we calculated the risk difference (RD) and 95% confidence interval (CI). For continuous outcomes, we calculated a mean difference (MD) or standardised mean difference (SMD), and 95% CI. We used GRADE to assess certainty of evidence for critical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 30 studies with 1519 participants, who had an average age of 63.7 years. Most studies recruited ambulatory participants (28 of the 30 studies) during the early subacute (14 studies) and chronic (14 studies) stages of recovery. Most studies (26) took place in high-income countries. Most study interventions lacked a balanced dose of control exposure (23 studies). Eleven studies included a follow-up period (mean 7.3 months; range 3 to 12 months). Most interventions combined cardiorespiratory training (usually walking or ergometer-based) and resistance training (weights, machines, bodyweight or elastic resistance) in a circuit-type format. Training o","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016002"},"PeriodicalIF":8.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130186","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":"Omega-3 fatty acid supplementation for distal symmetrical peripheral neuropathy in adults with diabetes mellitus.","authors":"Alexis Ceecee Britten-Jones, Tom A Linstrom, Eve Makrai, Sumeer Singh, Ljoudmila Busija, Richard J MacIsaac, Leslie J Roberts, Laura E Downie","doi":"10.1002/14651858.CD014623.pub2","DOIUrl":"10.1002/14651858.CD014623.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Diffuse distal symmetrical polyneuropathy (DSPN) is a common complication in people living with diabetes mellitus. There is currently no effective treatment for DSPN. There is a biological rationale that omega-3 polyunsaturated fatty acids (PUFAs) may modify peripheral nerve function in DSPN. However, there is a lack of certainty about the potential benefits and harms of omega-3 PUFAs as a treatment for DSPN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of oral omega-3 PUFA supplements as a treatment for DSPN in adults with diabetes mellitus, compared to placebo or no treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Neuromuscular Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two clinical trials registries, together with reference checking, to identify studies eligible for inclusion in the review. The latest search date was 12 June 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) involving adults with type 1 diabetes, type 2 diabetes, or impaired glucose tolerance who had evidence of DSPN, that compared omega-3 PUFA supplements with placebo treatments or no treatment. We excluded studies with an intervention period of less than 180 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcome was peripheral neuropathy impairment at six months after treatment. Other main outcomes were: symptoms of peripheral neuropathy, pain, quality of life, and adverse events, including any adverse events; adverse events leading to discontinuation of the intervention; and serious adverse events. We recorded outcomes as change from baseline, or the study endpoint measure, if change from baseline data were not reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 2 tool to assess bias in the included RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using meta-analysis where possible (inverse variance, random-effects model). Where this was not possible due to the nature of the data, we synthesised the results by summarising effect estimates. We used GRADE to assess the certainty of the body of the evidence for each key outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;This review included two completed RCTs that collectively involved 87 participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Based on findings from one study (43 participants with type 1 diabetes), oral omega-3 PUFA supplementation for six months may have little to no effect on the short-term risk of developing peripheral neuropathy impairment (RR 0.24, 95% CI 0.03 to 1.94; low-certainty evidence), peripheral neuropathy symptoms (MD -0.17, 95% CI -1.36 to 1.02; low-certainty evidence), or health-related quality of life (MD 0.02, 95% CI -0.06 to 0.10; low-certainty evidence), compared to a placebo treatment. From two studies (pooled estimates from outcomes repor","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014623"},"PeriodicalIF":8.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130224","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}