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Misoprostol for intrauterine device placement. 米索前列醇用于放置宫内节育器。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-23 DOI: 10.1002/14651858.CD015584.pub2
Lauren B Zapata, Emily Snyder, Antoinette T Nguyen, Nathalie Kapp, Angeline Ti, Maura K Whiteman, Kathryn M Curtis
{"title":"Misoprostol for intrauterine device placement.","authors":"Lauren B Zapata, Emily Snyder, Antoinette T Nguyen, Nathalie Kapp, Angeline Ti, Maura K Whiteman, Kathryn M Curtis","doi":"10.1002/14651858.CD015584.pub2","DOIUrl":"10.1002/14651858.CD015584.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Identifying effective approaches to reduce pain and improve providers' ease of intrauterine device (IUD) placement may reduce barriers to IUD access and use. The cervical softening and dilation effects of misoprostol might make IUD placement less painful for women and technically easier for providers. However, evidence suggests that misoprostol does not improve many outcomes and may only be helpful for some patients (e.g. those with a recent failed IUD placement).</p><p><strong>Objectives: </strong>To examine the effect of misoprostol for routine IUD placement on patient and provider outcomes compared to placebo or no treatment.</p><p><strong>Search methods: </strong>In November 2021 we searched CENTRAL, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ClinicalTrials.gov. We conducted update searches in July 2022 and September 2024. We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) in July 2025.</p><p><strong>Eligibility criteria: </strong>We included randomized controlled trials (RCTs) of women undergoing interval IUD placement (i.e. placement outside the postabortion or postpartum period) that compared misoprostol to placebo or no treatment. We included trials that examined the placement of currently available levonorgestrel (LNG)-releasing IUDs, or any copper T IUD, for women of any age, of any parity, and for any indication.</p><p><strong>Outcomes: </strong>Our core critical and important outcomes were pain (during tenaculum placement, during IUD placement, and after IUD placement before clinic discharge); providers' ease of placement; need for cervical dilation; placement success; patient satisfaction; misoprostol side effects (preplacement abdominal pain or cramping, and diarrhea); and adverse events (vasovagal reaction).</p><p><strong>Risk of bias: </strong>We used the Risk of Bias 2 tool (RoB 2) to assess the risk of bias for outcomes.</p><p><strong>Synthesis methods: </strong>We synthesized results for each outcome using meta-analysis. We calculated mean differences (MD) for continuous outcomes using inverse variance estimation and random-effects models. We calculated risk ratios (RR) for dichotomous outcomes using Mantel-Haenszel estimation and random-effects models. We used GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Included studies: </strong>We included 14 RCTs with a total of 1972 women. The trials were conducted in North America, South America, Europe and Africa, and were published between 2007 and 2022.</p><p><strong>Synthesis of results: </strong>The results below summarize the effect of misoprostol on outcomes compared to placebo or no treatment. Pain: misoprostol results in little to no difference in pain during tenaculum placement (MD -0.73, 95% confidence interval [CI] -1.19 to -0.28; 3 RCTs, 261 women; high-certainty evidence) and after IUD placement before clinic discharge (","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD015584"},"PeriodicalIF":8.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124619","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}
引用次数: 0
Call to action: building a better future together, powered by evidence, guided by collective impact. 行动呼吁:以证据为动力,以集体影响为指导,共同建设更美好的未来。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-22 DOI: 10.1002/14651858.ED000175
Karla Soares-Weiser, Zoe Jordan, Laura Boeira, Laurenz Mahlanza-Langer, Will Moy, Rhona Mijumbi, Ruth Foxlee, John N Lavis
{"title":"Call to action: building a better future together, powered by evidence, guided by collective impact.","authors":"Karla Soares-Weiser, Zoe Jordan, Laura Boeira, Laurenz Mahlanza-Langer, Will Moy, Rhona Mijumbi, Ruth Foxlee, John N Lavis","doi":"10.1002/14651858.ED000175","DOIUrl":"https://doi.org/10.1002/14651858.ED000175","url":null,"abstract":"","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"ED000175"},"PeriodicalIF":8.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HMG-CoA reductase inhibitors (statins) versus placebo for people with schizophrenia. 精神分裂症患者的HMG-CoA还原酶抑制剂(他汀类药物)与安慰剂。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-19 DOI: 10.1002/14651858.CD014565
Yusuke Saishoji, Saehyeon Kim, Masahiro Banno, Kunihiro Kohmura, Yuki Kataoka, Yasushi Tsujimoto
{"title":"HMG-CoA reductase inhibitors (statins) versus placebo for people with schizophrenia.","authors":"Yusuke Saishoji, Saehyeon Kim, Masahiro Banno, Kunihiro Kohmura, Yuki Kataoka, Yasushi Tsujimoto","doi":"10.1002/14651858.CD014565","DOIUrl":"10.1002/14651858.CD014565","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 HMG-CoA reductase inhibitors (statins) compared with placebo for schizophrenia in adults.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014565"},"PeriodicalIF":8.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085102","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}
引用次数: 0
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis. 单切口与常规多切口腹腔镜阑尾切除术治疗疑似无并发症阑尾炎的比较。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-19 DOI: 10.1002/14651858.CD009022.pub4
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
{"title":"Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis.","authors":"Ahmer Irfan, Ahsan Rao, Irfan Ahmed","doi":"10.1002/14651858.CD009022.pub4","DOIUrl":"10.1002/14651858.CD009022.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Appendicectomy is a well-established surgical procedure to manage acute appendicitis. The operation was historically performed as an open procedure and is currently performed using minimally invasive surgical techniques. A recent development in appendicectomy technique is the introduction of single-incision laparoscopic surgery. This incorporates all working ports (either one multi-luminal port or multiple mono-luminal ports) through a single skin incision; the procedure is known as single-incision laparoscopic appendicectomy or SILA. Unanswered questions remain regarding the efficacy of this novel technique, including its effects on patient benefit and satisfaction, complications, and long-term outcomes, when compared to multi-incision conventional laparoscopy (CLA). This is an update of a review published in 2011.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of single-incision laparoscopic appendicectomy compared with multi-incision laparoscopic appendicectomy, on benefits, complications, and short-term outcomes, in patients with acute appendicitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Central Register of Controlled trials (CENTRAL, the Cochrane Library 2018 Issue 2), Ovid MEDLINE (1983 to January 2024), Ovid Embase (1983 to January 2024), the WHO International Clinical Trial Register (January 2024), and Clinicaltrials.gov (January 2024). We also searched reference lists of relevant articles and reviews, conference proceedings, and ongoing trial databases. The searches were carried out on 20 January 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that compared the single-incision procedure SILA against CLA for patients (male and female) over the age of 10 years, diagnosed with appendicitis, or symptoms of appendicitis, and undergoing laparoscopic appendicectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently selected studies for inclusion, extracted data into a standardised form, and assessed the risk of bias in the studies. We extracted data relevant to the predetermined outcome measures. Where appropriate, we calculated a summary statistic: odds ratio (OR) with 95% confidence intervals (CIs) for dichotomous data and mean difference (MD) with 95% CI for continuous data. We used Review Manager Web for our statistical analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;This review was first published in 2011, when there was no RCT evidence available. For this update, we identified 11 RCTs involving 1373 participants (689 in the SILA groups and 684 in the CLA groups). The participants were similar at baseline in terms of age (mean 31.7 (SILA) versus 30.9 years (CLA)) and sex (female: 53.0% (SILA) versus 50.3% (CLA)). Diagnosis of appendicitis was based on clinical assessment; none of the studies used a diagnosis confirmed by imaging as part of their inclusion criteria. The certainty of the evide","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD009022"},"PeriodicalIF":8.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085080","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}
引用次数: 0
Calcium supplementation commenced before pregnancy for preventing hypertensive disorders and related problems. 在怀孕前开始补充钙,以预防高血压疾病和相关问题。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-18 DOI: 10.1002/14651858.CD011192.pub4
Catherine A Cluver, Christa Rohwer, Anke Rohwer, Maria Eduarda Dos Santos Santos Puga, Maria Regina Torloni, G Justus Hofmeyr
{"title":"Calcium supplementation commenced before pregnancy for preventing hypertensive disorders and related problems.","authors":"Catherine A Cluver, Christa Rohwer, Anke Rohwer, Maria Eduarda Dos Santos Santos Puga, Maria Regina Torloni, G Justus Hofmeyr","doi":"10.1002/14651858.CD011192.pub4","DOIUrl":"10.1002/14651858.CD011192.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality. Calcium supplementation commenced before pregnancy may prevent the development of these disorders. This is an update of a review last published in 2019.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of calcium supplementation commenced before pregnancy on hypertensive disorders of pregnancy and related maternal and neonatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, CINAHL, Portal Regional BVS-Lilacs, Scopus, Web of Science, WHO ICTRP and ClinicalTrials.gov on 7 January 2025 and searched reference lists of retrieved trials and relevant systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that compared calcium supplementation commenced before pregnancy with placebo or standard care. Trials conducted after 2010 needed to be prospectively registered. We applied a trustworthiness checklist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes for women were pre-eclampsia or pregnancy loss, and pre-eclampsia. The critical outcome for children was perinatal loss. Our main important outcomes for women were pregnancy loss at any gestational age, maternal death, maternal death or severe morbidity, and adverse effects. Our main important outcomes for children were preterm delivery before 37 weeks, neonatal death or severe morbidity, stillbirth, neonatal death, and early neonatal death.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used version 2 of the Cochrane tool for assessing risk of bias in randomised trials (RoB 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Two review authors independently selected trials, extracted data, and assessed risk of bias and trustworthiness. We pooled data using random-effects meta-analysis. We assessed the certainty of the evidence using GRADE. Because conception and pregnancy loss are intermediate outcomes potentially on the causal pathway to pre-eclampsia, we chose the composite outcome 'pre-eclampsia or pregnancy loss' as the first critical outcome (and most relevant to pregnant women), and included sensitivity analyses including only women who conceived during the trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included one multicentre, double-blind, randomised, placebo-controlled trial. It included 1355 parous women, whose most recent planned pregnancy had been complicated by pre-eclampsia or eclampsia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Pre-eclampsia or pregnancy loss at any gestational age Compared to placebo, calcium may result in little to no difference in pre-eclampsia or pregnancy loss at any gestational age (risk ratio (RR) 0.85, 95% confidence interval (CI) 0.67 to 1.07; 1 RCT, 1355 women; risk difference (RD) 28/1000 fewer, 95% CI 61 fewer to 13 more; low-certainty evidence). Sensitivity analysis including only women who conceived during the trial yielded ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD011192"},"PeriodicalIF":8.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079879","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}
引用次数: 0
Bioimpedance spectroscopy to estimate target weight in patients on maintenance haemodialysis. 生物阻抗谱估计维持性血液透析患者的目标体重。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-18 DOI: 10.1002/14651858.CD016044
Kaiane Stigger, Eduardo Ribes Kohn, Rony Kafer Nobre, Guilherme Pitol, Natan Feter, Maristela Bohlke
{"title":"Bioimpedance spectroscopy to estimate target weight in patients on maintenance haemodialysis.","authors":"Kaiane Stigger, Eduardo Ribes Kohn, Rony Kafer Nobre, Guilherme Pitol, Natan Feter, Maristela Bohlke","doi":"10.1002/14651858.CD016044","DOIUrl":"10.1002/14651858.CD016044","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 incorporating bioimpedance spectroscopy into the clinical assessment for estimating target weight in maintenance haemodialysis recipients compared with physical examination alone.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016044"},"PeriodicalIF":8.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079942","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}
引用次数: 0
Active treatments for unilateral amblyopia in adults. 成人单侧弱视的积极治疗。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-17 DOI: 10.1002/14651858.CD016116
Catherine Suttle, Miriam Conway, Lisa Asper, Rakhee Shah, Sieu Khuu, John G Lawrenson
{"title":"Active treatments for unilateral amblyopia in adults.","authors":"Catherine Suttle, Miriam Conway, Lisa Asper, Rakhee Shah, Sieu Khuu, John G Lawrenson","doi":"10.1002/14651858.CD016116","DOIUrl":"10.1002/14651858.CD016116","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of monocular and binocular (known as dichoptic) active treatments for unilateral amblyopia in adults.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016116"},"PeriodicalIF":8.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074560","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}
引用次数: 0
Melatonin for blood pressure control in adults. 褪黑素用于成人血压控制。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-16 DOI: 10.1002/14651858.CD016159
Muhammad Zia Ul Haq, Javeria Mansoor, Celia C Lima Dos Santos, Aida A Perez Ramos, Emilio Pinzon Cueva, Arash Harzand
{"title":"Melatonin for blood pressure control in adults.","authors":"Muhammad Zia Ul Haq, Javeria Mansoor, Celia C Lima Dos Santos, Aida A Perez Ramos, Emilio Pinzon Cueva, Arash Harzand","doi":"10.1002/14651858.CD016159","DOIUrl":"10.1002/14651858.CD016159","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Critical objective To assess the effects of oral melatonin supplementation (immediate‑release (IR) and controlled‑/sustained‑release CR/SR; any dose; ≥ 1 week) versus placebo or no treatment on change in systolic and diastolic blood pressure (SBP, DBP) in adults. Important objectives To examine dose‑response relationships between melatonin dose and changes in SBP and DBP. To assess effects by key participant and intervention characteristics (prespecified subgroups): baseline blood pressure status; concomitant antihypertensive medication use; presence of diagnosed sleep disorder/insomnia; melatonin formulation (IR versus CR/SR); blood pressure measurement method (office versus ambulatory versus home; daytime versus nocturnal); age (< 65 versus ≥ 65 years); sex. To evaluate adverse events (serious and non‑serious) and select patient‑important outcomes (quality of life, sleep quality). To describe any reported longer‑term cardiovascular outcomes (e.g. incident cardiovascular disease events, mortality) when sufficient data are available. These analyses are exploratory given anticipated sparse data.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016159"},"PeriodicalIF":8.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069105","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}
引用次数: 0
Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting: a network meta-analysis. 刺激腕穴PC6预防术后恶心呕吐:网络荟萃分析。
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-12 DOI: 10.1002/14651858.CD003281.pub5
Anna Lee, Jack Zhenhe Zhang, Jing Xie, Vesa Cheng, Man Kin Henry Wong, Derek King Wai Yau
{"title":"Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting: a network meta-analysis.","authors":"Anna Lee, Jack Zhenhe Zhang, Jing Xie, Vesa Cheng, Man Kin Henry Wong, Derek King Wai Yau","doi":"10.1002/14651858.CD003281.pub5","DOIUrl":"10.1002/14651858.CD003281.pub5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Postoperative nausea and vomiting (PONV) are common complications following surgery and anaesthesia. Antiemetic drugs are only partially effective in preventing PONV. Stimulating the PC6 acupoint(s) on the wrist offers an alternative approach, but the effectiveness of the various common techniques is unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To update and compare the effects and safety of PC6 acupoint stimulation with or without antiemetic drug(s) versus sham or antiemetic drug(s) for preventing postoperative nausea (PON) and postoperative vomiting (POV) in people undergoing surgery, and to identify the most effective techniques using network meta-analyses (NMAs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, ISI Web of Science, CINAHL, WHO Global Index Medicus, major trial registries, and reference lists of articles for studies up to 6 June 2025, with no language restrictions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Parallel randomised controlled trials of techniques that compared any combinations of PC6 acupoint stimulation, drug therapy, and sham for preventing PONV in children and adults were eligible. Interventions included invasive techniques (e.g. needle acupuncture) and noninvasive techniques (e.g. acupressure wristbands). Drug therapy included antiemetics that belonged to one of the following substance classes: 5-HT&lt;sub&gt;3&lt;/sub&gt; receptor antagonists, D&lt;sub&gt;2&lt;/sub&gt; receptor antagonists, corticosteroids, and antihistamines. The sham group included sham PC6 interventions and/or placebo saline antiemetic interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes: incidence of PON and POV. Important outcomes: need for rescue antiemetic therapy when prophylaxis failed and adverse events (side effects).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed the risk of bias in the included studies using RoB 1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We performed frequentist NMAs using random-effects models to report risk ratios (RRs) with 95% confidence intervals (95% CIs). We compared the relative effects (with sham as reference) of six broad classes of PC6 acupoint stimulation techniques and their combined use with antiemetic drugs on the outcomes. We summarised the safety data narratively due to heterogeneous reporting of adverse events (side effects). We assessed the certainty of evidence of the NMA treatment effect on outcomes according to the CINeMA and GRADE approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;This update included 77 trials, conducted between 1986 and 2022, involving 9847 participants. The majority were adults across several countries (USA, South Korea, India, China, Turkey, and Iran). There were 58 (33.9%) sham groups, 16 (9.4%) invasive PC6 acupoint stimulation groups, 50 (29.3%) noninvasive PC6 acupoint stimulation groups, 32 (18.7%) antiemetic(s) groups, 4 (2.3%) combined invasive PC6 acupoint stimulation and antiemetic(s) groups, 10 (5.8%) combin","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD003281"},"PeriodicalIF":8.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039262","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}
引用次数: 0
Ocular light exposure interventions for sleep, circadian rhythms, rest-activity cycles, mood, and cognitive function in older adults: An Overview of Cochrane and non-Cochrane Systematic Reviews. 眼光暴露干预对老年人睡眠、昼夜节律、休息-活动周期、情绪和认知功能的影响:Cochrane和非Cochrane系统综述
IF 8.8 2区 医学
Cochrane Database of Systematic Reviews Pub Date : 2025-09-12 DOI: 10.1002/14651858.CD016157
Resshaya Roobini Murukesu, Zahrah Alwi Alkaff, Charlene Bridges, Manuel Spitschan
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