Cochrane Database of Systematic Reviews最新文献

{"title":"Cardiorespiratory training for people with stroke.","authors":"Sharon Kramer, Joshua D Cheyne, Samantha Fawkner, Leanne Hassett, Liam Johnson, Gillian E Mead, Torsten Rackoll, James Smith, Vibeke Wagner, David H Saunders","doi":"10.1002/14651858.CD016000","DOIUrl":"10.1002/14651858.CD016000","url":null,"abstract":"<p><strong>Rationale: </strong>Low levels of cardiorespiratory fitness are common after stroke and are associated with post-stroke disability and increased risk of secondary stroke. Cardiorespiratory training interventions aim to increase cardiorespiratory fitness, improve physical function, reduce disability, and help prevent future strokes. Clinical guidelines recommend exercise as part of lifestyle modification for secondary prevention, and strongly recommend exercise for rehabilitation. This review is one of three reviews that were originally a single review on physical fitness training for stroke.</p><p><strong>Objectives: </strong>The primary objective of this review was to determine whether cardiorespiratory training after stroke has an effect on death, disability, adverse events, risk factors, fitness, walking, and indices of physical function when compared to a non-exercise control.</p><p><strong>Search methods: </strong>In April 2025, we searched nine bibliographic databases and two trials registers to identify studies for inclusion in the review. We checked reference lists, tracked citations, and contacted experts.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials comparing cardiorespiratory training interventions with usual care, no intervention, or a non-exercise intervention in people with stroke.</p><p><strong>Outcomes: </strong>Our critical outcomes were death, disability, adverse events, risk factors, fitness, walking, and indices of physical function, assessed at the end of the intervention and the end of the longest follow-up.</p><p><strong>Risk of bias: </strong>We used the Cochrane RoB 1 tool to assess the risk of bias in the included studies.</p><p><strong>Synthesis methods: </strong>The studies evaluated different comparisons (e.g. cardiorespiratory training versus no intervention/waiting list control or versus attention control or versus usual care), which we synthesised into a single comparison: cardiorespiratory training versus control. We used random-effects meta-analysis on arm-level data (risk difference (RD) for dichotomous data, and mean difference (MD) or standardised mean difference (SMD) for continuous data, with 95% confidence intervals (CIs)). For outcome data that we did not meta-analyse, we followed Synthesis Without Meta-analysis (SWiM) guidance. We used GRADE to assess the certainty of the evidence for critical outcomes.</p><p><strong>Included studies: </strong>We included 53 studies (2672 participants, with an average age of 61.9 years). Most studies recruited ambulatory participants in the early subacute (7 days to 3 months) or chronic (> 6 months) phases of recovery. Exercise duration recommendations were met in 49 studies, and frequency recommendations in 48. Twenty-eight studies lacked balanced exposure between groups. Programme duration was 12 weeks or more in 16 studies (maximum: 24 weeks). Sixteen studies had a post-intervention follow-up period (12 weeks to 12 mo","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016000"},"PeriodicalIF":11.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967023","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":"Strategies to improve recruitment to randomised trials.","authors":"Adwoa Parker, Gloria Mongelli, Camila Piccolo-Lawrance, Elizabeth Coleman, Athanasios Gkekas, Han-I Wang, Shoba Dawson, Heidi Green, Rosalind Way, Arti Rai, Hanne Bruhn, Frank Sullivan, Cherish Boxall, Markus Chan, Paul Manson, Catherine Hewitt, Caroline Fairhurst, Mike Clarke, Shaun Treweek","doi":"10.1002/14651858.MR000013.pub7","DOIUrl":"10.1002/14651858.MR000013.pub7","url":null,"abstract":"<p><strong>Background: </strong>Recruiting participants to randomised controlled trials (RCTs) is challenging. Identifying effective recruitment strategies would benefit health research: poor recruitment leads to underpowered trials, reducing the reliability of findings and increasing the risk of wasted resources, ethical concerns, and trial failure. Evidence to inform recruitment strategies is increasingly generated through Studies Within A Trial (SWATs), which are methodological studies embedded within host RCTs. This is an update of a review last published in 2018.</p><p><strong>Objectives: </strong>Primary: to quantify the effects of strategies to improve recruitment of participants to RCTs. Secondary: to evaluate recruitment strategies' cost-effectiveness and impact on retention, and the equity, diversity, and inclusion (EDI) characteristics of recruited participants.</p><p><strong>Search methods: </strong>We used MEDLINE, Embase, and six other databases to identify the studies included in the review. We also sought unpublished recruitment SWATs through social media and targeted email dissemination to trial methodology networks. The latest search date was 16 February 2023.</p><p><strong>Selection criteria: </strong>We included randomised SWATs evaluating trial recruitment strategies embedded in healthcare and non-healthcare trials. We excluded quasi-randomised, hypothetical, questionnaire-only, retention-only, or clinician incentive studies.</p><p><strong>Data collection and analysis: </strong>Primary outcome: proportion of eligible participants or centres recruited.</p><p><strong>Secondary outcomes: </strong>cost-effectiveness, retention rates, and EDI characteristics of included participants. We conducted random-effects meta-analysis for strategies evaluated in at least two studies; otherwise, we synthesised results narratively. We reported effects as risk differences (RDs) with 95% confidence intervals (CIs), and assessed between-trial heterogeneity. We used GRADE to assess the certainty of evidence for the primary outcome. We expressed cost-effectiveness as the incremental cost per additional participant recruited in pounds sterling (GBP).</p><p><strong>Main results: </strong>We identified 91 eligible studies (53 new to this update), providing 94 comparisons and involving at least 176,747 participants. Eighty-one studies involved strategies aimed at trial participants, while 10 evaluated strategies aimed at recruiters. All were healthcare studies. We found 65 recruitment strategies; 49 were evaluated in a single study. Only five strategies were supported by high-certainty evidence according to GRADE criteria, and we focus on these strategies in the summary below. Open-label trials versus blinded, placebo trials. Open-label trials recruited more participants than blinded trials (RD 10%, 95% CI 8% to 12%; 3 studies, 9004 participants), corresponding to approximately 10 additional participants per 100 approached. The studies involved mostly","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"MR000013"},"PeriodicalIF":11.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967055","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":"Pharmacological therapies for the prevention of fractures in men.","authors":"Lars Christian Braten, Cyrill Suter, Renea V Johnston, Sami A Hartzell, Teppo Järvinen, Rachelle Buchbinder","doi":"10.1002/14651858.CD014707.pub2","DOIUrl":"10.1002/14651858.CD014707.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Pharmacological therapies for fracture prevention usually target osteoporosis, a skeletal disorder characterised by compromised bone mass or quality (or both). As most participants in osteoporosis trials are women, a review of pharmacological therapies for fracture prevention in men was warranted.</p><p><strong>Objectives: </strong>To determine the benefits and harms of bisphosphonates, parathyroid (PTH) or parathyroid-related protein (PTHrP) analogues, denosumab, and romosozumab therapy for the prevention of fractures in men.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and two trial registries (ClinicalTrials.gov and WHO ICTRP) until 14 October 2025, with no restrictions on date or language of publication.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials that compared bisphosphonates, PTH or PTHrP analogues, denosumab, or romosozumab (alone or with calcium or vitamin D, or both) with placebo, other drugs, or non-pharmacological therapies in men aged 50 years or older. Our primary comparison was bisphosphonates versus placebo.</p><p><strong>Outcomes: </strong>Critical outcomes were incidence of hip fractures, symptomatic vertebral fractures, other (not hip or vertebral) fractures, disability, participants with adverse events, study withdrawals due to adverse events, and participants with serious adverse events. Our primary time point was the final time point reported in the trials.</p><p><strong>Risk of bias: </strong>We used Cochrane's RoB 2 tool to assess risk of bias.</p><p><strong>Synthesis methods: </strong>We used a random-effects model for meta-analysis employing the Mantel-Haenszel approach, and the DerSimonian and Laird method to estimate between-trial variance. We assessed the certainty of evidence using GRADE.</p><p><strong>Included studies: </strong>Seventeen trials (4132 participants) met our inclusion criteria. The average age of participants ranged from 52 to 73 years. Twelve trials used a placebo comparator versus bisphosphonate (7 trials, 2548 participants), PTH or PTHrP analogues (4 trials, 569 participants), denosumab (1 trial, 240 participants), and romosozumab (1 trial, 244 participants). For the other planned comparisons, a bisphosphonate was compared to vitamin D/vitamin D analogues (2 trials, 434 participants), to calcitonin (1 trial, 32 participants), to PTH or PTHrP analogues (1 trial, 19 participants), or to another bisphosphonate (1 trial, 301 participants), and one trial compared a bisphosphonate plus calcium to calcium tablets alone (46 participants).</p><p><strong>Synthesis of results: </strong>Placebo-controlled trials were largely susceptible to bias in selection of the reported result (83%), while most trials without a placebo control were also susceptible to bias arising from the randomisation process (100%) and in measurement of the outcome (80%). We are very uncertain about the effect of bisphosphonates on the ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014707"},"PeriodicalIF":11.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967048","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":"Iodine supplementation for preventing iodine deficiency disorders in children and adolescents.","authors":"Ines Velasco, Mikel Rueda-Etxebarria, Maria Angelica Trak-Fellermeier, Peter Taylor, Montserrat Rabassa Bonet, Yuan Chi, Heidrun Janka, José-Ramón Rueda","doi":"10.1002/14651858.CD014475.pub2","DOIUrl":"10.1002/14651858.CD014475.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Iodine is a micronutrient crucial in the early stages of human development, as it is essential for synthesising thyroid hormones involved in somatic growth and neurodevelopment. It is far better to prevent iodine deficiency than to treat it, since children are particularly vulnerable to iodine deficiency disorders, which involve a broad spectrum of consequences including endemic goitre, delayed growth and development of the central nervous system, intellectual impairment, and infant mortality. The primary dietary sources of iodine are iodised salt, seafood (animals and plants concentrate iodine from seawater), and grains from iodine-rich soils. Reliable evidence is needed on the benefits and harms of direct iodine supplementation in children and adolescents before considering its use to prevent the health consequences of iodine deficiency.</p><p><strong>Objectives: </strong>To assess the benefits and harms of iodine supplementation for preventing iodine deficiency in children and adolescents.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, eight other databases, and two trials registries to 8 May 2025. We also searched the reference lists of retrieved studies.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials (RCTs) evaluating the benefits and harms of iodine supplementation alone (orally or by injection) or in combination with vitamins and minerals (orally or by injection) compared with placebo.</p><p><strong>Outcomes: </strong>Our critical outcomes were cognitive function assessed by validated scales, growth, hypothyroidism, and adverse events. Important outcomes included health-related quality of life, all-cause mortality, and goitre.</p><p><strong>Risk of bias: </strong>We used the Cochrane RoB 2 tool to assess the risk of bias in the included studies.</p><p><strong>Synthesis methods: </strong>Two review authors independently selected trials, extracted data, and assessed risk of bias. We used random-effects meta-analysis to combine data. We assessed the certainty of the evidence using GRADE.</p><p><strong>Included studies: </strong>We included eight RCTs with a total of 2528 participants. The trials were conducted in seven countries between 1982 and 2009. The trials compared iodine supplementation (alone or with iron in one study) versus placebo. In one study, iodine supplementation was 150 μg daily for 28 weeks, while in the remaining studies, iodine supplementation was done in a single dose: 100 mg in a study on infants younger than 1 year, and a dose between 400 mg and 490 mg for children 6 to 17 years. Follow-up ranged from 3 to 22 months.</p><p><strong>Synthesis of results: </strong>Iodine supplementation versus placebo Iodine supplementation results in a slight increase in cognitive function compared to placebo (standardised mean difference 0.19, 95% confidence interval (CI) 0.04 to 0.34; 1 study, 166 participants; high-certainty evidence). Iodine su","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014475"},"PeriodicalIF":11.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918732","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":"Holmium laser enucleation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia.","authors":"Niranjan Sathianathen, Eu Chang Hwang, Sarah Jane Brown, Caitlin Bakker, Michael S Borofsky, Onuralp Ergun, Philipp Dahm","doi":"10.1002/14651858.CD013291.pub2","DOIUrl":"10.1002/14651858.CD013291.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>A range of surgical options is available for the treatment of benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP). The evidence is unclear regarding differences in functional, perioperative, and morbidity outcomes between these modalities.</p><p><strong>Objectives: </strong>To assess the effects of holmium laser enucleation of the prostate compared with other surgical treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia.</p><p><strong>Search methods: </strong>We searched multiple databases (including MEDLINE, Embase, CENTRAL, Web of Science, LILACS, and the International HTA database), trial registries, and conference abstracts through April 08, 2026.</p><p><strong>Eligibility criteria: </strong>We only included randomized trials of men over 40 years of age with a prostate volume of at least 20 mL (assessed by digital rectal examination, ultrasound, or conventional imaging) who exhibited lower urinary tract symptoms (LUTS) defined by an International Prostate Symptom Score (IPSS) of eight or greater undergoing surgical interventions for BPH.</p><p><strong>Outcomes: </strong>The critical outcomes measured were the urologic symptoms score, the quality-of-life score, and major adverse events. The important outcomes measured were: re-treatment, erectile function, ejaculatory function, transfusions, acute urinary retention, indwelling urinary catheter duration, and hospital stay duration.</p><p><strong>Risk of bias: </strong>We used the Cochrane risk of bias tool (RoB 1) to assess for potential sources of bias on a study and outcome level basis.</p><p><strong>Synthesis methods: </strong>We pooled outcome data using the random-effects model and performed meta-analyses using the Mantel-Haenszel method. We assessed statistical heterogeneity in the pooled data by visually inspecting forest plots and using the I<sup>2</sup> statistic to quantify it. We used the GRADE framework to assess the certainty of evidence.</p><p><strong>Included studies: </strong>We included 52 trials that included 6242 participants that compared HoLEP to other surgical interventions for benign prostatic hyperplasia. The median age of participants across the studies ranged from 65 to 74 years. The baseline prostate volume ranged from 30 cc to 142 cc. Baseline IPSS scores ranged from 19.6 to 28.6 (range 0-35).</p><p><strong>Synthesis of results: </strong>We prioritized comparing HoLEP with transurethral resection of the prostate (TURP) at short-term follow-up (up to 12 months), because TURP is the long-standing reference standard and the predominant comparator in randomized surgical trials. Findings for the four remaining comparisons (laser ablation, alternative energy source enucleation, other minimally invasive therapies, and simple prostatectomy), for long-term follow-up, and for all remaining outcomes are reported in full in the review. Compared to TURP, at short-term follow","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD013291"},"PeriodicalIF":11.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911077","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":"Imaging‑based models for predicting cerebrovascular complications of carotid stenosis.","authors":"Baobao Li, Xiangrong Du, Yuan Liu, Hongtao Zhang, Shitong Liu, Shengshu Wang, Xihai Zhao, Fugeng Sheng, Mingming Lu, Jianming Cai","doi":"10.1002/14651858.CD016391","DOIUrl":"10.1002/14651858.CD016391","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (prognosis). The objectives are as follows: Primary objective To systematically review and critically appraise multivariable prognostic models developed for adults (≥ 18 years) with carotid stenosis in which imaging biomarkers (e.g. plaque characteristics derived from magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound) constitute the core predictors. The primary focus is to evaluate the predictive performance of these models for cerebrovascular complications - specifically ipsilateral ischaemic stroke and transient ischaemic attack (TIA) - which are the clinical outcomes to be predicted. Where feasible, we will summarise and compare the models' discrimination (C‑statistic/area under the curve (AUC)) and calibration (calibration‑in‑the‑large, calibration slope, observed‑to‑expected ratio) across studies, and assess their potential for clinical application and external validation. For the purpose of defining symptomatic carotid stenosis as an eligibility criterion and subgroup variable, we will include studies that also considered retinal ischaemia (e.g. retinal embolism, amaurosis fugax) as a qualifying event. Secondary objectives To describe the combinations of imaging markers, modelling techniques, sample sizes, and variable‑selection strategies used in the development of the included models To evaluate the performance of these models for additional secondary clinical outcomes: plaque progression or regression, incident high‑risk imaging features, and the transition from asymptomatic to symptomatic disease To explore whether predictive performance differs according to imaging modality (MRI versus CT versus contrast‑enhanced ultrasound (CEUS)) or technical protocol (e.g. 3 T versus 1.5 T, spectral CT versus conventional CT) For studies that report both cerebrovascular and broader cardiovascular outcomes (major adverse cardiovascular events, myocardial infarction, etc.), we will only extract the performance metrics relating to cerebrovascular events for the primary analysis. Performance metrics for cardiovascular outcomes will be considered exploratory and will not form part of the main synthesis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016391"},"PeriodicalIF":11.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911044","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":"Thymosin-ɑ1 for people with chronic hepatitis B.","authors":"Cho Naing, Han Ni, Htar Htar Aung, Saint Nway Aye, Dimitrinka Nikolova, Yong Poovorawan, Chavdar Pavlov","doi":"10.1002/14651858.CD014610.pub2","DOIUrl":"10.1002/14651858.CD014610.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Chronic hepatitis B is a global public health concern. It is caused by infection with the hepatitis B virus (HBV). The goal of treating chronic HBV infection is to prevent progression to chronic hepatitis, cirrhosis, hepatic decompensation, liver failure, hepatocellular carcinoma, and death. Individual studies have evaluated various immunomodulatory therapies with inconsistent results. Thymosin-ɑ1 is known to have antiviral effects; however, results of randomised clinical trials on the effects of thymosin-α1 as a potential treatment for people with chronic HBV have been inconsistent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of thymosin-ɑ1 therapy in people with chronic hepatitis B.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, four other databases and six trials registers, in addition to reference checking, citation searching, and contacting study authors to identify trials for inclusion. The latest search date was 10 June 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that evaluated thymosin-α1 at any dose, route of administration, or formulation type, in people with chronic hepatitis B regardless of age, sex, or ethnicity. Thymosin-α1 could have been administered as monotherapy, in combination with an additional drug, or in addition to standard medical treatment and compared with placebo, no intervention, the same additional drug, or the same standard medical treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were all-cause mortality, serious adverse events, and health-related quality of life. Among our important outcomes were HBV-related morbidity, HBV-related mortality, non-serious adverse events, and the proportion of people without histological improvements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane Risk of bias 2 tool (RoB 2) to assess risk of bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We followed Cochrane methods. We conducted meta-analyses for predefined outcomes using data from the longest follow-up period, irrespective of the risk of bias judgements. We presented dichotomous outcome results as risk ratios (RRs) and continuous outcome results as mean differences, with 95% confidence intervals (CIs) at their longest follow-ups. We used the random-effects model for our primary analyses. We used GRADE to assess the certainty of the evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 10 RCTs conducted in Bangladesh, China, Italy, Korea, Singapore, and Taiwan, with 1349 randomised participants (range: 12 to 690; 1045 (77.5%) were male). Among the trials reporting age, none included participants younger than 17 years (age range: 17 to 75 years). The trials were published between 1991 and 2018, and assessed thymosin-ɑ1 in adults with chronic hepatitis B infection, with or without comorbidi","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD014610"},"PeriodicalIF":11.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911036","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":"Treatment for symptomatic hypermobility in childhood.","authors":"Rachal Quinlan, Kelly Gray, Luke M Davies, Louise Tofts, Cylie M Williams, Alan J Hakim, Verity Pacey","doi":"10.1002/14651858.CD016390","DOIUrl":"10.1002/14651858.CD016390","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, pharmacological, surgical, and multi-component interventions for musculoskeletal symptoms in children with hypermobility-associated conditions.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016390"},"PeriodicalIF":11.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900349","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 replacing missing teeth: antibiotic prophylaxis for dental implant placement with bone augmentation procedures.","authors":"Riccardo Federico Visconti, Hassan Maghaireh, Caroline Bolle, Marco Esposito","doi":"10.1002/14651858.CD016385","DOIUrl":"10.1002/14651858.CD016385","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 systemic prophylactic antibiotics versus no antibiotics or placebo in people undergoing dental implant placement with concomitant bone augmentation procedures, and to assess whether the effects of systemic prophylactic antibiotics differ according to the dosage, duration, timing of administration, and type of antibiotic.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016385"},"PeriodicalIF":11.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891101","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":"Long-term hormone therapy for perimenopausal and postmenopausal women.","authors":"Magdalena Bofill Rodriguez, Li Ning Yong, Sanja Mirkov, Christine Bekos, Anne Lethaby, Cindy Farquhar","doi":"10.1002/14651858.CD004143.pub7","DOIUrl":"10.1002/14651858.CD004143.pub7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hormone therapy is widely provided to control menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the long-term effects of prolonged use (at least one year) of hormone therapy on mortality, cardiovascular outcomes, cancer, gallbladder disease, fractures and cognition in perimenopausal and postmenopausal women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We used the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, three other databases and two trial registers, together with reference checking, citation searching and contact with study authors to identify the studies included in the review. The latest search date was 26 September 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised, double-blind trials in which peri- or postmenopausal women took hormone therapy or placebo for at least one year. We included various oestrogen formulations, with or without progestogens. We focused on studies assessing hormone therapy's effects on long-term clinical outcomes, including death, coronary events and cancer. Hormone therapy's efficacy in managing menopausal symptoms was beyond the scope of this review, and is assessed in other Cochrane reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently selected studies, assessed risk of bias and extracted data. We calculated risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, along with 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 24 studies - with two newly added in this update - involving 45,660 participants. We derived nearly 70% of the data from two well-conducted studies: the Heart and Estrogen/progestin Replacement Study (HERS 1998) and the large, multi-component Women's Health Initiative research programme, which included two hormone therapy arms (WHI 1998). Across all the studies, most participants were postmenopausal American women with one or more comorbidities. The mean participant age in most studies was over 60 years. Only one included study focused on perimenopausal women. We present full results for all included studies with available data in the main review. The results presented below are drawn from WHI 1998, in which the combined hormone therapy arm and the oestrogen-only arm were run concurrently, with women assigned to the appropriate trial based on their uterus status. One study with 16,608 postmenopausal women with an intact uterus compared combined continuous hormone therapy (conjugated equine oestrogen and medroxyprogesterone acetate) to placebo, and measured outcomes at an average of 5.6 years of follow-up. Based on this study, combined continuous hormo","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD004143"},"PeriodicalIF":11.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891124","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}