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NEWS - Systematic Reviews

To continue taking or to stop taking antiplatelet drugs for a few days before non-cardiac surgery in adults – Cochrane Library (link to abstract – $ for full-text)

Summary: To continue taking or to stop taking antiplatelet drugs for a few days before non-cardiac surgery in adults – Cochrane Library (free)

“We found low-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery may make little or no difference to mortality, bleeding requiring surgical intervention, or ischaemic events”.

 


Nurses as substitutes for doctors in primary care – Cochrane Library (free)

Summary: Nurses as substitutes for doctors in primary care – Cochrane Library (free)

“This updated Cochrane Review indicates that nurses can effectively expand the capacity of the primary care workforce”.

 


Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis – Critical Care Medicine (free for a limited period)

Source: Critical Care Reviews Newsletter

“In adults with septic shock treated with low dose corticosteroids, short- and longer-term mortality are unaffected, adverse events increase, but duration of shock, mechanical ventilation and ICU stay are reduced”.

 


Aldosterone Antagonist Therapy and Mortality in Patients With ST-Segment Elevation Myocardial Infarction Without Heart Failure: A Systematic Review and Meta-analysis – JAMA Internal Medicine (free for a limited period)

Invited Commentary: Mineralocorticoid Receptor Antagonists in ST-Segment Elevation Myocardial Infarction – JAMA Internal Medicine (free for a limited period)

Aldosterone antagonists are beneficial for patients with STEMI and reduced ejection fraction. This meta-analysis suggests that patients with STEMI and LVEF greater than 40% or without heart failure also have improved outcomes with aldosterone antagonists.

 


Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies – Cochrane Library (link to abstract – $ for full-text)

Summary: Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of harmful effects – Cochrane Library (free)

“Our findings suggest that methylphenidate may be associated with a number of serious adverse events as well as a large number of non-serious adverse events in children and adolescents, which often lead to withdrawal of methylphenidate”.

 


Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review – BMJ Open (free)

Commentaries: Moderate to severe mid-life anxiety may be linked to later life dementia – BMJ Open Blog (free) AND Anxiety in middle age linked to dementia later – Reuters (free) AND Expert reaction to a review of the association between mid-life anxiety and later life dementia – Science Media Centre (free)

“The current study isn’t designed to explain how anxiety and dementia might be connected, Iadecola added.

“We cannot say with confidence that anxiety is a cause (risk factor), an early manifestation of the dementia, or only coincidentally associated with it,”” (from Reuters)

 


Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis – Cochrane Library (free for a limited period)

News Release: Featured Review: Uterotonic agents for preventing postpartum haemorrhage – Cochrane Library (free)

Commentary: Review finds more effective drugs to stop bleeding after childbirth – University of Birmingham (free)

“New Cochrane Review suggests ergometrine plus oxytocin; misoprostol plus oxytocin; & carbetocin on its own, are more effective drugs for reducing excessive bleeding at childbirth rather than the current standard use of oxytocin on its own” (via @CochraneUK see Tweet)

 


Antifibrinolytics for heavy menstrual bleeding – Cochrane Library (link to abstract and summary)

“Antifibrinolytics appear effective tor treating for heavy menstrual bleeding, without substantially increasing the rate of adverse events” (via @CochraneLibrary see Tweet)

 


Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials – European Heart Journal (free)

Compared with triple antithrombotic therapy, dual antithrombotic therapy shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of major adverse cardiac events.

 


Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease – Cochrane Library (link to abstract – $ for full-text)

Summary: Radial artery versus femoral artery approach for performing coronary catheter procedures in people with coronary artery disease – Cochrane Library (free)

“Transradial approach for diagnostic coronary angiography or PCI (or both) in CAD may reduce short-term net adverse clinical events, cardiac death, all-cause mortality, bleeding, and access site complications”.

 


Non-invasive brain stimulation techniques for chronic pain – Cochrane Library (free)

“There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain”

 


Honey for acute cough in children – Cochrane Library (link to abstract – $ for full-text)

Summary: Honey for acute cough in children – Cochrane Library (free)

“Honey probably relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo, but may make little or no difference compared to dextromethorphan.”

 


Percutaneous vertebroplasty for osteoporotic vertebral compression fracture – Cochrane Library (link to abstract – $ for full-text)

Summary: Featured Review: Vertebroplasty for treating spinal fractures due to osteoporosis – Cochrane Library (free)

High quality evidence shows that vertebroplasty does not provide more clinically important benefits than placebo but may cause people harm”.

 


Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials – European Journal of Preventive Cardiology (link to abstract – $ for full-text)

“The findings of this meta-analysis suggested that the early discharge strategy after successful primary angioplasty is safe among selected low-risk STEMI patients. A shorter hospital stay could benefit both the patients and the healthcare systems”.

 


Macrolide antibiotics for bronchiectasis – Cochrane Library (link to abstract – $ for full-text)

Summary: Macrolide antibiotics for bronchiectasis – Cochrane Library (free)

“Long-term macrolide therapy may reduce the frequency of exacerbations and improve quality of life, although supporting evidence is derived mainly from studies of azithromycin, rather than other macrolides, and predominantly among adults rather than children. However, macrolides should be used with caution, as limited data indicate an associated increase in microbial resistance”.

 


Meta-analysis: Long-Term Outcomes of On- Versus Off-Pump Coronary Artery Bypass Grafting – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentary: Long-Term Outcomes of On- vs. Off-Pump CABG – American College of Cardiology, Latest in Cardiology (free)

“Off pump CABG. probably best used in a limited set of patients…” (via @keaglemd see Tweet)

 


Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data – The Lancet (free)

This meta-analysis of randomized trials showed CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. There was no mortality benefit in patients with left main disease.

 


Surgery for trigger finger – Cochrane Library (link to abstract – $ for full-text)

 


New Cochrane Systematic Reviews – Vaccines for Preventing Influenza and Its Complications

In Healthy Children (free) / Summary (free)

In The Elderly (free) / Summary (free)

In Immunosuppressed Adults With Cancer (free) / Summary (free)

In Healthy Adults (free) / Summary (free)

 


Transcatheter versus surgical aortic valve replacement in patients at low surgical risk: A meta-analysis of randomized trials and propensity score matched observational studies – Catheterization Cardiovascular Interventions (link to abstract – $ for full-text)

Commentary: Meta-Analysis Raises ‘Red Flag’ on TAVR in Low-Risk Patients – TCTMD (free)

“Data from six studies show that while short-term mortality is similar between TAVR and SAVR, more low-risk TAVR patients die by 2 years” (from TCTMD)

 


Nursing interventions for smoking cessation – Cochrane Library (free)

Summary: Does support and intervention from nurses help people to stop smoking? – Cochrane Library (free)

“There’s moderate quality evidence that behavioural support to motivate & sustain smoking cessation delivered by nurses can lead to a modest increase in the number of people who achieve prolonged abstinence” (via @CochraneUK see Tweet)

 


Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes: A Systematic Review and Meta-analysis – JAMA Cardiology (link to abstract – $ for full-text)

Commentaries: Could NOACs Have a Role for Secondary Prevention After STEMI? – TCTMD (free) AND Meta-Analysis: ACS Type Matters for DOAC Use in Secondary Prevention – MedPage Today (free registration required) AND Adding DOACs Beneficial for STEMI — Not Non-STEMI — But with Bleeding Risk – Physician’s First Watch (free)

“63 STEMI patients would need to receive a DOAC to prevent one cardiovascular event, while 96 would need to be treated to cause one major bleeding event”. (from Physician’s First Watch)

 


Risk of pre-eclampsia in women taking metformin: a systematic review and meta-analysis – Diabetic Medicine (free)

Source: ACP Journal Wise ($)

“Metformin was associated with lower gestational weight gain and a lower risk of pre-eclampsia compared with insulin”

 


Peritoneal dialysis for acute kidney injury – Cochrane Library (link to abstract – $ for full-text)

 


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