Systematic Reviews

Schedules for Self-monitoring Blood Pressure: A Systematic Review – American Journal of Hypertension (free)

Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold.”


Vitamin K for reversal of excessive vitamin K antagonist anticoagulation: a systematic review and meta-analysis – Blood Advances (free)

Our findings indicate that patients on VKA therapy who have an INR between 4.5 and 10.0 without bleeding are not likely to benefit from vitamin K administration in addition to temporary VKA cessation.”


Mode of delivery and preterm birth in subsequent births: A systematic review and meta-analysis – PLOS One (free)

“A previous cesarean section could increase the risk of preterm birth in subsequent pregnancies”


Epidural analgesia for adults undergoing cardiac surgery with or without cardiopulmonary bypass – Cochrane Library (free)

Summary: Epidural analgesia for heart surgery with or without the heart lung machine in adults – Cochrane Library (free)

“Compared with systemic analgesia, epidural analgesia may reduce the risk of myocardial infarction, respiratory depression, and atrial fibrillation / atrial flutter, as well as the duration of tracheal intubation and pain, in adults undergoing cardiac surgery.”


Paracetamol versus placebo for knee and hip osteoarthritis – Cochrane Library (free)

Summary: Paracetamol for treating people with hip or knee osteoarthritis – Cochrane Library (free)

Related: Paracetamol: widely used and largely ineffective (free)


Related Commentary on Twitter

Subacromial decompression surgery for rotator cuff disease – Cochrane Library (free)

Summary: Surgery for rotator cuff disease (free)

Related Studies: Subacromial Decompression vs Diagnostic Arthroscopy for Shoulder Impingement (free study and commentaries) AND Arthroscopic subacromial decompression for subacromial shoulder pain (free study and commentaries)

“The data in this review do not support the use of subacromial decompression in the treatment of rotator cuff disease manifest as painful shoulder impingement.”


Short‐acting insulin analogues versus regular human insulin for adult, non‐pregnant persons with type 2 diabetes mellitus – Cochrane Library (free)

Summary: Short-acting insulin analogues versus regular human insulin for type 2 diabetes mellitus – Cochrane Library (free)

“The current evidence from clinical trials suggests neither clear benefits nor clear harms from the use of short‐acting insulin analogues over regular human insulin.”


Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life – Cochrane Library (free)

Summary: Vitamin and mineral supplementation for preventing cognitive deterioration in cognitively healthy people in mid and late life – Cochrane Library (free)

Commentary: Preventing dementia: do vitamin and mineral supplements have a role? – Evidently Cochrane (free)


Related Commentary on Twitter


Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies – Osteoporosis International (link to abstract – $ for full-text)

Commentary: PPIs up risk for hip fracture in large meta-analysis – Univadis (free registration required)


Related Commentary on Twitter

Ezetimibe for the prevention of cardiovascular disease and all‐cause mortality events – Cochrane Library (free)

Summary: Ezetimibe for the prevention of heart disease and death – Cochrane Library (free)

In individuals with established atherosclerotic cardiovascular disease, Ezetimibe has modest beneficial effects, primarily driven by a reduction in non‐fatal MI and non‐fatal stroke, but with little or no effect on clinical fatal endpoints.


Perioperative alcohol cessation intervention for postoperative complications – Cochrane Library (free)

Summary: Effects of perioperative alcohol cessation interventions on postoperative complications following surgery – Cochrane Library (free)

“Intensive alcohol cessation interventions offered for four to eight weeks to participants undergoing all types of surgical procedures to achieve complete alcohol cessation before surgery probably reduced the number of postoperative complications.”


Diagnostic value of symptoms and signs for identifying urinary tract infection in older adult outpatients: Systematic review and meta-analysis – The Journal of Infection (free)

“A number of symptoms and signs typically associated with UTI, such as nocturia, urgency and abnormal vital signs, were of limited use in older adult outpatients.”


Graduated compression stockings for prevention of deep vein thrombosis – Cochrane Library (free)

Summary: Graduated compression stockings for prevention of deep vein thrombosis during a hospital stay – Cochrane Library (free)

“There is high-quality evidence that GCS are effective in reducing the risk of DVT in hospitalised patients who have undergone general and orthopaedic surgery”


Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD) – Cochrane Library (free)

Summary: Preventative antibiotic therapy for people with COPD – Cochrane Library (free)

“Use of continuous and intermittent prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients.”


Prokinetics for functional dyspepsia – Cochrane Library (free)

Summary: Medications which promote stomach movement to relieve upper abdominal discomfort that does not have a specific cause – Cochrane Library (free)

“we are unable to say whether prokinetics are effective for the treatment of functional dyspepsia.”


Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women – Cochrane Library (free)

“Based on the data available, we can be confident that pelvic floor muscle training can cure or improve symptoms of stress urinary incontinence and all other types of urinary incontinence”


Modifying the consistency of food and fluids for swallowing difficulties in dementia – Cochrane Library (free for a limited period)

Summary: Modifying the consistency of food and fluids for swallowing difficulties in dementia (free)

“We are uncertain about the immediate and long-term effects of modifying the consistency of fluid for swallowing difficulties in dementia”


Primary antifungal prophylaxis for cryptococcal disease in HIV‐positive people – Cochrane Library (free for a limited period)

Summary: Preventing cryptococcal disease in HIV-positive people – Cochrane Library (free)

“Antifungal prophylaxis reduced the risk of developing and dying from cryptococcal disease. Therefore, where CrAG screening is not available, antifungal prophylaxis may be used in patients with low CD4 counts at diagnosis and who are at risk of developing cryptococcal disease.”


Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis – The BMJ (free)

Editorial: Environmental metals and cardiovascular disease (free)

Commentary: Experts warn of cardiovascular risk from heavy metal pollution – University of Cambridge (free)

“Since metals are associated with cardiovascular disease even at relatively low levels of exposure, population wide strategies to minimize exposure can further contribute to overall cardiovascular prevention efforts” (from @bmj_latest see Tweet)


Antibiotics for prolonged wet cough in children – Cochrane Library (link to abstract and plain language summary – $ for full-text)

Commentary: Antibiotics for pediatric chronic wet cough: Cochrane review – Univadis (free registration required)


Meta-Analysis: Corticosteroids in Sepsis

23 Aug, 2018 | 22:32h | UTC

Colloids versus crystalloids for fluid resuscitation in critically ill people – Cochrane Library (link to abstract – $ for full-text)

Summary: Colloids or crystalloids for fluid replacement in critically people – Cochrane Library (free)

“Using starches, dextrans, albumin or FFP (moderate-certainty evidence), or gelatins (low-certainty evidence), versus crystalloids probably makes little or no difference to mortality. Starches probably slightly increase the need for blood transfusion and RRT (moderate-certainty evidence), and albumin or FFP may make little or no difference to the need for renal replacement therapy (low-certainty evidence)”.