Cochrane Db Syst Rev
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Pressure ulcers occur when people cannot reposition themselves to relieve pressure over bony prominences. They are difficult to heal, costly, and reduce quality of life. Dressings and topical agents (lotions, creams, and oils) for pressure ulcer prevention are widely used. However, their effectiveness is unclear. This is the third update of this review. ⋯ The included studies tested a wide variety of dressings and topical agents. The evidence for all interventions is uncertain or very uncertain; thus, it is unclear whether any of the dressings or topical agents studied make any difference to pressure ulcer development. Future studies should engage with stakeholders to determine priority interventions.
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Cochrane Db Syst Rev · Dec 2024
Interventions for preventing oral mucositis in people receiving cancer treatment: photobiomodulation.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of photobiomodulation for the prevention of oral mucositis in people undergoing treatment for head and neck cancers, other solid cancers, and haematological cancers.
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Knee osteoarthritis (OA) is a major public health issue causing chronic pain, impaired physical function, and reduced quality of life. As there is no cure, self-management of symptoms via exercise is recommended by all current international clinical guidelines. This review updates one published in 2015. ⋯ We found low- to moderate-certainty evidence that exercise probably results in an improvement in pain, physical function, and quality of life in the short-term. However, based on the thresholds for minimal important differences that we used, these benefits were of uncertain clinical importance. Participants in most trials were not blinded and were therefore aware of their treatment, and this may have contributed to reported improvements.
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Cochrane Db Syst Rev · Dec 2024
Review Meta AnalysisInterventions to prevent surgical site infection in adults undergoing cardiac surgery.
Surgical site infection (SSI) is a common type of hospital-acquired infection and affects up to a third of patients following surgical procedures. It is associated with significant mortality and morbidity. In the United Kingdom alone, it is estimated to add another £30 million to the cost of adult cardiac surgery. Although generic guidance for SSI prevention exists, this is not specific to adult cardiac surgery. Furthermore, many of the risk factors for SSI are prevalent within the cardiac surgery population. Despite this, there is currently no standard of care for SSI prevention in adults undergoing cardiac surgery throughout the preoperative, intraoperative and postoperative periods of care, with variations in practice existing throughout from risk stratification, decontamination strategies and surveillance. ⋯ This review provides the broadest and most recent review of the current evidence base for interventions to reduce SSI in adults undergoing cardiac surgery. Twenty-one interventions were identified across the perioperative period. Evidence is of low to very low certainty primarily due to significant heterogeneity in how interventions were implemented and the definitions of SSI used. Knowledge gaps have been identified across a number of practices that should represent key areas for future research. Efforts to standardise SSI outcome reporting are warranted.
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Cochrane Db Syst Rev · Dec 2024
Review Meta AnalysisChemotherapy alone versus chemotherapy plus radiotherapy for adults with early-stage Hodgkin's lymphoma.
Early-stage Hodgkin's lymphoma in adults is commonly treated with combined modality treatment of chemotherapy followed by radiotherapy. The role of radiotherapy has been questioned due to potential long-term adverse effects. ⋯ The chemotherapy regimens in the trials differed and data for regimens commonly used today were limited. Additional radiotherapy may slightly improve progression-free survival. The available data for overall survival and adverse events were of low and very low certainty, and we were unable to draw conclusions about the effects of additional radiotherapy on these outcomes. No studies evaluated infertility. High-quality, longer-term follow-up data are required and data on fertility are needed.