Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisThrombolysis for aneurysmal subarachnoid haemorrhage.
Aneurysmal subarachnoid haemorrhage continues to cause a significant burden of morbidity and mortality despite advances in care. Trials investigating local administration of thrombolytics have reported promising results. ⋯ There is some evidence that thrombolysis can probably improve outcomes after aneurysmal subarachnoid haemorrhage, without increasing the risk of haemorrhagic complications. Thrombolysis likely reduces the risk of poor functional outcome and cerebral artery vasospasm, and may reduce the risk of delayed cerebral ischaemia, but it likely makes little to no difference to case fatality or hydrocephalus, and may make little to no difference to the risk of cerebral infarction. However, the current evidence is still uncertain. The uncertainty is primarily due to the small total number of participants and outcome events. Data from further studies are required to confirm the efficacy of thrombolysis for improving outcomes after aneurysmal subarachnoid haemorrhage.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisCalorie (energy) labelling for changing selection and consumption of food or alcohol.
Overconsumption of food and consumption of any amount of alcohol increases the risk of non-communicable diseases. Calorie (energy) labelling is advocated as a means to reduce energy intake from food and alcoholic drinks. However, there is continued uncertainty about these potential impacts, with a 2018 Cochrane review identifying only a small body of low-certainty evidence. This review updates and extends the 2018 Cochrane review to provide a timely reassessment of evidence for the effects of calorie labelling on people's selection and consumption of food or alcoholic drinks. ⋯ Current evidence suggests that calorie labelling of food (including non-alcoholic drinks) on menus, products, and packaging leads to small reductions in energy selected and purchased, with potentially meaningful impacts on population health when applied at scale. The evidence assessing the impact of calorie labelling of food on consumption suggests a similar effect to that observed for selection and purchasing, although there is less evidence and it is of lower certainty. There is insufficient evidence to estimate the effect of calorie labelling of alcoholic drinks, and more high-quality studies are needed. Further research is needed to assess potential moderators of the intervention effect observed for food, particularly socioeconomic status. Wider potential effects of implementation that are not assessed by this review also merit further examination, including systemic impacts of calorie labelling on industry actions, and potential individual harms and benefits.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisTests for diagnosis of postpartum haemorrhage at vaginal birth.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisAnkle-foot orthoses for improving walking in adults with calf muscle weakness due to neuromuscular disorders.
Calf muscle weakness is a common symptom in slowly progressive neuromuscular disorders that lead to walking problems like instability and increased walking effort. The mainstay of treatment to improve walking in this population is the provision of ankle-foot-orthoses (AFOs). Since we are not aware of an up-to-date and complete overview of the effects of AFOs used for calf muscle weakness in slowly progressive neuromuscular disorders, we reviewed the evidence for the effectiveness of AFOs to improve walking in this patient group, in order to support clinical decision-making. ⋯ The available evidence for ankle-foot orthoses (AFOs) to improve walking in adults with calf muscle weakness comes from a limited number of small studies with heterogeneity in intervention characteristics and outcome assessment, and is of low to very low certainty. The evidence suggests that carbon AFOs may reduce walking energy cost (effort), increase walking speed, and enhance satisfaction, and leather AFOs may increase walking speed, while polypropylene and elastic AFOs may make little or no difference to walking speed. We are unable to draw conclusions about the effects of AFOs on perceived walking effort, balance, and use. Nor can we draw conclusions about adverse effects of using AFOs. The variety in the findings for AFOs made of different materials suggests further investigation is warranted to explore how different AFO materials impact walking improvement in people with calf muscle weakness due to slowly progressive neuromuscular disorders.
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Cochrane Db Syst Rev · Jan 2025
Transtracheal ultrasound for identifying endotracheal intubation in adults.
This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of transtracheal ultrasound for detecting endotracheal intubation in adult patients. Secondary objectives Secondary objectives include assessing the diagnostic accuracy of transtracheal ultrasound amongst the following subgroups: setting (e.g. prehospital, emergency department, intensive care unit, operating room) operator specialty (e.g. emergency medicine, non-emergency medicine) operator experience (e.g. attending physician, resident physician, non-physician) ultrasound technique (e.g. static, dynamic) ultrasound transducer (e.g. curvilinear, linear).