Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Nov 2024
Review Meta AnalysisResistance training for fatigue in people with cancer.
Cancer-related fatigue (CRF) is one of the most common symptoms associated with cancer and its treatment. Different types of exercise have demonstrated beneficial effects on CRF. Previous evidence syntheses provided promising but inconclusive results when focusing on the effects of resistance training. ⋯ Our review demonstrates beneficial effects of resistance training during anticancer therapy compared with no training on short-term CRF and QoL for people with cancer. Resistance training after anticancer therapy may also have a small beneficial effect on short-term QoL. Data on medium-, and long-term effects are sparse. In order to facilitate evidence syntheses beyond a narrative report of the data, investigators of resistance training programmes should report adverse events more consistently and completely for all study arms, including control groups.
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Cochrane Db Syst Rev · Nov 2024
Review Meta AnalysisSerum and urine nucleic acid screening tests for BK polyomavirus-associated nephropathy in kidney and kidney-pancreas transplant recipients.
BK polyomavirus-associated nephropathy (BKPyVAN) occurs when BK polyomavirus (BKPyV) affects a transplanted kidney, leading to an initial injury characterised by cytopathic damage, inflammation, and fibrosis. BKPyVAN may cause permanent loss of graft function and premature graft loss. Early detection gives clinicians an opportunity to intervene by timely reduction in immunosuppression to reduce adverse graft outcomes. Quantitative nucleic acid testing (QNAT) for detection of BKPyV DNA in blood and urine is increasingly used as a screening test as diagnosis of BKPyVAN by kidney biopsy is invasive and associated with procedural risks. In this review, we assessed the sensitivity and specificity of QNAT tests in patients with BKPyVAN. ⋯ There is insufficient evidence to suggest the use of urine BKPyV QNAT as the primary screening tool for BKPyVAN. The summary estimates of the test sensitivity and specificity of blood/serum/plasma BKPyV QNAT test at a threshold of 10,000 copies/mL for BKPyVAN were 0.86 (95% CI 0.78 to 0.93) and 0.95 (95% CI 0.91 to 0.97), respectively. The multiple cut-off model showed that the optimal cut-off was around 2000 copies/mL, with test sensitivity of 0.89 (95% CI 0.66 to 0.97) and specificity of 0.88 (95% CI 0.80 to 0.93). While 10,000 copies/mL is the most commonly used cut-off, with good test performance characteristics and supports the current recommendations, it is important to interpret the results with caution because of low-certainty evidence.
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Cochrane Db Syst Rev · Nov 2024
Review Meta AnalysisProphylactic use of inotropic agents for the prevention of low cardiac output syndrome and mortality in adults undergoing cardiac surgery.
As the burden of cardiovascular disease grows, so does the number of cardiac surgeries. Surgery is increasingly performed on older people with comorbidities who are at higher risk of developing perioperative complications such as low cardiac output state (LCOS). Surgery-associated LCOS represents a serious pathology responsible for substantial morbidity and mortality. Prevention of LCOS is a critical and worthwhile aim to further improve the outcome and effectiveness of cardiac surgery. However, guidelines consistently report a lack of evidence for pharmacological LCOS prophylaxis. ⋯ Prophylactic treatment with levosimendan may reduce the incidence of LCOS and probably reduces associated mortality in adult patients undergoing cardiac surgery when compared to placebo only. Conclusions on the benefits and harms of other inotropic agents cannot be drawn due to limited study data. Given the limited evidence available, there is an unmet need for large-scale, well-designed randomised trials. Future studies of levosimendan ought to be designed to derive potential benefit in specific patient groups and surgery types, and the optimal administration protocol.
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This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of psychotherapeutic interventions in the treatment of older adults with depression and whether the effects of different types of psychotherapeutic treatments vary for older adults with depression.
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Researchers conducting trials have a responsibility to publish the results of their work in a peer-reviewed journal, and failure to do so may introduce bias that affects the accuracy of available evidence. Moreover, failure to publish results constitutes research waste. ⋯ This review combines and updates two earlier Cochrane reviews. The two protocols and previous versions of the two updated reviews are available via 10.1002/14651858.MR000006 and 10.1002/14651858.MR000006.pub3 and 10.1002/14651858.MR000011 and 10.1002/14651858.MR000011.pub2.