Cochrane Db Syst Rev
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Financial incentives (money, vouchers, or self-deposits) can be used to positively reinforce smoking cessation. They may be used as one-off rewards, or in various schedules to reward steps towards sustained smoking abstinence (known as contingency management). They have been used in workplaces, clinics, hospitals, and community settings, and to target particular populations. This is a review update. The previous version was published in 2019. ⋯ Overall, our conclusion from this latest review update remains that there is high-certainty evidence that incentives improve smoking cessation rates at long-term follow-up in mixed population studies. The evidence demonstrates that the effectiveness of incentives is sustained even when the last follow-up occurs after the withdrawal of incentives. There is also now high-certainty evidence that incentive schemes conducted amongst pregnant people who smoke improve smoking cessation rates, both at the end of pregnancy and postpartum. This represents a change from the previous update in which we rated this evidence as moderate certainty. Current and future research might more precisely explore differences between trials offering low or high cash incentives and self-incentives (deposits), within a variety of smoking populations, focusing on low- and middle-income countries where the burden of tobacco use remains high.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisPreservation of the azygos vein versus ligation of the azygos vein during primary surgical repair of congenital esophageal atresia.
Esophageal atresia is one of the most common life-threatening congenital malformations and is defined as an interruption in the continuity of the esophagus with or without fistula to the trachea or bronchi. Definitive treatment is surgical ligation of the fistula if present and esophageal end-to-end anastomosis of the two pouches, thereby reconstructing the continuity of the esophagus. During this procedure, the surgeon may choose to either ligate or preserve the azygos vein, a major draining vein for the esophagus and surrounding structures, but no definitive consensus on the matter exists. ⋯ Current evidence suggests that preserving the azygos vein during primary surgical repair for esophageal atresia may result in large reductions in overall mortality, serious adverse events, anastomosis leakage, and sepsis or mediastinitis. No included data suggested that routine ligation of the azygos vein was beneficial. However, all the evidence was of low to very low certainty. Further research is still warranted as the results of this review may not be applicable to all newborns with congenital esophageal atresia.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisPreservation of the azygos vein versus ligation of the azygos vein during primary surgical repair of congenital esophageal atresia.
Esophageal atresia is one of the most common life-threatening congenital malformations and is defined as an interruption in the continuity of the esophagus with or without fistula to the trachea or bronchi. Definitive treatment is surgical ligation of the fistula if present and esophageal end-to-end anastomosis of the two pouches, thereby reconstructing the continuity of the esophagus. During this procedure, the surgeon may choose to either ligate or preserve the azygos vein, a major draining vein for the esophagus and surrounding structures, but no definitive consensus on the matter exists. ⋯ Current evidence suggests that preserving the azygos vein during primary surgical repair for esophageal atresia may result in large reductions in overall mortality, serious adverse events, anastomosis leakage, and sepsis or mediastinitis. No included data suggested that routine ligation of the azygos vein was beneficial. However, all the evidence was of low to very low certainty. Further research is still warranted as the results of this review may not be applicable to all newborns with congenital esophageal atresia.
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Cochrane Db Syst Rev · Jan 2025
Meta AnalysisGonadotropin-releasing hormone agonist protocols for pituitary suppression in assisted reproduction.
Gonadotropin-releasing hormone agonists (GnRHa) are commonly used in assisted reproduction technology (ART) cycles to prevent a luteinising hormone (LH) surge during controlled ovarian hyperstimulation (COH) prior to planned oocyte retrieval, thus optimising the chances of live birth. We compared the benefits and risks of the different GnRHa protocols used. ⋯ When comparing long and short GnRHa protocols, we found little or no difference in live birth and ongoing pregnancy rates, but there was evidence that the long protocol may improve clinical pregnancy rates overall. We were uncertain of any difference in OHSS and miscarriage rates for all comparisons, which were reported by only two studies each. There was insufficient evidence to draw any conclusions regarding other adverse effects or the cost-effectiveness and acceptability of the different treatment protocols.
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There is limited guidance on the best ways to stop using nicotine-containing vapes (otherwise known as e-cigarettes) and ensure long-term abstinence, whilst minimising the risk of tobacco smoking and other unintended consequences. Treatments could include pharmacological interventions, behavioural interventions, or both. ⋯ Cancer Research UK (PRCPJT-Nov22/100012). National Institute of Health Research (NIHR206123) REGISTRATION: Protocol available via DOI: 10.1002/14651858.CD016058.