Cochrane Db Syst Rev
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This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits of home visiting models for postpartum depression amongst mothers of young children, where either the mothers or the children are enrolled in early childhood home visiting programs or interventions. To identify core components essential for a home visiting program to effectively address postpartum depression in mothers of young children. The hypothesized core components of such a program include the priority level given to PPD intervention, the type of home visitors, the intensity of the program, the percentage of BIPOC participants, and the service recipients' baseline level of and risk for depression.
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Cochrane Db Syst Rev · Jan 2025
Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of dexmedetomidine compared with opioids, non-opioids and placebo in providing sedation and analgesia for procedural pain in newborn infants.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisCaesarean myomectomy in pregnant women with uterine fibroids.
Postpartum haemorrhage, defined as a blood loss of 500 mL or more within 24 hours of birth, is the leading global cause of maternal morbidity and mortality. Uterine fibroids are non-cancerous growths that develop in or around the uterus, and affect an increasing number of women. Caesarean myomectomy is the surgical removal of fibroids during a caesarean section. Traditionally, obstetricians have avoided this procedure given the risk of uncontrollable haemorrhage. There is also the risk of longer operating time and more days in the hospital. However, there could be potential benefits in removing uterine fibroids for improved fertility, and caesarean section may provide an effective and efficient opportunity to perform this procedure. Given the link between removal of uterine fibroids and postpartum haemorrhage, it is prudent to evaluate current literature and assess the benefits and harms of caesarean myomectomy in pregnant women with uterine fibroids. ⋯ The review was registered with PROSPERO (CRD42024554215) and available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024554215.
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisAlendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women.
Osteoporosis is an abnormal reduction in bone mass and bone deterioration, leading to increased fracture risk. Alendronate belongs to the bisphosphonate class of drugs, which inhibit bone resorption by interfering with the activity of osteoclasts (bone cells that break down bone tissue). This is an update of a Cochrane review first published in 2008. ⋯ This review is an update of the previous review (DOI: 10.1002/14651858.CD001155).
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Cochrane Db Syst Rev · Jan 2025
Review Meta AnalysisDirect factor Xa inhibitors versus low molecular weight heparins or vitamin K antagonists for prevention of venous thromboembolism in elective primary hip or knee replacement or hip fracture repair.
People undergoing major orthopaedic surgery are at increased risk of postoperative thromboembolic events. Low molecular weight heparins (LMWHs) are recommended for thromboprophylaxis in this population. New oral anticoagulants, including direct factor Xa inhibitors, are recommended as alternatives. They may have more advantages than disadvantages compared to LMWHs and vitamin K antagonists (VKAs, another type of anticoagulant). ⋯ Oral direct factor Xa inhibitors may have little to no effect on all-cause mortality, but the evidence is very uncertain. Oral direct factor Xa inhibitors may slightly reduce symptomatic VTE events when compared with LMWH. They may make little or no difference to major VTE events, but the evidence is very uncertain. In the evaluation of major bleeding, the evidence suggests rivaroxaban results in a slight increase in major bleeding events compared to LMWHs. The remaining oral direct factor Xa inhibitors may have little to no effect on major bleeding, but the evidence is very uncertain. Oral direct factor Xa inhibitors may reduce serious non-hepatic adverse events slightly compared to LMWHs. They may have little to no effect on serious hepatic adverse events, but the evidence is very uncertain. Due to the high rates of missing participants and selective outcome reporting, the effect estimates may be biased.