Tuesday, September 26, 2023

Izvantjelesna membranska oksigenacija (ECMO) u životno ugroženih odraslih bolesnika Istraživačko pitanje Poboljšava li ECMO dugotrajno preživljenje u kritično bolesnih odraslih osoba? Ključne poruke – ECMO je učinkovit u smanjenju smrtnosti u usporedbi s konvencionalnim liječenjem, ali je bio povezan s povećanim rizikom od ozbiljnog krvarenja. – Slabo su opisani ostali ishodi. – Ovi dokazi su nesigurni i neophodna su daljnja istraživanja. Što je izvantjelesna membranska oksigenacija? Izvantjelesna membranska oksigenacija (engl. extracorporeal membrane oxygenation, ECMO) oblik je održavanja...

Thursday, September 21, 2023

Koje su dobrobiti i štetni učinci silikonskih hidrogelnih naspram hidrogelnih mekih kontaktnih leća za nelagodu oka? Ključne poruke 1) Korisnici silikonskih hidrogelnih i hidrogelnih mekih kontaktnih leća mogu osjetiti sličnu udobnost oka, ali postoji visok stupanj nesigurnosti u rezultate. 2) Dugoročno, vjerojatnost rizika od neželjenog događaja na oku može biti veća kod produljenog korištenja silikonskih hidrogelnih kontaktnih leća u odnosu na hidrogelne meke kontaktne leće. Mali broj istraživanja i ograničenja u dokazima znače da postoji nesigurnost u ove rezultate. Što su silikonske...

Tempiranje spolnog odnosa u vrijeme ovulacije za parove koji pokušavaju začeti Pitanje sustavnog pregleda Pregledali smo i procijenili dokaze o učinku tempiranja snošaja (koristeći predviđanje razdoblja ovulacije) u odnosu na snošaj bez predviđanja razdoblja ovulacije kod parova koji pokušavaju zatrudnjeti. Dosadašnje spoznaje Brojni parovi imaju teškoća sa začećem i zabrinuti su za svoju plodnost. Svakog menstrualnog ciklusa, žena je plodna otprilike pet dana prije ovulacije (oslobađanja jajne stanice) do nekoliko sati nakon ovulacije, zbog ograničenog vremena preživljavanja spermija i...

Wednesday, September 13, 2023

Usporavaju li antioksidativni vitaminski i mineralni dodaci prehrani napredak starosne makularne degeneracije? Ključne poruke - Uzimanje antioksidativnih multivitaminskih dodataka prehrani može usporiti napredak starosne makularne degeneracije (SMD), bolesti oka koja zamagljuje centralni vid. - Vjerojatnije je da će osobe s umjerenim stadijem SMD-a imati koristi od antioksidativnih dodataka prehrani jer je u njih rizik napretka bolesti veći nego u osoba s ranim stadijem SMD-a. - Iako se antioksidativni vitaminski dodaci prehrani generalno smatraju sigurnima, istraživanja uključena u ovaj...

Title: Project Manager
Specifications: Permanent – Full Time
Salary:  £42,000 per Annum  
Location: UK /London Remote Based Role
Closing date: 09:00 2 Oct 2023
 
Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into four directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

To support the Evidence Production and Methods Department (EPM), Publishing and Technology department (P&T), Cochrane Library Product development and other Central Executive Teams (CET) in delivering on high priority projects: to project manage the highest priority EPM, P&T and other Cochrane projects where appropriate. These strategic projects can change, currently the focus is on delivering the Cochrane Library product development roadmap and Open Access, but we require a project manager who is flexible and can move across projects where required.        

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect: 

• An opportunity to truly impact health globally  
• A flexible work environment  
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here
• The deadline to receive your application is 09:00 2 Oct 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. 
• Read our Recruitment Privacy Statement

Tuesday, September 12, 2023 Category: Jobs

Koliko su lijekovi i e-cigarete učinkoviti za prestanak pušenja? Ključne poruke Neki lijekovi i e-cigarete (ručni uređaji koji rade zagrijavanjem tekućine koja obično sadrži nikotin i arome) mogu pomoći ljudima da prestanu pušiti na šest mjeseci ili dulje. Čini se da većini ljudi e-cigarete i lijekovi poput citizina (poznat pod nazivom Tabex) i vareniklina (poznat pod nazivima Chantix i Champix), pomažu kod prestanka pušenja, kao i istovremeno korištenje dvije vrste nikotinske nadomjesne terapije (nikotinski flaster i druga vrsta, poput žvakaće gume ili pastile). Potrebno je više dokaza o...

Monday, September 11, 2023

Key Points 

• Comprehensive study reveals nicotine e-cigarettes, varenicline and cytisine are the stop-smoking aids most likely to help people quit smoking.
• On average, for every 100 people trying to quit, around 14 are likely to succeed using an e-cigarette, varenicline or cytisine in any given quit attempt. This is compared to 6 in 100 who are likely to quit without using any aids.
• Dual nicotine replacement therapy (NRT) methods, like combining a patch with gum, may be almost as effective, with approximately 12 in 100 people likely to successfully quit. However, this estimate is less certain than those for the other stop-smoking aids.
• Using only one form of NRT, such as a patch alone, leads to around 9 in 100 people successfully quitting.
• The advanced "component network meta-analysis" (CNMA) approach analysed over 300 clinical trials to compare the effectiveness of various cessation methods.
• Cytisine, a highly effective smoking cessation medicine, is highlighted but is unavailable in most countries, including the UK. Many countries also have supply issues with varenicline currently.

A comprehensive new Cochrane analysis has found that nicotine e-cigarettes, varenicline and cytisine are the most effective options currently available for helping smokers quit long-term (going at least six months without smoking). This is closely followed by using two forms of nicotine replacement therapy at the same time, such as a nicotine patch alongside gum, lozenges or nasal sprays. The research was conducted by a team from the Nuffield Department of Primary Care Health Sciences at the University of Oxford with colleagues from the University of Leicester.

The study, published in the Cochrane Database of Systematic Reviews, compared the results for different stop-smoking aids that have been used in over 300 clinical trials involving more than 150,000 people. The researchers used a statistical technique to combine data from the studies into a single analysis called “component network meta-analysis” (CNMA). This meant they could compare smoking cessation methods against each other, using both direct comparisons within trials and indirect comparisons across trials. This provided a comprehensive view of the relative effectiveness of each method.

Dr Nicola Lindson, lead author and a Senior Researcher and Lecturer based within Oxford’s Nuffield Department of Primary Care Health Sciences, emphasised the potential impact of the findings: 

“Our research dives deep into the world of smoking cessation. By pulling together data from hundreds of studies and over 150,000 people, we can see that when people use the medicines licenced for quitting smoking or nicotine e-cigarettes, they are more likely to quit than if they do not use these aids. We have also shown that nicotine e-cigarettes, cytisine, and varenicline appear to help more people quit than other products used to stop smoking. Nicotine replacement therapy appears to be almost as effective, but only when a patch is used alongside another form of nicotine replacement, such as gum or nasal spray.

E-cigarettes were found to help around 14 smokers per 100 quit long-term, compared to 6 in 100 trying to quit without any of the stop-smoking aids studied. The smoking cessation medicines varenicline and cytisine were similarly effective. However, varenicline, a WHO essential medicine, is not currently available in Europe, South America, Japan, and parts of North America due to a manufacturing problem. Cytisine is not currently licensed or marketed in most countries outside of central and Eastern Europe, meaning it is unavailable in most of the world, including the UK and US. This leaves nicotine e-cigarettes and combination nicotine replacement therapies as the two most effective stop-smoking aids available to most people. These work better when people are also receiving behavioural support to quit. 

Using two types of nicotine replacement therapy (NRT) together, such as a nicotine patch plus a faster-acting NRT product like gum or lozenges, may be almost as effective as nicotine e-cigarettes, varenicline and cytisine. However, using a single form of NRT, like the patch or gum alone, resulted in fewer additional quitters. The review estimates that around 12 in 100 people using two forms of NRT together will quit successfully, compared to around 9 in 100 people using only one type. The estimate for combined NRT is less certain than those for other stop-smoking aids, as it was calculated from the combined effects of individual NRTs rather than directly from trials of combination therapies. 

Smoking is a significant health concern and cause of death worldwide. However, it is very difficult to quit. There are several products available to help with this, but the relative effectiveness of these methods has long been uncertain. This comprehensive analysis now offers clarity, providing people who smoke, healthcare professionals and policymakers with reliable data to make informed decisions." 

The researchers incorporated key factors like the effectiveness of various interventions and their safety profiles. The study's findings could be vital information to help reshape public health policies and strategies, offering smokers more effective tools to quit for good.

Dr Jamie Hartmann-Boyce, co-author who was based at the University of Oxford during the research and is now Assistant Professor at the University of Massachusetts Amherst, said: 

"In sifting through extensive data, we've gained valuable insights into effective smoking cessation methods. Smoking remains the leading cause of preventable disease and death worldwide, and though many people want to quit smoking, it can be hard to do so. Our findings provide clear evidence of the effectiveness of nicotine e-cigarettes and combination nicotine replacement therapies to help people quit smoking. The evidence also is clear on the benefits of medicines cytisine and varenicline, but these may be harder for some people to access at the moment. The best thing someone who smokes can do for their health is to quit smoking, and evidence shows that using varenicline, cytisine, or nicotine e-cigarettes in combination with behavioural support will give them the best chances of successfully doing so."

The review focused exclusively on evaluating the efficacy of a range of smoking cessation methods, aligning with its defined scope and primary research focus. It did not delve into broader aspects of the public health discourse regarding e-cigarettes, such as their usage among non-smokers and adolescents. While the review uncovered no substantial evidence of significant adverse effects, it's important to note that most studies tracked participants for a period ranging from six to twelve months, leaving a gap in data concerning potential long-term consequences.

The massive study concluded that more data on serious side effects and the number of people who stop using a product due to side effects would be beneficial. However, this robust analysis provides strong evidence to inform treatment guidelines and policies aimed at helping smokers quit. 

• Read the plain language summary and full Cochrane review
  

Lindson N, Theodoulou A, Ordóñez-Mena JM, Fanshawe TR, Sutton AJ, Livingstone-Banks J, Hajizadeh A, Zhu S, Aveyard P, Freeman SC, Agrawal S, Hartmann-Boyce J. Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta‐analyses. Cochrane Database of Systematic Reviews 2023, Issue 9. Art. No.: CD015226. DOI: 10.1002/14651858.CD015226.pub2.

 

Tuesday, September 12, 2023

Kemoterapija koja sadrži platinu za žene prije ili nakon operacije ranog trostruko negativnog raka dojke Ključne poruke Kemoterapija koja uključuje lijek na bazi platine - karboplatinu, poboljšava preživljenje i smanjuje mogućnost povratka raka za osobe s ranim trostruko negativnim rakom dojke. Međutim, također je povezana s većim brojem nuspojava. Što je trostruko negativan rak dojke? Trostruko negativan rak dojke čini 15% slučajeva raka dojke. To je vrsta raka dojke koja nema nijedan od tri receptora koji se obično nalaze na stanicama raka dojke – estrogenski, progesteronski i HER2...

Thursday, August 31, 2023

Specifications: 12-Months Fixed Term – Contract
Salary: £42,000 per annum  
Location: UK – Remote/Flexible
Closing date: 13 Sep 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

Reporting to the Senior Managing Editor and working with members of the Editorial Production and Methods Directorate, the role holder will need to have good awareness of Cochrane guidance for different types of standard and complex systematic reviews (intervention, qualitative, diagnostic test accuracy, prognosis, rapid and overview), plan how they will need to be handled in their team, and work to ensure that deadlines are met. The role holder will also be required to ensure that pilots aimed at innovating the editorial process can be supported as needed.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect: 

• An opportunity to truly impact health globally  
• A flexible work environment  
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 13th Sep, 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. 
• Read our Recruitment Privacy Statement

Thursday, August 31, 2023 Category: Jobs

Koje su dobrobiti i rizici različitih terapija kortikosteroidima koji se daju intravenozno za prevenciju bronhopulmonalne displazije u prerano rođene djece? Ključne poruke · U ovom pregledu smo upotrijebili mrežnu meta-analizu (MMA), relativno novi alat koji omogućuje usporedbe između svih relevantnih opcija liječenja, uključujući one koje nisu bile izravno uspoređivane jedna s drugom u prethodnim kliničkim ispitivanjima. · MMA je uspjela dodati malu količinu informacija postojećim podacima, ponajviše usporedbama između učinaka različitih doza kortikosteroida za prevenciju bronhopulmonalne...

Jesu li intervencije za umor učinkovite za osobe sa zatajenjem bubrega kojima je potrebna dijaliza? Što je proučavano u ovom sustavnom pregledu? Umor je čest i iscrpljujući simptom koji može ograničiti kvalitetu života u ljudi koji su na dijalizi. Umor je povezan s narušenom kvalitetom života, kardiovaskularnim bolestima, smrću i depresijom kod ljudi na dijalizi. Nekoliko je potencijalnih intervencija, uključujući lijekove ili druge nefarmakološke tretmane (npr. tjelovježba, dijeta, masaža, aromaterapija, akupresura), procijenjeno za učinak kod umora u ljudi na dijalizi. Kako je proveden...

Evaluacija strategija praćenja žena s epitelnim karcinomom jajnika nakon završetka primarnog liječenja Ključne poruke Rana kemoterapija za recidive karcinoma jajnika možda neće produžiti život i može smanjiti kvalitetu života. Imajte na umu da je ovo ispitivanje provedeno prije nego su trenutne opcije liječenja bile dostupne, pa se možda ne odnosi na žene koje se danas liječe od karcinoma jajnika. Individualizirano praćenje od strane medicinske sestre nakon liječenja može poboljšati kvalitetu života više od redovnog medicinskog praćenja, ali vjerojatno ne dovodi do velike razlike u tjeskobi,...

When it comes to starting a family, timing is everything

A new Cochrane review of methods to increase chances of successful conception suggests that timed intercourse using urine ovulation tests probably improves live birth and pregnancy rates in women under 40 who had been trying to conceive for less than 12 months, compared to intercourse without ovulation prediction.

The Cochrane review, conducted jointly with researchers from University of Oxford, the Royal Berkshire Hospital in Reading, and the Princess Anne Hospital in Southampton, included seven randomised controlled trials involving 2,464 women or couples who had been trying to conceive.

Each month there is a narrow window for successful conception due to the limited lifespan of the sperm and egg, which begins from around five days before ovulation (egg release) and lasts until several hours afterwards.

The period of a woman’s cycle can be identified by different methods, including urine ovulation tests (dipstick devices that can detect changes in hormones released into the urine, signifying when ovulation will occur), fertility awareness-based methods (FABM) (including calendar tracking, monitoring changes in cervix fluid and body temperature) or identifying when the egg is released on ultrasound. This review aimed to assess the benefits and risks of timed intercourse on pregnancy, live birth, negative effects and quality of life in couples trying to conceive.

The study found that timing intercourse around the fertile period using a urine ovulation test increased the chances of pregnancy and live birth to between 20% to 28%, compared to 18% without using urine ovulation tests. This was specifically in women under 40 trying to conceive for under 12 months.

Tatjana Gibbons, a DPhil researcher at Oxford’s Nuffield Department of Women's & Reproductive Health and lead author on the study, said: ‘‘Many couples find it difficult to achieve a pregnancy, which can lead to concerns about their fertility.'

The finding that a simple and easily available urine test can increase a couple’s chance of successful conception is quite exciting because it can empower couples with more control over their fertility journey and could potentially reduce the need for infertility investigations and treatments."

 

Professor Christian M Becker of Nuffield Department of Women's & Reproductive Health said: "The high threshold of evidence required in a Cochrane review makes even this moderate quality evidence for the effectiveness of urine ovulation tests quite impressive, as well as surprising considering how long they have been available for."

However, the researchers cautioned that because many of the studies were funded by the manufacturers of the urine ovulation test, the results should be interpreted with caution.

They also found that there was insufficient evidence to conclude the effect of the other methods in the study, including timed intercourse on clinical pregnancy (ultrasound-confirmed pregnancy), the use of FABM in timed intercourse compared to intercourse without ovulation prediction.

• Read the plain language and full review on the Cochrane Library 

Gibbons T, Reavey J, Georgiou EX, Becker CM. Timed intercourse for couples trying to conceive. Cochrane Database of Systematic Reviews 2023, Issue 9. Art. No.: CD011345. DOI: 10.1002/14651858.CD011345.pub3. 

Friday, September 15, 2023

Wednesday, August 30, 2023

Wednesday, August 30, 2023