What’s being served up in the Cochrane Library?

The reviews are flying into the Cochrane Library quicker than balls off Murray’s racquet this week and several aces have been served! Here’s my pick of the past fortnight.

It’s all strawberries and Pimms in SW19 but in WC1 the good folk of the Cochrane Heart Group are concentrating on garlic sandwiches and tea. Now I like a nice cuppa but a garlic sandwich? Even Jamie Oliver might balk at that, but the suggestion crops up in a new review on preventing cardiovascular disease (CVD) through providing fruit and vegetables to encourage people to eat more of them, or just advising them to do so. I asked heart doctor Harry Boardman to take a look.

Interferon improves survival after surgery for melanoma

Key message: interferon alpha improves both disease-free survival and overall survival of people with high-risk cutaneous melanoma. Interferon is also valid as a reference standard for future trials of other new treatments.

Cutaneous melanoma is a type of skin cancer that’s on the rise in all Western countries and carries with it a poor chance of survival for those in whom the cancer has spread, with around 10% surviving longer than five years. For those whose cancer has not spread, their outlook after surgery is variable; between 40% and 90% are alive after five years. Interferon alpha is the only drug approved for adjuvant (additional) treatment of high-risk cutaneous melanoma after surgery, but not enough has been known about its benefits for it to be offered as a standard treatment.

After stroke: the Cinderella of falls prevention research

Key message: There is a lack of evidence on interventions which aim to prevent falls in people after they have had a stroke. This is in contrast to good evidence on some effective  preventive measures for older people living in the community.

It’s Age UK’s annual Falls Awareness Week this week, with an emphasis this year on healthy feet. The excellent review from the Cochrane Bone, Joint and Muscle Trauma Group on preventing falls in older people living in the community, which we blogged about when it was updated last autumn, has useful evidence on a range of strategies to prevent falls, including some relating to feet!

Hot off the press: catch this Cochrane evidence!

New and updated Cochrane reviews are now published daily

If your idea of a present is a new or updated Cochrane review then it’s now Christmas every day with the arrival of Publish When Ready here in Cochraneland. In a huge change to the system for publishing reviews and protocols in the Cochrane Library, new arrivals appear daily, throughout the day, instead of once a month. In the time it takes me to make a cup of tea, a new review may have popped into the Library, ready for my consumption. It’s all rather exciting! It’s also rather alarming, as I have the distinct feeling that with such a rapid flow of  evidence I may miss things and fail to shout about stuff that you might like to know about. It may calm down (or I may speed up!) but with the sudden arrival of a very large amount of new evidence I thought I’d give you a bit of a round-up. So here are my picks of the week on surgery, drugs and rock’n’roll, with some talking treatment thrown in.

New evidence on benefits of formoterol for asthma, but there are still unanswered questions

Key message: The addition of new evidence to this review has shown a significant reduction in asthma-related non-fatal serious adverse events in adults with asthma who are given regular formoterol as well as inhaled steroids.

When asthma is not well controlled by low-dose inhaled corticosteroids (ICS), many asthma guidelines recommend adding another type of medicine, a long-acting beta₂-agonist, such as formoterol. These have been shown to improve lung function, quality of life and asthma symptoms but there are concerns about their safety when used regularly.

Taking antibiotics? Probiotics can cut your risk of diarrhoea

Key message: moderate quality evidence suggests that probiotics are both safe and effective for preventing Clostridium difficile-associated diarrhoea.

It’s no surprise that a new Cochrane review made headline news on the BBC’s health pages last week and was featured in many other health news reports too, as its focus was the use of probiotics to prevent Clostridium difficile-associated diarrhoea (CDAD) in people taking antibiotics.