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Treating intermittent claudication with Tibetan medicine Padma 28: does it work?

The authors concluded that Padma 28 provides significant relief from peripheral arterial occlusive disease-related symptoms (e.g. walking distance). However, given the methodological limitations of this review, the reliability of the authors' conclusions is questionable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Drug therapy for improving walking distance in intermittent claudication: a systematic review and meta-analysis of robust randomised controlled studies

This review concluded that several drugs were shown to improve walking distance in people with intermittent claudication, but with limited benefits. Overall the authors' conclusions were supported by the results, but they should be interpreted with some caution due to the possibility of publication bias, a lack of information on study quality and differences between studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

The effect of peripheral percutaneous transluminal angioplasty on quality of life in patients with intermittent claudication

This review assessed the effects of percutaneous transluminal angioplasty (PTA) on quality of life (QOL) in patients with intermittent claudication. The authors concluded that PTA may improve QOL in this patient group, but that good-quality evidence is lacking. The authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Studies on the effectiveness and safety of cilostazol, beraprost sodium, prostaglandin E1 for the treatment of intermittent claudication

This review assessed cilostazol, beraprost sodium and prostaglandin E1 (PGE1) for treating intermittent claudication to improve walking distance. The authors concluded that cilostazol and PGE1 are effective, but further studies ofberaprost sodium are needed. A narrow literature search limits the reliability of these conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Beta-adrenergic blocking agents and intermittent claudication: systematic review

This review assessed the use of beta-blockers in patients with intermittent claudication (IC). The authors concluded there was no evidence to suggest that clinicians should be cautious in prescribing beta-blockers to patients with IC. Limitations in the conduct of the review and methods of analysis mean that the results of the meta-analyses are unreliable. However, the authors' overall conclusions are suitably cautious.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Intermittent claudication: functional capacity and quality of life after exercise training or percutaneous transluminal angioplasty. Systematic review

The authors assessed exercise training and percutaneous transluminal angioplasty (PTA) for intermittent claudication. They concluded that functional capacity improves significantly after PTA, but found no difference after exercise training. Both PTA and exercise training improve quality of life. The evidence to support the conclusions is weak. Better research is needed to determine the relative effectiveness of the two treatments.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

A Systematic Review and Economic Evaluation of Cilostazol, Naftidrofuryl Oxalate, Pentoxifylline and Inositol Nicotinate for the Treatment of Intermittent Claudication in People with Peripheral Arterial Disease

Peripheral arterial disease (PAD) is a condition in which there is blockage or narrowing of the arteries that carry blood to the legs and arms. It is estimated to affect around 4.5% of people aged between 55 and 74 years within the UK. The most common symptom of PAD is intermittent claudication (IC), characterised by pain in the legs on walking that is relieved with rest.

Health Technology Assessment - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: December 2011
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Clinical Guidelines for Type 2 Diabetes: Prevention and Management of Foot Problems [Internet]

The aim of the guideline is to provide recommendations to help health care professionals in their management of people with Type 2 diabetes. The guideline is aimed at all health care professionals providing care to people with diagnosed Type 2 diabetes in primary and secondary care, irrespective of location. Depending on the type, stage and severity of clinical problem, the guidelines may also be valuable to those who work in the tertiary sector of diabetes care.

NICE Clinical Guidelines - School of Health and Related Research (ScHARR), University of Sheffield.

Version: 2003
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Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children [Internet]

To assess the test performance of antinuclear antibody (ANA), rheumatoid factor (RF), and cyclic-citrullinated peptide (CCP) tests in children and adolescents with undiagnosed musculoskeletal (MSK) pain or joint swelling, compared with clinical diagnoses of pediatric systemic lupus erythematosus (pSLE) and juvenile idiopathic arthritis (JIA). To explore differences in test performance for accuracy modifiers including age, sex, race or ethnicity, comorbidities, and recent infections. To evaluate the impact of test results on clinical decisionmaking and clinically important outcomes such as referrals, ordering of additional tests, clinical management, and anxiety experienced by children and parents.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: March 2012
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Drug Class Review: Beta Adrenergic Blockers: Final Report Update 4 [Internet]

Beta blockers inhibit the chronotropic, inotropic, and vasoconstrictor responses to the catecholamines, epinephrine, and norepinephrine. Beta blockers differ in their duration of effect (3 hours to 22 hours), the types of beta receptors they block (β1-selective or β1/β2-nonselective), whether they are simultaneously capable of exerting low level heart rate increases (intrinsic sympathomimetic activity [ISA]), and in whether they provide additional blood vessel dilation effects by also blocking alpha-1 receptors. All beta blockers are approved for the treatment of hypertension. Other US Food and Drug Administration-approved uses are specific to each beta blocker and include stable and unstable angina, atrial arrhythmias, bleeding esophageal varices, coronary artery disease, asymptomatic and symptomatic heart failure, migraine, and secondary prevention of post-myocardial infarction. The objective of this review was to evaluate the comparative effectiveness and harms of beta blockers in adult patients with hypertension, angina, coronary artery bypass graft, recent myocardial infarction, heart failure, atrial arrhythmia, migraine or bleeding esophageal varices.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2009
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Treatment Strategies for Patients With Peripheral Artery Disease [Internet]

For patients with peripheral artery disease (PAD), the optimal treatment for cardiovascular protection, symptom relief, preservation of walking and functional status, and prevention of amputation is not known. This review assessed the comparative effectiveness of antiplatelet therapy, medical therapy, exercise, and endovascular and surgical revascularization in PAD patients with intermittent claudication (IC) or critical limb ischemia (CLI).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2013
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Drug Class Review: Agents for Overactive Bladder: Final Report Update 4 [Internet]

Overactive bladder is defined by the International Continence Society as a syndrome of urinary frequency and urgency, with or without urge incontinence, appearing in the absence of local pathological factors. Treatment of overactive bladder syndrome first requires a clear diagnosis. In patients with incontinence, multiple forms can be present and it is important to determine which form is dominant. Non-pharmacologic, non-surgical treatment consists of behavioral training (prompted voiding, bladder training, pelvic muscle rehabilitation), transcutaneous electrical nerve stimulation, catheterization, and use of absorbent pads. Pharmacologic treatment for overactive bladder syndrome includes darifenacin, flavoxate hydrochloride, hyoscyamine, oxybutynin chloride, tolterodine tartrate, trospium chloride, scopolamine transdermal, and solifenacin succinate. The purpose of this systematic review is to compare the benefits and harms of drugs used to treat overactive bladder syndrome.

Drug Class Reviews - Oregon Health & Science University.

Version: March 2009
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A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement) [Internet]

Guidelines recommend that cardiovascular disease risk scoring methods are used to identify patients who are asymptomatic, but at high risk of future cardiovascular disease.

NICE Clinical Guidelines - Royal College of General Practitioners (UK).

Version: May 2008
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Lipid Modification: Cardiovascular Risk Assessment and the Modification of Blood Lipids for the Primary and Secondary Prevention of Cardiovascular Disease [Internet]

The scope for this guideline was limited to the identification and assessment of cardiovascular disease (CVD) risk and to the assessment and modification of lipids in people at risk of CVD or people with known cardiovascular disease. The guideline development group wishes to make it clear that lipid modification should take place as part of a programme of risk reduction and also include attention to the management of all other known risk factors.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care (UK).

Version: May 2008
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Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update)

Over 90% of people with diabetes have Type 2 diabetes. This is still perceived as the milder form, and while this may be true in some respects, such as the risk of ketoacidosis, the causation of Type 2 diabetes is more complex and the management is not necessarily easier. Type 2 diabetes can cause severe complications, affecting the eye, the nervous system and the kidney. The overall risk of cardiovascular disease is more than doubled, and life expectancy is reduced by an average 7 years. In 2002, NICE published a suite of five guidelines dealing with different aspects of the care of Type 2 diabetes. The rising prevalence of the disease, and the range of complications which can arise, reinforce the importance of up-to-date guidance and accordingly NICE have asked the National Collaborating Centre for Chronic Conditions (NCC-CC) to produce this guideline, amalgamating and updating the previously published work.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2008
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Screening for Type 2 Diabetes Mellitus: Update of 2003 Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]

Diabetes poses a tremendous and increasing clinical and public health burden for Americans; 19.3 million Americans over the age of 20 years are affected, one third of whom are undiagnosed.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: June 2008
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Total hip arthroplasty for osteoarthritis

In people with osteoarthritis of the hip, there is not enough evidence to be certain about whether the posterior (back) or the lateral (side) approach to total hip replacement surgery is better.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Anaesthesia for hand and forearm surgery via single, double or multiple injections placed close to nerves in the armpit

A common method of regional anaesthesia for hand, wrist or forearm surgery is to inject local anaesthetic into the tissues surrounding nerves in the armpit. This is because in the armpit (axilla) the key nerves for the lower part of the arm are close together and are easier to locate. This type of anaesthesia is called axillary brachial plexus block. Successful blocking of the nerves produces a numb and limp arm that enables pain‐free surgery. This review compared the effects of single, double and multiple (three or four) injections of local anaesthetic.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Referral Guidelines for Suspected Cancer in Adults and Children [Internet]

The guideline is divided into sections which cover in detail specific topics relating to twelve groups of cancers: lung, upper gastrointestinal cancers, lower gastrointestinal cancers, breast cancer, gynaecological cancers, urological cancers, haematological cancers, skin cancers, head and neck including oral cancers, brain/central nervous system cancers, bone and sarcoma, and children’s and young people’s cancers.

NICE Clinical Guidelines - Clinical Governance Research and Development Unit (CGRDU), Department of Health Sciences, University of Leicester.

Version: June 2005
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Screening for Developmental Dysplasia of the Hip [Internet]

Developmental dysplasia of the hip (DDH) can lead to the later development of chronic pain, osteoarthritis, and limitations in activity. Screening for DDH has been practiced for over 40 years, but recommendations from major professional societies differ.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: March 2006
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Medical Encyclopedia

  • Toxic synovitis
    Toxic synovitis is a condition affecting children that causes hip pain and limping.
  • Slipped capital femoral epiphysis
    A slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone.
  • Breathing - slowed or stopped
    Breathing that slows down or stops from any cause is called apnea.
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Systematic Reviews in PubMed

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