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Results: 1 to 20 of 120

Percutaneous needle aspiration, injection, and re‐aspiration with or without benzimidazole coverage for uncomplicated hepatic hydatid cysts

Two randomised clinical trials on the puncture, aspiration, injection, and re‐aspiration method for patients with uncomplicated hepatic hydatid cyst were identified. One trial compared puncture, aspiration, injection, and re‐aspiration with surgical treatment. The other trial compared puncture, aspiration, injection, and re‐aspiration with or without albendazole with albendazole alone. Both trials had high risk of bias. The number of participants enrolled and the follow‐up duration are insufficient for a definite conclusion to be drawn. In general, there is insufficient evidence to support or refute the puncture, aspiration, injection, and re‐aspiration method with or without benzimidazole coverage for patients with uncomplicated hepatic hydatid cyst.

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

Version: 2011

Steroid therapy for meconium aspiration syndrome in newborn infants

More research needed to show whether corticosteroids could reduce complications and mortality in newborn babies with meconium aspiration syndrome.

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

Version: 2009

Restriction of oral intake of water for aspiration lung disease in children

Primary aspiration of food and fluid can cause serious lung consequences in infants and children. Treatment recommendations for children who have primary aspiration of thin fluids includes restriction of thin fluids and provision of thickened fluids. Children often refuse to drink thickened fluids presenting a challenge for families to ensure that the child takes sufficient fluid. Allowing children who have thin fluid aspiration to drink water may assist in providing enough fluid without endangering the lung . This review found no evidence about drinking water in children with primary aspiration of thin fluids.

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

Version: 2012

Lung lavage for meconium aspiration syndrome in newborn infants

Meconium aspiration syndrome (MAS) is a disease of the newborn lung in which meconium, the fetal stool, is passed before birth and then is inhaled into the lung. Little effective treatment is available, other than supportive measures including artifical respiration and, occasionally, the use of heart‐lung bypass. This review examined whether cleansing the lung using a natural chemical called surfactant, or another similar fluid, is helpful in MAS. This cleansing procedure is known as lung lavage. Lung lavage with diluted surfactant may help improve the clinical course of infants with MAS, in particular, the likelihood of survival without the need for heart‐lung bypass. More trials will be needed to properly evaluate lavage treatment in MAS.

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

Version: 2013

Percutaneous needle aspiration does not seem to help patients with uncomplicated amoebic liver abscesses

Amoebiasis (disease caused by the protozoan Entameoba histolytica) remains an important clinical problem in countries around the world, with 40 to 50 million people affected. Mortality rates are significant, with 40,000 to 110,000 deaths each year. In fact, amoebiasis mortality is second only to malaria as cause of death from protozoan parasites. The most common complication of amoebiasis is the formation of a pus‐filled mass inside the liver (liver abscess). Metronidazole is the drug of choice for treatment of amoebic liver abscesses followed by a luminal agent to eradicate the asymptomatic carrier state. Cure rates are 95% with disappearance of fever, pain, and anorexia within 72 to 96 hours. This review compares the standard treatment with a more invasive alternative, where pus‐filled mass is drained by image‐guided percutaneous procedure (performed through the skin). Seven low quality randomised trials were included. All the seven studies included a total of 310 patients, but due to selective outcome reporting bias, less patients could be included in our analyses. Pooled analysis of three homogenous trials showed that needle aspiration did not significantly increase the proportion of patients with fever resolution. Benefits could be observed in resolution time of pain and tenderness. No additional benefit has been found with percutaneous needle aspiration plus metronidazole versus metronidazole alone for uncomplicated amoebic liver abscesses in hastening clinical and radiologic resolution. However, this conclusion is based on trials with methodological flaws and with insufficient sample sizes, and requires further confirmation in larger well‐designed, randomised trials.

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

Version: 2009

Surfactant for meconium aspiration syndrome in full term/near term infants

The lungs of newborn babies' can be damaged by meconium aspiration syndrome. Meconium aspiration syndrome is caused when a stressed baby passes a bowel movement while still in the womb and then breathes some of this material into the lungs. Pulmonary surfactant, the complex combination of chemicals that line the surface of the lung, may be altered or inactivated in babies who have meconium aspiration. It is thought that treatment with additional surfactant might be able to help overcome this damage. This review of trials found that surfactant can reduce breathing difficulties and breathing failure in babies suffering from meconium aspiration syndrome.

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

Version: 2008

The review found that both, D&C and vacuum aspiration, are safe and effective methods for first trimester termination of pregnancy and complications are rare.

There are several different surgical techniques for early termination of pregnancy (abortion in the first three months). These are dilatation and curettage (D&C to scrape out the contents of the uterus), vacuum aspiration (sucking out the contents of the uterus with a manual or power‐operated device). Hysterotomy (surgery through the uterus, like caesarean section) is not commonly used. The cervix (opening of the uterus) can be prepared beforehand with hormones to minimise the risk of damage. The review found that both, D&C and vacuum aspiration, are safe and effective methods for first trimester termination of pregnancy and complications are rare. The review does not reveal women's or surgeons' preference of one method over the other.

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

Version: 2009

Simple aspiration versus leaving a drainage tube in (intercostal tube drainage) for primary spontaneous pneumothorax in adults without obvious underlying lung disease

When air collects between the lung and the chest wall (the pleural space) this is described as a pneumothorax. This may be caused by trauma or lung disease, but sometimes it happens spontaneously without any obvious cause. When this happens the lungs cannot expand properly, which makes it difficult to breathe effectively. The person becomes breathless and has chest pain. It is important to treat the pneumothorax by removing the collection of air and allowing healing of the pleura, a thin membrane that covers the lungs to make a lining for them in the chest. For initial management where medical intervention is needed, the air can be removed either by simple aspiration, drawing the air out through a thin tube, or by insertion of a much larger chest tube in the space between the ribs (intercostal tube drainage). Both are done using local anaesthesia. Simple aspiration is technically easier to do. The review authors searched the medical literature and identified one randomized controlled study eligible for inclusion. The included study comprised a total of 60 patients with primary spontaneous pneumothorax; 27 of these underwent simple aspiration and 33 underwent intercostal tube drainage. The review found that simple aspiration is immediately as effective as intercostal tube drainage for primary spontaneous pneumothorax. However, simple aspiration is associated with less likelihood of being hospitalized. There was no significant difference between the two treatments with regard to the following: duration of hospitalization, early failure rate and one year success rate. The inclusion of only one small study in this review may have led to important differences between these two treatments being undetected.

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

Version: 2013

Routine prophylactic drugs in normal labour for reducing gastric aspiration and its effects

No good evidence for drugs, like antacids, in normal labour to reduce the small chance of inhaling some stomach contents if general anaesthesia is required.

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

Version: 2010

Fact sheet: Understanding thyroid gland tests

The thyroid gland is a vitally important hormonal gland, which mainly works for body’s metabolism. It is located in the front part of the neck below the voice box and is butterfly-shaped. The functions of the thyroid gland include the production of the thyroid hormones triiodothyronine (T3) and tetraiodothyronine, also called thyroxine (T4).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 6, 2011

Still pregnant after your due date: When is induction necessary?

If a pregnant woman’s due date has passed but there are no other problems, there is little risk for the unborn child. Yet if the baby is more than one week late, inducing labor will lower the risk of complications.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 25, 2012

Inhaled insulin: How safe is it?

There is currently not enough evidence to reliably evaluate the long-term benefits and harms of inhaled insulin. In most people with diabetes, inhaled insulin cannot completely replace insulin injections. The manufacturer of the inhaled insulin Exubera has taken it off the market.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 3, 2012

Fact sheet: Managing pain during childbirth

Knowing your baby is coming soon can be very exciting. But your feelings about labor might be mixed, especially if you have not given birth before. Is the pain as bad as many women say it is, or can you just breathe your way through it? Pregnant women usually want to know as much as possible about what labor will be like and what will help them cope.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 16, 2013

Fact sheet: Medication for people with chronic asthma

Shortness of breath, wheezing, coughing, chest tightness: these are all typical asthma symptoms, commonly experienced by most people with chronic asthma. But even if they do not have any symptoms, the disease is active. Left untreated, chronic asthma can lead to frequent asthma attacks as well as impaired physical fitness and lower quality of life.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 3, 2012

Follicular flushing during oocyte retrieval in assisted reproductive technology

Flushing of the follicles during egg collection is not useful, as it prolongs the operating time and increases the need for pain relief without increasing the chances of a pregnancy or increasing the number of eggs recovered.

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

Version: 2010

Endotracheal intubation at birth for preventing morbidity and mortality in vigorous, meconium‐stained infants born at term

Meconium is the first stool of a newborn baby, greenish‐black in colour and rather sticky in consistency.  If a baby is distressed before birth meconium may be passed into the amniotic fluid and if the baby then gasps the meconium‐stained fluid may pass into the lungs.  Once in the lungs the meconium can make the baby ill by obstructing the airways and causing inflammation this is called meconium aspiration syndrome.  It is possible to reduce the amount of meconium getting into the lungs by sucking it from the baby’s throat and windpipe (trachea) soon after birth but it is not certain if this leads to overall benefit for the vigorous term newborn baby.  Furthermore, placing a tube in the windpipe (endotracheal intubation) of a vigorous term baby is not always easy and could cause harm.  Four studies enrolled 2844 term infants and randomly allocated them to intubation to clear the airways or routine resuscitation without intubation.  No benefit was found from routine intubation compared to routine resuscitation for vigorous term babies.  The outcomes reported included: meconium aspiration syndrome, lung air leaks, need for oxygen, noisy breathing (stridor) and fits but there were no significant differences between the two groups.  Routine endotracheal intubation of vigorous term babies born through meconium‐stained amniotic fluid cannot be recommended.  For non‐vigorous babies endotracheal intubation is probably indicated until more information becomes available.

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

Version: 2009

Surgical procedures to evacuate incomplete miscarriage

Vacuum aspiration is a safe and quick treatment for incomplete miscarriages.

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

Version: 2010

Preoperative fasting for adults to prevent perioperative complications

General anaesthetic reduces reflexes that stop regurgitated gastric juices reaching the lungs. As this can be dangerous, people are often advised to have nothing to eat or drink from the midnight before surgery. However, the review of trials found that drinking clear fluids up to a few hours before surgery did not increase the risk of regurgitation during or after surgery. Some people are considered more likely to regurgitate under anaesthetic, including those who are pregnant, elderly, obese or have stomach disorders. More research is needed to determine whether these people can also safely drink up to a few hours before surgery.

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

Version: 2010

Pain control in first trimester surgical abortion.

Multiple methods of pain control in first trimester surgical abortion at less than 14 weeks gestational age using electric or manual suction aspiration are available, and appear both safe and effective. Pain control methods can be divided in local anesthesia, conscious sedation, general anesthesia and non‐pharmacological methods. Data to support the benefit of the widely used local aneathetic is inadequate. While general anesthesia achieved complete pain control during the procedure, other forms of anesthesia such as conscious sedation with a paracervical block improved postoperative pain control.

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

Version: 2009

Preoperative fasting for children to prevent complications during surgery

General anaesthetics inhibit the protective reflexes that stop the stomach contents reaching the lungs. In order to prevent the inadvertent inhalation of stomach contents, children are often advised to have nothing to eat or drink from the midnight before surgery. However, the review of trials found that drinking clear fluids up to a few hours before surgery did not increase the risk of regurgitation during or after surgery. Indeed there is an added benefit of a more comfortable preoperative experience in terms of thirst and hunger. Some children are considered more likely to regurgitate under anaesthetic, including those who are obese or have stomach disorders. More research is needed to determine whether these children can also safely drink up to a few hours before surgery.

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

Version: 2010

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