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Results: 1 to 20 of 103

No evidence to assess surgical treatment in asymptomatic gallstones

Cholecystectomy is currently advised only for symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. Literature search was performed for evidence from randomised clinical trials to find whether cholecystectomy was indicated in patients with silent (asymptomatic) gallstones. There is no randomised trial comparing cholecystectomy versus no cholecystectomy in silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone‐associated pancreatitis, and/or gall‐bladder cancer for sufficient duration of follow‐up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.

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

Version: 2009

Antibiotics for asymptomatic bacteriuria in pregnancy

Antibiotics can reduce the risk of kidney infections in pregnant women who have a urine infection but no symptoms of infection.

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

Version: 2009

Duration of treatment for asymptomatic bacteriuria during pregnancy

Asymptomatic bacteriuria is a urinary tract infection (without symptoms) common in pregnancy. If untreated, it can lead to pyelonephritis (kidney infection). Antibiotic treatment is recommended. This review aimed to identify whether single‐dose antibiotic treatments are as effective as longer ones for maternal and newborn outcomes. The review of 13 studies, involving over 1622 women, found that a one‐day regimen is significantly less effective than a seven‐day regimen.

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

Version: 2012

Firm evidence for effect of Chinese medicinal herbs for asymptomatic hepatitis B virus carriers is still awaited

Chinese medicinal herbs have a long history in the treatment of liver diseases. Three randomised clinical trials were included. Due to their poor methodologic quality and the existing small number of trials, there is currently insufficient evidence for treating asymptomatic hepatitis B virus carriers with Chinese medicinal herbs like the herbal compound 'Jianpi Wenshen recipe', Phyllanthus amarus and Astragalus membranaceus. Methodologically better and larger randomised trials are needed comparing medicinal herbs versus placebo.

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

Version: 2009

Carotid endarterectomy for asymptomatic carotid stenosis

For most people with a narrowing of the carotid artery which is not causing symptoms a surgical operation to remove the narrowing carries a risk and has little benefit. Carotid stenosis is a narrowing of a major artery in the neck taking blood to the brain. This can cause a stroke. If the narrowing is severe and has caused symptoms, surgery to remove the narrowing (carotid endarterectomy) reduces the risk of stroke. However, if the narrowing has not caused any symptoms the risk of stroke is not very high. Although this low risk can be lowered further by surgery, the surgery itself can sometimes cause a stroke or death. The overall effect of surgery is a small benefit.

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

Version: 2008

Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment

We reviewed the evidence about whether treatment of retinal breaks (holes or tears in the retina) and retinal lattice degeneration (thinning and atrophy of retinal tissue) can prevent retinal detachment, a serious vision‐threatening problem.

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

Version: 2014

Should the primary cancer be surgically removed in asymptomatic patients with unresectable stage IV colorectal cancer? 

A majority of patients with advanced colorectal cancer cannot be cured of their disease. This is because it has spread widely throughout the body and is therefore not resectable. In many of these patients, the original cancer that caused the problem is relatively asymptomatic and the patient is not aware of it. Most of these patients will be treated with a combination of chemotherapy and possibly radiotherapy. From a clinical perspective, a major problem in dealing with these patients is what to do with the primary cancer. Some studies have suggested that resecting the primary cancer can prolong survival and prevent complication arising from the cancer, such as obstruction or bleeding. This review addresses the question of whether surgically removing the primary cancer is beneficial to patients with advanced and unresectable colorectal cancer. No randomised controlled trials were identified.

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

Version: 2012

Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth

Wisdom teeth, or third molars, generally erupt into the mouth between the ages of 17 to 24 years. These are normally the last teeth to erupt and mostly into a position closely behind the last standing teeth (second molars). Space for these teeth to erupt can be limited and more than other teeth, wisdom teeth often fail to erupt or erupt only partially. Failure of the third molars to fully erupt is often due to impaction of the wisdom teeth against the second molars (teeth directly in front of the wisdom teeth). This occurs when the second molars are blocking the path of eruption of the third molar teeth and act as a physical barrier preventing further eruption. An impacted wisdom tooth is called asymptomatic if the patient does not experience signs or symptoms of pain or discomfort associated with this tooth.

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

Version: 2012

Indomethacin for asymptomatic patent ductus arteriosus in preterm infants

Indomethacin for very preterm or small babies with signs of PDA but no symptoms can prevent PDA, but more research is needed on long‐term outcomes. A common complication for very preterm (premature) or very small babies is PDA (patent ductus arteriosus). PDA is an open channel between the lungs and heart which should have closed after birth, and can cause life‐threatening complications. Indomethacin is often given to all babies at risk to prevent PDA, but it can cause adverse effects. It can also be given only to those babies who have early signs of PDA, but who have not yet developed symptoms. The review of trials found that this selective use of indomethacin can prevent PDA and has short‐term benefits, but more research is needed on longer term outcomes.

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

Version: 2009

Different antibiotic regimens for treating pregnant women with bacteria in their urine and without symptoms of urinary tract infection

Between 5% and 10% of pregnant women have bacteria in their urine without symptoms of infection (asymptomatic bacteriuria). If left untreated, women may go on to develop serious complications such as kidney infection or preterm birth. In this review we looked at studies comparing different antibiotic treatments for asymptomatic bacteriuria to see which antibiotics or which course of the same antibiotics (shorter versus longer courses) were most effective for reducing infection. We also looked at side effects such as vomiting. The studies included in this review failed to demonstrate any newer antibiotic or regimen which would be better than the older antibiotics and the traditional regimen.

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

Version: 2010

Pulp management for caries in adults: maintaining pulp vitality

The management of the pulp in extensively decayed, vital and asymptomatic teeth presents something of a clinical problem and there is no agreement as to the most effective treatment modality. For example, there is no consensus as to whether the tooth should be indirectly pulp capped or directly pulp capped; whether a two‐stage procedure should be carried out, nor as to which material is most effective. Recently, a variety of newer bonding materials have been introduced but the outcome regarding their use when included in the restoration of a carious tooth with respect to symptoms and maintenance of vitality is unknown.

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

Version: 2012

Screening for peripheral arterial disease

Peripheral arterial disease (PAD) is caused by fatty deposits on the walls of the arteries (or atherosclerosis) that leads to narrowing of the arteries (or stenosis) and obstructions in the major vessels supplying the lower legs. PAD can cause discomfort or pain in the lower legs when walking. People with PAD have an increased risk of death, heart and cerebrovascular disease and often receive treatment to manage their cardiac risk. They suffer from significant functional limitations in their daily activities, and the most severely affected are at risk of limb loss. Many people with PAD do not have any symptoms. Only some people have discomfort or pain in the lower legs when walking, so PAD often goes undetected. One possible way to identify this disease is to screen the population at increased risk of PAD. It is important to determine the effectiveness of screening in preventing heart and cerebrovascular diseases or further progression of PAD.

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

Version: 2014

Prophylactic versus selective antibiotics for term newborn infants of mothers with risk factors for neonatal infection

Several factors increase the risk of serious infection in term newborn infants, for example, the presence in the birth canal of a bacterium that causes infection in the newborn (group B streptococcus), rupture of membranes more than a day before delivery, or high temperature in the mother during labour. Some paediatricians routinely prescribe an antibiotic for the newborn infant if any of these factors is present, even if the infant appears to be completely well. Others believe that it is safe and appropriate to observe these infants and only treat those who develop signs of illness, or have other evidence of infection during the first day after birth. We found two small trials that addressed this question. Neither provided enough evidence to guide practice. A further larger randomized trial is needed.

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

Version: 2009

Treatment for cardiac problems caused by anthracycline chemotherapy for childhood cancer

Anthracyclines are anti‐cancer drugs that are used in the treatment of different types of childhood cancer. An important adverse effect of anthracyclines is damage to the heart that can lead to asymptomatic (without complaints) or symptomatic (with complaints) cardiac problems during and after cancer treatment. There are several drugs available to treat other types of cardiac problems in adults, but it is not known if these drugs are beneficial in treating cardiac problems caused by anthracyclines in childhood cancer patients and survivors. If a physician is confronted with a childhood cancer patient or survivor with anthracycline‐induced cardiac problems, he or she should be able to make an informed decision to treat this patient based on high‐quality evidence about the beneficial and adverse effects of the treatment options. We searched for and summarised studies that evaluated drugs for treating anthracycline‐induced cardiac problems in childhood cancer patients and survivors.

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

Version: 2011

Surgery for small abdominal aortic aneurysms that do not cause symptoms

An aneurysm is a ballooning of an artery (blood vessel), which can happen in the major artery in the abdomen (aorta). The cause is unknown. Ruptured aneurysms cause death unless surgical repair is rapid, which is difficult to achieve. Surgery for patients with aneurysms more than 5.5 cm in diameter or who have associated pain is considered necessary to relieve symptoms and to reduce the risk of rupture and death, although there are risks associated with surgery. Surgical repair of the aneurysm consists of insertion of a prosthetic inlay graft either by open surgery or endovascular repair.

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

Version: 2012

Chinese medicinal herbs for cholelithiasis

Cholelithiasis (gallstone disease) causes significant morbidity, severe complications, and economic burden worldwide. Though current surgical therapies are effective for gallstones, some types of gallstones (e.g., calcium bilirubinate calculi) cannot easily be eradicated by surgery and they often recur in the bile duct system, putting people at high risk of severe complications. The objective of this review was to evaluate the benefits and harms of Chinese medicinal herbs for people with cholelithiasis. Though some Chinese medicinal herbs appear to be safe for people with asymptomatic, mild, or moderate disease, they have not been conclusively shown to have curative effects on gallstones due to the low methodological quality (high risk of bias) of the included trials. Thus, randomised clinical trials with low risk of bias should be conducted to assess the effects of Chinese medicinal herbs before they can be used widely in the clinic.

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

Version: 2013

Interventions for trichomoniasis in pregnancy

Metronidazole is effective against a trichomoniasis infection during pregnancy, but may increase the risk of preterm and low birthweight babies.

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

Version: 2011

Screening for oesophageal cancer

Oesophageal cancer is a common cause of cancer related death in the world. The prognosis in the advanced stages is unfavourable, but the early oesophageal cancers are asymptomatic and curable, and usually go undetected until they have spread beyond the oesophageal wall. Endoscopy with iodine staining or cytologic examination are two common screening tests for early oesophageal cancer. These screening tests were started in the 1970s, but the true benefit is inconsistent and is uncertain due to lead‐time bias, which is the amount of time by which the diagnosis is advanced by the screening procedure; and length‐time bias, where screening is more likely to detect slow‐growing disease rather than altering the person's duration of life. This review intended to determine the efficacy of the two screening tests for oesophageal cancer. We identified 3482 studies but none were RCTs of screening. Several non‐comparative studies showed that the screening tests may increase the incidence of reported oesophageal cancer and improve the survival results after a screening test, but these results could indicate bias rather than a true causative effect. Therefore, there is a strong need for randomised controlled trials (RCTs), especially long‐term RCTs, to determine the efficacy, cost‐effectiveness, and any adverse effects of screening for oesophageal cancer.

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

Version: 2012

Antibiotic prophylaxis for short‐term catheter bladder drainage in adults

Catheters may be used to drain urine from the bladder in hospital for short periods of time (less than two weeks). This may cause a urinary infection, or an increase in the number of bacteria in the urine. The review found that people who had antibiotics before or during catheter use were less likely to have an infection, and less likely to have a large number of bacteria or pus cells in the urine. However, there was no evidence concerning the chance of allergic reactions or other side effects from the antibiotics. Antibiotic‐resistant bacteria were identified in most studies but there was no definite link made to the use of antibiotics.

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

Version: 2013

Minimally invasive versus surgical treatment of an aneurysm of the popliteal artery

The popliteal artery is a blood vessel situated behind the knee joint. Sometimes it weakens and expands like a balloon, known as an aneurysm. If left untreated, the blood clot within the aneurysm may embolise or the aneurysm may rupture or get blocked. Any of these complications can lead to limb loss or even death. Traditionally, popliteal artery aneurysm (PAA) has been treated surgically. However, it is also possible to treat the condition by deploying an endovascular stent graft through a small puncture in the groin. An endovascular stent graft is a fabric tube supported by a metal mesh which sits snugly and forms a seal within the artery. The success of the procedure is determined by the ability of the surgically applied graft or the stent graft to remain unblocked. Blockage of the graft decreases the leg circulation, which may require emergency surgery. Some consider the surgical technique to be the gold standard, although the feasibility of the endovascular technique has been well documented in many retrospective studies. Level‐1 evidence is only obtained however when two techniques are pitted against each other in a prospective randomised controlled trial (RCT).

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

Version: 2014

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