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Results: 18

Extracranial‐intracranial arterial bypass surgery for occlusive carotid artery disease

Patients with symptomatic occlusion (obstruction) of the carotid artery have a high risk of subsequent stroke. Anticoagulant treatment and antiplatelet agents are not very effective in these patients and a surgical procedure known as extracranial‐intracranial (EC/IC) arterial bypass surgery has been a treatment option. In this review, we included 21 trials (two randomised controlled trials and 19 non‐random studies, with a total of 2591 patients). We found that EC/IC bypass surgery in patients with symptomatic carotid artery occlusive disease was no better or worse than medical care alone. A multi‐centre trial comparing EC/IC bypass surgery with best medical treatment in patients with both a high risk of stroke and haemodynamic compromise (impaired blood flow) is underway, and aims to discover whether EC/IC bypass surgery is beneficial in this specific group of patients.

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

Version: 2010

Carotid endarterectomy for carotid stenosis in patients selected for coronary artery bypass graft surgery

People who have coronary artery disease requiring coronary artery bypass graft (CABG) surgery often have narrowing of other arteries. If the carotid artery, the artery carrying blood to the brain, is narrow (called carotid stenosis), this may increase the risk of stroke and other brain damage, complicating CABG surgery. Surgery to remove the carotid narrowing might prevent these complications of CABG surgery, but also has risks. We found no reliable evidence from randomised trials to indicate whether or not to perform preventive carotid surgery in patients who are going to have CABG surgery.

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

Version: 2009

Carotid endarterectomy for symptomatic carotid stenosis

Strokes cause long‐term disability and death. The chances of dying are much higher with subsequent strokes, which often occur within one year of the first attack. Strokes are often associated with blockages and severe narrowing in the internal carotid and other large blood vessels carrying oxygenated blood from the heart to the brain. Surgical removal of the fatty deposits and blood clots from inside the carotid artery wall may reduce the risk of stroke but carries a risk of peri‐operative complications including disabling stroke and death. This review identified three randomised controlled trials, which included over 6000 patients who were mostly elderly, predominantly male, had a recent non‐disabling stroke or transient ischaemic attack and had confirmed narrowing of the appropriate carotid artery. Many of the participants had heart disease, diabetes and high blood pressure. Increased degree of narrowing, advanced age, male sex and recent transient ischaemic attack or stroke were associated with increasing benefit from surgery. Patients with lesser degrees of narrowing were harmed.

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

Version: 2011

Cardiac testing for coronary artery disease in potential kidney transplant recipients

Background: Patients with chronic kidney disease (CKD) are at increased risk of coronary artery disease (CAD) and adverse cardiac events. Screening for CAD is therefore an important part of preoperative evaluation for kidney transplant candidates. There is significant interest in the role of non‐invasive cardiac investigations and their ability to identify patients at high risk of CAD. 

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

Version: 2012

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis

Currently there is insufficient evidence to support the use of endovascular treatment for vertebral artery stenosis in routine clinical practice. The vertebral arteries supply blood to the back of the brain and if narrowing (stenosis) of the artery occurs there is a risk of causing stroke. Because of difficulty accessing the vertebral artery, standard treatment has been conservative in most centres. The narrowing can also be treated by percutaneous transluminal balloon angioplasty. This involves passing a fine tube (catheter) through the skin (percutaneously) in to the arterial system. The catheter has a small balloon at its tip. The catheter is moved through the arterial system until the balloon reaches the point of arterial narrowing in the vertebral artery. The balloon is briefly inflated which stretches the artery (angioplasty) to reduce the degree of narrowing. Sometimes a device known as a stent is then placed inside the artery to prevent it narrowing again after the angioplasty. Angioplasty and stenting are called endovascular treatment. This review found results from one arm of a trial only involving a very small number of patients. The results suggest that endovascular treatment can be carried out with a high degree of technical success at the time of treatment but there is insufficient evidence to determine whether the risk benefit ratio favours endovascular intervention over conservative management. Randomised trials need to be designed to determine whether the endovascular treatment is more successful than conservative treatment at reducing the long term risk of stroke or death.

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

Version: 2008

Increased fruit and vegetable intake to prevent cardiovascular disease

Cardiovascular disease (CVD) is a global burden and varies between regions. This regional variation has been linked in part to dietary factors and low fruit and vegetable intake has been associated with higher rates of CVD. This review assessed the effectiveness of increasing fruit and vegetable consumption as a single intervention without the influence of other dietary patterns or other lifestyle modifications in healthy adults and those at high risk of CVD for the prevention of CVD. We found 10 trials involving 1730 participants in which six examined the provision of fruit and vegetables to increase intake and four trials examined dietary advice to increase fruit and vegetable intake. There were variations in the type of fruit and vegetable provided but all interventions investigating provision involved only one fruit or vegetable component. There were also variations in the number of fruit and vegetables that participants were advised to eat. Some studies advised participants to eat at least five servings of fruit and vegetables a day while others advised at least eight or nine servings per day.The duration of the interventions ranged from three months to one year. Adverse effects were reported in three of the included trials and included increased bowel movements, bad breath and body odour. None of the included trials were long enough to examine the effect of increased fruit and vegetable consumption on cardiovascular disease events such as heart attacks. There was no strong evidence that provision of one type of fruit or vegetable had beneficial effects on blood pressure and lipid levels but most trials were short term. There was some evidence to suggest beneficial effects of dietary advice to increase fruit and vegetable consumption but this is based on findings from two trials. More trials are needed to confirm these findings.

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

Version: 2013

Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 7, 2014

Statins for children with inherited high blood cholesterol

Familial hypercholesterolemia is an inherited disease in which blood cholesterol level is high. Vascular diseases often occur at an earlier age than usual, especially amongst men. Thus lifelong therapies to reduce blood cholesterol (started in childhood) are needed. In children with familial hypercholesterolemia, diet has been the main treatment option. Resins, such as cholestyramine and colestipol, have also been used effectively to lower low‐density lipoprotein (LDL) cholesterol. However, these usually taste unpleasant and are poorly tolerated; so they are poorly adhered to. Since the 1990s statin trials have been carried out among children and adolescents with familial hypercholesterolemia. Statins have decreased their serum LDL cholesterol levels by about one third in these studies. Additionally, in one study, statins improved the arterial function and in another study they reduced the thickness of the already thickened neck artery. Even though statins seem to be safe and well‐tolerated in children, their long‐term safety in this age group is not firmly established.

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

Version: 2014

Childhood Craniopharyngioma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood craniopharyngioma

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 9, 2014

Testing Treatments: Better Research for Better Healthcare. 2nd edition

How do we know whether a particular treatment really works? How reliable is the evidence? And how do we ensure that research into medical treatments best meets the needs of patients? These are just a few of the questions addressed in a lively and informative way in Testing Treatments. Brimming with vivid examples, Testing Treatments will inspire both patients and professionals.

Pinter & Martin.

Version: 2011
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Unusual Cancers of Childhood (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 11, 2014

Laryngeal Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of laryngeal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 20, 2014

Salivary Gland Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of salivary gland cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 8, 2014

Oropharyngeal Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of oropharyngeal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 3, 2014

Pheochromocytoma and Paraganglioma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of pheochromocytoma and paraganglioma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 10, 2014

Thyroid Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of thyroid cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 10, 2014

Lip and Oral Cavity Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of lip and oral cavity cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 31, 2014

Hypopharyngeal Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of hypopharyngeal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 20, 2013

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