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To investigate if using ultrasound to look at anal muscles after childbirth reduces women's suffering from gas, liquid or solid stool leakage

Many women have a tear to the skin between the vagina and anus (the perineum) following childbirth. These tears can sometimes involve the muscles that control the function of the anus, and women can suffer for the rest of their lives with difficulty controlling gas, liquid and solid stool. Evidence shows that by properly repairing these tears, complications can be reduced. The muscles can often be difficult to see with the naked eye due to a number of factors including reduced lighting, swelling of the tissues and poor pain relief.

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

Version: 2015

Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis

‐ There were no harmful side effects (such as increased pain or damage to your joints) of exercise found in this review.  This was true for exercising on land or in the water, although most of the studies were not long enough to tell if exercise might cause joint damage.

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

Version: 2009

Mechanical devices for urinary incontinence in women

Urinary incontinence is involuntary loss of urine. The common types are stress and urge incontinence. Mechanical devices are made of plastic or other materials. They are placed within the urethra or vagina in order to stop or control the leakage of urine. This review of trials found that using mechanical devices might be better than no treatment but the evidence is weak. There was not enough evidence to recommend any specific type of device or to show whether mechanical devices are better than other forms of treatment such as pelvic floor muscle training.

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

Version: 2015

Exercise for improving balance in older people

This updated review includes 94 (62 new to this update) randomised controlled trials involving 9821 participants. Most participants were women living in their own home. Some studies included frail people residing in hospital or residential facilities.

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

Version: 2012

Physical treatments for idiopathic facial paralysis

Bell's palsy is an acute disorder of the facial nerve, which produces full or partial loss of movement on one side of the face. The facial palsy gets completely better without treatment in most, but not all, people. Physical therapies, such as exercise, biofeedback, laser treatment, electrotherapy, massage and thermotherapy, are used to hasten recovery, improve facial function and minimise sequelae. For this updated review we found a total of 12 studies with 872 participants, most with high risk of bias. Four trials studied the efficacy of electrical stimulation (313 participants), three trials studied exercises (199 participants), and five studies combined some form of physical therapy and compared with acupuncture (360 participants). There is evidence from a single study of moderate quality that exercises are beneficial to people with chronic facial palsy when compared with controls and from another low quality study that it is possible that facial exercises could help to reduce synkinesis (a complication of Bell's palsy), and the time to recover. There is insufficient evidence to decide whether electrical stimulation works, to identify risks of these treatments or to assess whether the addition of acupuncture to facial exercises or other physical therapy could produce improvement. In conclusion, tailored facial exercises can help to improve facial function, mainly for people with moderate paralysis and chronic cases, and early facial exercise may reduce recovery time and long term paralysis in acute cases, but the evidence for this is of poor quality. More trials are needed to assess the effects of facial exercises and any risks.

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

Version: 2012

Early elbow movement compared to delayed elbow movement after a broken elbow in adults

The elbow plays an important role in any arm movement such as reaching or lifting. A broken bone, commonly referred to as a fracture, in the elbow can result from a simple fall onto an outstretched arm. A fracture may occur in one or more of parts of the three bones that form the elbow joint. These parts are the upper sections of the two forearm bones (the radius and the ulna) and the lower section of the upper arm bone (the humerus). A well‐documented problem after an injury to the elbow is elbow stiffness and loss of normal movement. After initial treatment, which may involve surgery for more serious fractures, treatment may involve immediate gentle movement of the elbow, using a sling for support only, or it may involve a period of time resting still in a sling or plaster cast. It is not known which approach results in better movement and function of the elbow after the fracture has healed.

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

Version: 2011

Advice on diet for malnutrition as a result of disease in adults

Ill people often have a poor appetite or feel sick due to treatments and eat less than usual. If this reduced food intake is prolonged, it can cause weight loss, malnutrition and death. Healthcare professionals may offer advice to encourage good eating habits of high‐protein and high‐energy foods so that weight can be gained and the person's nutritional status improved. Oral nutritional supplements are commonly offered with or without advice on increasing food intake. Forty‐five studies with a total of 3186 people are included in this review in four different comparisons: dietary advice to no advice; to oral nutritional supplements; to dietary advice plus oral nutritional supplements; and to dietary advice and nutritional supplements given together compared with no additional help. Follow‐up ranged from 18 days to 24 months. There are some significant results for change in weight, muscle bulk and strength suggesting that nutritional intervention is beneficial although for some comparisons there are big differences between the studies. The authors conclude that nutritional intervention appears to be more effective than no help at improving weight, muscle bulk and strength. More research is needed to work out the best ways to help people who are losing weight because of illness in order to improve their clinical outcomes and quality of life.

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

Version: 2012

Exercise for type 2 diabetes mellitus

Exercise, dietary changes and medications are frequently used in the management of type 2 diabetes. However, it is difficult to determine the independent effect of exercise from some trials because exercise has been combined with dietary modifications or medications, or compared with a control which includes another form of intervention. The review authors aimed to determine the effect of exercise on blood sugar control in type 2 diabetes.

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

Version: 2009

Interventions for swallowing difficulty in long‐term, progressive muscle disease

People with progressive muscle disease often develop swallowing difficulties (dysphagia) as a result of weakness. These changes in swallowing function can lead to weight loss or inability to gain weight, as well as breathing problems due to food inhalation into the airways and recurrent respiratory infections. Fear or embarrassment about symptoms such as choking, coughing, or spluttering while eating and long meal times can also lead to psychological and social difficulties for those living with dysphagia. We wanted to find out how effective a range of different interventions are for treating dysphagia in people with long‐term, progressive muscle disease.

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

Version: 2016

Botulinum toxin type A for masseter hypertrophy

Masseter muscle hypertrophy occurs as a soft enlargement of the jaw muscles near the angle of the lower jaw and seldom presents a major health problem. However, in some individuals the swelling can be associated with pain or may be so large that it causes facial disfigurement. Although the cause of the condition is unclear it does appear to be more common in certain ethnic groups.

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

Version: 2013

The effect of anti‐spasticity agents in people with multiple sclerosis

Multiple sclerosis (MS) is a chronic disease of the nervous system which affects young and middle‐aged adults. Spasticity, a common problem in people with MS, is a disorder of voluntary movement caused by damage to the central nervous system. The main sign is the resistance to passive movement of a limb but other associated features ‐ pain, spasms, loss of function ‐ affect people's quality of life more directly.

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

Version: 2008

Heart failure: Overview

Lots of people with heart failure avoid physical exercise to prevent breathlessness and heavy breathing. But exercise has been shown to be good for heart failure in the long term: Studies show that special cardio training programs can imrpove fitness and quality of life.

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

Version: August 27, 2014

Corticosteroid therapy for Duchenne muscular dystrophy

DMD is an incurable disease beginning in childhood that almost exclusively affects boys. Muscle wasting and loss of walking lead to wheelchair dependence and early death. Randomised controlled trials (RCTs) have shown that corticosteroids improve muscle strength and function for up to six months and strength up to two years (evidence on function at two years is limited). Data from other study types suggest that corticosteroids produce better function over a five‐year period in many patients. Overall, long‐term benefit remains unclear, and has to be weighed against long‐term side effects. It is also unclear whether different corticosteroids differ greatly in side effects. Earlier versions of this review found insufficient evidence to determine whether an intermittent regimen is as effective as a daily regime, or produces fewer side effects.

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

Version: 2016

How does the thyroid work?

The thyroid is a vitally important hormonal gland that regulates metabolism and growth in the body. The thyroid hormones T3 and T4 increase the basal metabolic rate. In other words, they make the body cells work harder, using more energy. If more energy is needed for metabolic processes in the body – for instance for growth, when it is cold, or during pregnancy – more hormones are produced and transported into the blood.

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

Version: January 7, 2015

Epilepsy: Overview

In epilepsy, certain areas of the brain or all areas of the brain are overactive, sending too many signals. Some people have their first seizure in childhood, and others have their first seizure in older age.Medication can help to prevent seizures and maintain a good quality of life.

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

Version: January 13, 2016

Chronic obstructive pulmonary disease (COPD): Medication for COPD

Medication is an integral part of the daily treatment of chronic obstructive pulmonary disease (COPD). Although it may not be able to cure the condition, it can help relieve the symptoms and prevent acute breathing problems.The possible treatment options mainly depend on the severity of the disease. In early stages of COPD, people usually only need to take medication when they have acute breathing problems. As the symptoms become more frequent and more severe, certain drugs need to be taken regularly. People who have advanced COPD often take several medications at the same time.These are the most commonly used medications:Drugs that open up the airways (bronchodilators): beta2-agonists, anticholinergics, and methylxanthines if neededAnti-inflammatory drugs: Drugs containing steroids (corticosteroids) and PDE 4 inhibitorsOther drugs called mucolytics are used to dissolve mucus in the bronchi and make it easier to cough it up as phlegm. Antibiotics may also help relieve acute breathing problems. Flu vaccines can prevent additional infections that can make the breathing problems worse.

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

Version: August 12, 2015

Metastatic breast cancer: Treatments and possible consequences

When breast cancer is diagnosed, the aim of treatment is usually to remove all of the tumor. But this is no longer possible if it has spread to other parts of the body. Then the aim of treatment is to keep your overall health and quality of life as good as possible for as long as possible.The goal of treatment for metastatic breast cancer is to stop or slow down the growth of the tumor. It is also possible to reduce the symptoms and possible side effects of treatment and to treat associated medical conditions. Cancer-related pain can be treated with well-managed pain relief therapy. If treatment is carefully planned and tailored to a person's specific situation, and if their overall health is good, it is often possible to keep the disease under control for years, even if they have metastatic tumors, and have a good quality of life despite the symptoms.

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

Version: April 7, 2016

Comparing Fingolimod with other MS Drugs

How does fingolimod compare in multiple sclerosis?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 30, 2011

Chronic obstructive pulmonary disease (COPD): Overview

Chronic obstructive pulmonary disease (COPD) is quite common, even more so than asthma. A typical symptom is a persistant cough. When the condition is advanced, it gets harder and harder to breathe. At that point even everyday activities such as climbing stairs, gardening, or taking a walk can leave you out of breath. COPD develops gradually over the course of many years.

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

Version: August 12, 2015

What is anti-clotting medication and how is it used safely?

Anti-clotting medication is used to prevent blood clots from forming, and therefore lower the risk of certain cardiovascular diseases like heart attacks and strokes. As the name suggests, they make sure that the blood does not clot as quickly.

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

Version: November 26, 2014

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