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Topical preparations for preventing stretch marks in pregnancy

Stretch marks commonly develop during pregnancy, particularly in the third trimester. They affect 50% to 90% of women. They appear as red lines or streaks that fade slowly after the pregnancy to leave pale lines on the skin. The abdomen, breasts and thighs are most often affected. They do not disappear entirely, therefore any treatment which prevents them would be welcomed by many women. In this review, we identified randomised controlled trials and quasi‐randomised controlled trials that compared topical creams, lotions and ointments containing active ingredients with placebo or no treatment, and topical preparations with active ingredients versus other topical preparations.

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

Version: 2012

Interventions for the treatment of stretch marks: a systematic review

Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed.

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

Version: 2014

Pregnancy and birth: Weight gain in pregnancy

It is important for pregnant women to have a balanced diet, both for themselves and their child. This helps them put on a good amount of weight. But how much weight gain is considered to be “normal” in pregnancy? Can mothers-to-be eat as much as they like? And how can they lose weight again afterwards?“Don’t worry – the weight will soon drop off when you start breastfeeding!”, “Be careful – I never lost the weight after my second baby”, “Eat anything you want – you’re eating for two!”… As with so many issues surrounding pregnancy, it can seem as though everyone has an opinion about weight gain. With all the contradictory advice going around, it can be hard to know what to do.

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

Version: March 19, 2014

How does skin work?

The skin is one of our body’s heaviest and largest organs. Depending on body size and shape, it weighs between 3.5 and 10 kilograms (7.5 and 22 pounds) and is 1.5 to 2 square meters big.

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

Version: July 28, 2016

Budesonide for maintenance of remission in Crohn's disease

Budesonide is a corticosteroid drug which is rapidly broken down by the liver, reducing corticosteroid‐related side effects (e.g., moon face). Research showing that budesonide is effective in treating active Crohn's disease has led to clinical trials examining the effect of budesonide on reducing disease recurrence in non‐active Crohn's disease.

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

Version: 2014

Atopic Eczema in Children: Management of Atopic Eczema in Children from Birth up to the Age of 12 Years

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2007
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Pituitary Tumors Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of pituitary tumors.

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

Version: May 27, 2016

Outcomes of Maternal Weight Gain

The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on outcomes of gestational weight gain and their confounders and effect modifiers, outcomes of weight gain within or outside the 1990 Institute of Medicine (IOM) guidelines, risks and benefits of weight gain recommendations, and anthropometric measures of weight gain.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: May 2008
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Unusual Cancers of Childhood Treatment (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: August 10, 2016

Obsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

This guideline has been developed to advise on the identification, treatment and management of obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD). Although distinct disorders, OCD and BDD share a number of common features and there is a high degree of similarity between the treatments for the two conditions. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, people with OCD, a carer and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with OCD and BDD while also emphasising the importance of the experience of care for people with OCD, BDD, and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2006
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Cancer of the Upper Aerodigestive Tract: Assessment and Management in People Aged 16 and Over

There is no single universal definition of the upper aerodigestive tract; for the purposes of this guideline, it encompasses the oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, and paranasal sinuses. The vast majority of cancers at these sites are squamous cell carcinomas (National Head and Neck Cancer Audit, 2014). Some other cancers with less common histological diagnoses, such as mucosal melanomas of the upper aerodigestive tract, are also covered by this guideline.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: February 2016
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Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins

Varicose veins are dilated, often palpable subcutaneous veins with reversed blood flow, most commonly found in the legs. Estimates of the prevalence of varicose veins vary. Visible varicose veins in the lower limbs are estimated to affect at least a third of the population. There is little reliable information available in the literature on the proportion of people with varicose veins who progress to venous ulceration. One study reported that 28.6% of those who had visible varicose veins without oedema or other complications progressed to more serious venous disease after 6.6 years.83 However there was no information about the numbers progressing to ulceration. Other data on the lifetime prevalence of varicose veins estimate that approximately 3–6% of people who have varicose veins in their lifetime will develop venous ulcers.71 Risk factors for developing varicose veins are unclear although prevalence rises with age and they often develop during pregnancy. In some people varicose veins are asymptomatic or cause only mild symptoms, but in others they cause pain, aching or itching and can have a significant effect on their quality of life. Varicose veins may become more severe over time and can lead to complications such as changes in skin pigmentation, eczema, superficial thrombophlebitis, bleeding, loss of subcutaneous tissue, lipodermatosclerosis or venous ulceration.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2013

Headaches: Diagnosis and Management of Headaches in Young People and Adults [Internet]

Many non-specialist healthcare professionals can find the diagnosis of headache difficult, and both people with headache and their healthcare professionals can be concerned about possible serious underlying causes. This leads to variability in care and may mean that people with headaches are not always offered the most appropriate treatments. People with headache alone are unlikely to have a serious underlying disease. Comparisons between people with headache referred to secondary care and those treated in primary care show that they do not differ in terms of headache impact or disability.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: September 2012

Advanced Breast Cancer: Diagnosis and Treatment

Breast cancer is the most common cancer for women in England and Wales, with about 37,000 new cases diagnosed and 11,000 deaths recorded in England and Wales each year. In men breast cancer is rare, with about 270 cases diagnosed, and 70 deaths in England and Wales each year. Of these new cases in women and men, around 10% are diagnosed in the advanced stages, when the tumour has spread significantly within the breast or to other organs of the body. In addition, there is a significant number of women who have been previously treated with curative intent who subsequently develop either a local recurrence or metastases. Over recent years there have been important developments in the investigation and management of these patients including new chemotherapy, and biological and hormonal agents. There is some evidence of practice variation across the country and of patchy availability of certain treatments and procedures. A clinical guideline will help to address these issues and offer guidance on best practice.

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

Version: February 2009
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Noninvasive Treatments for Low Back Pain [Internet]

Low back pain is common, and many pharmacological and nonpharmacological therapies are available. This review examines the evidence on the comparative benefits and harms of noninvasive treatments for low back pain.

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

Version: February 2016

Type 1 Diabetes in Adults: Diagnosis and Management

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

The Prevention and Management of Pressure Ulcers in Primary and Secondary Care

Prevention of pressure ulcers usually involves an assessment to identify people most at risk of pressure ulcers, such as elderly, immobile people or those with spinal cord injury. Assessments are most commonly carried out using specific pressure area risk scores (for example, the Braden or Waterlow scales for predicting pressure sore risk or the, Glamorgan scale for paediatric pressure ulcers).

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: April 2014

Systematic Reviews in PubMed

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