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Treatments for Ankyloglossia and Ankyloglossia With Concomitant Lip-Tie [Internet]

We systematically reviewed the literature on surgical and nonsurgical treatments for infants and children with ankyloglossia and ankyloglossia with concomitant lip-tie.

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

Version: May 2015
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Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review

This review concluded that frenotomy was likely to be an effective treatment for ankyloglossia, but that this needed to be confirmed in further randomised controlled trials. Given the quality, quantity and variability of the included data, the conclusions should be interpreted with caution.

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

Version: 2007

Tongue-tie and frenotomy in infants with breastfeeding difficulties: achieving a balance

AIMS: Currently there is debate on how best to manage young infants with tongue-tie who have breastfeeding problems. One of the challenges is the subjectivity of the outcome variables used to assess efficacy of tongue-tie division. This structured review documents how the argument has evolved. It proposes how best to assess, inform and manage mothers and their babies who present with tongue-tie related breastfeeding problems.

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

Version: 2014

Intravenous immunoglobulin for the treatment of Kawasaki disease in children

Good evidence that intravenous immunoglobulin treatment within the first 10 days of symptoms reduces coronary artery abnormalities (heart damage) in children with Kawasaki disease. Kawasaki disease is a disease that primarily affects children under five years old. The cause of Kawasaki disease is not known. Its symptoms are persistent fever, red eyes and lips, strawberry tongue, rash and swollen lymph nodes. If not detected and treated immediately, Kawasaki disease can result in heart damage and occasionally death. Intravenous immunoglobulin involves injecting antibodies purified from donated blood. The review of trials found that intravenous immunoglobulin given within the first 10 days of the disease reduces the risk of damage to the coronary arteries of the heart in children, without serious adverse effects.

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

Version: 2008

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

“ACE Inhibitors” and “ARBs” To Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease

You have coronary heart disease, a disease affecting the arteries of your heart. You may have had a heart attack or suffer from chest pains with exercise, but your symptoms are not changing. Your coronary heart disease is in “stable” condition. This means that your symptoms have not changed or become worse. Your doctor recommends adding a medicine called an ACE Inhibitor or an ARB. You do not take medicine for high blood pressure (also called “hypertension”).

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: July 9, 2010

Alzheimer's disease: Overview

Alzheimer's disease is the most common cause of dementia. People who have dementia become forgetful and find it increasingly difficult to express themselves in words. Some, mainly older, people have a combined form of Alzheimer’s and vascular dementia. Vascular dementia is caused by blood flow problems in the brain.

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

Version: September 18, 2013

Parkinson's Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

It is almost 200 years since James Parkinson described the major symptoms of the disease that came to bear his name. Slowly but surely our understanding of the disease has improved and effective treatment has been developed, but Parkinson’s disease remains a huge challenge to those who suffer from it and to those involved in its management. In addition to the difficulties common to other disabling neurological conditions, the management of Parkinson’s disease must take into account the fact that the mainstay of pharmacological treatment, levodopa, can eventually produce dyskinesia and motor fluctuation. Furthermore, there are a number of agents besides levodopa that can help parkinsonian symptoms, and there is the enticing but unconfirmed prospect that other treatments might protect against worsening neurological disability. Thus, a considerable degree of judgement is required in tailoring individual therapy and in timing treatment initiation. It is hoped that this guideline on Parkinson’s disease will be of considerable help to those involved at all levels in these difficult management decisions. The guideline has been produced using standard NICE methodology and is therefore based on a thorough search for best evidence.

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

Version: 2006
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Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both

The guideline applies to adults (aged 18 and over) with symptoms suggestive of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease (GORD), or both.

NICE Clinical Guidelines - Internal Clinical Guidelines Team (UK).

Version: September 2014
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Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Review of Reviews for the U.S. Preventive Services Task Force [Internet]

Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Interventions to help adults quit smoking might stop or reduce tobacco-related illness.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: September 2015
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Motor Neurone Disease: The Use of Non-Invasive Ventilation in the Management of Motor Neurone Disease [Internet]

Motor neurone disease (MND) is a fatal neurodegenerative disease. It is characterised by the onset of symptoms and signs of degeneration of primarily the upper and lower motor neurones. This leads to progressive weakness of the bulbar, limb, thoracic and abdominal muscles. Respiratory muscle weakness resulting in respiratory impairment is a major feature of MND, and is a strong predictor of quality of life and survival. Non-invasive ventilation can improve symptoms and signs related to respiratory impairment and hence survival.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: July 2010
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Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease

Many people naturally assume that the claims made for foods and nutritional supplements have the same degree of scientific grounding as those for medication, but that is not always the case. The IOM recommends that the FDA adopt a consistent scientific framework for biomarker evaluation in order to achieve a rigorous and transparent process.

National Academies Press (US).

Version: 2010
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Diagnosis and Management of Metastatic Malignant Disease of Unknown Primary Origin

The term “cancer of unknown primary” refers to a condition in which a patient has metastatic malignancy without an identified primary source. This is a very heterogeneous disease in which the type of tumour, the extent of spread, and the outcome of treatment all vary widely. When categorising patients with cancer of unknown primary, one important factor initially considered is the cell type of origin of the metastatic disease. The majority of patients have malignancy which appears to derive from epithelial cells, and hence are regarded as having carcinoma of unknown primary. Patients with tumours of non-epithelial lineage (melanoma, sarcoma, lymphoma, germ-cell) form a distinct and important minority, since subsequent management can often be satisfactorily undertaken even in the absence of an identifiable primary source. Such patients are not considered in this guideline, since their care is adequately defined in existing guidelines for their specific tumour type. The term “carcinoma of unknown primary” (CUP) is used henceforth to refer to those patients with metastatic malignancy of epithelial, neuroendocrine or undifferentiated lineage whose investigation and management is considered within the scope of this guideline.

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

Version: July 2010
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[Treatment and rehabilitation of dysphagia following cerebrovascular disease]

INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation and acupuncture. CONCLUSIONS. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people's social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner.

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

Version: 2014

Enzyme replacement therapy in late-onset Pompe disease: a systematic literature review

This review concluded that alglucosidase alfa treatment was effective and well tolerated, and attenuated progression of late-onset Pompe disease in most patients. Responses to treatment were classified as improved, stabilised or declined; the magnitude, and therefore clinical significance, of the changes was unclear. Given the paucity of the evidence available, the authors' conclusion seems overly strong.

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

Version: 2013

Transient Loss of Consciousness (‘Blackouts’) Management in Adults and Young People [Internet]

There are a number of existing guidelines, for epilepsy, falls and cardiac arrhythmias; which all relate to transient loss of consciousness (TLoC), but there is no guideline which addresses the initial assessment and management of patients who blackout. As such patients may come under the care of a range of clinicians, the lack of a clear pathway contributes to their misdiagnosis, and inappropriate treatment.

NICE Clinical Guidelines - National Clinical Guideline Centre for Acute and Chronic Conditions (UK).

Version: August 2010
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Gingivitis and periodontitis: Overview

Gingivitis (inflamed gums) is usually harmless and goes away quickly. But sometimes gingivitis can spread to the tissues that support our teeth and keep them firmly in place (periodontium). This is called periodontitis. You can read about what can be done to stop it from getting worse and preventative oral hygiene.

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

Version: June 18, 2014

Diarrhea: Overview

Diarrhea is often the result of a viral, bacterial or other type of infection. In Germany and other countries, diarrhea is most commonly caused by rotaviruses. For mild diarrhea, it is often enough to simply drink plenty of fluids so you do not dehydrate, and wait for it to run its course.

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

Version: February 5, 2014

Feverish Illness in Children: Assessment and Initial Management in Children Younger Than 5 Years

It is a requirement of the Children’s National Service Framework that all ill children should have access to high-quality, cost-effective, evidence-based care. Because it is difficult to evaluate the severity of the illness, there is a need for evidence-based guidance to inform healthcare professionals about how to judge whether a child who presents with a fever is likely to develop a serious illness. Healthcare professionals also need advice to support their decision on whether to observe the child, perform diagnostic tests, start treatment such as antibiotics or refer onwards for specialist care. The guidance should also include advice on the best ways to detect fever, the management of fever itself, and what to tell parents and carers who have made contact with healthcare services. The guidance should be applicable to primary and secondary care and should take account of the number of agencies that are involved in giving health care and giving advice to parents and carers. It is also important that parental preferences, as well as the child’s best interests in terms of health outcomes, should be taken into account when considering the various options for investigation and treatment.

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

Version: May 2013
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Transoral Robotic Surgery: A Review of Clinical and Cost-Effectiveness [Internet]

The purpose of this report is to summarize the clinical and cost-effectiveness for the use of transoral robotic surgery (TORS) in the management of early stage oral and oropharyngeal cancer and obstructive sleep apnea (OSA) compared to open surgical techniques, increased doses of chemoradiation, or no treatment.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 12, 2015
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