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Results: 9

Angiotensin converting enzyme (ACE) inhibitors versus angiotensin receptor blockers for primary hypertension

Hypertension, or persistent high blood pressure above 140/90 mmHg, is a prevalent risk factor that is associated with strokes and heart disease. To prevent these events, angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are used widely to treat hypertension, with ARBs often substituted for ACE inhibitors due to a reputation of having fewer side effects. However, while studies have shown a preventive benefit for ACE inhibitors, there are no such studies for ARBs. Therefore, we aimed to further test this substitution by reviewing studies that directly compared an ACE inhibitor and an ARB.

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

Version: 2014

Antioxidants to reduce pain in chronic pancreatitis

Chronic pancreatitis is a persistent inflammation of the pancreas that in the long run can cause irreparable damage. The major causes of chronic pancreatitis are genetics, alcohol toxicity and other conditions that might damage or obstruct the pancreas. This inflammation can cause pain that often is severe and leaves patients socially isolated and unable to perform their jobs. Unfortunately, treatment options are scarce, and often strong morphine‐like pain medications are needed. Patients might benefit from alternative medication without the adverse effects associated with morphine‐like medication. This review summarises the evidence from randomised trials on the effects of antioxidants in chronic pancreatitis. Antioxidants are substances that prevent damage to cells caused by toxic byproducts of oxygen in the body. Levels of these byproducts are increased in chronic pancreatitis. Antioxidants constitute a large group that contains many natural and man‐made products. Examples include vitamin C, vitamin E, flavonoids (present in tea and cocoa) and many specialised medications. We found 12 randomised trials on this topic. The quality of these trials was mixed, and many had small sample sizes and high rates of dropout. Evidence shows that antioxidants may reduce pain in patients with chronic pancreatitis, but the reported reduction in pain was small. Whether this small decrease really had an impact on patients' complaints is not clear. Given the methodological problems of these trials, a strong conclusion could not be drawn. Use of antioxidants resulted in adverse effects in about 16% of study participants. Most adverse effects were mild, such as headache, nausea and constipation. However, participants who developed these adverse effects tended to stop using antioxidant medication. Other outcomes important for decision making such as use of analgesics, rate of exacerbation of pancreatitis and quality of life, were not very well reported. Therefore, we were unable to reach conclusions on these outcomes.

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

Version: 2014

Effectiveness of dental auxiliaries performing clinical tasks traditionally provided by a dentist

Some tasks undertaken by dentists could be delegated to appropriately trained dental auxiliaries, which might liberate time for dentists to undertake more complex procedures and could improve access to dental care and reduce costs. However, before such an approach can be advocated, it is important to know the relative effectiveness of dental auxiliaries and dentists in providing these tasks.

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

Version: 2014

Motivational interviewing (MI) for alcohol misuse in young adults is not effective enough

We reviewed the evidence about the effect of MI (a two‐way approach of guiding others to bring out and strengthen the reasons for change) for alcohol misuse (risky, damaging or too much drinking) in young people. We found 66 studies.

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

Version: 2014

Methotrexate for treatment of inactive Crohn's disease

Crohn's disease is a chronic inflammatory disease of the intestines that frequently occurs in the lower part of the small intestine, called the ileum. However, Crohn’s disease can affect any part of the digestive tract, from the mouth to the anus. The most common symptoms are abdominal pain and diarrhea. Prevention of clinical relapse (resumption of symptoms of active disease) in patients in remission is an important objective in the management of Crohn’s disease. Methotrexate is a drug that suppresses the body's natural immune responses and may suppress inflammation associated with Crohn’s disease. The purpose of this systematic review was to examine the effectiveness and side effects of methotrexate used to maintain remission in Crohn's patients.

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

Version: 2014

Monitoring of stimulated cycles in fertility treatment involving in vitro fertilisation (IVF) and intra‐cytoplasmic sperm injection (ICSI)

Review question: can ultrasound alone be used safely without adding estradiol blood test measurements to monitor women undergoing controlled ovarian hyperstimulation during IVF and ICSI? We reviewed the evidence on monitoring women undergoing controlled ovarian hyperstimulation as part of IVF or ICSI by transvaginal ultrasound (TVUS) only versus traditional combined monitoring (TVUS) and blood hormone (estradiol) levels.

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

Version: 2014

Advanced training in trauma life support for hospital staff

Training in 'advanced trauma life support' (ATLS) is increasingly used in both rich and poor countries. ATLS is intended to improve the way in which care is given to injured people, thereby reducing death and disability. Some research has been done that suggests ATLS programmes improve the knowledge of staff who have been trained, but there have been no controlled trials to show the impact of ATLS‐trained staff (or staff trained in similar programmes) on the rates of death and disability of injured patients themselves. The review calls for more research and puts forward suggestions about how future research might be conducted.

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

Version: 2014

Advanced training in trauma life support for ambulance crews

Injury is one of the top ten causes of death and disability worldwide. It results in an early loss of life for many young people and ongoing high medical care costs among survivors. Advanced life support (ALS) training for ambulance crews with emphasis on trauma is believed to have contributed to a reduction in the number of deaths from injury in predominantly high‐income countries where this service is available. ALS services are also being adapted for low‐ and middle‐income countries. This review of trials found there is no evidence to suggest that ALS training for ambulance personnel improves the outcomes for injured people.

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

Version: 2014

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

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