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Prevents bladder infections caused by bacteria from an indwelling urinary catheter. Also helps prevent calcium from clogging the catheter.

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The use of optical spectroscopy for in vivo detection of cervical pre-cancer

In order to investigate the effectiveness of optical spectroscopy for in vivo diagnosis of cervical pre-cancerous conditions, a series of published studies are surveyed. The six optical technologies investigated include fluorescence spectroscopy, reflectance spectroscopy, and their combination using point probe or multispectral imaging approaches. Searching in the well-known databases, the most recent published works were sought out. Various aspects of the studies were evaluated including the details of the technology used, the pathologic threshold for tissue classification and the gold standard, the study population and prevalence of disease in this population, the method of measurement, the number of clinicians involved in the study, the classification and validation algorithms, and the performance in terms of sensitivity, specificity and, when available, the area under the receiver operating characteristic curve. Forty-four studies conducted from 1994 to 2012 were evaluated. The data are gathered in two comprehensive tables, and five illustrations are provided to simplify a comparison between studies from different points of view. There is a broad band of studies from small pilot studies through phase III clinical trials. Among the reviewed articles, only three factors were found to influence the performance of the optical spectroscopy studies. Multispectral approaches show higher specificity than the point probe approaches (p = 0.001). The use of acetic acid before measurement and prevalence of disease among the studied population, also, have an impact on the sensitivity and specificity of the studies (p < 0.05), respectively.

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

Version: 2014

Accuracy of several cervical screening strategies for early detection of cervical cancer: a meta-analysis

This review concluded that thin liquid-based cytology was promising for primary cervical cancer screening in resourced regions, and visual inspection with Lugol iodine could be used in resource-constrained regions. Caution is necessary when comparing the performance estimates for different screening tests, as these were derived from different study populations and the authors excluded many randomised controlled trials.

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

Version: 2012

Radiofrequency ablation for the treatment of liver cancer (hepatocellular carcinoma)

Liver cancer (hepatocellular carcinoma) is the fifth most common cancer worldwide. In the majority of patients, hepatocellular carcinoma is diagnosed at advanced stages of the disease and is mostly accompanied by liver cirrhosis. To date, there is no medical cure for patients with hepatocellular carcinoma, and treatment aims to slow tumour growth. In high‐income countries, about 30% of patients present with the more favourable early hepatocellular carcinoma. For these patients, percutaneous ablation techniques (destruction of the cancer cells by heat, cold, or chemical substances such as ethanol), surgical resection (removal of part of the liver), and liver transplantation (which is limited by organ donor shortage) are currently considered potentially curative treatments. Radiofrequency (thermal) ablation (RFA) is the most elaborated of the percutaneous interventions, so far. Heat caused by alternating electric current is administered by probes that are inserted through the skin (percutaneously).

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

Version: 2014

A systematic review of diagnostic procedures to detect midgut neuroendocrine tumors

This review compared diagnostic yield in tests for midgut neuroendocrine tumours. It concluded that urinary 5-hydroxy indole acetic acid level should be used in patients with flushing/persistent unexplained diarrhoea; abdominal CT scan and OctreoScan should be used for suspected neuroendocrine tumours. Yield estimates were varied within tests and the reported data are not sufficient to support the practice recommendations provided.

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

Version: 2010

The effectiveness of topical negative pressure in the treatment of pressure ulcers: a literature review

This narrative review of the effectiveness of topical negative pressure in the treatment of pressure ulcers concluded that topical negative pressure was not proven to be more effective than other interventions. The reliability of these conclusions is limited by the small size of included studies and the lack of information on participants, outcomes, study selection and data extraction.

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

Version: 2008

Percutaneous ethanol injection for the treatment of early liver cancer

Liver cancer (hepatocellular carcinoma) is the fifth most common cancer worldwide. In the majority of people, liver cancer is diagnosed at advanced stages of the disease and is mostly accompanied by liver cirrhosis. In high‐income countries, about 30% of people present with the more favourable early liver cancer. For these people, percutaneous ablation techniques (destruction of the cancer cells by heat, cold, or chemical substances such as ethanol), surgical resection (removal of part of the liver), and liver transplantation (which is limited by organ donor shortage) are currently considered potentially curative treatments. We aimed to investigate the role of percutaneous injection of ethanol (PEI) and acetic acid (PAI) as compared with other treatments or no intervention for early liver cancer. This review excluded the effects of radiofrequency thermal ablation as this has been already addressed in a previous Cochrane Hepato‐Biliary Group systematic review.

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

Version: 2015

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

Despite limitations with the available evidence, the authors concluded that radiofrequency ablation was more effective in improving three-year overall survival in patients with hepatocellular carcinoma compared with percutaneous ethanol injection. Given the limitations with the included studies, and the potential for bias in the review, the authors' conclusions should be interpreted with caution, as they may not be reliable.

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

Version: 2009

Misoprostol for termination of pregnancy with intrauterine fetal demise in the second and third trimester of pregnancy: a systematic review

The review concluded that among women with foetal death in the second or third trimester, vaginal misoprostol was less effective than oral misoprostol at achieving uterine evacuation within 24 hours, but not within 48 hours. In view of the limitations of the evidence base, small sample sizes and heterogeneity between studies, the authors' conclusions may not be reliable.

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

Version: 2009

Systematic review of topical antimicrobial therapy for acute otitis externa

The authors concluded that topical antimicrobial treatment was very effective for acute otitis externa, although there was little difference between different antimicrobials. Their conclusions about the effectiveness of antimicrobials versus placebo are likely to be reliable, but few studies compared the same treatments and this limited comparisons between antimicrobials.

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

Version: 2006

HPV testing in primary cervical screening: a systematic review and meta-analysis

The review concluded that evidence from good quality RCTs supported cervical cancer prevention via primary screening with HPV testing starting at age 30 or 35. The review conclusions reflect the evidence and are likely to be reliable.

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

Version: 2012

Systematic review: evidence-based management of hepatocellular carcinoma. An updated analysis of randomized controlled trials

The review assessed treatments for hepatocellular cancer published in recent randomised trials. There is evidence of lower recurrence with radiofrequency ablation compared with percutaneous ethanol injection, but no benefit in survival. Systemic treatments do not seem to significantly improve survival. Doubt about whether all relevant studies were included in the review casts some uncertainty on the conclusions.

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

Version: 2006

The effectiveness of topical preparations for the treatment of earwax: a systematic review

This review concluded that current evidence suggests little difference in the efficacy of water-based and oil-based preparations for the treatment of earwax. Non-water, non-oil-based preparations appear most effective for clearing earwax and improving syringing, but further research is needed. Given the limitations of the included studies, the authors were appropriately cautious in their conclusions.

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

Version: 2004

Cervical Cancer Screening (PDQ®): Health Professional Version

Expert-reviewed information summary about tests used to detect or screen for cervical cancer.

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

Version: February 12, 2015

Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2

Since the publication of the NICE clinical guideline on the prevention of healthcare-associated infections (HCAI) in primary and community care in 2003, many changes have occurred within the NHS that place the patient firmly at the centre of all activities. First, the NHS Constitution for England defines the rights and pledges that every patient can expect regarding their care. To support this, the Care Quality Commission (CQC), the independent regulator of all health and adult social care in England, ensures that health and social care is safe, and monitors how providers comply with established standards. In addition, the legal framework that underpins the guidance has changed since 2003.

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

Version: March 2012
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Gastrointestinal Complications (PDQ®): Health Professional Version

Expert-reviewed information summary about constipation, impaction, bowel obstruction, and diarrhea as complications of cancer or its treatment. The management of these problems is discussed.

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

Version: August 28, 2014

Psychosis with Coexisting Substance Misuse: Assessment and Management in Adults and Young People

This clinical guideline covers the assessment and management of adults and young people (aged 14 years and older) who have a clinical diagnosis of psychosis (schizophrenia, bipolar disorder or other affective psychosis) and coexisting substance misuse (harmful use of any psychotropic substance including alcohol and legal or illicit drugs).

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

Version: 2011
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Negative Pressure Wound Therapy Devices [Internet]

The Center for Medicare Management at the Centers for Medicare and Medicaid Services (CMS) requested this report from The Technology Assessment Program (TAP) at the Agency for Healthcare Research and Quality (AHRQ). AHRQ assigned this report to the following Evidence-based Practice Center: ECRI Institute EPC (Contract Number: 290-2007-10063).

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: November 12, 2009
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Local Hepatic Therapies for Metastases to the Liver From Unresectable Colorectal Cancer [Internet]

To characterize the comparative effectiveness and harms of various local hepatic therapies for metastases to the liver from unresectable colorectal cancer (CRC) in two distinct populations: patients with liver-dominant metastases (i.e., majority of disease located in the liver) who are not eligible for continued systemic chemotherapy because their disease is refractory (i.e., they have experienced disease progression while on therapy), and patients who are candidates for local liver therapies as an adjunct to systemic chemotherapy. Local hepatic therapies include ablation, embolization, and radiotherapy approaches.

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

Version: December 2012
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Irrigating solutions for use in root canal treatment of teeth

Root canal treatment may be carried out as an alternative to dental extraction on a tooth in which the nerve has been injured or has died. Root canal treatment is carried out because the offending canal is infected or the pulp severely inflamed. The aim of root canal treatment is to eliminate bacteria from, and prevent their further entry to the root canal system. The technique involves cleaning and removal of any remaining bacteria and nerve canal contents. Elimination of any remaining infection improves the chance of success, and irrigation of the canal with certain types of solutions during the procedure can be helpful in achieving this. A range of antiseptic and antibacterial irrigating solutions are available. Sodium hypochlorite (NaOCl) in a variety of strengths has been used by dentists for many years, but concerns have been raised about its toxicity and the occasional report of pain when higher concentrations are used. Chlorhexidine, an antimicrobial, has also been used in a variety of concentrations as either a solution or gel. Combinations of antibiotic and a detergent (MTAD) have been recently developed and are being used increasingly.

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

Version: 2012

The use of propofol for medium and long-term sedation in critically ill adult patients: a meta-analysis

The authors concluded that using propofol for prolonged sedation in critically ill patients appeared to be safe and may reduce duration of mechanical ventilation. It reduced the length of intensive care unit stay when compared to long acting benzodiazepines, but not when compared to midazolam. The authors' conclusions reflect the evidence presented and are likely to be reliable.

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

Version: 2008

Systematic Reviews in PubMed

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