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Hyaluronidase for cervical ripening and induction of labour

Hyaluronidase injected into the cervix increased cervical favourability but its effect on induction of labour is unknown and its use is not recommended.

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

Version: 2009

Saline irrigation for the management of skin extravasation injury in neonates

Preterm and sick term infants requiring intravenous fluids and medications are vulnerable to tissue injury secondary to extravasation that is, leakage of fluid into the surrounding tissue. Such injury can result in scarring with consequent cosmetic issues and, in some infants, functional limitation. Remedial surgical intervention may be required for some babies. Saline flush out, with or without prior infiltration of hyaluronidase (a protein that helps the breakdown of barriers that hold tissue planes together), is widely used in the management of severe extravasation injury in neonates and aims to prevent or reduce complications following the extravasation. Conservative treatment with normal wound care and various topical dressings is commonly used. We planned to examine if saline flush out with or without prior hyaluronidase infiltration into the injured area resulted in better short and long‐term cosmetic and functional outcomes when compared to normal wound care. We did not find any study that currently answers this question.

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

Version: 2012

Hyaluronidase for reducing perineal trauma during vaginal birth

Vaginal deliveries are associated with perineal trauma that may be unexpected tears or surgical as a result of episiotomy. Many techniques have been used to prevent perineal trauma, such as antenatal perineal massage or perineum warm compresses. Their effectiveness in reducing perineal trauma has been identified by researchers. Perineal hyaluronidase (HAase) injection was widely used in the 1950s and 1960s to reduce the occurrence of perineal trauma, pain, and the need for episiotomy. The review authors searched the medical literature for randomised controlled trials that compared perineal HAase injection during the second stage of labour with perineal placebo injection or no intervention. They identified four randomised controlled trials involving 599 women (with data available for 595 women). The methodological quality of two out of the four trials included in this review was poor.

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

Version: 2014

Systematic review of effectiveness and complications of adhesiolysis in the management of chronic spinal pain: an update

This review assessed adhesiolysis techniques for the management of chronic low back pain due to epidural scarring. The authors concluded that percutaneous and spinal endoscopic adhesiolysis may be effective. Limitations in the review methods and incomplete reporting cast doubt on the reliability of these conclusions.

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

Version: 2007

Interventions for the management of oral submucous fibrosis

Oral submucous fibrosis is a chronic disease which is commonly found in patients in the Asian subcontinent and the Far East and is characterised by the build up of constricting bands of collagen in the cheeks and adjacent structures of the mouth. The precise cause is unknown but chewing of betel quid as well as other areca nut containing products, excessive use of chillies and spices, poor nutrition and vitamin and iron deficiency have been suggested.

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

Version: 2008

Anaesthesia for treating distal radial fracture in adults

Wrist fractures (breaks) are very common, especially in women with osteoporosis. Bone fragments may need to be put back into place. Anaesthesia is used to prevent pain during treatment and several methods are in common use. General anaesthesia involves a loss of consciousness. Regional anaesthesia involves an injection (either into a vein or into tissue surrounding nerves) to numb the injured arm. Local anaesthesia is an injection directly into the fracture site. Sedation usually involves a drug to allay anxiety and promote sleepiness. The review found there was not enough evidence from randomised trials to decide which is the best method.

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

Version: 2009

Induction of Labour

The purpose of this guideline is to review all aspects of the methodology of induction of labour and the appropriateness of different approaches in the various clinical circumstances that may call for such an intervention.

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

Version: July 2008
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Strategies to Reduce Cesarean Birth in Low-Risk Women [Internet]

The Evidence-based Practice Center systematically reviewed evidence addressing strategies to reduce cesarean birth.

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

Version: October 2012
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Pain Management Injection Therapies for Low Back Pain [Internet]

Low back pain is common and injections with corticosteroids are a frequently used treatment option. This report reviews the current evidence on effectiveness and harms of epidural, facet joint, and sacroiliac corticosteroid injections for low back pain conditions.

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

Version: March 20, 2015
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Drug Class Review: Agents for Overactive Bladder: Final Report Update 4 [Internet]

Overactive bladder is defined by the International Continence Society as a syndrome of urinary frequency and urgency, with or without urge incontinence, appearing in the absence of local pathological factors. Treatment of overactive bladder syndrome first requires a clear diagnosis. In patients with incontinence, multiple forms can be present and it is important to determine which form is dominant. Non-pharmacologic, non-surgical treatment consists of behavioral training (prompted voiding, bladder training, pelvic muscle rehabilitation), transcutaneous electrical nerve stimulation, catheterization, and use of absorbent pads. Pharmacologic treatment for overactive bladder syndrome includes darifenacin, flavoxate hydrochloride, hyoscyamine, oxybutynin chloride, tolterodine tartrate, trospium chloride, scopolamine transdermal, and solifenacin succinate. The purpose of this systematic review is to compare the benefits and harms of drugs used to treat overactive bladder syndrome.

Drug Class Reviews - Oregon Health & Science University.

Version: March 2009
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A Systematic Review of the Clinical Effectiveness and Cost-Effectiveness of Pharmalgen® for the Treatment of Bee and Wasp Venom Allergy

Each year in the UK, there are between two and nine deaths from anaphylaxis caused by bee and wasp venom. Anaphylactic reactions can occur rapidly following a sting and can progress to a life-threatening condition within minutes. To avoid further reactions in people with a history of anaphylaxis to bee and wasp venom, the use of desensitisation, through a process known as venom immunotherapy (VIT), has been investigated and is in use in the UK. VIT consists of subcutaneous injections of increasing amounts of purified bee and/or wasp venom extract. Pharmalgen® products (ALK Abelló) have had UK marketing authorisation for VIT (as well as diagnosis) of allergy to bee venom (using Pharmalgen Bee Venom) and wasp venom (using Pharmalgen Wasp Venom) since March 1995.

Health Technology Assessment - NIHR Journals Library.

Version: March 2012
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Drug Class Review: Beta Adrenergic Blockers: Final Report Update 4 [Internet]

Beta blockers inhibit the chronotropic, inotropic, and vasoconstrictor responses to the catecholamines, epinephrine, and norepinephrine. Beta blockers differ in their duration of effect (3 hours to 22 hours), the types of beta receptors they block (β1-selective or β1/β2-nonselective), whether they are simultaneously capable of exerting low level heart rate increases (intrinsic sympathomimetic activity [ISA]), and in whether they provide additional blood vessel dilation effects by also blocking alpha-1 receptors. All beta blockers are approved for the treatment of hypertension. Other US Food and Drug Administration-approved uses are specific to each beta blocker and include stable and unstable angina, atrial arrhythmias, bleeding esophageal varices, coronary artery disease, asymptomatic and symptomatic heart failure, migraine, and secondary prevention of post-myocardial infarction. The objective of this review was to evaluate the comparative effectiveness and harms of beta blockers in adult patients with hypertension, angina, coronary artery bypass graft, recent myocardial infarction, heart failure, atrial arrhythmia, migraine or bleeding esophageal varices.

Drug Class Reviews - Oregon Health & Science University.

Version: July 2009
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Vaginal Birth After Cesarean: New Insights

To synthesize the published literature on vaginal birth after cesarean (VBAC). Specifically, to review the trends and incidence of VBAC, maternal benefits and harms, infant benefits and harms, relevant factors influencing each, and the directions for future research.

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

Version: March 2010
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Protective activity of medicinal plants and their isolated compounds against the toxic effects from the venom of Naja (cobra) species

ETHNOPHARMACOLOGICAL RELEVANCE: Various medicinal plants have protective properties against the toxicities of the venom of cobra snake (Naja species). They may be used as local first aid for the treatment of snakebite victims, and can significantly inhibit lethality, cardio-, neuro-, nephro- and myotoxicity, hemorrhage, and respiratory paralysis induced by the cobra snake venom. The plants or their extracts may also complement the benefits of conventional anti-serum treatment.

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

Version: 2014

Role of adhesiolysis in the management of chronic spinal pain: a systematic review of effectiveness and complications

This review assessed percutaneous adhesiolysis and spinal endoscopic adhesiolysis for chronic low back pain and lower extremity pain. The authors concluded that there is moderate to strong evidence to support percutaneous adhesiolysis with hypertonic sodium chloride and spinal endoscopic adhesiolysis with epidural steroids. Limitations in the reporting of the results make it difficult to adequately assess the robustness of the conclusions.

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

Version: 2005

Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature

This review concluded that there was good evidence for short-term and long-term pain relief with local anaesthetic and steroids for chronic pain emanating as a result of disc herniation or radiculitis and fair evidence for pain relief with local anaesthetic only. These 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: 2012

Percutaneous lysis of epidural adhesions: evidence for safety and efficacy

This review concluded that there was strong evidence that percutaneous adhesiolysis treatment for chronic low back pain was effective in the short term and moderate evidence it was effective in the long term. Complications occured, but evidence was limited. Given the small number of studies and poor reporting in the review, the authors' conclusions should be interpreted with some caution.

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

Version: 2008

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