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Ways of communicating to a woman that she has breast cancer

For women to wait for and receive a first diagnosis of breast cancer (primary diagnosis) is an extremely stressful experience. Studies conducted to date suggest that what a woman is told at this time has the potential to influence her sense of well being, the way she copes with the news, how much she remembers of what was discussed (her recall) and her overall level of satisfaction with the encounter.

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

Version: 2016

Detecting melanoma

In order to detect melanoma early on, you can either check your skin for abnormalities yourself or have a doctor examine it. Skin cancer can be treated more effectively if it is detected before it spreads to other parts of the body.The older you get, the more your skin changes, and new moles or age spots (solar lentigo) may develop. This is a normal part of aging. So some people decide to wait and keep an eye on any skin abnormalities. Others want to know right away if something is wrong, and go to a doctor to have it checked out. But it is only rarely a serious disease like cancer.People who have been diagnosed with melanoma say that the affected mole had changed in size, shape or color before. Carefully checking your skin on a regular basis is a good way to notice any changes. Women often devote more time to skin care than men and are more attentive. So it is often women who find abnormalities.A full-body check involves inspecting every square inch of your skin, including the skin between your toes, on the soles of your feet and on your ears. Some people use a mirror for parts of their body that are difficult to see, or they might ask a friend or partner to help. Keeping a record of things like the size of suspicious-looking moles or taking pictures of them can make it easier to tell later on whether it has changed.It is not always easy to know what kinds of skin changes might be cancer. If you find an abnormality, it is best to have your doctor inspect it more closely if it does not go away after four to eight weeks. Skin cancer is not painful at an early stage. If it does hurt, the cancer may have already reached an advanced stage.

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

Version: September 10, 2015

How does the gallbladder work?

The gallbladder stores and concentrates bile from the liver. The bile then helps to digest and absorb fats from food in the duodenum, the first section of the small intestine.

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

Version: August 7, 2016

Comprehensive review of anticoagulation strategies in renal replacement therapies

Bibliographic details: Mammen C, Brown T, Prestidge T, White CT.  Comprehensive review of anticoagulation strategies in renal replacement therapies. Current Pediatric Reviews 2013; 9(3): 250-266

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

Version: 2013

Tooth decay: Overview

Protecting teeth from tooth decay and cavities is child’s play: A healthy diet, sugary foods and drinks in moderation, and good oral hygiene are the essentials. Here you can find information on the most important dental care products and when you might need fissure sealants on your back teeth.

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

Version: June 18, 2014

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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Antipsychotic medications for cocaine dependence

Cocaine dependence is often associated with medical, psychological and social problems for individual and public health, generating problems for the community. Users play a role in the spread of infectious diseases such as AIDS, hepatitis and tuberculosis, as well as in crime, violence and neonatal drug exposure. Use of drugs such as antidepressants, anticonvulsants and dopamine agonists to treat cocaine abuse or dependence is not supported by evidence from Cochrane reviews. The use of antipsychotic agents has also been considered, particularly because cocaine can induce hallucinations and paranoia that mimic psychosis.

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

Version: 2016

Transcranial magnetic stimulation (TMS) for the treatment of obsessive compulsive disorder (OCD)

Transcranial magnetic stimulation was introduced as neurophysiological technique in 1985 when Anthony Barker and his team developed a compact machine that permitted a non‐invasive stimulation of the cerebral cortex. In addition it has been suggested that TMS could have therapeutic potential. Its' capability for excitation or inhibition of cortical areas in a non‐invasive way represents a remarkable advance in neuroscience researches. Some studies have evaluated the therapeutic effects of repetitive TMS in controlled studies on patients with obsessive‐compulsive disorder observing some changes in their behaviour in terms of compulsive urges or improvements in mood. This review has evaluated the current evidence for TMS as a therapeutic treatment for obsessive‐compulsive disorder (OCD). There is a lack of evidence for the effect of TMS in the treatment of OCD.

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

Version: 2009

The course of non-melanoma skin cancer

Non-melanoma skin cancers include basal cell cancer and squamous cell cancer. Basal cell cancer is the most common kind of skin cancer, but it usually grows slowly. Squamous cell cancer is somewhat more aggressive. Most of these tumors are discovered before they spread to other parts of the body, though.Basal cell cancerBasal cell cancer (basal cell carcinoma) mainly affects people over the age of 40 and is most commonly found on the face, neck or other parts of the head that are frequently exposed to sunlight. It usually grows slowly and stays in the area where it first developed. So it is generally discovered at a stage where it can be completely removed in surgery. But it is still not totally harmless: if it is only treated at a later stage, or not treated at all, it can enter deeper layers of tissue. This can cause damage to things like your nose, eyes and facial bones.Basal cell cancer rarely spreads to other parts of the body (metastasis), so it is rarely fatal. Only about 1 out of 1,000 people who have basal cell cancer die of it.Squamous cell cancerSquamous cell cancer (squamous cell carcinoma) is particularly common in older people over the age of 60. It nearly always develops on parts of the body that are exposed to the sun, especially on the face, ears, lower lip and the back of your hands.Like basal cell cancer, squamous cell cancer grows where it first developed, damaging nearby tissue. But it is more aggressive than basal cell cancer, particularly if it grows in an old scar, a sore, or on your lips or ears.If left untreated, there is a danger that the cancer might spread to other parts of the body. But most squamous cell cancer tumors are discovered before metastases develop. Then it is usually quite easy to treat them. About 40 to 50 out of 1,000 people with this type of cancer die of it.

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

Version: September 10, 2015

Second‐generation antipsychotic drugs for obsessive compulsive disorder

This review found some trials comparing the effects of adding second‐generation antipsychotic drugs or placebo to antidepressants in obsessive compulsive disorder. There were only 11 trials on three second‐generation antipsychotic drugs (olanzapine, quetiapine and risperidone). While not much can be said about olanzapine, quetiapine and risperidone showed some efficacy benefit, but also adverse effects.

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

Version: 2010

Meditation therapy for anxiety disorders

Although meditation therapy is widely used in many anxiety‐related conditions there is still a lack of studies in anxiety disorder patients. The small number of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessive‐compulsive disorders compared with Relaxation/Meditation. Drop out rates appear to be high, and adverse effects of meditation have not been reported. More trials are needed.

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

Version: 2009

A systematic review of the PTSD checklist's diagnostic accuracy studies using QUADAS

Bibliographic details: McDonald SD, Brown WL, Benesek JP, Calhoun PS.  A systematic review of the PTSD checklist's diagnostic accuracy studies using QUADAS. Psychological Trauma: Theory, Research, Practice, and Policy 2014; August 25

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

Version: 2014

Selective serotonin re‐uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) is a common and disabling disorder, which frequently follows a chronic course. It is characterised by intrusive thoughts of imagined harm, which are difficult to dispel, and ritualistic behaviour such as repetitive washing of hands and repetitive checking for risk of harm. Individual randomised controlled trials have demonstrated that antidepressants are effective for OCD. This review summarises all the available evidence for one class of antidepressant drugs, the selective serotonin re‐uptake inhibitors (SSRIs) (including citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline) compared to placebo in the treatment of OCD in adults. The review included 17 studies (3097 participants), and showed that SSRIs were effective in reducing the symptoms of OCD. Based on 13 studies (2697 participants), the review showed that people receiving SSRIs were nearly twice as likely as those receiving placebo to achieve clinical response (defined as a 25% or more reduction in symptoms). Indirect comparisons of effectiveness suggested that although individual SSRI drugs were similar in their effectiveness, they differed in terms of their adverse effects. The most common adverse effect reported by participants was nausea. Further studies involving head to head comparisons between different SSRI drugs are required to obtain more reliable information on differences between SSRIs, both in terms of effectiveness and adverse effects.

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

Version: 2009

Detecting non-melanoma skin cancer

In order to detect non-melanoma skin cancer, you can either check your skin for abnormalities yourself or have a doctor examine it. Non-melanoma skin cancer can be treated more effectively if it is detected before it spreads to other parts of the body.It can be worrying if a spot on your skin changes in size, shape, color or looks abnormal. A lot of people know that changes like this could be a sign of skin cancer. But most suspicious-looking areas of skin are harmless.The older you get, the more your skin changes, and new moles or age spots (solar lentigo) may develop. This is a normal part of aging. So some people decide to wait and keep an eye on any skin abnormalities. It is only rarely a serious medical condition.Carefully checking your skin on a regular basis is a good way to notice any changes, or any wounds that do not heal as quickly as usual. It isn’t always easy to know what is normal and what isn’t. If you find something that looks abnormal to you, it is best to have your doctor inspect it more closely if it does not go away after four to eight weeks. Skin cancer is not usually painful in early stages. If it does hurt, the cancer may have already reached an advanced stage.

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

Version: September 10, 2015

Sclerotherapy (injection techniques) for spider veins on the legs

Sclerotherapy has been used for centuries to treat spider veins. The technique involves the injection of a chemical into the veins. This is sometimes followed by compression with bandages or stockings.

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

Version: 2012

Bismuth revisited: an effective way to prevent travelers' diarrhea

Bibliographic details: Rao G, Aliwalas M G, Slaymaker E, Brown B.  Bismuth revisited: an effective way to prevent travelers' diarrhea. Journal of Travel Medicine 2004; 11(4): 239-24215541227

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

Version: 2004

Is the use of fluoride toothpaste during early childhood associated with discolouration/mottling of teeth?

There is strong evidence that the use of toothpaste containing fluoride can prevent tooth decay (caries) in both children and adults. However, a possible adverse effect associated with the use of fluoride toothpaste is the mottling of permanent teeth due to the swallowing of excessive fluoride by young children with developing teeth. This dental fluorosis can range from, typically, mild white patches on the teeth to severe mottling of the teeth with brown staining. The aim of this review was to evaluate whether the use of fluoride toothpaste by children is associated with an increased risk of developing dental fluorosis in children. The review included 25 studies of different designs; some providing stronger evidence than others. There is some evidence that brushing a child's teeth with a toothpaste containing fluoride, before the age of 12 months, may be associated with an increased risk of developing fluorosis. There is stronger evidence that higher levels of fluoride (1000 parts per million (ppm) or more) in toothpaste are associated with an increased risk of fluorosis when given to children under 5 to 6 years of age. However, for some children (those considered to be at high risk of tooth decay by their dentist), the benefit to health of preventing decay may outweigh the risk of fluorosis. In such circumstances, careful brushing by parents/adults with toothpastes containing higher levels of fluoride would be beneficial.

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

Version: 2010

Treatments for melasma (darker than normal skin occurring in patches)

Melasma is a psychologically distressing skin disorder also known as ‘chloasma’ or ‘mask of pregnancy’. Darker patches of skin gradually develop on the cheeks, forehead, nose, and upper lip. It is more common in women and is associated with pregnancy and medication containing hormones. Melasma is divided into three types: epidermal, dermal, and mixed melasma. Epidermal melasma is the most superficial with an increase in the skin pigment (melanin) in the top layer of skin (epidermis). In dermal melasma, there is increased skin pigment in the second deeper layer of the skin (the dermis). Mixed melasma is a combination of epidermal and dermal melasma.

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

Version: 2010

Head lice: Overview

Head lice are tiny parasites that live in our hair and feed on blood from our scalp. Their bites can itch and some people find them quite repulsive. But there are a number of different effective treatments for getting rid of these bloodthirsty little creatures.

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

Version: December 3, 2015

How can I get enough iron?

The human body needs iron for a lot of reasons. Most of the iron in our bodies is found in our blood. As part of the red pigment in blood, it helps the blood carry oxygen. More severe cases of iron deficiency are often associated with tiredness and exhaustion as a result. People who eat a balanced diet can normally get enough iron that way. 

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

Version: March 20, 2014

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