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Somatostatin analogues in the treatment of recurrent bleeding from gastrointestinal vascular malformations: an overview and systematic review of prospective observational studies

This review concluded that a significant number of patients with bleeding gastrointestinal angiodysplasia responded to treatment with octreotide by reducing the need for blood products. The possibility of publication bias and the small sample sizes and lower quality study designs suggest that the authors' 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: 2010

Percutaneous sclerotherapy for vascular malformations: a systematic review

BACKGROUND: This systematic review assessed the available published evidence on the safety and efficacy of percutaneous sclerotherapy for patients with congenital vascular malformations.

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

Version: 2014

Childhood Vascular Tumors Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of childhood vascular tumors.

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

Version: April 4, 2017

Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins

Varicose veins are dilated, often palpable subcutaneous veins with reversed blood flow, most commonly found in the legs. Estimates of the prevalence of varicose veins vary. Visible varicose veins in the lower limbs are estimated to affect at least a third of the population. There is little reliable information available in the literature on the proportion of people with varicose veins who progress to venous ulceration. One study reported that 28.6% of those who had visible varicose veins without oedema or other complications progressed to more serious venous disease after 6.6 years.83 However there was no information about the numbers progressing to ulceration. Other data on the lifetime prevalence of varicose veins estimate that approximately 3–6% of people who have varicose veins in their lifetime will develop venous ulcers.71 Risk factors for developing varicose veins are unclear although prevalence rises with age and they often develop during pregnancy. In some people varicose veins are asymptomatic or cause only mild symptoms, but in others they cause pain, aching or itching and can have a significant effect on their quality of life. Varicose veins may become more severe over time and can lead to complications such as changes in skin pigmentation, eczema, superficial thrombophlebitis, bleeding, loss of subcutaneous tissue, lipodermatosclerosis or venous ulceration.

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

Version: July 2013
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Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

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

Version: 2010
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Computed tomography angiography or magnetic resonance angiography for detecting blood vessel abnormalities in patients with intracerebral haemorrhage

Blood vessel abnormalities are the leading cause of bleeding in the brain (known as intracerebral haemorrhage) in young adults. Early detection of blood vessel abnormalities may improve outcome if treatment can prevent bleeding recurrence. This review looked at different tests used to identify blood vessel abnormalities in the brain. Intra‐arterial digital subtraction angiography (IADSA) is the standard test used and involves positioning a tube, introduced through a blood vessel in the groin, into blood vessels near the brain. Dye is directly injected into the brain's blood vessels using this tube. Computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) are newer tests that may be done without any injections (MRA) or only through an injection into the arm (CTA and MRA). This review investigated the accuracy of CTA or MRA, or both, compared with IADSA after intracerebral haemorrhage. We found eight studies (involving 526 participants) that compared CTA with IADSA and three studies (involving 401 participants) that compared MRA with IADSA. Both CTA and MRA appear to have good accuracy when compared with IADSA. However, the studies were small and were limited in many cases by their design. Further research that looks at accuracy, practicality, and costs is needed.

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

Version: 2014

Antenatal Care: Routine Care for the Healthy Pregnant Woman

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

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

Version: March 2008
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Computed Tomography Angiography for Diagnosis of Stroke or Transient Ischemic Attack: A Review of the Clinical Effectiveness [Internet]

The objective of this report is to review the evidence with respect to clinical effectiveness of computed tomography angiogram (CTA) in the diagnosis of patients presenting with symptoms of stroke or transient ischemic attacks (TIA).

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

Version: November 30, 2016
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Vein Illumination Devices for Vascular Access: A Review of Clinical Effectiveness [Internet]

The purpose of this report is to retrieve and review the existing evidence on the efficacy of vascular transillumination devices for pediatric patients in acute care settings.

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

Version: November 29, 2016
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Treatment of brain arteriovenous malformations: a systematic review and meta-analysis

The authors of this review noted a decrease in mortality over time, but stated that treatment of brain arteriovenous malformations remained associated with considerable risks and incomplete efficacy. They recommended that randomised controlled trials should be conducted to compare different treatments for the condition. This recommendation appears appropriate given that the review located only observational studies (which cannot determine causality).

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

Version: 2011

Acardiac twin: a systematic review of minimally invasive treatment modalities

This review of the literature aimed to determine pregnancy outcomes after minimally invasive treatment for occluding vascular supply to acardiac twins. A MEDLINE search was performed until 2002 using the terms 'acardiac', 'acardius', 'twin reversed arterial perfusion (TRAP) sequence' and 'chorangiopagus parasiticus' and 207 articles published in the English-language literature were identified. These articles and the corresponding cited references in English were reviewed. We identified 32 reports involving 74 cases of acardiac twin treated by minimally invasive techniques. Seventy one cases were included for analysis including 40 treated by cord occlusion and 31 by intrafetal ablation. Cord occlusion was first attempted by embolization (n = 5), cord ligation (n = 15), laser coagulation (n = 10), bipolar diathermy (n = 7) and monopolar diathermy (n = 3). Intrafetal ablation was performed by alcohol (n = 5), monopolar diathermy (n = 9), interstitial laser (n = 4) and radiofrequency (n = 13). The overall median gestational ages at treatment and delivery were 21 (range, 14-28) weeks and 36 (range, 19-42) weeks, respectively, with a median treatment-delivery interval of 13 (range, 0-25) weeks. The overall pump twin survival rate was 76% (n = 54). Intrafetal ablation was associated with later median gestational age at delivery (37 vs. 32 weeks, P = 0.04) and higher median treatment-delivery interval (16 vs. 9.5 weeks, P = 0.02) compared with cord occlusion techniques. It was also associated with a lower technical failure rate (13% vs. 35%, P = 0.03), lower rate of premature delivery or rupture of membranes before 32 weeks (23% vs. 58%, P = 0.003) and higher rate of clinical success (77% vs. 50%, P = 0.02) than cord occlusion techniques. There were no statistically significant differences in terms of outcome between the subgroups of fetoscopic- or ultrasound-guided cord occlusion techniques. This review suggests that intrafetal ablation is the treatment of choice for acardiac twins because it is simpler, safer and more effective when compared with the cord occlusion techniques.

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

Version: 2003

Omega-3 Fatty Acids and Maternal and Child Health: An Updated Systematic Review

To update a prior systematic review on the effects of omega-3 fatty acids (n-3 FA) on maternal and child health and to assess the evidence for their effects on, and associations with, additional outcomes.

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

Version: October 2016
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Autism: The Management and Support of Children and Young People on the Autism Spectrum

This guideline has been developed to advise on the management and support of children and young people on the autism spectrum. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, children and young people with autism, their carers 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 children and young people with autism while also emphasising the importance of the experience of care for children and young people with autism and their carers.

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

Version: August 2013

Safety of Vaccines Used for Routine Immunization in the United States

To conduct a systematic review of the literature on the safety of vaccines recommended for routine immunization of children, adolescents, and adults in the United States as of 2011.

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

Version: July 2014

Prenatal exposure to misoprostol and congenital anomalies: systematic review and meta-analysis

This review concluded that prenatal exposure to misoprostol is associated with an increased risk of Mobius sequence and terminal transverse limb defects. This appears to be a well-conducted review and the authors' conclusions appear to be supported by the findings. However, the poor quality of the limited number of included studies suggests that the findings should be interpreted with caution.

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

Version: 2006

Diagnosis and Management of Infantile Hemangioma [Internet]

To systematically review evidence addressing the diagnosis and management of infantile hemangiomas (IH).

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

Version: January 2016
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Stereotactic Body Radiation Therapy [Internet]

Conduct a systematic literature scan for published data for the treatment of stereotactic body radiation therapy (SBRT) and provide a broad overview of the current state of SBRT for solid malignant tumors.

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

Version: May 2011
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Health Effects of Military Service on Women Veterans [Internet]

Women Veterans are among the fastest growing groups of new VA health care users of the VA healthcare system, and currently reflect approximately eight percent of all U.S. Veterans. With Operation Enduring Freedom and Iraqi Freedom (OEF/OIF), women comprise a larger percentage of the military (11.3 percent) than of prior military operations. As of fiscal year 2010, 51.3 percent of female OEF/OIF Veterans had enrolled in VA health care, in sharp contrast to women from previous eras (an estimated 11 percent). Of this group, 88 percent have used VA health care more than once.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: May 2011

Routine echocardiography in the management of stroke and transient ischaemic attack: a systematic review and economic evaluation

Study found that, transthoracic echocardiography in second harmonic imaging mode is a cost-effective use of NHS resources in those cases where clinicians deem it the most appropriate method of testing to identify cardiac sources of stroke and transient ischaemic attack. However, the study highlights that there is a lack of evidence in several areas and the results of the economic evaluation should be treated with caution.

Health Technology Assessment - NIHR Journals Library.

Version: March 2014

Screening for Bilirubin Encephalopathy [Internet]

Kernicterus or chronic bilirubin encephalopathy is a devastating disease. Thus, it is important to examine strategies to prevent the development of kernicterus.

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

Version: October 2009
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