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Emergency sclerotherapy is not better than pharmacological therapy for acute variceal bleeding in cirrhosis

Variceal bleeding in cirrhosis is associated with a high risk of death. Although banding ligation of varices is considered the choice for endoscopic treatment, emergency sclerotherapy is frequently used particularly where ligation is not available or when it is not feasible. However, vasoactive drugs stop bleeding in most patients, and emergency sclerotherapy may carry risks to the patient and is more demanding on the health‐care system. All of the identified randomised clinical trials comparing emergency sclerotherapy with vasopressin (+/‐ intravenous or transdermal nitroglycerin), terlipressin, somatostatin, or octreotide have been reviewed. A total of 17 randomised trials including 1817 patients were included. Sclerotherapy did not appear to be superior to the vasoactive drugs in terms of control of bleeding, number of transfusions, 42‐day rebleeding and mortality, or rebleeding and mortality before other elective treatments. However, adverse events were significantly more frequent and severe with sclerotherapy than with vasoactive drugs.

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

Version: 2010

Interventions to prevent blood loss during the treatment of pre‐cancerous abnormalities in the cervix (cervical intraepithelial neoplasia).

Surgery for pre‐cancerous cervix lesions (cervical intraepithelial neoplasia) often causes significant bleeding during surgery or within 14 days. This review found that good surgical technique can reduce immediate blood loss and bleeding can also be reduced by some drugs. Vasopressin reduces blood flow by constricting blood vessels. Tranexamic acid reduces blood loss after knife and laser cone biopsy. Stitches also reduce blood loss but can interfere with later visual examination of the cervix.

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

Version: 2014

How does the pituitary gland work?

The pituitary gland regulates important body functions and the hormonal system. For instance, it regulates body temperature, heart beat and urine production, as well as sleep, hunger and thirst. About the size of a pea, it is a protrusion at the base of the brain. The gland lies well protected in a small cavity of the cranial bones, level with the nose, and in the middle of the head.

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

Version: January 7, 2015

Bedwetting: Overview

Bedwetting is more common among children and teenagers than you might think. Regular “accidents” in the middle of the night can be troubling for the entire family. But the problem usually goes away on its own over time. There are various things you can do to help your child in the meantime.

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

Version: February 6, 2014

Unusual Cancers of Childhood Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

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

Version: February 2, 2017

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