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Cholecystectomy is currently advised only for symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. Literature search was performed for evidence from randomised clinical trials to find whether cholecystectomy was indicated in patients with silent (asymptomatic) gallstones. There is no randomised trial comparing cholecystectomy versus no cholecystectomy in silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone‐associated pancreatitis, and/or gall‐bladder cancer for sufficient duration of follow‐up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.

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

Version: 2009

Growth of bacteria in the urine without any complaints (asymptomatic bacteriuria) is commonly detected in women up to 60 years, people with diabetes and in the elderly. It is not clear whether antibiotic treatment for this condition is of benefit for non‐pregnant adults.

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

Version: 2015

Chinese medicinal herbs have a long history in the treatment of liver diseases. Three randomised clinical trials were included. Due to their poor methodologic quality and the existing small number of trials, there is currently insufficient evidence for treating asymptomatic hepatitis B virus carriers with Chinese medicinal herbs like the herbal compound 'Jianpi Wenshen recipe', Phyllanthus amarus and Astragalus membranaceus. Methodologically better and larger randomised trials are needed comparing medicinal herbs versus placebo.

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

Version: 2009

For most people with a narrowing of the carotid artery which is not causing symptoms a surgical operation to remove the narrowing carries a risk and has little benefit. Carotid stenosis is a narrowing of a major artery in the neck taking blood to the brain. This can cause a stroke. If the narrowing is severe and has caused symptoms, surgery to remove the narrowing (carotid endarterectomy) reduces the risk of stroke. However, if the narrowing has not caused any symptoms the risk of stroke is not very high. Although this low risk can be lowered further by surgery, the surgery itself can sometimes cause a stroke or death. The overall effect of surgery is a small benefit.

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

Version: 2008

Indomethacin for very preterm or small babies with signs of PDA but no symptoms can prevent PDA, but more research is needed on long‐term outcomes. A common complication for very preterm (premature) or very small babies is PDA (patent ductus arteriosus). PDA is an open channel between the lungs and heart which should have closed after birth, and can cause life‐threatening complications. Indomethacin is often given to all babies at risk to prevent PDA, but it can cause adverse effects. It can also be given only to those babies who have early signs of PDA, but who have not yet developed symptoms. The review of trials found that this selective use of indomethacin can prevent PDA and has short‐term benefits, but more research is needed on longer term outcomes.

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

Version: 2009

We reviewed the evidence about whether treatment of retinal breaks (holes or tears in the retina) and retinal lattice degeneration (thinning and atrophy of retinal tissue) can prevent retinal detachment, a serious vision‐threatening problem.

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

Version: 2014

A majority of patients with advanced colorectal cancer cannot be cured of their disease. This is because it has spread widely throughout the body and is therefore not resectable. In many of these patients, the original cancer that caused the problem is relatively asymptomatic and the patient is not aware of it. Most of these patients will be treated with a combination of chemotherapy and possibly radiotherapy. From a clinical perspective, a major problem in dealing with these patients is what to do with the primary cancer. Some studies have suggested that resecting the primary cancer can prolong survival and prevent complication arising from the cancer, such as obstruction or bleeding. This review addresses the question of whether surgically removing the primary cancer is beneficial to patients with advanced and unresectable colorectal cancer. No randomised controlled trials were identified.

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

Version: 2012

Asymptomatic bacteriuria is a urinary tract infection (without symptoms) common in pregnancy. If untreated, it can lead to pyelonephritis (kidney infection). Antibiotic treatment is recommended. This review aimed to identify whether single‐dose antibiotic treatments are as effective as longer ones for maternal and newborn outcomes. In general, the risk of bias of trials included in this review was largely unclear. The overall quality of the evidence was assessed using the GRADE approach. The review of 13 studies, involving over 1622 women, found that a seven‐day regimen is more effective than a one‐day course, especially for the outcome of low birthweight (high quality evidence), but this result is based on just one study. There were no clear differences between a single dose and a four‐ to seven‐day short course of antibiotics for other review outcomes, including kidney infection (very low quality evidence) and preterm birth (moderate quality evidence). Women with a single‐dose regimen reported fewer side effects (low quality evidence). More trials are needed to confirm which length of treatment is best for women and babies.

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

Version: 2015

This review, produced through Cochrane Oral Health, seeks to assess the effects of removal compared with conservative management of impacted wisdom teeth, in the absence of symptoms and without evidence of local disease, in adolescents and adults. This is an update of an existing review published in 2012.

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

Version: 2016

Peripheral arterial disease (PAD) is caused by fatty deposits on the walls of the arteries (or atherosclerosis) that leads to narrowing of the arteries (or stenosis) and obstructions in the major vessels supplying the lower legs. PAD can cause discomfort or pain in the lower legs when walking. People with PAD have an increased risk of death, heart and cerebrovascular disease and often receive treatment to manage their cardiac risk. They suffer from significant functional limitations in their daily activities, and the most severely affected are at risk of limb loss. Many people with PAD do not have any symptoms. Only some people have discomfort or pain in the lower legs when walking, so PAD often goes undetected. One possible way to identify this disease is to screen the population at increased risk of PAD. It is important to determine the effectiveness of screening in preventing heart and cerebrovascular diseases or further progression of PAD.

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

Version: 2014

Nasopharyngeal cancer is a rare cancer worldwide, but it is common in the Cantonese population of southern China. Due to its deep location in the nose and non‐specific initial symptoms nasopharyngeal cancer is often detected late. While the prognosis for advanced nasopharyngeal cancer is very poor, early‐stage nasopharyngeal cancer is potentially curable. Therefore early identification by screening might lead to improved outcomes. There are two common screening tests: the Epstein‐Barr virus (EBV) blood test and nasopharyngoscopy (a procedure that allows the internal surfaces of the nose and throat to be examined with a fibre‐optic instrument). Studying the benefits of screening for nasopharyngeal cancer started in the 1970s, but the value of this approach remains uncertain.

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

Version: 2015

Whether testing healthy people for Helicobacter pyloriand treating those infected routinely with a course of antibiotics decreases the number of new cases of gastric cancer.

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

Version: 2015

An aneurysm is a ballooning of an artery (blood vessel), which, in the case of an abdominal aortic aneurysm (AAA), occurs in the major artery in the abdomen (aorta). Ruptured AAAs cause death unless surgical repair is rapid, which is difficult to achieve. Surgery is considered necessary for people with aneurysms of more than 5.5 cm in diameter or who have associated pain, to relieve symptoms and to reduce the risk of rupture and death. However, risks are associated with surgery. Surgical repair consists of insertion of a prosthetic inlay graft, either by open surgery or endovascular repair.

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

Version: 2015

A bacterial infection of the urine without any of the typical symptoms that are associated with a urinary infection (asymptomatic bacteriuria) occurs in a small number (2% to 10%) of pregnancies. Because of the changes happening in their body, pregnant women are more likely to develop a kidney infection (pyelonephritis) if they have a urinary infection, and the infection may also possibly contribute to having a low birthweight baby or preterm birth (before 37 weeks).

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

Version: 2015

Atrial fibrillation is a common cardiac arrhythmia that makes the heart beat rapidly and irregularly. This can occur for brief episodes or may be continuous. Symptoms of the disease include heart palpitations, chest pain, shortness of breath, light‐headedness and fatigue. The condition is rare in those younger than 40 years of age but is more common as people age. Not everyone with atrial fibrillation experiences symptoms, so some people are unaware that they have it; others may experience mild symptoms that they do not attribute to the disease. Atrial fibrillation hinders efficient flow of blood through the heart, resulting in increased risk of clot formation. If these clots leave the heart, they can block the vessels supplying blood to the brain, causing a stroke. Treatment with anticoagulant medication is designed to prevent the formation of blood clots and can reduce the risk of stroke by over 60%.

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

Version: 2016

The popliteal artery is a blood vessel situated behind the knee joint. Sometimes it weakens and expands like a balloon, known as an aneurysm. If left untreated, the blood clot within the aneurysm may embolise or the aneurysm may rupture or get blocked. Any of these complications can lead to limb loss or even death. Traditionally, popliteal artery aneurysm (PAA) has been treated surgically. However, it is also possible to treat the condition by deploying an endovascular stent graft through a small puncture in the groin. An endovascular stent graft is a fabric tube supported by a metal mesh which sits snugly and forms a seal within the artery. The success of the procedure is determined by the ability of the surgically applied graft or the stent graft to remain unblocked. Blockage of the graft decreases the leg circulation, which may require emergency surgery. Some consider the surgical technique to be the gold standard, although the feasibility of the endovascular technique has been well documented in many retrospective studies. Level‐1 evidence is only obtained however when two techniques are pitted against each other in a prospective randomised controlled trial (RCT).

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

Version: 2014

Visceral leishmaniasis (or kala‐azar) is caused by a parasite, results in fever, a large spleen and other health problems, occuring in India, Bangladesh and Nepal, east Africa, the Mediterranean region and Brazil. Without treatment people die, and proper treatment can result in cure, so diagnosis is important. Many of the tests that are used to determine if a person has visceral leishmaniasis are complicated, costly, painful and sometimes dangerous for the patients. Now rapid diagnostic tests that are safe and easy to perform are available.

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

Version: 2014

This Cochrane review found that there was not enough evidence to determine whether one route of bladder drainage was more likely to reduce urinary tract infection than another. The evidence suggests that participants with suprapubic catheters were less likely to have catheter‐associated pain compared with those with indwelling urethral catheters. The quality of evidence in this review was low, and many of the trials did not report important outcomes such as catheter‐associated quality of life and ease of use. The included trials reported few adverse effects, but it is not clear if this is because the adverse effects did not occur or were simply not reported. Because of the limited evidence, we need more high‐quality trials. It is important that these trials report symptomatic urinary tract infection, pain from using catheters, quality of life, adverse effects and ease of use.

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

Version: 2016

The risk of deep vein thrombosis (DVT) is very low in healthy airline passengers. People who have a higher risk can wear compression stockings for prevention.

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

Version: March 23, 2017

It is not clear whether it would be beneficial to routinely test the urine of pregnant women for bacteria (bacteriuria screening). It is also not possible to say whether antibiotics should be used if high levels of bacteria are detected in the urine but there are no noticeable urinary tract problems.

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

Version: December 16, 2015

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