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Interventions for late trabeculectomy bleb leaks

Trabeculectomy is an eye operation in which a drainage fistula is created in the wall of the eye to reduce intraocular pressure, which is the goal of treating glaucoma. The fluid drained from the eye forms a blister‐like reservoir called "filtering bleb" where the fluid from the eye is then absorbed. Extensive scarring of the subconjunctival tissue leads to failure of the operation, therefore, drugs that inhibit cell growth and scar formation are used. Sometimes these drugs lead to thin walled and avascular filtering blebs, which are prone to leaks and infections. Such late‐onset filtering blebs and associated infections are a dangerous and common complication after filtering glaucoma surgery. For late‐onset bleb leaks, various treatments ranging from antibiotic eye drops to surgical closure of the leak have been suggested. The aim of this review was to compare any interventions to treat bleb leaks with conservative treatment and different interventions with each other. The literature search for this review identified only one randomised controlled trial (RCT) that compared two surgical techniques covering the leaking filtering bleb with different types of tissue. The two surgical techniques were (1) conjunctival advancement whereby the conjunctiva (tissue covering the sclera) is dissected and mobilised forward to cover the leaking area, and (2) amniotic membrane transplant. The amniotic membrane is a thin, transparent tissue covering the foetus in the womb that is obtained after birth.

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

Version: 2012

Oral contraceptives to treat cysts of the ovary

Women of reproductive age usually release an egg about once a month. The ovary gets an egg from the inside of the ovary to its surface by creating a blister or fluid‐filled space around the developing egg. When the blister (or cyst) reaches the surface of the ovary, it bursts and releases the egg into the abdominal cavity. After this occurs, the blister can develop into another type of cyst, which makes a hormone (progesterone) that helps the pregnancy to grow. Most of these cysts come and go without problems. Sometimes, however, the cysts get large or painful; others may remain for months. Several decades ago, health care providers learned that women taking birth control pills had fewer cysts, since the pills usually kept an egg from being released. Based on this fact, many clinicians started treating these cysts with birth control pills to make them go away faster.

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

Version: 2014

Antiviral agents for treatment of herpes simplex virus infection in neonates

The virus herpes simplex (herpes) causes a rare but devastating disease in the newborn that can range from skin and eye infection to shock, organ failure, brain infection, and death. Newborn herpes infection is an uncommon complication of active genital herpes in the mother around the time of delivery or after direct contact with a herpes blister ("fever blister", "cold sore") of an infected caregiver. We reviewed five studies conducted to assess the effects of antiviral agents (medications that reduce the spread of virus in the body) on mortality and long‐term complications of herpes disease in the newborn. Antiviral agents were shown to reduce mortality from the condition, but the reduction was not statistically significant due to the small number of infants in the study. There was insufficient trial data to guide caregivers regarding the duration of antiviral therapy or dose.

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

Version: 2009

Unit‐dose packaging of drugs for treating malaria

Malaria is a parasitic disease spread by mosquitoes in areas such as sub‐Saharan Africa, South‐East Asia and South America. Millions of people are infected with malaria each year. It is thought that packaging a course of treatment in units of a single dose may better ensure the correct dosage is taken, thus increasing the success of treatment. The review found insufficient good quality evidence from randomized controlled trials to determine if unit‐dose packaging of drugs saves lives, but there is some indication that it might improve treatment adherence. More research is needed.

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

Version: 2009

Chickenpox: Overview

The typical signs of chickenpox are a very itchy skin rash with red blisters and a mild fever. This contagious viral infection mainly affects preschool and school-age children between the ages of two and ten. Chickenpox is unpleasant, but it rarely leads to any serious complications in otherwise healthy children.

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

Version: April 6, 2017

Endovascular coiling versus neurosurgical clipping for patients with aneurysmal subarachnoid haemorrhage

Endovascular coiling of ruptured aneurysms in the brain leads to a better outcome than surgical clipping. Bleeding on the surface of the brain is called a subarachnoid haemorrhage. The bleeding usually comes from the rupture of a weak spot in an artery carrying blood to the brain. This weak spot is like a small balloon, or blister, which is called an aneurysm. The outcome after subarachnoid haemorrhage is generally poor: half the patients die within one month; and of those who survive the initial month, just under half remain dependent on someone else for help with activities of daily living such as walking, dressing, and bathing. One of the risks in patients with subarachnoid haemorrhage is rebleeding. There are two main ways to try to stop this: operative clipping of the neck of the aneurysm or blocking of the aneurysm from inside by endovascular coiling. This review shows that the number of people who survive and are independent in their daily living is higher after coiling than after clipping. The evidence comes mainly from one large trial.

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

Version: 2008

Interventions for pemphigus vulgaris and pemphigus foliaceus

This review of clinical trials aimed to find out which is the most effective and safest treatment option for pemphigus vulgaris and pemphigus foliaceus.

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

Version: 2009

Interventions for the skin infection impetigo

Impetigo causes blister‐like sores. The sores can fill with pus and form scabs, and scratching can spread the infection. Impetigo is caused by bacteria. It is contagious and usually occurs in children. It is the most common bacterial skin infection presented by children to primary care physicians. Treatment options include topical antibiotics (antibiotic creams), oral antibiotics (antibiotics taken by mouth), and disinfectant solutions. There is no generally agreed standard treatment, and the evidence on what intervention works best is not clear.

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

Version: 2015

What treatment options are there for warts?

Warts are almost always harmless and usually go away on their own after a few weeks or months. But they can be bothersome and unattractive. They may also cause pain, especially on the feet. Different treatments are available that can help warts go away faster.Warts are caused by the human papilloma virus (HPV), of which there are more than 100 different types. Warts are most common on the hands and feet, and on your face. They may also appear in the genital and anal areas. This information does not cover treatment of genital warts.Warts are more common in children and young people. They usually appear one at a time and usually go away on their own within a few weeks or months. So many people decide not to have them treated and just wait until they disappear.Warts can be very bothersome and a real annoyance if they are on a prominent part of the body. Some people also have a lot of warts that have not cleared up. Many of them are interested in getting effective treatment.There are a number of different treatments that can improve the chances of getting rid of warts faster, but they do not always work. There is not yet a treatment that has been shown to help with warts on the bottom of the feet. Because these warts also press inwards, they are especially difficult to treat. Also, new warts may continue to develop afterwards, because a successful treatment does eliminate the possibility of viruses or infected skin cells growing back.Two common treatments for warts are salicyclic acid and cryotherapy. There have also been the most thorough studies into the effectiveness of these treatments.

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

Version: July 30, 2014

Medications or surgery for the treatment of open angle glaucoma

Open angle glaucoma (OAG) is the most common form of glaucoma and an important cause of blindness. Having a high intraocular pressure (IOP) is an important risk factor. Treatment for OAG aims to lower the IOP and thus reduce the risk of progressive loss of vision. IOP can be lowered by medications (eye drops), laser therapy or surgery. There are many different types of eye drops available and these are compared in a Cochrane review (Vass 2007). Surgery for glaucoma has also evolved in the last 40 years. The most common type is called trabeculectomy, or drainage surgery, that creates an opening at the wall of the eye to release fluid and reduce the IOP. Surgery may have complications during and after the operation and may fail in the long‐term due to scarring. Drainage surgery forms a 'bleb' i.e. small blister like elevation on the surface of the eye which can sometimes be uncomfortable.

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

Version: 2012

Pressure ulcers: Overview

If you have to sit or lie in the same position for a very long time, you are at greater risk of developing pressure ulcers (also called bedsores or pressure sores). These wounds take a long time to heal and can be very painful, so it is all the more important to stop them from developing in the first place. Read about how to prevent them and how to help someone who is at risk.

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

Version: September 23, 2015

Calcium antagonists for aneurysmal subarachnoid haemorrhage

A subarachnoid haemorrhage is a bleed in the so‐called subarachnoid space, which is the very small space between the brain and the skull, and which contains blood vessels that supply the brain. The cause of the bleeding usually is a rupture of a bulge in one of these vessels. This bulging or blister on a vessel is called an aneurysm. A subarachnoid haemorrhage is a relatively uncommon type of stroke; it accounts for about one in 20 (5%) of all strokes. Subarachnoid haemorrhage often occurs at a relatively young age: half the patients are younger than 55 years old. The outcome of patients after subarachnoid haemorrhage is generally poor: half the patients die within one month after the haemorrhage, and of those who survive the initial month, half remain dependent on someone else for help with activities of daily living (e.g. walking, dressing, bathing). One of the causes of poor outcome is a complication of subarachnoid haemorrhage called secondary ischaemia (ischaemia means lack of blood). This complication occurs four to 10 days (hence secondary) after the haemorrhage. The cause is not exactly known, but one of the factors involved is narrowing of blood vessels in the brain. Calcium antagonists are a type of drug that block calcium channels in cells and are often used for the treatment of high blood pressure. They have also been shown to counteract the narrowing of blood vessels after subarachnoid haemorrhage and to protect the brain against periods of ischaemia. This review of 16 trials, involving 3361 patients, has found that the outcome after subarachnoid haemorrhage, in terms of survival and being independent in activities of daily living, is improved by treatment with calcium channel blockers (antagonists). If the largest trial is excluded from the analysis, the results are no longer statistically significant, and therefore the evidence is not beyond all doubt. However, given the high likelihood of benefits and the modest risks associated with this treatment, the review authors conclude that calcium antagonists, in the form of oral nimodipine 60 mg every four hours, are useful in patients with subarachnoid haemorrhage from a ruptured aneurysm. Magnesium is another calcium antagonist with promising results, but larger trials with this drug are needed before we can be certain about a beneficial effect.

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

Version: 2008

Treating Infantile Hemangiomas in Children: A Review of the Research for Parents and Caregivers

This summary will answer these questions: What is an infantile hemangioma (IH)? How are IHs treated? What have researchers found about how well the treatments work? What are possible side effects of medicines and laser treatments to treat IHs? What should I talk about with my child's health care professional?

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: June 21, 2016

Interventions for preventing and treating incontinence‐associated dermatitis in adults

Incontinence‐associated dermatitis (IAD) is an inflammation of the skin due to contact with urine or stool. IAD occurs in people with involuntary loss of urine or stool (incontinence). The main symptom of IAD is skin redness. In addition, bullae, skin lesions, and skin infection may occur. IAD affects one to five in ten incontinent adults and is a risk factor for pressure‐related skin problems. To prevent and treat IAD, skin cleansing and skin care products are recommended. Many skin care products and procedures are available. The skin care products can be divided into cleansers, moisturisers, and protectants which may be combined (for example, a cleanser/moisturiser). In practice, products and procedures are the same for both prevention and treatment.

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

Version: 2016

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