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Irregular bleeding associated with infrequent or no ovulation occurs most commonly in adolescents and in women approaching the menopause. It may also occur in those with polycystic ovary syndrome. This irregular bleeding may also be heavy. Hormonal treatments are commonly given to these women, but there is insufficient evidence to recommend whether progestogens alone or progestogens in combination with oestrogen are most effective for irregular uterine bleeding associated with infrequent or no ovulation.

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

Version: 2012

Heparin and related substances, including glycosaminoglycans, chondroitin, low‐molecular‐weight heparin (LMWH), heparinoids, heparitin sulfate, hyaluronic acid and keratan sulphate, have been demonstrated a few positive effects on delaying the progression of diabetic kidney disease (DKD). This review looked for randomised studies assessing the effect of heparin and related substances on preventing the onset of DKD. No study was available. Well designed and high quality randomised studies that address this issue are needed.

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

Version: 2010

Scleroderma is a connective tissue disease causing fibrosis and commonly affects the skin and internal organs such as the GI tract, lungs, kidney and heart. Most people with scleroderma also have raynaud's phenomenon (RP). RP is defined as vasospasm of arteries or arterioles causing pallor and at least one other colour change upon reperfusion such as cyanosis or redness. Primary RP occurs in the absence of causes such as connective tissue disease. Secondary RP occurs in people with underlying diseases that affect blood vessels especially scleroderma and lupus. The RP that occurs in scleroderma is often more severe in that there is not only vasospasm but also a fixed blood vessel deficit with intimal proliferation and therefore narrowing of the blood vessels. Raynaud's phenomenon may also be accompanied by digital ulcers which are possibly secondary to ischemia.

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

Version: 2009

Age‐related macular degeneration (AMD) is a progressive and degenerative disease of the retina, causing blood vessels to develop under the retina which eventually lead to visual impairment. Antiangiogenic therapy is a new approach to the treatment of neovascular age‐related macular degeneration. Interferon is one antiangiogenic agent thought to function by preventing the growth of vascular endothelial cells which help to form these new blood vessels. This review included one randomized controlled trial with 481 participants, all aged over 50 years from 45 different centers. The trial compared interferon alfa therapy to placebo with a follow up of 52 weeks. The proportion of participants who had lost at least three lines of vision at 52 weeks did not differ significantly between the control and treatment groups. The results of the trial were inconclusive and suggested that if anything, the intervention could be harmful. Since several new antiangiogenic interventions are now available, it is unlikely that further studies on interferon alfa can be justified.

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

Version: 2010

Silicone gel sheeting is a soft, self‐adhesive sheet that is applied to intact skin. It is thought to prevent the development of new abnormal scars and also to treat existing scars. This review aimed to assess the evidence on whether silicone gel sheeting prevents the development of abnormal scars in people with newly healed wounds or if it is an effective way to treat existing abnormal scars. Most of the studies identified were of poor quality and it is unclear whether silicone gel sheeting helps prevent abnormal scarring, or is effective in treating existing abnormal scars.

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

Version: 2013

Trachoma is the commonest cause of preventable vision loss and is common in poor communities. Repeated bouts of conjunctivitis caused by chlamydia infection lead to scarring and turning in of the eyelid. The lashes rub the cornea causing opacification and blindness. Environmental sanitation is a package of measures aimed at eliminating factors that encourage proliferation of flies and the spread of the disease. Some of these interventions include provision of water and latrines as well insecticide spray to control flies and health education programmes to improve the personal and environmental hygienic practices of the people. We included six studies involving 12,294 participants of different ages and both sexes in this review. The trials were conducted in The Gambia, Mali, Tanzania, Niger and Ethiopia. Two studies looked at insecticide spray, one looked at insecticide spray and provision of latrines, one study looked at provision of latrines, and two studies looked at health education with one of them having health education combined with water supply. Prevalence of active trachoma, prevalence of Chlamydia trachomatis and fly count measures were the main outcomes assessed. Two studies conducted in the same area found insecticide spray effective in reducing active trachoma but one study in a different setting found the spray ineffective. A separate study found health education on personal and environmental hygiene to be effective in reducing active trachoma, however, another study found that a modest health education programme combined with a modest water supply was not effective in reducing active trachoma. One study on latrine provision found no impact on trachoma. However, more research is needed.

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

Version: 2012

Multiple sclerosis is an illness in which the myelin sheaths around the nerves of the brain and spinal cord are damaged, affecting the ability of nerve cells to communicate with each other. A wide range of clinical presentations and neurological symptoms can occur with the disease, and these can progress to physical and cognitive disability often with a variable clinical course. Although very little is known about the mechanism and causes of this disease genetic, immunologic and environmental factors have all been implicated. Studies have shown a characteristic geographical pattern of disease distribution both in occurrence and progression, which appear to be correlated with sun light exposure and lack of vitamin D and are considered to be predisposing factors for MS. Vitamin D deficiency is said to affect the general well being of patients with MS and is also associated with poorer neurologic outcomes. People suffering with MS are usually given regular vitamin D preparations after assessment of their serum levels of vitamin D.This review sought to evaluate the benefits and harms of this Vitamin D administration to people of MS.The current level of evidence from this review is based on only one trial with potential high risk of bias, which does not at present allow confident decision‐making about the use of Vitamin D in MS. The review authors suggest that until further high‐level evidence is available, clinicians should continue to follow local guidelines when administering vitamin D to people with MS.However, the question of the safety and effectiveness of Vitamin D in people of MS remains unanswered.

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

Version: 2011

Asthma is a common illness causing wheezing, coughing and difficulty with breathing in adults and children. Asthma is becoming increasingly common worldwide and this is especially true in higher income countries. There has been a move towards delivery of asthma care via primary care based asthma clinics in such countries. Such clinics comprise organised routine asthma care within a dedicated, regular time slot; these are usually nurse led and supported by doctors. However it is not yet known whether these clinics are effective.

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

Version: 2012

Kidney transplantation is the treatment of choice for most patients with end‐stage renal disease (ESRD). Strategies to increase donor organ availability and to prolong the transplanted kidney's survival have become priorities in kidney transplantation. Standard immunosuppressive therapy consists of initial treatment and maintenance regimes to prevent rejection and short courses of more intensive immunosuppressive therapy to treat episodes of acute rejection. This review compared tacrolimus and cyclosporin used as primary immunosuppression for kidney transplant recipients. Thirty studies (4102 patients) were included. Tacrolimus was shown to be superior to cyclosporin in improving graft survival and preventing acute rejection after kidney transplantation, but increases post‐transplant diabetes, neurological and gastrointestinal side effects. There was insufficient information to assess the cost of tacrolimus versus cyclosporin, and there was a general failure to consider global quality of life (QOL) for transplant recipients which may inform our understanding of patient preference and compliance.

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

Version: 2008

The aim of this systematic review is to outline the possible benefits (i.e. prolonging survival) and also the disadvantages (adverse events) of therapy with interferon‐alpha, administered alone or in combination with other proven drug regimens (otherwise known as chemotherapy) to patients affected by follicular non‐Hodgkin's lymphoma. Interferons are proteins secreted by vertebrate cells that exhibit various biological actions. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, augment natural killer cell activity, and show several other immunomodulatory functions. Interferons, types alfa‐2a or alfa‐2b, are usually administered in combination with other drugs to treat a variety of infective and neoplastic diseases. The results showed a significant benefit in progression‐free survival in patients treated with interferon‐alpha alone or combined with chemotherapy as compared with comparator therapies. There was, however, less evidence that interferon‐alpha supported any benefit on overall survival. Furthermore, the presence of relevant drug‐related adverse events suggested that a careful analysis of the risks and benefits has to be performed when making a specific clinical decision about this therapy.

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

Version: 2010

Fifty‐one studies with more than 1.6 million participants, mainly of observational nature were included in this systematic review. Studies looked for an association between green tea consumption and cancer of the digestive tract, gynecological cancer including breast cancer, urological cancer including prostate cancer, lung cancer and cancer of the oral cavity. The majority of included studies were of medium to high methodological quality. The evidence that the consumption of green tea might reduce the risk of cancer was conflicting. This means, that drinking green tea remains unproven in cancer prevention, but appears to be safe at moderate, regular and habitual use.

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

Version: 2016

Many different interventions, dosages and administration routes of luteal phase support have been investigated. We made seven different comparisons to prepare a complete overview of this topic.

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

Version: 2016

We reviewed the evidence about the effect of systemic antibiotics on malignant wounds. We were looking for evidence relating to possible side effects of this treatment, and the impact on quality of life and other symptoms.

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

Version: 2017

HIV is still a major cause of death worldwide, particularly in Africa. HIV multiplies in the blood and damages the immune system. Therefore if HIV‐positive, one is more vulnerable to contract infections. The current drug treatment, antiretroviral therapy (ART), stops the virus from multiplying thereby allowing the body's immune system to recover. Interleukin‐ 2 (IL‐2) is a protein in the body which helps the process of multiplication of white blood cells which are the cells that fight infections. Although IL‐2 increases the amount of white cells we do not know if by increasing these we can add additional benefits to the use of ART alone. The aim of this Cochrane Review was to find out if using an extra treatment with antiretroviral therapy (ART), namely IL‐2, compared to using ART alone can reduce illness and death in HIV‐positive adults.

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

Version: May 25, 2017

To evaluate the effectiveness of various techniques of laser photocoagulation in sickle cell disease‐related proliferative retinopathy (development of sight‐threatening complications due to excessive growth of blood vessels in the back of the eye).

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

Version: 2015

After kidney transplantation, patients receive a combination of immunosuppressive medications to prevent rejection of the transplanted kidney. These regimens usually contain a calcineurin‐inhibitor (tacrolimus or cyclosporin A), corticosteroids and an antiproliferative agent (mycophenolic acid (MPA), e.g. mycophenolate mofetil (MMF), or azathioprine (AZA)). MPA is considered to be of stronger immunosuppressive potency than AZA, but the benefits on survival of the graft and its safe use over a long period of time are insufficiently understood.

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

Version: 2015

POVCH is a significant complication following vitrectomy (removal of the vitreous gel from the posterior chamber of the eye) for the treatment of proliferative retinopathy (the growth of abnormal blood vessels from the retina, a layer of tissue at the back of the eye), occurring in approximately 30% of cases. POVCH has two main forms: early, when haemorrhage (bleeding) is present in the first few postoperative days, and late, when haemorrhage occurs a number of months after surgery. The presence of POVCH delays visual recovery, can lead to elevated pressure within the eye, and can make further treatment for diabetic retinopathy difficult. Ten per cent of patients require revision surgery, which has significant implications for resources, time, and cost. The use of anti‐VEGF before surgery (preoperatively) has been proposed as an intervention to reduce the incidence of POVCH.

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

Version: 2015

We reviewed the evidence about the effect of deep anterior lamellar keratoplasty (DALK) (new technique) versus penetrating keratoplasty (standard technique) in people with keratoconus.

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

Version: 2014

We reviewed the evidence concerning the effectiveness and safety of fulvestrant in prolonging time without further progression of cancer in women with advanced hormone‐sensitive breast cancer. We found nine studies testing whether or not fulvestrant is superior to other treatment options.

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

Version: 2017

Diabetic retinopathy is a problem of the back of the eye that occurs in people with diabetes. In later stages of the disease, new blood vessels grow in the back of the eye and cause problems with vision. This advanced form of the disease is known as proliferative diabetic retinopathy. Anti‐VEGF has been developed to block the growth of these new vessels. It has to be injected into the eye.

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

Version: 2014

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