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Conclusions There is limited scientific evidence that elective replacement of peripheral intravenous catheters reduces the incidence and the severity of thrombophlebitis. The appropriate intervals for PIC replacement have not been adequately assessed. No scientific studies have investigated the cost effectiveness of this method.

Swedish Council on Health Technology Assessment (SBU).

Version: June 2, 2005

Superficial thrombophlebitis (ST) is a relatively common inflammatory process associated with a blood clot (thrombus) that affects the superficial veins. Symptoms and signs include local pain, itching, tenderness, reddening of the skin, and hardening of the surrounding tissue. There is some evidence to suggest an association between ST and venous thromboembolism (VTE). Treatment aims to relieve the local symptoms and to prevent the extension of the clot into a deep vein, ST recurrence, or the development of more serious events caused by VTE.

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

Version: 2013

Superficial thrombophlebitis is an inflammatory condition of the veins just below the surface of the skin. The development of superficial thrombophlebitis frequently complicates the insertion of needles into the veins for catheters to give medication or fluids in hospitalised patients. The best treatment for these blood clots in the hands and arms remains unclear. While local treatment has the potential to improve the painful symptoms and patient discomfort, it may not prevent complications, including infection or the extension or transit of the clot into the deep vein system.

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

Version: 2015

This review evaluated evidence for elective replacement of peripheral intravenous catheters (PICs) in adults. The authors concluded that there is limited scientific evidence suggesting that elective replacement of PICs might reduce the risk and severity of thrombophlebitis, and that appropriate intervals for PIC replacement have not been investigated. Though unpublished studies might have been missed, these conclusions appear appropriate.

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

Version: 2006

This review examined the effects of heparin for the treatment of deep vein septic thrombosis. The authors tentatively concluded that the timely use of heparin with appropriate antibiotics may be beneficial. The overall reliability of this conclusion is uncertain, given the lack of controlled evidence and methodological weaknesses in the review process.

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

Version: 2007

The objective of this report is to perform a systematic review of the beneficial and harmful effects of rivaroxaban 15 mg and 20 mg for the treatment of deep vein thrombosis (DVT) and/or pulmonary embolism (PE).

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: August 2015

Constant evolution in techniques to treat varicose veins has been driven by the need for: better patient comfort, reduced side effects and the desire for better and longer-lasting clinical results. New developments towards foam sclerotherapy (FS) warrant questions regarding their clinical and economic evidence. The purpose of this review is therefore to compare the available evidence on FS for patient with varicose veins compared with alternative treatment modalities (i.e., surgery, endovascular thermal ablation, or liquid sclerotherapy) in terms of their comparative clinical effectiveness, safety, cost-effectiveness, and evidence-based guidelines.

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

Version: February 12, 2015

Contraception can be divided into two broad categories: hormonal and nonhormonal. There are two categories of hormonal contraception: combined oestrogen and progestogen and progestogen-only. Long-acting reversible contraception (LARC) is defined in this guideline as methods that require administering less than once per cycle or month.

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

Version: October 2005

Inducing labour with intravenous prostaglandin is effective but has adverse effects. Induction of labour is common when continuing the pregnancy poses a greater risk to the mother or her unborn child. Prostaglandins, produced naturally by the body, can ripen the cervix and stimulate contractions. This review found that giving prostaglandins intravenously during the third trimester of pregnancy is effective in inducing labour, but is more expensive and causes more adverse effects than oxytocin (another hormone for inducing labour).

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

Version: 2013

While younger women with early‐stage, oestrogen‐sensitive breast cancer are almost invariably treated with surgery plus endocrine therapy, (which deprives the cancer of the hormonal stimulus that induces its growth), women over the age of 70 years are frequently offered endocrine therapy alone. This is known as primary endocrine therapy.

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

Version: 2014

Peripheral arterial disease is relatively common, particularly in late middle age. Blockages in the leg arteries can reduce blood flow in the legs enough to cause cramping leg pain that limits walking (termed intermittent claudication). They can become severe and cause critical limb ischaemia, pain at rest, leg ulceration and gangrene that requires amputation. When a patient with critical limb ischaemia is being assessed for vascular surgery or if they are unsuitable or refuse surgery, they are treated conservatively as with bed rest. Drug therapy may be used to relieve symptoms and reduce progression of disease. Vasodilator drugs such as prostaglandins increase local blood flow to the leg but may not improve blockages (stenoses). Naftidrofuryl is also vasoactive and blocks serotonin. It has been used intravenously in severe critical limb ischaemia for rapid effect.

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

Version: 2012

Propofol is an anaesthetic drug (an induction agent) which is given to induce and maintain anaesthesia in adults undergoing surgery. Propofol is a popular induction agent because it provides a smooth induction and faster recovery than other drugs such as thiopental. The main disadvantage of propofol is that it often causes people severe pain. This is because propofol is usually injected into a hand vein and can cause skin irritation. This can make the anaesthesia experience unpleasant. One method for preventing propofol‐induced pain is to give lidocaine either before the propofol injection or mixed in with the propofol. Lidocaine is a commonly used low‐cost local anaesthetic drug. The objective of this review was to determine how effective lidocaine was in reducing the high pain levels caused by the injection of propofol.

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

Version: 2017

About one in five adults have varicose veins. These bumpy, bluish veins are mostly a cosmetic issue for a lot of people. But they sometimes cause heavy-feeling legs, pain or muscle cramps. Read about the treatment options for varicose veins.

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

Version: July 13, 2016

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

This guide summarizes evidence on the effectiveness and safety of three treatments for osteoarthritis of the knee: use of the supplements glucosamine, chondroitin, or both combined; viscosupplementation (injection of hyaluronan into the knee); and arthroscopic lavage and debridement of the knee joint. The evidence evaluated comes primarily from comparisons of each treatment approach with a placebo. This guide does not address other treatments, such as exercise, physical therapy, pain medications, corticosteroid injections, or knee replacement.

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

Version: April 8, 2009

We reviewed evidence about the effectiveness and safety of antimicrobial‐impregnated central venous catheters (CVCs) on bloodstream infections and death in adults who needed a CVC, and found 57 relevant studies.

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

Version: 2016

Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein and then dislodges to travel in the blood (an embolus). A venous thrombus most commonly occurs in the deep veins of the legs or pelvis; this is then called a deep vein thrombosis (DVT). Blood flow through the affected vein can be limited by the clot, and it can cause swelling and pain in the leg. If it dislodges and travels to the lungs, to the pulmonary arteries, it is called a pulmonary embolism (PE), which in some cases may be fatal. VTE as a term includes both DVT and PE. Major risk factors for VTE include a prior history of DVT, age over 60 years, surgery, obesity, prolonged travel, acute medical illness, cancer, immobility, thrombophilia (an abnormal tendency for the blood to clot) and pregnancy.

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

Version: June 2012

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

Mistletoe extracts have been studied in Europe as a treatment for many illness including cancer. Read about the use of mistletoe therapy in cancer patients and the results of clinical trials in this expert-reviewed summary.

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

Version: February 15, 2017

Varicose veins are enlarged tortuous superficial veins at least 3mm in diameter that usually affect the great (GSV) and small (SSV) saphenous veins in the lower limbs. Varicose veins are caused by decreased elasticity of the vein wall and poorly functioning valves within the vein, resulting in blood pooling in the veins and vein enlargement. The symptoms of varicose veins can range in severity from occasional discomfort to severe ulceration of the skin. Approximately 10 to 40% of Western populations have varicose veins, and varicosities can cause considerable disability, resulting in decreased quality of life and loss of work days. If left untreated, varicose veins can progress to chronic venous insufficiency, which increases the likelihood of tissue damage and development of venous stasis ulcers.

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

Version: August 19, 2014

Systematic Reviews in PubMed

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