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Results: 16

The lateral flow urine lipoarabinomannan (LF‐LAM) test for diagnosis of tuberculosis in people living with human immunodeficiency virus (HIV)

Tuberculosis (TB) is a common cause of death in people with human immunodeficiency virus (HIV) infection, but diagnosis is difficult, and depends on testing for TB in the sputum and other sites, which may take weeks to give results. A rapid and accurate point‐of‐care test could reduce delays in diagnosis, allow treatment to start promptly, and improve linkage between diagnosis and treatment.

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

Version: 2016

Understanding urine tests

Most people will have already given a urine sample  at some point in their lives. Urine samples are needed for urine tests, which are used for things like testing for particular diseases or monitoring their progress. For instance, urine test strips can be used to indicate whether you have a urinary tract infection.

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

Version: January 22, 2013

Urinary alkalisation for uncomplicated urinary tract infections

Urinary tract infection (UTI) is the most common form of bacterial infection among women and can cause pain and frequent urination.

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

Version: 2016

The effectiveness of blood testing in the management of pyelonephritis in pregnancy for improving outcomes

Urinary tract infections (UTIs) are a common infection among women, with most women having developed a UTI at least once in their lifetime. Pyelonephritis, a UTI which affects the upper urinary tract and kidneys, is one of the most prevalent conditions that require hospitalisation among pregnant women. In general, both urine and blood samples are taken for diagnosis and to tailor the necessary antibiotic therapy to the needs of the patient. Some severe cases of pyelonephritis require hospitalisation and intravenous administration of antibiotics. Several previous studies have reported that excluding blood testing or 'blood culture' samples and using only urine samples in managing the condition could be as safe and effective as the current approach, in which both urine and blood samples are analysed. Previous research has also suggested that urine samples render blood samples superfluous, as blood samples offer no additional clinical value for the management of pyelonephritis. Testing only urine samples could also be significantly cost‐saving.

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

Version: 2015

Prophylactic antibiotics to reduce the risk of urinary tract infections after urodynamic studies

Urodynamics is an invasive test which involves inserting a catheter into the bladder in order to help with diagnosis of bladder symptoms. It carries the risk of causing a urinary tract infection. We need to balance the risk of a urinary tract infection and the symptoms associated with such an infection (such as fever, pain passing urine) against the risk and cost of giving prophylactic antibiotics. Some people also pick up an increased number of bacteria in the urine but do not develop the signs of an infection (asymptomatic bacteriuria). We looked at the use of prophylactic antibiotics for the prevention of urinary tract infections and bacteriuria. We identified nine trials including 973 people. We found that people were less likely to have bacteria in their urine after urodynamic studies if they had antibiotics (4% versus 12%). While they did have fewer urinary tract infections (20% compared with 28% with no antibiotics), this did not reach statistical significance. There were too few adverse effects, such as fever, pain when passing urine or a reaction to the antibiotics, for the findings to be reliable. However, people were less likely to have blood in their urine with antibiotics. There was no information about other treatments which might help reduce infections, nor about different doses or types of antibiotics.

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

Version: 2012

Interventions for preventing recurrent urinary tract infections during pregnancy

Recurrent urinary tract infections (RUTI) are common in women generally, and particularly in pregnant women. A urinary tract infection (UTI) is an infection of the urinary tract (bladder, kidneys) due to the presence of bacteria in the urine (bacteriuria). During pregnancy, UTI may be a serious complication that is associated with adverse pregnancy outcomes for both mother and child including preterm birth and small‐for‐gestational‐age babies. Therefore, it is important to define the optimal intervention for preventing RUTI during pregnancy to improve pregnancy outcomes. Interventions used to prevent RUTI in pregnant women can be pharmacological (antibiotics) or non‐pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far, little is known about the best way to prevent RUTI in pregnant women.

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

Version: 2015

Short courses of antibiotics (2‐4 days) are as effective as longer treatment for bladder infections in children.

Bladder and kidney infections (urinary tract infections ‐ UTI) are common in children. Bladder infections cause pain on passing urine and frequency of urination. Some children keep getting repeat bouts. Standard courses of antibiotics (7‐10 days) are used to clear the infection. Shorter courses may reduce adverse effects and costs, but there has been concern that they might reduce the chances of clearing the infection and increase the risk of recurrence. A review of studies found that short courses of antibiotics (2‐4 days) used for bladder infections are as effective as standard courses at clearing UTI, with no increase in recurrence.

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

Version: 2010

Adjustment of antimicrobial agents for adults with sepsis, severe sepsis or septic shock

Broad‐spectrum antimicrobial treatment is defined as the use of an antibiotic or a combination of antibiotics which act against a wide range of disease‐causing bacteria. Broad‐spectrum antimicrobial treatment can reduce mortality rates in patients with sepsis, severe sepsis or septic shock. Sepsis is a serious medical condition which is characterized by an inflammatory response to an infection that can affect the whole body. The patient may develop this inflammatory response to microbes in their blood, urine, lungs, skin or other tissues. However, there is a risk that empirical broad‐spectrum antimicrobial treatment can expose patients to overuse of antimicrobials and increase the resistance of micro‐organisms to treatment. De‐escalation has been proposed as a means of adjusting initial, adequate broad‐spectrum treatment by changing the antimicrobial agent or discontinuing an antimicrobial combination according to the patient's culture results (a means of identifying the microbe causing the infection). In this updated Cochrane review we searched the databases until October 2012. We found no published randomized controlled trials (RCTs). We found one ongoing RCT. There is no adequate or direct evidence on whether de‐escalation of antimicrobial agents is effective and safe for adults with sepsis, severe sepsis or septic shock. Appropriate studies are needed to investigate the potential benefits proposed by de‐escalation treatment.

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

Version: 2013

Urethral Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of urethral cancer.

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

Version: July 19, 2016

Antibiotics for covert bacteriuria in children

Covert bacteriuria occurs when bacteria are found in urine either during routine screening or incidentally during other investigations. Unlike urinary tract infections, children with covert bacteriuria do not appear to have symptoms at the time of diagnosis. There is uncertainty about whether antibiotic treatment can help to clear infection, reduce recurrence, or prevent kidney damage. Any harmful effects of providing treatment also need to be identified and understood.

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

Version: 2012

The accuracy of two imaging tests in detecting vesicoureteral reflux

Some children are born with an anatomic abnormality that allows backwards flow of urine from the bladder to the kidney. This is called vesicoureteral reflux or VUR. Children with VUR have more urinary tract infections and develop more renal scars than children without VUR. This is especially the case if VUR is severe. As such, clinicians are interested in finding out which children have VUR. Unfortunately, testing for VUR (using a voiding cystourethrogram or a VCUG or MCUG) involves bladder catheterisation and exposure to radiation. Accordingly, clinicians are interested in finding alternative tests that could replace the VCUG. The authors compared the accuracy of two other imaging tests (ultrasound and DMSA renal scan) to see whether these could replace the VCUG test. Neither test was found to be sufficiently accurate to replace the VCUG test. Although the DMSA scan seems to be good at ruling out high‐grade VUR, it falsely labels many children as being at risk for high‐grade VUR. Accordingly, DMSA does not appear to be useful as a screening test.

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

Version: 2016

Rapid diagnostic tests for visceral leishmaniasis

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

Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

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

Version: August 11, 2016

Depression (PDQ®): Patient Version

Expert-reviewed information summary about the diagnosis, assessment, and treatment of depression in adults and children who have cancer.

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

Version: March 30, 2016

Last Days of Life (PDQ®): Patient Version

Expert-reviewed information summary about care during the last days to last hours of life, including common symptoms, ethical dilemmas that may arise, and the role of the oncologist in caring for patients and their families during this time.

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

Version: April 8, 2016

Testing Treatments: Better Research for Better Healthcare. 2nd edition

How do we know whether a particular treatment really works? How reliable is the evidence? And how do we ensure that research into medical treatments best meets the needs of patients? These are just a few of the questions addressed in a lively and informative way in Testing Treatments. Brimming with vivid examples, Testing Treatments will inspire both patients and professionals.

Pinter & Martin.

Version: 2011

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