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Comparison of two surgical techniques for the control of eye pressure in people with glaucoma

Increased eye pressure is the major risk factor for developing glaucoma (a group of eye diseases that lead to progressive, irreversible damage to the optic nerve (the nerve that transmits visual information from the retina to the brain)). Glaucoma is the second biggest cause of blindness worldwide. Eye pressure can be controlled surgically. Trabeculectomy (penetrating eye surgery) is the removal of a full‐thickness block of the trabecular meshwork (eye filtration tissue) to make a hole that allows aqueous (watery fluid present in the front part of the eyes and partly responsible for eye pressure) to filter out of the eye. It is the standard surgical procedure and has been widely practised for over 40 years. Non‐penetrating filtering surgical procedures, in which aqueous is allowed to filter out without the removal of a full‐thickness block of trabecular tissue, also aim to control eye pressure and have the reputation of being safer than trabeculectomy. The most widely practised non‐penetrating surgical procedures for glaucoma are viscocanalostomy and deep sclerectomy. Each procedure involves a different level of partial‐thickness surgical dissection into the eye filtration tissue. Surgical success is defined as lowering the eye pressure to normal limits (less than 21 mmHg) for at least 12 months after surgery. This review included five trials with 311 eyes (267 participants). These studies included 160 eyes which had trabeculectomy compared to 151 eyes that had non‐penetrating glaucoma surgery, of which 101 eyes had deep sclerectomy and 50 eyes had viscocanalostomy. This review showed that trabeculectomy is better in terms of achieving total success (pressure controlled without eyedrops) than non‐penetrating filtering procedures. Although when we looked at the outcome of partial success (pressure controlled with additional eyedrops) it was more imprecise and our results could not exclude one surgical approach being better than the other. However, the review noted that these studies had some limitations regarding their design and were too small to give definitive information on differences in complications following surgery. None of the studies measured quality of life.

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

Version: 2014

Eye patches for corneal abrasion

The aim of this Cochrane Review was to find out what effect using an eye patch for corneal abrasions has on healing and pain relief compared with not patching. Cochrane researchers collected and analysed all relevant studies to answer this question and found 12 studies.

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

Version: 2016

Punctal plugs for dry eye syndrome

The aim of this Cochrane Review was to determine whether punctal plugs, which are inserted into the tear ducts to block tear drainage, can treat dry eye syndrome. Cochrane review authors searched for all relevant studies and identified 18 clinical trials.

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

Version: 2017

Conjunctivitis: Overview

Typical symptoms of conjunctivitis include sticky eyelids in the morning, and itchy and burning eyes. This infection is usually harmless, but it is contagious and can be quite persistent, depending on the cause. Here you can read about effective treatments and how to prevent infection.

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

Version: May 20, 2015

Infectious diarrhea: Traveler's diarrhea

When people travel to faraway countries, their stomach and bowel often have to get used to new foods and new ways of preparing food. Diarrhea is quite common during travels to distant countries. Traveler's diarrhea typically only lasts a few days and usually doesn't need to be treated. There are certain things you can do to try to avoid getting it.The risk is higher in the tropics and subtropics. There are a number of reasons for this. For instance, your stomach and bowel might have a hard time coping with unfamiliar foods such as very spicy dishes and exotic ingredients. Poor hygiene, high temperatures and inadequate cooling of foods make it easier for bacteria to thrive in foods or water. Traveler's diarrhea is most often caused by bacteria. But viruses can also be transmitted through foods or water.If diarrhea is severe or lasts a long time, it is particularly important to replace the lost fluids and salts. You should see a doctor if the symptoms don't improve or if you develop severe diarrhea within a few days or weeks of returning from travels to a distant country.

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

Version: May 4, 2016

What kinds of allergy tests are there?

Various tests can be used to find out what kind of substance is causing an allergic reaction: skin tests, blood tests and challenge tests. Your doctor will usually decide which test to use based on your description of the symptoms and your medical history.

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

Version: April 20, 2016

Hay fever and dust mite allergies: Allergen-specific immunotherapy (desensitization)

People who have hay fever or a dust mite allergy sneeze a lot, and have a runny or stuffy nose. Many of those who have very severe and bothersome symptoms try out allergen-specific immunotherapy (desensitization). This treatment aims to make the immune system “get used to” the substances triggering the allergy, so that it no longer reacts as strongly to them.The goal of allergen-specific immunotherapy is to reduce allergy symptoms in the medium to long term. It has to be repeated regularly and takes quite a long time to start working. This treatment is also known as desensitization. It aims to do exactly that: make the immune system less sensitive. In people who are allergic to something, their body is oversensitive or hypersensitive to an allergen (the substance that causes their allergic reaction). Their body produces antibodies to fight the allergen, even though the allergen is harmless. These antibodies are part of a chain reaction that leads to allergy symptoms. In allergen-specific immunotherapy, people are given allergen extracts to try to train their body to react differently: It’s a bit like being “vaccinated” against your own allergy.Allergen-specific immunotherapy (SIT) can't be used for every allergy. It is called "specific" because the allergen extract has to be tailored to the individual person's allergic response. There are still no suitable SIT extracts for some substances that cause allergies. But there are extracts for many of the common allergens found in the air, for mold, for animal allergens, and for some toxic substances (like the poison in bee stings).

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

Version: March 23, 2017

Topical treatment for blepharokeratoconjunctivitis (BKC) in children

The aim of this Cochrane review was to find out if topical treatment (by eye drops or ointments) for BKC in children improves symptoms and is safe. Cochrane researchers collected and analysed all relevant studies to answer this question and included one study in this review.

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

Version: February 7, 2017

Sublingual immunotherapy (tablets, spray or drops under the tongue) to treat inflammation of the conjunctiva due to allergy

Conjunctivitis means inflammation of the conjunctiva. The conjunctiva is the thin 'skin' that covers the white part of the eyes and the inside of the eyelids. Allergic conjunctivitis is the inflammation of the conjunctiva due to allergy. The most common cause is an allergy to pollen during the hay fever season. Symptoms include red eyes, itching, increased tearing and swelling of the conjunctiva and eyelids. If allergic conjunctivitis is combined with nasal allergy, the condition is termed allergic rhinoconjunctivitis. When medications do not provide enough relief another option is immunotherapy, which builds immunity to the allergen causing the reaction. Immunotherapy can be given under the tongue, nasally or by injection. This review included 42 trials with a total of 3958 participants with allergic conjunctivitis; 2011 who had sublingual immunotherapy and 1947 who had placebo. This review found that sublingual immunotherapy (that is, administered under the tongue) can reduce symptoms of allergic conjunctivitis.

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

Version: 2011

Symptoms of migraines and other types of headaches

Headaches come in many forms. The most common are tension headaches, cluster headaches and migraines. Headaches that have no specific cause such as an illness or injury are referred to as primary headaches. Headaches that are caused by a medical condition or injury are known as secondary headaches. The three most common types of headaches are tension headaches, cluster headaches and migraines. Tension headachesNearly everyone has tension headaches from time to time. The paincan be described as a dull - not pulsating - pain, accompanied by a feeling of pressure or tightness, that is felt on both sides of the head,is mild to moderate,can last anywhere from 30 minutes to several days,usually occurs once a month at most,does not cause nausea, but might be accompanied by sensitivity to light, anddoes not get worse during physical activity.People who have migraines sometimes have tension headaches too.Common types of headaches: Where they typically occur Illustration: Common types of headaches: Where they typically occur - as described in the informationCluster headachesCluster headaches affect only one side of your head, near the temple and around the eye. The headaches are usually on the same side of the head. Cluster headachesare very painful,feel like burning or stabbing pain,last from 15 minutes to three hours,happen very often: every other day, usually several times in one day, andare accompanied by other symptoms such as a stuffy nose or watery eyes.Cluster headaches are quite rare. They are more common in men.MigraineMigraine headaches are not as common as tension headaches. Nevertheless, a lot of adults and children have them. Women have more migraines than men, often before or after their menstrual cycle.Headaches are considered to be migraines after five or more attacks with typical symptoms have occurred. Migraine symptoms typically include the following:Moderate to severe pulsating, throbbing or pounding pain usually concentrated in the front part of your headPain on one side of your head, although it may switch sidesHeadache attacks lasting from at least four hours up to three days (at least two hours in children)Sensitivity to light and/or noiseoften nausea as wellSymptoms that get worse during physical activityMigraines may also be accompanied by vision problems, flashes of light, an impaired sense of smell or unusual skin sensations such as tingling. These disturbances are described as "auras." They may occur before or during migraine attacks. Auras usually go away after about an hour, but may also last longer.A person who has a migraine often needs to lie down somewhere dark and quiet because they find light, sounds and movement unbearable. This heightened sensitivity is one of the main differences between migraines and other types of headaches.Children who have migraines will usually try to avoid bright light. They usually look pale during a migraine attack, and often feel sick and have to vomit. They may also have abdominal (lower belly) pain lasting between one hour and three days. This is called an "abdominal migraine."

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

Version: November 19, 2015

Unusual Cancers of Childhood Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

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

Version: June 23, 2017

Neuroblastoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood neuroblastoma.

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

Version: June 23, 2017

How does our sense of taste work?

The strong link between taste and emotions has to do with our evolution: Taste helped us “test” the food we ate, so it was important for our survival. A bitter or sour taste was an indication of poisonous plants or of rotting protein-rich food. Sweet and salty tastes are often a sign of nutrient-rich foods.

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

Version: August 17, 2016

Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of adult non-Hodgkin lymphoma.

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

Version: July 12, 2017

Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood non-Hodgkin lymphoma.

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

Version: July 12, 2017

Antihistamines as an addition to topical nasal steroids for allergic rhinitis in children

Allergic rhinitis is a very common chronic illness affecting 10% to 40% of children worldwide. Seasonal allergic rhinitis (hay fever) is most common around springtime. The symptoms are mostly sneezing, a runny nose and watery eyes. We looked for trials that compared antihistamines (either oral or topical) in addition to a topical nasal steroid with a topical nasal steroid alone in children who had allergic rhinitis. We wanted to know whether adding antihistamines (oral or topical) in the therapy of children with allergic rhinitis who already use topical nasal steroids would have additional benefits for them. We found one trial that had been carried out in children comparing oral antihistamines in addition to topical nasal steroids with topical nasal steroids alone but it did not provide sufficient data to draw any conclusions. Most of the trials focused only on adults or included a small number of children. Unfortunately, the trials which included children along with adults did not report whether there were any differences in the effect of treatment or adverse effects in children in comparison with adults. We are therefore unable to draw a conclusion as to whether or not this combination therapy has beneficial effect in children with allergic rhinitis or whether the benefits are acceptable in terms of the adverse effects.

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

Version: 2010

Hay fever and dust mite allergies: Medication for the relief of allergic rhinitis

People with seasonal hay fever often have very severe, but temporary, symptoms – for example during the grass pollen season. Others are allergic to dust mites and have allergy symptoms all year round. Whatever the cause of allergic rhinitis, particular medications can relieve it.Although medications for the treatment of allergic rhinitis can have side effects, they are usually well tolerated. Various medications can reduce the symptoms. You can talk with your doctor to find the most suitable one for you.Factors that influence the choice of medication include the severity and type of allergic rhinitis (seasonal or year-round), as well as personal preferences and experiences. For instance, some people would prefer to take tablets rather than use a nasal spray. Others might feel tired when they use a certain medication, and decide to try a different one instead. Age and other things like medical conditions or pregnancy can play a role too.

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

Version: March 23, 2017

Hay fever and dust mite allergies: Overview

If you have hay fever or a dust mite allergy, you’re not alone: These conditions affect about one in four people. Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve these allergies.

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

Version: March 23, 2017

Antibiotics to prevent infection of the brain coverings (meningitis) in patients with basilar skull fracture

Basilar skull fracture (7% to 15.8% of all skull fractures) places the central nervous system in contact with bacteria from the nose and throat and may be associated with cerebrospinal fluid leakage (occurring in 2% to 20.8% of patients). Blood or watery discharge from the nose or ears, bruising behind the ear or around the eyes, hearing loss, inability to perceive odours or facial asymmetry may lead physicians to the diagnosis of basilar skull fracture. Patients with a basilar skull fracture may develop meningitis and some doctors give antibiotics in an attempt to reduce this risk.

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

Version: 2015

Infectious diarrhea: Overview

Diarrhea is very common. It is usually caused by viruses and goes away on its own after a few days. But more severe or longer lasting diarrhea needs to be treated because it can lead to the loss of dangerously high levels of fluid and salt, especially in young children and older people.

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

Version: June 30, 2016

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