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Nutritional support in children and young people with cancer undergoing chemotherapy

The provision of safe, appropriate and effective nutritional support for children and young people undergoing treatment for cancer is now well recognised as an important part of their care. It may help to reverse malnutrition seen at diagnosis, prevent malnutrition associated with the cancer, promote weight gain and growth and improve quality of life. Nutritional support may be provided by one of two methods: intravenous nutritional liquids delivered through a central or peripheral vein which bypass the gut (parenteral nutrition); or nutritional liquids or solids that pass through any part of the gut, regardless of method of delivery (e.g. orally or via a tube; enteral nutrition).

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

Version: 2015

Dopamine agonists to prevent ovarian hyperstimulation syndrome in women undergoing assisted reproduction technology

OHSS occurs because of overstimulation of the ovaries (female reproductive organs that produce eggs and sex hormones) in fertility treatment (called assisted reproductive technology). It is characterised by enlarged ovaries and movement of fluid from the blood vessels to other body cavities, resulting in abdominal (stomach) bloating, increased risk of blood clots and a reduction in the blood supply to important organs. In most cases, the condition is mild and resolves itself without treatment, but some women develop a moderate or severe form of OHSS, which requires hospitalisation. There is no cure for OHSS other than waiting for it to settle down and reducing symptoms while in hospital. Medicines called dopamine agonists have been introduced to try and prevent OHSS.

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

Version: 2016

Cordyceps sinensis (a Chinese medicinal herb) for treating chronic kidney disease

People with chronic kidney disease (CKD) experience gradual worsening of kidney function. Cordyceps (Cordyceps sinensis), which is sometimes known as Chinese caterpillar fungus, is widely used in traditional Chinese medicine to treat people with CKD. We conducted this review to investigate if Cordyceps was a safe and effective treatment for people with CKD.

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

Version: 2014

Astragalus (a traditional Chinese medicine) for treating chronic kidney disease

Chronic kidney disease affects increasing numbers of people around the world, but as yet, effective strategies to control its progression have not been universally accepted. Astragalus is one of most widely used herbs for treating kidney disease. We conducted this review to evaluate the benefits and potential harms of Astragalus for the treatment of people with chronic kidney disease.

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

Version: 2014

Cordyceps sinensis (a traditional Chinese medicine) for kidney transplant recipients

Kidney transplant recipients need to take several immunosuppressive drugs following surgery to prevent rejection. However, these drugs can cause side effects which compromise long‐term survival for both patients and grafted kidneys.

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

Version: 2015

Androgens for the anaemia of chronic kidney disease in adults

Anaemia, which occurs when red blood cell and haemoglobin levels fall below normal, is a common problem among adults with chronic kidney disease (CKD). Anaemia can cause breathlessness, dizziness and chest pain (angina); reduce ability to think clearly; limits ability to exercise; and contributes to sexual problems, poor appetite and reduced quality of life. Anaemia may also cause longer hospital stays, and sometimes death.

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

Version: 2014

Interventions for problems with swallowing and poor nutrition in patients who have had a recent stroke

Stroke is often complicated by problems with swallowing (dysphagia) and poor nutrition. Normal oral feeding in those with swallowing problems may lead to pneumonia and an increased risk of death. Therapies to improve swallowing are designed to accelerate recovery of swallowing function and reduce the risk of developing pneumonia. We reviewed 33 studies involving 6779 patients (the average age of patients across the studies was 71 years). There was some evidence that acupuncture and behavioural interventions may reduce dysphagia but the roles of drug therapy, neuromuscular electrical stimulation, pharyngeal electrical stimulation, physical stimulation, transcranial direct current stimulation, and transcranial magnetic stimulation remain unclear. Liquid food may be given directly into the stomach through feeding tubes, either via the gullet, using a nasogastric tube (NGT), or directly into the stomach via a percutaneous endoscopic gastrostomy (PEG) tube. Starting tube feeding (with either NGT or PEG) early after stroke may reduce death although the information available remains inconclusive. If longer‐term feeding is required PEG feeding provides better nutrition and is more secure than a NG tube. The available trial evidence does not support the routine use of protein and energy supplements in acute stroke patients who are able to take food by mouth; supplements may show benefit in those who have signs of malnutrition, for example through reducing pressure sores.

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

Version: 2012

Exercise training for adults with chronic kidney disease

Exercise regimens are based on the frequency, intensity and duration of exercise training as well as the type of activity and the individual's initial level of physical fitness. All these factors have to be taken into account when aiming to achieve the goal with the regular exercise training and or rehabilitation.

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

Version: 2011

Tripterygium wilfordii Hook F (a traditional Chinese herbal medicine) for primary nephrotic syndrome

Primary nephrotic syndrome (NS) is a relatively rare kidney disease (diagnosed in up to 7/100,000 children and 3/100,000 adults annually). However the resulting kidney damage causes loss of proteins in urine (proteinuria) leading to low level albumin in the bloodstream, which can cause raised lipids and severe, generalised swelling. Primary NS can also lead to blood clotting (thromboembolism), infection, and acute kidney injury, and may become life threatening. Treatment for primary NS aims to relieve symptoms, avoid complications, and prolong life. Immunosuppressive treatments are of importance for primary NS. In China, a traditional Chinese herbal medicine, Tripterygium wilfordii Hook F (TwHF) has been used for over two decades as an immunosuppressive agent to decrease proteinuria and preserve kidney function. TwHF is prescribed alone or in combination with corticosteroids or other immunosuppressive agents such as cyclophosphamide (CPA).

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

Version: 2013

Dietary patterns for adults with chronic kidney disease

People who have kidney disease can experience a lower life expectancy, complications including heart disease, and may need treatment for severe kidney failure, such as dialysis. Patients and doctors wish to identify treatments that protect people against kidney failure or heart disease. For both doctors and people who have kidney disease, lifestyle changes such as diet are very important as possible ways to improve health and well‐being, and provide people with a chance to 'self‐manage' their care for kidney disease.

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

Version: 2017

No evidence to support or refute glucocorticosteroids for patients with primary biliary cirrhosis

Primary biliary cirrhosis is a chronic progressive cholestatic liver disease of presumed autoimmune aetiology. The clinical course might be improved by glucocorticosteroids. Only two small randomised clinical trials on this topic were identified. The trials were not large enough in terms of sample size or length of follow up to allow changes in mortality to be adequately evaluated. Glucocorticosteroids were associated with improvement in serum markers of inflammation and liver histology, both of which were of uncertain clinical significance. Glucocorticosteroids were also associated with adverse events, including reduced bone mineral density. Further trials are necessary if the effectiveness of glucocorticosteroids is to be properly evaluated.

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

Version: 2008

Cyclosporin A was without significant effects on mortality, liver transplantation, or progression of primary biliary cirrhosis, and patients given cyclosporin A experienced more adverse events

Primary biliary cirrhosis (PBC) is a chronic disease of the liver that is characterised by destruction of bile ducts. Estimates of annual incidence range from 2 to 24 people per million population, and estimates of prevalence range from 19 to 240 people per million population. PBC primarily affects middle‐aged women. The forecast for the symptomatic patient after diagnosis is between 10 and 15 years. The cause of PBC is unknown, but the dynamics of the disease resemble the group 'autoimmune disease'. Therefore, one might expect a noticeable effect of administering an immune repressing drug (immunosuppressant). This review evaluates all clinical data on the immunosuppressant cyclosporin A for PBC.

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

Version: 2009

Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis

Sick preterm infants are easily affected by reduced oxygen levels, cold and poor blood circulation. Their blood becomes acid with a build up of lactic acid (metabolic acidosis) that their kidneys cannot correct. Metabolic acidosis in preterm infants may cause bleeding in the brain (intra or periventricular haemorrhage) and problems with longer‐term neurodevelopment (including hearing, vision and cognitive ability). Solutions of the alkaline sodium bicarbonate or tris‐(hydroxymethyl) amino methane (THAM) can be given to correct the acidity. These solutions are more concentrated than blood (hyperosmolar), which can change blood flow and cause bleeding in the brain, especially when given rapidly or in large quantities. The rationale for their use is to prevent the adverse outcomes that are associated with acidosis in preterm infants.

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

Version: 2011

Protein supplementation of human milk for promoting growth in preterm infants

Not enough evidence to show the effect of protein supplementation of breast milk for promoting growth in preterm babies. Breast milk is the best source of nutrition for full‐term babies but babies born preterm (before 37 weeks) have different nutritional needs. It is possible that premature breast milk may not meet all these needs. Preterm infants need more protein but also use up protein more quickly than full‐term babies. The review of trials found that adding protein to breast milk increases short‐term weight gain and body growth. However, too much protein given in formula can cause problems with infant development in the longer term. More research is needed to find the safest and most effective levels of protein supplementation.

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

Version: 2009

Causes and signs of edema

Edema (or "oedema") means swelling. The condition called edema arises when part of the body becomes swollen because fluid builds up in the tissue. It most commonly affects the arms and legs. That is called peripheral edema.

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

Version: December 30, 2016

Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of plasma cell neoplasms (including multiple myeloma).

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

Version: March 23, 2017

Haemodilution for acute ischaemic stroke

We wanted to compare the effectiveness of haemodilution (diluting the blood) treatment, started within 72 hours of stroke onset, versus control or no treatment in people with ischaemic stroke to assess the impact on death or dependence.

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

Version: 2014

Lipid‐lowering agents for nephrotic syndrome

Nephrotic syndrome is a relatively rare disease in which the kidneys leak protein into the urine. A common early sign is swelling in the feet and face. Other signs and symptoms of nephrotic syndrome include low levels of protein in the blood, and high levels of fats in the blood, particularly cholesterol and triglycerides.

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

Version: 2013

Nutrition for critically ill children in paediatric intensive care units

There is little evidence to support or refute the need to provide nutrition to critically ill children in a paediatric intensive care unit during the first week of their critical illness.

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

Version: 2016

Bile acids for primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterised by progressive inflammation and scarring of liver bile ducts. Destruction of bile ducts leads to incidence of bile flow to the gut, resulting in the development of biliary cirrhosis and end‐stage liver disease. PSC is most common in young males and its aetiology is still not fully understood. The disease is usually classified as an autoimmune disorder, but other aetiological factors cannot be excluded. There is a strong association of PSC with inflammatory bowel diseases, particularly ulcerative colitis, which coexists in approximately 70% of patients. Besides its progressive and irreversible nature, PSC is also associated with an increased risk for cholangiocarcinoma, which contributes to an even higher morbidity and mortality of this disease.

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

Version: 2011

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