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Corticosteroids for preventing postherpetic neuralgia

Postherpetic neuralgia is a painful condition that is one of the most common complications of an acute herpes zoster infection. Herpes zoster presents as a localised rash resembling localised chicken pox, often called 'shingles'. Postherpetic neuralgia may persist lifelong once it occurs and has major implications for quality of life and use of healthcare resources. Corticosteroids have a potent anti‐inflammatory action, which it has been suggested might minimise nerve damage and thereby relieve or prevent the pain experienced by people suffering from this condition. Five trials were identified from a systematic search of the literature which were of high enough quality to be included in the review. These trials involved 787 participants in total. We were able to combine the results from two trials (114 participants) and there was no significant difference between the corticosteroid and control groups in the presence of postherpetic neuralgia six months after the onset of the acute herpetic rash. Two of the three other included trials reported results at less than one month, so these participants did not fulfil the current criteria for a diagnosis of postherpetic neuralgia. The last trial reported results in a format unsuitable for meta‐analysis. There were no significant differences in serious or non‐serious adverse events between the corticosteroids and placebo groups. There was also no significant difference between the treatment groups and placebo groups in other secondary outcome analyses and subgroup analyses. It can be concluded that, based on moderate quality evidence, corticosteroids are not effective in preventing postherpetic neuralgia.

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

Version: 2013

Anti‐vascular endothelial growth factor for diabetic macular oedema

Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. The retina at the macula thickens and this can cause gradual loss of central vision. Grid or focal laser photocoagulation is effective in treating DMO and has been used for several years, but vision is rarely improved.

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

Version: 2014

Steroids with antiangiogenic properties for treating neovascular age‐related macular degeneration

Neovascular age‐related macular degeneration (AMD) is associated with rapid loss of vision due to abnormal growth of blood vessels in the macula. Corticosteroids that reduce this growth of blood vessels have been tested for treatment of such vision loss. This review included three trials evaluating two different types of steroids, triamcinolone acetonide and anecortave acetate, for the treatment of neovascular AMD. The findings across the three trials, which included a total of 809 participants, were consistent with no evidence of benefit, in terms of preventing vision loss, with antiangiogenic steroids compared with placebo or photodynamic therapy. Based on available evidence, there is little benefit of steroids with anti‐angiogenic properties in the treatment of neovascular age‐related macular degeneration.".

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

Version: 2013

Systemic corticosteroids for acute gout

‐ there is no precise information about side effects and complications. Only a minority of the patients treated with the steroid oral prednisolone reported minor side effects.

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

Version: 2008

Intravitreal steroids for macular edema in people with diabetes

Macular edema, swelling of the center of the retina (the part of the eye responsible for our sharpest vision), is an important cause of poor vision in patients with diabetes. New forms of therapy are desirable because the current treatment including laser photocoagulation does not control all cases of diabetic macular edema (DME) and because laser therapy may destroy normal retinal tissue. Intraocular steroids in the form of intravitreal triamcinolone acetate injection (IVTA) and surgical implantation of fluocinolone acetonide (FAI) or dexamethasone drug delivery system (DDS) are promising new therapies. This systematic review included seven randomized clinical trials involving 632 eyes from five countries evaluating the effectiveness and safety of intravitreal steroids for treating DME. Two trials were at low risk of bias, one was at median risk of bias, two were at high risk of bias, and the remaining two had an unclear risk of bias. In this systematic review, the preponderance of data suggest a beneficial effect from IVTA. The average improvement in visual acuity was 7.5 letters more (‐0.15 LogMAR; 95% CI ‐0.21 to ‐0.09) in the IVTA treated eyes than in those treated with other therapies at three months (based on three trials), 11.5 letters more (‐0.23 LogMAR; 95% CI ‐0.33 to ‐0.13) at six months (two trials), 14.5 letters more (‐0.29 LogMAR; 95% CI ‐0.47 to ‐0.11) at nine months (one trial), and 5.7 letters more (‐0.11 LogMAR; 95% CI ‐0.20 to ‐0.03) at 24 months (one trial). Improved clinical outcomes were also reported in FAI and dexamethasone DDS trials. Elevation of intraocular pressure and cataract progression occur in both IVTA and implants treated eyes but appear manageable.

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

Version: 2009

Image‐guided versus blind glucocorticoid injection for shoulder pain

This summary of a Cochrane review presents what we know from research on whether using images (e.g. ultrasound) to guide injections into specific sites in the shoulder improves outcomes (e.g., pain, function) compared to no images in patients with shoulder pain.

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

Version: 2012

Treating Infantile Hemangiomas in Children: A Review of the Research for Parents and Caregivers

This summary will answer these questions: What is an infantile hemangioma (IH)? How are IHs treated? What have researchers found about how well the treatments work? What are possible side effects of medicines and laser treatments to treat IHs? What should I talk about with my child's health care professional?

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

Version: June 21, 2016

Comparing Inhaled Nasal Corticosteroids

How do nasal corticosteroids compare in allergic rhinitis?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

Interleukin‐1 inhibitors for acute gout

Gout results from the deposition of crystals of uric acid in and around joints. The main treatments for gout are drugs that lower uric acid blood levels and resolve the crystal deposits. Acute gout flares result in significant pain and disability and treatment aims at reducing the pain and resolving the arthritis quickly.

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

Version: 2014

Grid laser photocoagulation for macular oedema after branch retinal vein occlusion (BRVO)

Review question: We assessed the role of macular grid laser (laser performed in a grid pattern) compared to other new treatments.

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

Version: 2015

Steroids inserted into the eye versus observation for macular edema secondary to central retinal vein occlusion

We aimed to examine the benefits and harms of inserting steroids into the eye for treating macular edema secondary to central retinal vein occlusion (CRVO‐ME).

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

Version: 2015

Topical pimecrolimus for eczema

This review of clinical trials aimed to find out whether topical pimecrolimus is better than topical corticosteroids or tacrolimus for treating eczema in infants, children and adults by assessing the improvement of eczema and adverse events associated with treatments.

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

Version: 2009

Treatments for erosive lichen planus affecting mucosal sites

Erosive lichen planus (ELP) is a condition that affects the mouth, oesophagus (food pipe or gullet), and anogenital region. It is caused by an over‐active immune system. It is often more painful and debilitating than the non‐erosive types of lichen planus. Depending on the site involved, affected individuals may experience pain, and difficulty eating; passing urine; or having sexual intercourse. Treatment is difficult and aimed at controlling symptoms, rather than cure. Several creams and tablets have been used with varying results.

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

Version: 2016

Silicone gel sheeting for preventing the development of hypertrophic and keloid scars and for treating existing hypertrophic and keloid scars

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

Aspirin, steroid and non‐steroidal anti‐inflammatory drugs use for treating Alzheimer's disease

Inflammation may play an important role in the development of Alzheimer’s disease. There is also some evidence from community surveys that people receiving anti‐inflammatory drugs for various medical conditions may be less likely to develop Alzheimer's disease. Fourteen studies met our inclusion criteria for this review and none of the exclusion criteria. Aspirin, steroid and non‐steroidal anti‐inflammatory drugs (NSAIDs) (traditional and the selective cyclooxygenase‐2 (COX‐2) inhibitors) showed no significant benefit in the treatment of Alzheimer's disease. Therefore, the use of these drugs cannot be recommended for the treatment of Alzheimer's disease.         

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

Version: 2012

Stopping long‐acting beta2‐agonists for children well controlled on combination therapy

Asthma is the most common long‐term medical condition in children. Poorly controlled asthma often leads to flare‐ups that require extra treatment, hospital stays, or treatment in the emergency department.

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

Version: 2015

Interventions for the management of oral ulcers in Behçet's disease

This review has been conducted to assess the effects of different interventions, administered systemically or topically, for the prevention or treatment of oral ulcers in people with Behçet's disease. The interventions could be compared with an alternative intervention, no intervention or the administration of a placebo.

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

Version: 2014

Different types of intranasal steroids for chronic rhinosinusitis

We reviewed the evidence for the benefits and harms of different types of intranasal (in the nose) steroids given to people with chronic rhinosinusitis.

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

Version: 2016

Asking men to pass a catheter into their own urethra to try to stop a urethral stricture from coming back

About one in 300 men are affected by a condition called urethral stricture where part of the urethra scars causing it to become narrow. Most urethral strictures are caused by injury or infection. The main symptom is difficulty passing urine. In at least half of patients, urethral strictures come back within two years after they have a surgical operation called optical urethrotomy to stretch their urethral stricture. For this reason there is considerable interest in finding ways to reduce the chance of a urethral stricture coming back.

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

Version: 2015

Drugs for itching in adult palliative care patients

Pruritus is the medical term for itching. This symptom can be a problem in palliative care settings where treatments for cancer or severe kidney disease are given at the same time. In this updated review, we searched for high quality clinical trials of drugs for preventing or treating itch in palliative care.

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

Version: 2016

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