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Corticosteroids including ACTH (adrenocorticotrophin hormone) for childhood epilepsy other than epileptic spasms

We wanted to assess whether corticosteroids including ACTH are an effective treatment for children with epilepsy. Corticosteroids are sometimes used as an additional therapy to antiepileptic drugs in children with uncontrolled epilepsy. The role of corticosteroids in children with epilepsy is yet to be established.

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

Version: 2015

Drugs for treating headache after a lumbar puncture

Lumbar puncture involves getting a sample of spinal fluid though a needle inserted into the lower back. Post‐dural puncture headache (PDPH) is the most common side effect of a lumbar puncture. The symptom of PDPH is a constant headache that gets worse when upright and improves when lying down. Lots of drugs are used to treat PDPH, so the aim of this review was to assess the effectiveness of these drugs.

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

Version: 2015

Corticosteroids for myasthenia gravis

Myasthenia gravis is caused by the body's antibodies impairing transmission of nerve impulses to muscles, resulting in fluctuating weakness and fatigue. Acute attacks can be life threatening because of swallowing or breathing difficulties. Seven randomised controlled trials which included in all 199 participants are published. None fulfilled the presently accepted standards of a high‐quality trial. All these studies have risks of bias and have a weak statistical power. Limited evidence from randomised controlled trials suggests that corticosteroids offer short‐term benefit compared with placebo (dummy treatment). This supports the conclusions of observational studies and expert opinion. Limited evidence from randomised controlled trials does not show any difference in efficacy between corticosteroids and either azathioprine or intravenous immunoglobulin. All trials had design flaws which limit the strength of the conclusions. Further randomised controlled trials are needed.

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

Version: 2011

The use of anti‐inflammatory corticosteroids for treating acute worsening in people with multiple sclerosis

This review is un update of the Cochrane Review, "Corticosteroids or ACTH for acute exacerbations in multiple sclerosis," first published in The Cochrane Library 2000, Issue 4.

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

Corticosteroids for Guillain‐Barré syndrome

Guillain‐Barré syndrome is an uncommon paralysing illness, usually caused when the person's immune system attacks their own nerves, which consequently become inflamed. In 25% of people affected, the disease leads to a need for artificial ventilation. About 5% of people with the disease die and about 10% are left disabled. Corticosteroids (such as prednisolone) reduce inflammation and so should reduce nerve damage.

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

Version: 2016

Medical and surgical treatment for ocular myasthenia

Ocular myasthenia is a form of myasthenia gravis in which weakened eye muscles cause double vision or drooping eyelids. It accounts for approximately 50% of people with myasthenia gravis. Myasthenia gravis is an autoimmune disorder in which the body's own antibodies block the transmission of nerve impulses to muscles, causing fluctuating weakness and muscles that tire easily. Approximately half of people who have ocular myasthenia will go on to develop generalised myasthenia gravis and weakness affecting other muscles. For the majority of people this will be within the first two years of developing ocular symptoms.

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

Version: 2012

Prostate Cancer: Diagnosis and Treatment

The original Prostate Cancer: Diagnosis and Treatment Guideline published in 2008 was the first clinical guideline produced by the National Collaborating Centre for Cancer (NCC-C); accordingly this is now the first NCC-C clinical guideline to be reviewed and updated. Many areas of the original guideline are unchanged as there is little or no new evidence; other aspects have been completely rewritten. As ever there are still many topics where the research evidence is incomplete or conflicting, and so the Guideline Development Group (GDG) have been required to reach a consensus using the evidence available to them in several areas. In places where it was clear that further work needed to be done, new research recommendations have been made which we hope will be used as the basis for future research work.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: January 2014
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Practice parameter: medical treatment of infantile spasms. Report of the American Academy of Neurology and the Child Neurology Society

OBJECTIVE: To determine the current best practice for treatment of infantile spasms in children.

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

Version: 2004

Comparative Clinical and Cost-Effectiveness of Drug Therapies for Relapsing-Remitting Multiple Sclerosis [Internet]

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system that is more common in women than in men, by a factor of approximately 3:1. Canada has the fifth-highest worldwide prevalence at 240 per 100,000 persons.

CADTH Therapeutic Review - Canadian Agency for Drugs and Technologies in Health.

Version: October 2013
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Pasireotide (Signifor): Treatment of Adult Patients with Cushing Disease [Internet]

Cushing disease is a rare disease caused by persistent exposure to excess glucocorticoid due to abnormal secretion of adrenocorticotrophic hormone (ACTH) from a pituitary adenoma. Major clinical signs and symptoms include obesity, hypertension and cardiovascular disease, glucose intolerance, dyslipidemia, fatigue and muscle weakness, various dermatologic manifestations, neuropsychological changes, bone loss, and limited immune function. Cushing disease is associated with a decrease in quality of life (QoL) and increased mortality primarily due to cardiovascular complications. First-line treatment is surgical resection of the pituitary tumour; however, remission is not always achieved and even when it is, up to 25% of patients will experience recurrence in the long term. Despite poor evidence of efficacy and significant safety concerns, several drugs that have not been approved by Health Canada to treat Cushing disease have been used in these patients in clinical practice.

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

Version: August 2015
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Autism: Recognition, Referral, Diagnosis and Management of Adults on the Autism Spectrum

Autism is a lifelong condition with particular issues for adults, which are addressed by this NICE guideline. While some people are diagnosed in childhood, a large proportion of adults with autism find obtaining a diagnosis in adulthood difficult or impossible. Under-recognition of autism in adults can lead to inadequate care, masking of coexisting mental and physical health problems, and to social and economic exclusion. This guideline aims to address these widespread problems and increase the uptake of interventions by adults with autism to enable them to live more independent lives.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Atopic Eczema in Children: Management of Atopic Eczema in Children from Birth up to the Age of 12 Years

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

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

Version: December 2007
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Efficacy of high-dose ACTH versus low-dose ACTH in infantile spasms: a meta-analysis with direct and indirect comparison of randomized trials

Bibliographic details: Zeng L, Luo R, Zhang L.  Efficacy of high-dose ACTH versus low-dose ACTH in infantile spasms: a meta-analysis with direct and indirect comparison of randomized trials. Journal of Pediatric Neurology 2011; 9(2): 141-149

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

Version: 2011

A systematic review of the adjunctive use of systemic corticosteroids for pulmonary tuberculosis

This review assessed adjunctive systemic corticosteroids in the treatment of pulmonary tuberculosis (PTB). The authors concluded that adjunctive systemic corticosteroids can safely provide significant clinical and radiologic benefits for selected patients with advanced PTB. Since most of the included studies were conducted over 20 years ago, the relevance of the results to current practice is unknown.

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

Version: 2003

Bacterial Meningitis and Meningococcal Septicaemia: Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care

This guideline covers bacterial meningitis and meningococcal septicaemia, focusing on management of these conditions in children and young people aged younger than 16 years in primary and secondary care, and using evidence of direct relevance to these age groups where available.

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

Version: 2010
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Tuberculosis: Prevention, Diagnosis, Management and Service Organisation

This guideline makes recommendations on the prevention, diagnosis and management of latent and active tuberculosis (TB), including both drug susceptible and drug resistant forms of the disease. It covers the organisation of relevant TB services. It relates to activities undertaken in any setting in which NHS or public health services for TB are received, provided or commissioned in the public, private and voluntary sectors.

NICE Guideline - Internal Clinical Guidelines Team (UK).

Version: January 2016
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Which method is best for the induction of labour? A systematic review, network meta-analysis and cost-effectiveness analysis

For women with favourable cervix, the study found that misoprostol and oxytocin with amniotomy are more likely to be successful than other agents in achieving vaginal delivery within 24 hours. Cost-effectiveness analysis suggested that titrated (low-dose) oral misoprostol solution and buccal/sublingual misoprostol were most likely to represent value for money, although there was a lot of uncertainty in the cost-effectiveness estimates.

Health Technology Assessment - NIHR Journals Library.

Version: August 2016
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Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care

This guideline has been developed to advise on the treatment and management of bipolar disorder. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, patients and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high quality care for those with bipolar disorder while also emphasising the importance of the experience of care for patients and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2006
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Coeliac Disease: Recognition, Assessment and Management

Coeliac disease is an autoimmune condition associated with chronic inflammation of the small intestine, which can lead to malabsorption of nutrients. Dietary proteins, known as glutens, which are present in wheat, barley and rye activate an abnormal mucosal immune response. Clinical and histological improvements usually follow when gluten is excluded from the diet.

NICE Guideline - Internal Clinical Guidelines Team (UK).

Version: September 2015
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Systematic Reviews in PubMed

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