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Wound cleansing to help pressure ulcers heal.

Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the elderly, malnourished or acutely ill, who cannot reposition themselves. The three trials identified found no good evidence that cleansing pressure ulcers (bed sores) using a particular technique, or cleansing with a particular solution, helps healing. Very little research has studied the cleansing of pressure ulcers and therefore we are unable to draw any firm conclusions.

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

Version: 2013

Replacing heparin with saline to prevent complications in long term central venous catheters in children

A central venous catheter (CVC) is a long, thin, flexible tube which is inserted into a large central vein. This enables access to the blood stream for people with serious medical conditions to receive medications and fluids, as well as the collection of blood specimens. Long term central venous catheters are used to access the blood system in children with complex medical conditions like cancer. To stop the catheter from becoming blocked it is usual to use heparin, a drug that prevents clots forming, to flush the catheter. However, some studies have shown that heparin is not necessary, and that normal saline (a sterile salt water solution) can be safely used instead. Heparin may be associated with complications, such as bleeding and infection, along with higher costs for health care providers. While the complications such as infections and occlusions are uncommon, practices vary around the world and there are many inconsistencies regarding the best flush solution to use to prevent complications in long term catheters.

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

Version: 2015

Nasal saline irrigation for acute upper airway infection symptoms

Acute upper respiratory tract infections (URTIs) include colds, influenza and infections of the throat, nose or sinuses. They are usually self limiting viral infections, though sometimes symptoms may persist for many weeks beyond the clearance of the initial infection, with or without establishment of secondary bacterial infections. The aim of treatment is predominantly for relief of symptoms, though some treatments may have a role in reducing the duration of post‐viral symptoms, such as cough. Saline nose spray and larger volume nasal washes have become more popular as one of many treatment options for URTIs, and they have been shown to have some effectiveness for chronic sinusitis and following nasal surgery. However, little is known about their effectiveness in the treatment of acute URTI or which symptoms they may be effective for.

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

Version: 2015

Intravenous fluids for preventing prolonged labour in women giving birth to their first baby

Labour may be considered to be a period of prolonged exercise. Labouring women may become dehydrated as a result of the physical exertion caused by the muscles of the womb contracting. In many institutions women are subjected to a questionable policy of restricted oral intake. Only sips of water or ice chips are allowed. In institutions where this is employed, women are given routine intravenous fluids (through a "drip").The aim of this review was to evaluate the impact of the routine administration of intravenous fluids (using a 'drip') on the duration of labour in women who were in their first pregnancy. We also wanted to determine any side‐effects of intravenous fluids on the mother and the newborn.

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

Version: 2013

Normal saline versus lower‐chloride solutions for kidney transplantation

People with kidney failure may have a kidney transplant to replace the function of their own kidneys. During a kidney transplant operation, patients receive fluids through their veins to keep them hydrated. Maintaining good hydration helps the transplanted kidney to work after the operation. The choice of fluids that are given during and after the operation may have an effect on how the transplant kidney works after surgery and on the patient's acid‐base measures in the blood.

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

Version: 2016

Giving intravenous nutrients to adults during surgery to prevent hypothermia

We wanted to find out about the effects that intravenous nutrients (amino acids or sugars given into the bloodstream through a tube or a catheter in a vein) have on adults having surgery. Giving intravenous nutrients increases a person's metabolism, and this may increase the body heat produced. We wanted to know if giving intravenous nutrients during a surgical procedure could keep people warm, and if intravenous nutrients can keep them from having problems caused by being cold.

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

Version: 2016

Colistimethate sodium powder and tobramycin powder for inhalation for the treatment of chronic pseudomonas aeruginosa lung infection in cystic fibrosis: systematic review and economic model

BACKGROUND: Cystic fibrosis (CF) is an inherited condition characterised by the abnormal transport of chloride ions across transporting epithelia. This leads to the production of thick sticky mucus in the lungs, pancreas, liver, intestine and reproductive tract, and an increase in the salt content in sweat. Among other problems, people with CF experience recurrent respiratory infections and have difficulties digesting food. CF affects over 9000 individuals in the UK. CF shortens life expectancy and adversely affects quality of life. In 2010, CF was recorded as the cause of 103 deaths in England and Wales.

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

Version: 2013

Air versus saline in the loss of resistance technique for identification of the epidural space

A survey of anaesthesiologists showed that 53% of those who replied used loss of resistance technique (LOR) with saline, 37% used LOR with air and 6% LOR with both air and saline; 3% used a different technique with or without one of the above LOR approaches. The methods used for identification of the epidural space are important for good quality of anaesthesia and for avoidance of complications such as epidural haematoma (i.e. accumulation of blood between the skull and the dura mater) and occasional low back pain.

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

Version: 2014

Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy (local anaesthetic administration into the surgical wound in people undergoing laparoscopic cholecystectomy)

About 10% to 15% of the adult western population have gallstones. Between 1% and 4% become symptomatic each year. Removal of the gallbladder (cholecystectomy) is the mainstay treatment for symptomatic gallstones. More than half a million cholecystectomies are performed per year in the United States alone. Laparoscopic cholecystectomy (removal of the gallbladder through a keyhole, also known as a port) is now the preferred method of cholecystectomy. While laparoscopic cholecystectomy is generally considered to be less painful than open surgery, pain is one the major reasons for delayed hospital discharge after laparoscopic cholecystectomy. Administration of local anaesthetics (drugs that numb part of the body, similar to the ones used by the dentist to prevent people from feeling pain) into the surgical wound (local anaesthetic wound infiltration) may be an effective way of decreasing pain after laparoscopic cholecystectomy. However, the benefits and harms of local anaesthetic wound infiltration is not known. We sought to answer these questions by reviewing the medical literature and obtaining information from randomised clinical trials on the benefits related to the treatment. When conducted well, such studies provide the most accurate information on the best treatment. We also considered comparative non‐randomised studies for treatment‐related harms. Two authors searched the literature until February 2013 and obtained information from the studies thereby minimising errors.

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

Version: 2014

Different types of implants for reconstructive breast surgery after mastectomy

We assessed the effects of different types of breast implants on short‐term and long‐term surgical complications, cosmetic outcomes, satisfaction with the surgical procedure and the quality of life in women undergoing breast reconstruction following a mastectomy (breast removal).

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

Version: 2016

Injection treatment for painful Achilles tendons in adults

The Achilles tendon connects the calf muscles to the heel bone. Painful and stiff Achilles tendons are common overuse injuries in people undertaking sports, such as running, but also occur for other reasons in inactive people. The underlying cause is an imbalance between the damage and repair processes in the tendon. Painful Achilles tendons are often disabling and can take a long time to get better. Many treatments exist for this condition and this review set out to find out whether treatment with an injection, with a variety of agents, decreases pain and allows people to return to their previous activities.

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

Version: 2015

Saline irrigation for chronic rhinosinusitis

We reviewed the evidence for the benefits and harms of nasal saline irrigation in patients with chronic rhinosinusitis.

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

Version: 2016

Passive immunisation (giving antibodies) for preventing rubella (German measles) after contact with it

People who have had rubella (German measles), or rubella vaccine, have antibodies against the virus in their blood. These antibodies protect them from getting rubella should they come into contact with it again. These antibodies can be extracted from blood donated by these people.

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

Version: 2015

Chest physiotherapy for acute bronchiolitis in children younger than two years of age

We reviewed the evidence about the effect of chest physiotherapy in infants younger than two years of age with acute bronchiolitis.

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

Version: 2017

Eye drops made from autologous serum as treatment for dry eye

We conducted this Cochrane review to find out whether autologous serum eye drops work as treatment for dry eye. Cochrane researchers searched for all relevant studies seeking an answer to this question and found five studies.

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

Version: February 28, 2017

Interventions for children with ear discharge occurring at least two weeks following grommet placement

This review compares the effects and safety of interventions in children with grommets who develop ear discharge beyond the immediate postoperative period.

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

Version: 2016

Hydration with sodium bicarbonate for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials

The review concluded that evidence from this systematic review favoured hydration with sodium bicarbonate (as compared with sodium chloride) for prevention of contrast nephropathy. The review was generally well conducted, but the poor quality of some of the included trials limits the reliability of the authors’ conclusions.

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

Version: 2010

Prevention of contrast media-induced nephropathy by isotonic sodium bicarbonate: a meta-analysis

The authors concluded that sodium bicarbonate was more effective than normal saline in preventing contrast media-induced nephropathy, but results differed among trials. Further research is required. Evidence appeared to support the authors’ cautious conclusions, but the lack of reporting of review methods and trials quality make it difficult to comment on the reliability of the conclusions.

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

Version: 2008

Sodium bicarbonate for the prevention of contrast induced-acute kidney injury: a systematic review and meta-analysis

This review assessed whether hydration with sodium bicarbonate helped prevent contrast-induced acute kidney injury (CI-AKI) and found no evidence of benefit within large randomised trials. The conclusion was based on a subgroup of included studies. The low quality of included studies, poor reporting of the review process and questions regarding the synthesis made the reliability of the conclusions unclear.

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

Version: 2009

Sodium bicarbonate for prevention of contrast-induced acute kidney injury: a systematic review and meta-analysis

This review concluded that use of sodium bicarbonate in patients who underwent intravascular iodinated contrast-enhanced radiography procedures reduced the risk of contrast-induced acute kidney injury. This was a borderline effect and there was no benefit for other outcomes. The included studies had variable findings and were low quality. The authors' conclusions are appropriately cautious and likely to be reliable.

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

Version: 2010

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