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Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connects tissues not normally connected.

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To assess the effects of treatments for prevention of scar tissue (called adhesions) anti‐adhesion treatment) inside the womb after surgical treatment in women having difficulty becoming pregnant.

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

Version: 2017

This review of trials assessed the effects of barriers agents on pelvic pain, live birth and adhesion formation after pelvic surgery.

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

Version: 2015

The aim of this Cochrane Review was to find out how well ocriplasmin works in the treatment of symptomatic vitreomacular adhesion (sVMA). Cochrane Review authors collected and analysed all relevant studies to answer this question and found four studies.

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

Version: 2017

Not stitching the peritoneum after caesarean section takes less theatre time and therefore has less cost, but information on possible long‐term disadvantages are limited.

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

Version: 2014

Abdominal adhesions are web like structures that commonly form following abdominal or pelvic surgery. They are a result of damage to the lining of the abdomen and can cause multiple conditions such as chronic pelvic pain and infertility. Many types of solid, liquid, gel and pharmacological agents have been developed which, when applied during surgery, supposedly reduce the chance that adhesions will develop. However, there has been considerable disagreement as to which agent is more effective. We aimed to summarise the evidence from Cochrane Reviews regarding anti‐adhesion agents in gynaecological surgery.

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

Version: 2015

Review question: This Cochrane systematic review evaluated all fluid and pharmacological agents that aim to prevent adhesion formation after gynaecological surgery (gels were defined as fluid agents).

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

Version: 2014

Adhesions in the abdomen cause abnormal bonding between adjacent peritoneal surfaces and are common after operations in the abdomen. They are composed of fibrous tissue but also contain blood vessels, fat and nerves. They result in a spectrum of problems that affect the patient (intestinal blockage, infertility and possibly pain); the surgeon (difficulties in access and dissection, prolongation of operative time, increase in blood loss, predisposition to bowel injury); the health care provider (increased cost due to readmissions and litigation). Prevention is the key. This review focus on the evaluation of the safety and efficacy of two preventive agents applied in the abdomen during general surgical operations, Hyaluronic acid /carboxymethyl cellulose membrane and 0.5% ferric hyaluronate gel.

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

Version: 2009

Almost all boys are born with "natural" phimosis. During the first few months, it protects the sensitive head of the penis from rubbing against things, becoming too dry and coming into contact with germs like viruses or bacteria. Treatment is only needed if the foreskin still can’t be pulled back in older boys or adult men.

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

Version: October 7, 2015

Ulcerative colitis is a chronic inflammatory disease of the colon. Vedolizumab (formerly known as MLN‐02) is a synthetic antibody that blocks the adhesion and migration of white blood cells into the gut, reducing intestinal inflammation. This medication is given to patients intravenously. Four studies including 606 patients were included in this review. Pooled analysis of these trials revealed vedolizumab is significantly more effective than placebo (sham infusion) for inducing clinical remission and response (improvement of symptoms), as well as endoscopic remission (healing of inflamed mucosa in the colon) in patients with moderate to severely active ulcerative colitis. Evidence from one study suggests that vedolizumab is superior to placebo for preventing relapse (recurrence of active disease) in patients with ulcerative colitis in remission. Patients receiving vedolizumab were no more likely than placebo patients to experience side effects or serious side effects. Commonly reported side effects included: worsening ulcerative colitis, headache, nasopharyngitis (inflammation of nose and throat), upper respiratory tract infection, nausea, and abdominal pain. Further research is needed in order to define the optimal dose, frequency of drug administration and the long‐term effectiveness and safety of vedolizumab used for induction and maintenance of remission in ulcerative colitis. Vedolizumab should be compared to other currently approved therapies of ulcerative colitis in these studies.

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

Version: 2014

Crohn's disease is a chronic inflammatory disease of the intestines. Crohn's disease frequently occurs in the lower part of the small intestine, called the ileum, but it can affect any part of the digestive tract, from the mouth to the anus. The most common symptoms of Crohn's disease are abdominal pain, often in the lower right area, and diarrhea. Natalizumab blocks the adhesion and migration of white blood cells into the gut reducing chronic inflammation associated with Crohn's disease. Four high quality studies were reviewed. The studies tested 1692 people over the age of eighteen who had moderate to severe Crohn's disease. The subjects received 1 to 3 infusions of natalizumab (at a dosage of 300 mg or weight based dosages of 3, 4 or 6 mg/kg) or placebo (fake infusions). The studies lasted for 12 weeks. The results of the studies indicate that natalizumab is effective therapy for some people with active Crohn's disease. People with active disease responded positively to even one treatment of the drug and the studies examined showed increased benefits with additional injections of natalizumab. More people improved through treatment using natalizumab than those using the fake treatments. The drug was generally well tolerated and side effects occurred infrequently. Serious side effects occurred rarely (range 7 to 11% for natalizumab and placebo patients). Few patients withdrew from the studies due to side effects (2 to 8% for natalizumab compared to 3 to 7% for placebo). Side effects that occurred during the trials included: headache, worsening of Crohn's disease, abdominal pain, arthralgia, colitis, influenza syndrome, infection, nausea, vomiting, fatigue, hypersensitivity‐like reactions, and the development of antibodies against natalizumab. Recently, it was found that two patients who received natalizumab in combination with interferon beta‐1 for multiple sclerosis and one patient who received natalizumab in combination with azathioprine for Crohn's disease developed a severe disease called progressive multifocal leukoencephalopathy (PML) resulting in two deaths. PML is a serious infection of the nervous system. However an investigation of more than 3500 patients who took natalizumab found no new cases of PML. It was discovered that PML is not always fatal and regular testing of patients could provide adequate safety and ensure the well‐being of those taking natalizumab. However, the benefits of natalizumab for people with Crohn's disease should be carefully weighed against the potential risk of serious adverse events such as the possibility of infection of the nervous system.

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

Version: 2009

Malignant occlusion of the biliary tract can be relieved by insertion of a stent, which allows passage of the biliary fluid. However, stents often clog. This Review examines if ursodeoxycholic acid (a bile acid) and/or antibiotics may prevent clogging of biliary stents. At present there is not sufficient evidence to recommend ursodeoxycholic acid and/or antibiotics for biliary stented patients.

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

Version: 2009

We reviewed the evidence about whether treatment of retinal breaks (holes or tears in the retina) and retinal lattice degeneration (thinning and atrophy of retinal tissue) can prevent retinal detachment, a serious vision‐threatening problem.

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

Version: 2014

Colorectal cancer (bowel cancer) is the third most commonly diagnosed cancer in the world. Surgery is the primary curative treatment for those with early stage disease. However, a number of patients relapse after primary surgery, presumably due to cancer cells that have spread undetected to other parts of the body. In general, once colorectal cancer has spread it is no longer curable. Hence, adjuvant treatments are given around the time of surgery to eliminate any remnant cells to improve a patient's chance of cure.

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

Version: 2012

The endometrium refers to the tissue that lines the womb and is shed during menstruation. Women with endometriosis have endometrial tissue growing outside the womb, within the pelvic cavity. This tissue responds to reproductive hormones causing painful periods, chronic lower abdominal pain and difficulty conceiving. Currently the only reliable way of diagnosing endometriosis is to perform keyhole surgery and visualise the endometriotic deposits inside the abdomen. Because surgery is risky and expensive, various tests within the endometrium that can be obtained during an in‐office womb sampling procedure have been assessed for their ability to detect endometriosis non‐invasively or with minimal invasion. An accurate test could lead to the diagnosis of endometriosis without the need for surgery, or it could reduce the need for diagnostic surgery so only women who were most likely to have endometriosis would require it. Review teams have also evaluated other non‐invasive ways of diagnosing endometriosis using blood, urine and imaging tests as well as a combination of several testing methods in separate Cochrane reviews within this series.

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

Version: 2016

We reviewed the evidence about the effect of using either a scalpel (knife) or electrosurgery in surgical operations on the abdomen.

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

Version: 2017

The main question addressed by this review is how effective are different options for treating extensive tooth decay in children's milk teeth to resolve the child's symptoms (typically pain, swelling, abnormal movement) and tooth signs (as shown on an x‐ray).

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

Version: 2014

Women with endometriosis have endometrial tissue (the tissue that lines the womb and is shed during menstruation) growing outside the womb within the pelvic cavity. This tissue responds to reproductive hormones, causing painful periods, chronic lower abdominal pain and difficulty conceiving. Currently, the only reliable way of diagnosing endometriosis is to perform keyhole surgery and visualise the endometrial deposits inside the abdomen. Because surgery is risky and expensive, we evaluated whether the results of blood tests (blood biomarkers) can help to detect endometriosis non‐invasively. An accurate blood test could lead to the diagnosis of endometriosis without the need for surgery, or it could reduce the need for diagnostic surgery to a group of women who were most likely to have endometriosis. Separate Cochrane reviews from this series evaluate other non‐invasive ways of diagnosing endometriosis using urine, imaging, endometrial and combination tests.

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

Version: 2016

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