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Antiepileptic drugs for the primary and secondary prevention of seizures after subarachnoid haemorrhage

The purpose of this review was to examine whether the routine use of antiepileptic medication in preventing epileptic seizures following subarachnoid haemorrhage can be justified. This includes patients who have not yet had a seizure (primary prevention) and those who have already had one (secondary prevention).

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

Version: 2013

Drugs to prevent clots after bleeding in the brain

People with stroke due to bleeding in the brain (also known as intracerebral haemorrhage: ICH) are more likely to develop clots in their blood vessels due to immobility (in the early stages) and due to other medical conditions (in the long term). Blood clots in the lungs, brain, or other organs can cause serious illness or death. Drugs that prevent clots (also known as 'antithrombotic drugs') might be useful to stop clot formation in people with ICH. However, these drugs can also cause serious bleeding complications.

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

Version: 2017

Detecting non-melanoma skin cancer

In order to detect non-melanoma skin cancer, you can either check your skin for abnormalities yourself or have a doctor examine it. Non-melanoma skin cancer can be treated more effectively if it is detected before it spreads to other parts of the body.It can be worrying if a spot on your skin changes in size, shape, color or looks abnormal. A lot of people know that changes like this could be a sign of skin cancer. But most suspicious-looking areas of skin are harmless.The older you get, the more your skin changes, and new moles or age spots (solar lentigo) may develop. This is a normal part of aging. So some people decide to wait and keep an eye on any skin abnormalities. It is only rarely a serious medical condition.Carefully checking your skin on a regular basis is a good way to notice any changes, or any wounds that do not heal as quickly as usual. It isn’t always easy to know what is normal and what isn’t. If you find something that looks abnormal to you, it is best to have your doctor inspect it more closely if it does not go away after four to eight weeks. Skin cancer is not usually painful in early stages. If it does hurt, the cancer may have already reached an advanced stage.

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

Version: September 10, 2015

Treatments for non‐metastatic squamous cell carcinoma of the skin

Squamous cell carcinoma (SCC) of the skin is the second most common skin cancer in people of white origin, most frequently occurring on sun‐exposed areas of the body. People with fair skin and those with certain genetic conditions or an impaired immune system are at greater risk of developing SCC of the skin. Clinically, SCC often appears as a persistent red, scaly patch which may bleed if traumatised although lesions may also look like warts or non‐healing sores. Occasionally SCC of the skin returns, even after apparently successful treatment and may spread to other parts of the body. However, it rarely causes death. Most skin SCCs are treated surgically, either by cutting out the cancer with a margin of normal‐looking skin, or occasionally by Mohs micrographic surgery in which visible tumour is removed and examined under the microscope, with further stages of excision and microscopic examination until all the tumour has gone. If surgery is not possible, radiotherapy may be used as a treatment. Other treatments sometimes used include curettage and cautery (where tumour is scraped off and the wound sealed with a small electrical current to stop bleeding and destroy remaining cancer cells), and cryotherapy, in which cancer cells are destroyed by freezing. Sometimes combinations of treatment are used for more aggressive skin SCC that has a high risk of recurring and spreading. Other more novel treatments have also been used but are not generally recommended.

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

Version: 2010

Skin patch or vaginal ring compared to pills for birth control

The skin patch and the vaginal (birth canal) ring are two methods of birth control. Both methods contain the hormones estrogen and progestin. The patch is a small, thin, adhesive square that is applied to the skin. The contraceptive vaginal ring is a flexible, lightweight device that is inserted into the vagina. Both methods release drugs like those in birth control pills. These methods could be used more consistently than pills because they do not require a daily dose. This review looked at how well the methods worked to prevent pregnancy, if they caused bleeding problems, if women used them as prescribed, and how safe they were.

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

Version: 2013

Skin puncture versus exposing the femoral artery for minimally invasive repairs of abdominal aortic aneurysms

Abdominal aortic aneurysms are a ballooning of the largest blood vessel in the abdomen, the abdominal aorta, due to weakness of the vessel wall. This ballooning may lead to life‐threatening rupture. Repair of the aneurysm is recommended if the risk of rupture is calculated to be greater than the risk of surgery. Most repairs involve putting in an artifical graft, a tube composed of fabric, to help reinforce the artery wall. There are two main methods for repair. One is an open technique in which the whole abdomen is opened and the graft is used to replace the diseased part of the vessel. The other technique is an endovascular aneurysm repair. With this technique the graft is fed into the abdominal aorta through an artery in the groin (the femoral artery) and avoids the large abdominal incision. This review looked at an alternative method for introducing the graft into the femoral artery, percutaneous access. Instead of making an incision in the groin to expose the femoral artery (a cut‐down), a needle is inserted to the femoral artery then a flexible guide wire inserted through the needle. The needle is removed and a plastic tube introduced into the femoral artery over the guide wire (percutaneous access), with a small cut in the skin to allow the passage of the plastic tube. Once introduced, the guide wire can be removed leaving the tube in place in the artery. The graft and all other materials can then be fed into the artery via the plastic tube. Once the procedure is complete the tube can be withdrawn. The surface incision can usually be closed with one stitch.

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

Version: February 21, 2017

Skin Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of skin cancer.

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

Version: July 12, 2017

Treatments for acute bleeds in people with acquired hemophilia A

Acquired hemophilia A is a rare but severe bleeding disorder caused by the autoantibody directed against factor VIII (FVIII, a blood clotting protein) in patients with no previous history of a bleeding disorder. This bleeding disorder occurs more frequently in the elderly and may be associated with several other conditions, such as solid tumours, autoimmune diseases, or with drugs; it is also sometimes associated with pregnancy. However, in about half of the cases the causes are unknown. Bleeding occurs in the skin; mucous membranes; and muscles; with joint bleeds being unusual. Therapies for acquired hemophilia A include treatments to stop acute bleeds and to destroy the FVIII autoantibodies. Acute bleeds can be treated with recombinant activated FVII or activated prothrombin complex concentrate (aPCC). If these are unavailable, FVIII concentrates or 1‐desamino‐8‐D‐arginine‐vasopressin (DDAVP) fresh frozen plasma can be attempted; however, these last two options are not usually effective, and it is not known if one of these products is better than the other.

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

Version: 2014

Scalpel or no‐scalpel approach to the vas

Vasectomy is a surgical method used in men to cut or tie the vas deferens. The vas is a tube that delivers sperm from the testicles. The purpose of vasectomy is to provide permanent birth control. Usually the operation involves cutting the skin of the scrotum with a scalpel. A newer technique uses a sharp instrument to puncture the skin instead. The intent is to have fewer problems with bleeding, bruising, and infection. This review looked at whether the no‐scalpel approach to the vas worked as well as the scalpel method. It also studied any side effects of the methods and whether the men liked the method.

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

Version: 2017

Antibiotics to reduce pain and improve recovery following tonsillectomy

Tonsillectomy is a commonly performed operation in children and adults. Following the operation nearly all patients experience significant pain, need regular painkillers and are unable to resume normal diet and activities for several hours. Rarer but more dangerous complications, such as bleeding from the operated area, also occur. Antibiotics are commonly prescribed to reduce some or all of these undesirable consequences of tonsillectomy.

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

Version: 2012

Once versus twice daily injections of low molecular weight heparin for the initial treatment of blood clots in the veins

Blood clots in the veins (venous thromboembolism (VTE)) can develop spontaneously or after surgery or bed rest. Venous thromboembolism can be life threatening if clots travel to the lungs. Blood‐thinning drugs such as heparin are used to dissolve clots. Low molecular weight heparin (LMWH) can be given by injection, enabling people to leave hospital. The usual treatment is two injections a day, but once a day would be more convenient. This review included five studies with a combined total of 1508 participants. The combined data showed no statistically significant difference in recurrent VTE between the once daily and twice daily treatment regimens. A comparison of major bleeding events, improvement of the blood clot size and death also showed no statistically significant difference between the two treatment regimens. None of the five included studies reported information on post‐thrombotic syndrome (ongoing swelling of the affected leg, pain, and skin changes). One daily injection with LMWH is therefore as effective and safe as twice daily injections.

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

Version: 2015

Comparing NSAIDs

How do NSAIDs compare in reducing pain?

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

Version: May 1, 2011

Psoriasis: Overview

Psoriasis is characterized by clearly defined patches of red and scaly skin. This non-contagious condition typically starts in adulthood and comes and goes in cycles. Living with the visible skin patches often affects people's emotional well-being too. There are various treatment options.

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

Version: May 18, 2017

Pruritus (PDQ®): Patient Version

Expert-reviewed information summary about pruritus (itching of the skin) as a complication of cancer or its treatment. Approaches to the management and treatment of pruritus are discussed.

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

Version: June 15, 2016

Drug therapy for treating idiopathic thrombocytopenic purpura during pregnancy

Idiopathic thrombocytopenic purpura (ITP) is an immune‐mediated hematologic disorder caused by a low blood platelet count (thrombocytopenia). Antiplatelet antibodies act against the platelets resulting in platelet destruction by the spleen. In adults, the clinical features of ITP often have an insidious onset and are highly variable, ranging from no symptoms, mild bruising, to mucosal bleeding, and skin discolorations. Management of ITP during pregnancy is complex because of large differences between maternal and fetal platelet counts. The circulating antibodies can cross the placenta and cause a neonatal passive immune thrombocytopenia that may increase the risk of cerebral haemorrhage in the newborn infant. For this reason, it seems reasonable that cesarean section delivery is safer for the infant than vaginal delivery yet the mode of delivery may not affect the rate of haemorrhage. Many different pharmacological interventions are used for treating this medical disorder and treatment for ITP in pregnant women is not standardised. Some of these drugs have potential side effects for pregnant women and some can cause fetal malformation.

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

Version: 2012

Rituximab for eradicating inhibitors in people with acquired haemophilia A

We reviewed the evidence about the effect of rituximab for treating people with acquired haemophilia A.

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

Version: 2016

Enlarged hemorrhoids: How can you relieve the symptoms yourself?

There is a lot of advice out there about how to relieve the symptoms of enlarged hemorrhoids yourself – including things like avoiding constipation, and using special ointments or warm baths. Some of these approaches can actually help, but many of them have not been tested in good scientific studies.If someone has enlarged hemorrhoids (also known as “piles”), trying to prevent constipation and changing their toilet habits can make an important difference. Various medications and other measures can also be tried out to relieve the symptoms. But this will not make enlarged hemorrhoids shrink again.

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

Version: January 29, 2014

What happens during a lumbar puncture (spinal tap)?

During a lumbar puncture (also known as a spinal tap), a small amount of cerebrospinal fluid (CSF) is extracted from the spinal (vertebral) canal using a special needle. Analyzing the cerebrospinal fluid in a laboratory can help detect diseases of the brain and spinal cord.

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

Version: May 23, 2016

Interventions for actinic keratoses

Actinic keratoses are a skin disease caused by long‐term sun exposure. Damaged skin shows small, red, rough, scaly, flat spots called actinic keratoses or lesions, which feel like patches of dry skin. Symptoms such as bleeding and pain can be associated with actinic keratoses. Moreover, actinic keratoses have the potential to develop into skin cancer if left untreated. The reasons for treatment may include cosmetic appearance, relief of symptoms, or prevention of skin cancer. Treatment can be directed either at individual lesions or to larger areas of the skin where several visible and less visible lesions occur (field‐directed treatment).

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

Version: 2016

Does the speed of injection make a difference to the amount of pain and bruising in people having heparin injections?

Heparin is a drug used to help stop blood from clotting. It comes in two forms ‐ unfractionated heparin and low molecular weight heparin. These are usually given by injection just underneath the skin. The heparin goes into the layer of fat under the skin so that it is released slowly into the body.This type of injection can sometimes cause bruising and pain where the needle goes in. It can also sometimes cause a swelling that contains blood, called a haematoma.

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

Version: 2015

Systematic Reviews in PubMed

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