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Chronic infection of the airways by Pseudomonas aeruginosa in people with cystic fibrosis is associated with deterioration in respiratory function. Intravenous antibiotics are the standard therapy for pulmonary exacerbations caused by this micro‐organism. Many centres advocate the use of elective (regular) three‐monthly antibiotics to reduce the frequency of exacerbations and therefore slow the deterioration of lung function. Alternatively, intravenous antibiotics are only prescribed when symptoms indicate. Elective therapy may encourage multi‐resistance to antibiotics. This review aimed to identify randomised and quasi‐randomised controlled trials that evaluated the results of the two different approaches. No clear conclusions were identified. This review will no longer be regularly updated. Searches will still be undertaken on a two‐yearly basis by the Cochrane Cystic Fibrosis & Genetic Disorders Group. If, in future, relevant trials are identified, the review will be updated again.

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

Version: July 11, 2012

Not enough evidence on non‐surgical interventions for treating problematic piles (haemorrhoids) during pregnancy and in the early weeks after birth (puerperium).

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

Version: July 20, 2005

Infection with the parasite Trypanosoma cruzi causes American trypanosomiasis or Chagas disease. There is evidence that trypanocidal drug treatment, using nitrofuran and imidazolic compounds, can treat acute trypanosomiasis cruzi infections. However, it is not clear if these interventions are effective for chronic infection specifically overt, chronic Chagasic cardiomyopathy. We systematically reviewed the literature for randomized, double blind, controlled clinical trials with or without placebo published since 1965 when these treatments first became available. We found a single double blind randomized clinical trial and five case‐control or case series which addressed trypanocidal treatment of chronic Typanosoma cruzi infection (chronic Chagas disease) in human beings. After reviewing this limited evidence we concluded that treatment with these drugs is not sufficiently well supported regarding clinical value and capacity to eliminate tissue parasitism or induce disappearance of circulating antibodies. Currently new drugs are being developed and clinical trials are needed to evaluate their use in chronic Typanosoma cruzi infection and related diseases.

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

Version: October 18, 2005

Antibiotics are very effective at clearing urinary tract infections in pregnancy, and complications are very rare.

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

Version: January 19, 2011

Patent ductus arteriosus (PDA) occurs when an artery near the heart and lungs stays open and does not close off after birth. Babies born early (preterm) have an increased risk of complications and death due to PDA. Indomethacin has been used to close the PDA; however, it can reduce blood flow in organs such as brain, kidneys and intestine. There is no agreement on the ideal dose and duration of treatment with indomethacin. In order to reduce the adverse effects of indomethacin on blood flow, some investigators have recommended administering the same total dose as a continuous infusion over 36 hours. In this review, the analysis of the two eligible trials found that the data was insufficient to reach a conclusion regarding the effectiveness of the 36‐hr continuous infusion method. The blood flow lowering side‐effects of indomethacin were reduced by the continuous infusion method, but there was insufficient data to recommend this administration method versus the traditional method.

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

Version: January 23, 2008

Restless legs syndrome (RLS) is a sensorimotor movement disorder characterized by uncomfortable sensations in the legs and an urge to move them. The syndrome is very common and its lifestyle impacts justify a search for more effective and acceptable interventions.

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

Version: October 8, 2008

As people age (especially women), they become more prone to infections in the bladder (UTI ‐ urinary tract infections). Older people are more likely to have adverse reactions to drugs. Up to the present time older women with uncomplicated UTI were treated longer than younger patients ‐ without any scientific evidence and with an increased risk of adverse drug reactions. We defined three groups of treatment durations: single‐dose, short (3 to 6 days) and longer courses (7 to 14 days).

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

Version: July 16, 2008

The way an infant's blood is circulated changes soon after birth. Initially, premature infants have an opening (a patent ductus arteriosus, PDA) between the large blood vessel to the lungs and the large blood vessel that carries oxygenated blood to the rest of the body. Early symptomatic treatment of PDA, when clinical signs first appear, helps reduce the amount of time an infant needs assisted breathing (mechanical ventilation) and the likelihood of chronic lung disease and damaging inflammation of the gut (necrotising enterocolitis). Standard therapy includes restricting fluids, diuretics and cyclooxygenase inhibitors like indomethacin or ibuprofen. The PDA is closed surgically if these medical treatments do not work. Only one randomised controlled study could be included in this review (including 154 preterm infants that needed breathing support). Indomethacin and surgery gave similar benefits. There were no differences in deaths during the hospital stay, chronic lung disease, necrotising enterocolitis, cerebral or other bleeding. Surgery was more effective in closing the PDA (three needed to treat for one to benefit) but it was associated with complications (pneumothorax and retinopathy of prematurity). The one study found was carried out over 30 years ago. Clinical practice has changed a great deal and surgical closure of a PDA is safer. Therefore, whether the results of the study are applicable today is debatable. Updates of this review in July 2007 and February 2012 did not identify any additional randomised controlled studies for inclusion, but three observational studies indicated an increased risk for one or more of the following outcomes associated with PDA ligation: chronic lung disease, retinopathy of prematurity and neurosensory impairment.

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

Version: March 28, 2013

This is an update of the Cochrane review "Pharmacologic treatment for memory disorder in multiple sclerosis" (first published in The Cochrane Library 2011, Issue 10).

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

Version: December 17, 2013

Physostigmine is an acetylcholinesterase inhibitor; it works by obstructing the enzyme responsible for ACh destruction in the synaptic cleft. Studies conducted more than 20 years ago suggested that physostigmine could improve memory in people with or without dementia. Investigation of this property has been limited by the very short half‐life of physostigmine. Various forms of administering the drug have been tried to overcome this problem, most recently a controlled‐release (CR) oral formulation, and a skin patch. An additional limiting factor has been a high incidence of adverse effects, including nausea, vomiting and diarrhoea. Physostigmine appears to have no advantage over some newer anticholinesterase drugs. The short half‐life remains a serious disadvantage and requires complex forms of administration. There is no reason to recommend further research into this drug.

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

Version: April 23, 2001

Blood clots (venous thromboembolism) sometimes cause blockages in veins after surgery, during bed rest, or spontaneously. These clots can be fatal when they travel to the lungs. Vitamin K antagonists (VKAs), 99% of which consist of warfarin, are effective in preventing renewed blood clot formation, because they thin the blood. Low‐molecular‐weight heparins (LMWHs) are drugs that thin the blood and are used for people who are at risk of major bleeding, people who cannot take vitamin K antagonists, and pregnant women.

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

Version: July 24, 2017

The human appendix is a tube at the connection of the small and the large intestines. Possible functions of the appendix may be to protect the body against infection and to maintain healthy levels bacteria in the gut when recovering from diarrhoea. Appendicitis covers a variety of clinical conditions resulting from inflammation of the appendix.

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

Version: June 2, 2017

Spinal stenosis is the narrowing of the spinal canal in the lower back region caused by thickening of the soft tissues and bones. It is a common condition for which surgery is usually performed after non‐surgical treatments (such as physiotherapy) have failed to bring sufficient relief to patients. Spinal stenosis is a common cause of low back pain that radiates to the legs, and it is more common in older adults. Surgery for lumbar spinal stenosis normally involves taking pressure off the spinal cord or spinal nerves (known as decompression) by removing bone and soft tissues from around the spinal canal. Another common surgical approach is to fuse two or more vertebrae together after decompression in the patient whose spine seems to be unstable. The usefulness of some types of surgery for lumbar spinal stenosis, however, has been questioned, and previous studies have reported that patients who receive fusion are more likely to have major complications and higher costs when compared with patients who undergo decompression only. More recently, spinal implants were created to help indirectly reduce pressure in the spinal canal and at the same time stabilise the bones. However, these implants have also been linked to worse outcomes (e.g., higher reoperation rates) when compared to conventional decompression.

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

Version: November 1, 2016

Uterine fibroids (benign tumours) can cause varied symptoms such as heavy bleeding, pain and reduced likelihood of pregnancy. Surgery (hysterectomy or myomectomy) has traditionally been the main treatment option but it carries a risk of complications. Uterine artery embolization (UAE) is a newer treatment option which blocks the blood supply to the womb and thus shrinks the fibroids and reduces their effects. The evidence was current to April 2014.

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

Version: December 26, 2014

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

The Institute for Quality and Efficiency in Health Care (IQWiG, Germany) last tested how sitagliptin (trade name: Januvia or Xelevia) compares with standard treatments in 2016. The results of two studies comparing sitagliptin/metformin with glimepiride/metformin were available for analysis. The assessment was based mainly on the longer-lasting of the two studies.

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

Version: October 20, 2016

In 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of the combination of dulaglutide plus metformin compared with the combination of a sulfonylurea plus metformin in adults with type 2 diabetes. There were no available studies comparing dulaglutide / metformin directly with the approved standard therapies. The data that was analyzed comes from what is called an adjusted indirect comparison of two studies. The results of this kind of comparison are generally less conclusive than the results of a direct comparison. For this analysis, IQWiG used the data from two studies that were sufficiently comparable in terms of participants and dose. One study compared dulaglutide / metformin with sitagliptin / metformin, and the other compared glimepiride / metformin with sitagliptin / metformin.

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

Version: May 4, 2015

Vandetanib (trade name: Caprelsa) has been approved in Germany since February 2012 for the treatment of advanced medullary thyroid cancer in adults.

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

Version: May 4, 2017

Albiglutide (trade name: Eperzan) has been approved in Germany since March 2014 for the treatment of type 2 diabetes in adults who cannot lower high blood sugar levels enough through exercise and diet alone.

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

Version: January 2, 2015

In 2015 insulin degludec (trade name: Tresiba) was approved in Germany for the treatment of type 1 and type 2 diabetes in teenagers and children over the age of one. This drug is a long-acting insulin analogue. It is used to regulate blood sugar levels for up to 24 hours.

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

Version: June 1, 2015

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