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Unfractionated heparin versus low molecular weight heparin for avoiding heparin‐induced thrombocytopenia in postoperative patients

Heparin is a natural agent used to prevent clot formation in the vessels. Two types of heparins are widely used, unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Heparin‐induced thrombocytopenia (HIT) is an adverse reaction that can occur during treatment with heparin. It is common in practice and its most important consequence is a paradoxical increase in the risk of clotting (thromboembolic) complications. A number of factors are thought to influence its frequency, including the type of heparin and the type of patient, with patients who have had a surgery at higher risk. We compared the risk of HIT in people who had had surgery and had been exposed to UFH or LMWH. A better understanding of this problem will allow safer management of postoperative patients who need thromboprophylaxis with heparin.

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

Version: 2017

Heparin versus normal saline for maintaining an open (patent) arterial line

For most patients who require intensive care, the success of clinical decision making and interventions is dependent on the accuracy of blood pressure and pulse measurements of samples taken using an arterial catheter. Maintaining the patency of these catheters is therefore essential for minimizing both patient discomfort (blood clots and reduced blood flow to a limb, infection and scarring) and additional expenses incurred by the need to replace a blocked catheter. This summary of a Cochrane review presents what we know from the available research about which solution (heparin or normal saline) is more effective in maintaining the patency of arterial catheters in adult patients. Heparin is a powerful drug in terms of its ability to prevent clots from forming in the catheter, but its use is not without risk of bleeding, an allergic reaction and low platelet counts. Patients can experience serious adverse events when given heparin.

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

Version: 2014

Non‐steroidal anti‐inflammatory drugs, including aspirin and paracetamol (acetaminophen) in people taking methotrexate for inflammatory arthritis

This summary of a Cochrane review describes what we know from research about any safety issues from using non‐steroidal anti‐inflammatory drugs, or NSAIDs, including aspirin, or paracetamol (acetaminophen), or both, along with methotrexate in people with inflammatory arthritis.

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

Version: 2011

Interferon alpha for patients with chronic hepatitis D

Hepatitis D virus is unique in that it can only infect a person who is already infected by hepatitis B virus. Chronic hepatitis D is a difficult‐to‐treat infection. Several antiviral and immunomodulating agents have been evaluated in treatment of hepatitis D. However, with the exception of interferon, all of them proved ineffective. This meta analysis of six randomised clinical trials of interferon shows that even Interferon alpha is not an ideal drug for this infection. Among the 169 participants included in primary meta analysis, interferon alpha induced loss of virus, normalisation of liver tests, and improvement in the liver biopsy in more patients compared with those who were left untreated. Unfortunately, most of these patients did not have sustained response after stopping treatment. Additional analysis of two trials comparing a higher dose of interferon alpha with lower dose among randomly assigned participants showed no significant difference in outcome between the two groups. There were differences in dosage and duration of interferon alpha used among included trials as well as some other methodological weakness which places a high risk of bias in this meta analysis.

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

Version: 2012

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