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Magnesium for treating sickle cell disease

We reviewed the evidence of the effect of intravenous (given into a vein) magnesium and oral (taken by mouth) magnesium on the frequency of painful crises (sickle cell crises with severe pain due to blockages of the blood supply to bones, joints, lungs, liver, spleen, kidney, eye or central nervous system), length of hospital stay and quality of life in people with different types of sickle cell disease.

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

Version: 2017

Use of topiramate for the treatment of essential tremor

The authors of this review tried to assess the effectiveness and safety of topiramate in people with essential tremor.

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

Version: 2017

Patient‐controlled analgesia with remifentanil versus alternative analgesic methods for pain relief in labour

Pain relief during labour can be provided in a number of different ways. These include epidural analgesia, by injection of anaesthetic medication around the nerve roots in the spine, intramuscular or continuous intravenous opioids, and inhalational analgesia such as with nitrous oxide. Remifentanil is a relatively recently introduced potent, short‐acting opioid, which gives control over pain relief.

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

Version: 2017

Asthma education for school staff

Teachers and school staff need to know how to manage asthma in schools. If they have little knowledge of asthma, staff may not know how best to protect a child with asthma, or may fail to act in the event of a serious attack. We aimed to assess the benefits and possible harms of asthma education for school staff, and to explore how this education can best be delivered.

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

Version: 2017

Medical treatment for people with primary sclerosing cholangitis

Primary sclerosing cholangitis is a disease that affects the bile ducts. Bile ducts are tubes that transport the bile produced by liver cells. Primary sclerosing cholangitis is a relatively uncommon disease, with 1 in 10,000 people affected. It is more common among men, and most people receive the diagnosis at between 30 and 50 years of age. Primary sclerosing cholangitis can lead to liver damage, liver failure, and bile duct cancer, and it decreases a person's longevity. Various medical treatments for primary sclerosing cholangitis have been tested. The best way to treat patients with primary sclerosing cholangitis remains unclear. We sought to resolve this issue by searching for studies conducted to explore this topic. We included all randomised clinical trials whose results were reported until February 2017. We included only trials in which participants had not undergone liver transplantation before participating in the trial. Apart from using standard Cochrane methods, which allow comparison of only two treatments at a time (direct comparison), we planned to use an advanced method (network meta‐analysis) that would allow comparison of many different individual treatments as reported by research trials. However, because of the nature of the available information, we could not determine whether results of the network meta‐analysis were reliable. So, we used standard Cochrane methods instead.

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

Version: 2017

Targeting lower or higher oxygen levels in preterm infants

Background: Giving additional ('supplemental') oxygen to babies born very early ('extremely preterm infants') who have breathing difficulties has been common practice since the 1940s. Despite this, there is little agreement as to what levels of oxygen will maximise short‐ or long‐term survival and development. Technology ('pulse oximetry') that can easily measure the level of oxygen in a baby's blood (oxygen saturation) has been in widespread use since the 1990s. Despite this, until recently there were no randomised trials that had tested whether it is better to target lower or higher oxygen saturation levels in extremely preterm infants, from birth or soon thereafter. As a result there is a great deal of variation in the target ranges aimed for in different newborn care units around the world.

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

Version: 2017

Amylase in drain fluid for the diagnosis of pancreatic leak after partial removal of the pancreas

The pancreas is an organ in the abdomen that secretes pancreatic juice that aids digestion; and it contains cells that produce important hormones such as insulin. Partial removal of the pancreas (pancreatic resection) is performed to remove cancerous and non‐cancerous growths in the pancreas. During this process, new connections (anastomoses) are made between the pancreas and intestines and bile duct (a tube that transports bile from the liver to the intestines). These connections may break down and result in leakage of pancreatic content into the abdomen; this can lead to severe infections within the abdomen and in the blood stream, which can even lead to the death of the patient.

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

Version: 2017

Direct comparison of two antipsychotics (chlorpromazine versus clotiapine) for treating schizophrenia

The aim of this review was to find good quality evidence comparing the efficacy of chlorpromazine versus clotiapine for schizophrenia.

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

Version: 2017

Written and personalised action plans to help adults manage their asthma

People with asthma may be given a written personalised action plan for managing their asthma. This plan provides information on which medicines they should take and when. Other people may be given education on how they should look after their asthma. This review set out to see if using a plan on its own or with education helps improve outcomes for people with asthma.

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

Version: 2017

Needle characteristics that reduce the occurrence of post‐dural puncture headache (PDPH)

A lumbar puncture is a needle inserted into the lower part of the spine to draw fluid, to test for conditions affecting the brain and spinal cord. It can also be used for treatment (for instance, for the management of pain in caesarean section).

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

Version: 2017

Heart surgery for aortic valve replacement through a small incision versus the standard full incision at the front of the chest

We reviewed the evidence on the effect of a smaller "keyhole"‐type cut (instead of the usual full cut down the breastbone) on aortic valve replacement surgery in adults. We wanted to see if both were as safe and effective as each other.

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

Version: 2017

Infant pacifiers for reduction in risk of sudden infant death syndrome

Sudden unexpected death of an infant generally occurs during sleep from birth to one year of age but mainly occurs between one and four months of age. Despite the success of several prevention campaigns, sudden infant death syndrome remains a leading cause of infant mortality (death). A variety of factors have been identified as increasing the risk of sudden infant death syndrome such as male sex, preterm (before the due date) birth, overheating, exposure to cigarette smoke, and infants lying on their stomachs. Pacifier use has been proposed as a non‐invasive intervention to reduce the risk of SIDS. This review was undertaken to examine whether infant pacifiers can reduce the risk of SIDS.

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

Version: 2017

Intravenous or inhalational anaesthesia for abdominal surgery assisted by a computerized surgical robot

This review assessed anaesthesia provided for computerized robotic assisted surgery in the abdomen via the veins or by breathing into the lungs (inhalation).

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

Version: 2017

Exercise‐based cardiac rehabilitation for patients following a heart transplantation

We wanted to find out if exercise training versus no exercise training following heart transplant effects numbers of deaths, hospital admissions, harms, exercise capacity, health‐related quality of life, return to work and costs.

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

Version: 2017

De‐escalation techniques for psychosis‐induced aggression or agitation

Aggression is a willingness to inflict harm, regardless of whether this is behaviourally or verbally expressed and regardless of whether physical harm is sustained.

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

Version: 2017

Medical interventions to prevent graft rejection after liver transplantation

Liver transplantation is the main treatment option for people with severe advanced liver disease. When organs or tissues are transplanted from one person (organ donor) to another (organ recipient), the body of the organ recipient identifies the donor organ (or graft) as a foreign body and mounts a response against it in a way similar to the natural body defence mechanism against infections (immune response). This can lead to graft rejection and graft loss resulting in death of the organ recipient. Various medical interventions are used either alone or in combination (immunosuppressive regimen) to prevent graft rejections. The combination of interventions used in the first few months after liver transplantation (induction immunosuppressive regimen) often differs from the combination used for the rest of the patient's life (maintenance immunosuppression). It is unclear which immunosuppressive regimen after liver transplantation is the best. We sought to identify the best maintenance immunosuppressive regimen by searching for existing studies on the topic. We included all randomised clinical trials reported until October 2016. We included only trials of participants who had previously undergone liver transplantation. We excluded trials of participants who had undergone multi‐organ transplantation (e.g. liver and kidney transplantations) or participants with established graft rejections. Apart from using standard Cochrane methods, which allow comparison of only two interventions at a time (direct comparison), we also employed advanced methods that allow comparison of the many different interventions individually compared in the trials (network meta‐analysis).

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

Version: 2017

Chlorhexidine mouthrinse to reduce gingivitis and plaque build‐up

Gingivitis is a reversible condition when gums become red, swollen and can bleed easily. Gingivitis is also very common ‐ studies suggest that as many as 50% to 90% of adults in the UK and USA suffer from it. In susceptible people gingivitis may lead to periodontitis, which is not reversible. In periodontitis inflammation is accompanied by loss of ligaments and bone supporting the teeth. If untreated it may eventually lead to tooth loss. Severe periodontitis is the sixth most widespread disease globally.

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

Version: 2017

Medical treatment for people with non‐alcohol related fatty liver disease

We aimed to assess different medications to treat people with non‐alcohol related fatty liver disease.

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

Version: 2017

Home or foster home alternatives to institutional long‐term care for functionally dependent older people

The aim of this Cochrane Review was to assess the effects of home or foster home alternatives to institutional care for older people who depend on others for their care.

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

Version: 2017

Medical treatment of alcohol‐related liver disease

Alcohol‐related liver disease or alcoholic liver disease is liver disease related to excessive alcohol consumption. It includes a spectrum of liver diseases that includes alcoholic steatosis (simple fatty liver or simple steatosis or accumulation of fat in liver cells), alcoholic hepatitis (inflammation of liver cells), and alcoholic cirrhosis (destruction of liver cells and replacement with scar tissue). This can cause major health problems such as excessive tiredness, and liver failure leading to vomiting blood, confusion, and death. A number of medical treatments have been used to treat alcohol‐related liver disease. The best way to treat alcohol‐related liver disease is not clear. We sought to resolve this issue by searching for existing studies on the topic. We included all randomised clinical trials whose results were reported until February 2017. We included only studies in which participants had not undergone liver transplantation previously and those who did not have liver disease due to other causes such as viral infections. Apart from using standard Cochrane methods which allow comparison of only two treatments at a time (direct comparison), we planned to use an advanced method which allows comparison of the many different treatments that are individually compared in the trials (network meta‐analysis). However, because of the nature of the information available, we could not determine whether the network meta‐analysis results were reliable. Therefore, we used standard Cochrane methodology.

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

Version: 2017

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