Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2006
Review Meta AnalysisSurgery versus medical therapy for heavy menstrual bleeding.
Heavy menstrual bleeding (HMB) significantly impairs the quality of life of many otherwise healthy women. Perception of HMB is subjective and management usually depends upon what symptoms are acceptable to the individual. Medical treatment options include oral medication and a hormone-releasing intrauterine system (LNG-IUS). Surgical options include conservative surgery (uterine resection or ablation) and hysterectomy. ⋯ Surgery, especially hysterectomy, reduces menstrual bleeding at one year more than medical treatments but LNG-IUS appears equally effective in improving quality of life. The evidence for longer term comparisons is weak and inconsistent. Oral medication suits a minority of women long term.
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Cochrane Db Syst Rev · Apr 2006
ReviewStrategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease.
Patients with longstanding ulcerative colitis and colonic Crohn's disease have an increased risk of colorectal cancer compared with the general population. This review assesses the evidence that endoscopic surveillance may prolong life by allowing earlier detection of colon cancer or its pre-cursor lesion, dysplasia, in patients with inflammatory bowel disease. ⋯ There is no clear evidence that surveillance colonoscopy prolongs survival in patients with extensive colitis. There is evidence that cancers tend to be detected at an earlier stage in patients who are undergoing surveillance, and these patients have a correspondingly better prognosis, but lead-time bias could contribute substantially to this apparent benefit. There is indirect evidence that surveillance is likely to be effective at reducing the risk of death from IBD-associated colorectal cancer and indirect evidence that it may be acceptably cost-effective.
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Pre-eclampsia is a common disorder of pregnancy with uncertain etiology. In Chinese herbal medicines, a number of herbs are used for treating pre-eclampsia. Traditional Chinese medicine considers that, when a woman is pregnant, most of the blood of the mother is directed to the placenta to provide the baby with the required nutrition; other maternal organs may in consequence be vulnerable to damage. These organs include the liver, the spleen, and the kidneys. The general effects of Chinese herbal medicines that can protect these organs may be valuable in pre-eclampsia by encouraging vasodilatation, increasing blood flow, and decreasing platelet aggregation. The use of Chinese herbal medicine is often based on the individual and presence of traditional Chinese medicine symptoms. ⋯ The effect of Chinese herbal medicine for treating pre-eclampsia remains unclear. There are currently no randomized controlled trials to address the efficacy and safety of Chinese herbal medicine for the treatment of pre-eclampsia. Well conducted randomized controlled trials are required.
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Paracoccidioidomycosis is a fungal infection found in particular geographic localities in Latin America. Treatment can last for up to two years is often associated with complications, including relapse, but people may die without it. ⋯ The small number of participants and the short follow-up period impede definitive conclusions.
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Nicobrevin is a proprietary product marketed as an aid to smoking cessation. It contains quinine, menthyl valerate, camphor and eucalyptus oil. ⋯ There is no evidence available from long-term trials that Nicobrevin can aid smoking cessation.