Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2010
ReviewInterventions for treating brain arteriovenous malformations in adults.
Brain arteriovenous malformations (AVMs) are the single most common cause of intracerebral haemorrhage in young adults. Brain AVMs also cause seizure(s) and focal neurological deficits (in the absence of haemorrhage, migraine or an epileptic seizure); approximately one fifth are incidental discoveries. Various interventions are used in an attempt to eradicate brain AVMs: neurosurgical excision, stereotactic radiotherapy/'radiosurgery' (using gamma knife, linear accelerator, proton beam, or 'Cyber Knife'), endovascular embolisation (using glues, particles, fibres, coils, or balloons), and staged combinations of these interventions. This is an update of a Cochrane review first published in 2006. ⋯ There is no evidence from randomised trials with clear clinical outcomes comparing different interventional treatments for brain AVMs against each other or against usual medical therapy to guide the interventional treatment of brain AVMs in adults. One such trial (ARUBA) is ongoing.
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Paediatric pes planus ('flat feet') is a common childhood condition with a reported prevalence of 14%. Flat feet can result in pain and altered gait. No optimal strategy for non-surgical management of paediatric flat feet has been identified. ⋯ The evidence from randomised controlled trials is currently too limited to draw definitive conclusions about the use of non-surgical interventions for paediatric pes planus. Future high quality trials are warranted in this field. Only limited interventions commonly used in practice have been studied and there is much debate over the treatment of symptomatic and asymptomatic pes planus.
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Cochrane Db Syst Rev · Jul 2010
ReviewOrthodontics for treating temporomandibular joint (TMJ) disorders.
Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders many treatment modalities have been identified some of which are also considered in other Cochrane reviews. The disorder also has a normal cycle of events appearing to spontaneously improve without treatment. ⋯ There are insufficient research data on which to base our clinical practice on the relationship of active orthodontic intervention and TMD. There is an urgent need for high quality randomised controlled trials in this area of orthodontic practice.When considering consent for patients it is essential to reflect the seemingly random development/alleviation of TMD signs and symptoms.