Reviews

Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: Meta-analysis of controlled clinical trials
According to clinical trial evidence in patients with stable mild-to-moderate asthma with AERD, acute exposure to COX-2 inhibitors is safe, and selective NSAIDs exhibit a small risk. Thus COX-2 inhibitors could be used in patients with AERD or in patients with general asthma unwilling to risk nonselective NSAID exposure when oral challenge tests are unavailable. Morales DR, Lipworth BJ, Guthrie B, Jackson C, Donnan PT, Santiago VH. J Allergy Clin Immunol. 2013 Dec 30. pii: S0091-6749(13)01774-0. [Epub ahead of print] PMID: 24388008

Metal protein attenuating compounds for the treatment of Alzheimer's dementia
There is an absence of evidence as to whether clioquinol (PBT1) has any positive clinical benefit for patients with AD, or whether the drug is safe. We have some concerns about the quality of the study methodology; there was an imbalance in treatment and control groups after randomisation (participants in the active treatment group had a higher mean pre-morbid IQ) and the secondary analyses of results stratified by baseline dementia severity. The planned phase III trial of PBT1 has been abandoned and this compound has been withdrawn from development. The second trial of PBT2 was more rigorously conducted and showed that after 12 weeks this compound appeared to be safe and well tolerated in people with mild Alzheimer's dementia. Larger trials are now required to demonstrate cognitive efficacy. Sampson EL, Jenagaratnam L, McShane R. Cochrane Database Syst Rev. 2014 Feb 21;2:CD005380. [Epub ahead of print] PMID: 24563468

Preventing early infant sleep and crying problems and postnatal depression: a randomized trialAn education program reduces postnatal depression symptoms, as well as sleep and cry problems in infants who are frequent feeders. The program may be best targeted to frequent feeders. Hiscock H, Cook F, Bayer J, Le HN, Mensah F, Cann W, Symon B, St James-Roberts I. Pediatrics. 2014 Feb;133(2):e346-54. Epub 2014 Jan 6. PMID: 24394682

Dietary interventions for preventing complications in idiopathic hypercalciuria
Long-term adherence (five years) to diets that feature normal levels of calcium, low protein and low salt may reduce numbers of stone recurrences, decrease oxaluria and calcium oxalate relative supersaturation indexes in people with idiopathic hypercalciuria who experience recurrent kidney stones. Adherence to a low salt, normal calcium level diet for some months can reduce calciuria and oxaluria. However, the other dietary interventions examined did not demonstrate evidence of significant beneficial effects.No studies were found investigating the effect of dietary recommendations on other clinical complications or asymptomatic idiopathic hypercalciuria. Escribano J, Balaguer A, Roqué I Figuls M, Feliu A, Ferre N. Cochrane Database Syst Rev. 2014 Feb 11;2:CD006022. [Epub ahead of print] PMID: 24519664

 

Effectiveness of general practice-based health checks: a systematic review and meta-analysis

General practice-based health checks are associated with statistically significant, albeit clinically small, improvements in surrogate outcome control, especially among high-risk patients. Most studies were not originally designed to assess mortality. Si S, Moss JR, Sullivan TR, Newton SS, Stocks NP.

Br J Gen Pract. 2014 Jan;64(618):e47-53. PMID: 24567582

Nasal endoscopy is recommended for diagnosing adults with chronic rhinosinusitis
Computed tomography is not considered necessary in case of a positive nasal endoscopy. While nasal endoscopy cannot rule out chronic rhinosinusitis, we advise computed tomography only for patients with a prolonged or complicated course of rhinosinusitis. Wuister AM, Goto NA, Oostveen EJ, de Jong WU, van der Valk ES, Kaper NM, Aarts MC, Grolman W, van der Heijden GJ. Otolaryngol Head Neck Surg. 2014 Mar;150(3):359-64. Epub 2013 Dec 9. PMID: 24567340

Systematic Review and Meta-analyses: Fever in Pregnancy and Health Impacts in the Offspring
We found substantial evidence to support the contention that maternal fever during pregnancy may negatively affect offspring health. The harmful effects seemed to cover both short- and longer-term health outcomes; however, for several outcomes, the evidence was insufficient to judge any association. Dreier JW, Andersen AM, Berg-Beckhoff G. Pediatrics. 2014 Feb 24. [Epub ahead of print] PMID: 24567014