Interventions for cutaneous molluscum contagiosum.

BACKGROUND: Molluscum contagiosum is a common skin infection that is caused by a pox virus and occurs mainly in children. The infection usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.This is an update of a Cochrane Review first published in 2006, and updated previously in 2009. OBJECTIVES: To assess the effects of specific treatments and management strategies, including waiting for natural resolution, for cutaneous, non-genital molluscum contagiosum in people without immune deficiency. SEARCH METHODS: We updated our searches of the following databases to July 2016: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We searched six trial registers and checked the reference lists of included studies and review articles for further references to relevant randomised controlled trials. We contacted pharmaceutical companies and experts in the field to identify further relevant randomised controlled trials. SELECTION CRITERIA: Randomised controlled trials of any treatment of molluscum contagiosum in people without immune deficiency. We excluded trials on sexually transmitted molluscum contagiosum and in people with immune deficiency (including those with HIV infection). DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed methodological quality, and extracted data from selected studies. We obtained missing data from study authors where possible. MAIN RESULTS: We found 11 new studies for this update, resulting in 22 included studies with a total of 1650 participants. The studies examined the effects of topical (20 studies) and systemic interventions (2 studies).Among the new included studies were the full trial reports of three large unpublished studies, brought to our attention by an expert in the field. They all provided moderate-quality evidence for a lack of effect of 5% imiquimod compared to vehicle (placebo) on short-term clinical cure (4 studies, 850 participants, 12 weeks after start of treatment, risk ratio (RR) 1.33, 95% confidence interval (CI) 0.92 to 1.93), medium-term clinical cure (2 studies, 702 participants, 18 weeks after start of treatment, RR 0.88, 95% CI 0.67 to 1.14), and long-term clinical cure (2 studies, 702 participants, 28 weeks after start of treatment, RR 0.97, 95% CI 0.79 to 1.17). We found similar but more certain results for short-term improvement (4 studies, 850 participants, 12 weeks after start of treatment, RR 1.14, 95% CI 0.89 to 1.47; high-quality evidence). For the outcome 'any adverse effect', we found high-quality evidence for little or no difference between topical 5% imiquimod and vehicle (3 studies, 827 participants, RR 0.97, 95% CI 0.88 to 1.07), but application site reactions were more frequent in the groups treated with imiquimod (moderate-quality evidence): any application site reaction (3 studies, 827 participants, RR 1.41, 95% CI 1.13 to 1.77, the number needed to treat for an additional harmful outcome (NNTH) was 11); severe application site reaction (3 studies, 827 participants, RR 4.33, 95% CI 1.16 to 16.19, NNTH over 40).For the following 11 comparisons, there was limited evidence to show which treatment was superior in achieving short-term clinical cure (low-quality evidence): 5% imiquimod less effective than cryospray (1 study, 74 participants, RR 0.60, 95% CI 0.46 to 0.78) and 10% potassium hydroxide (2 studies, 67 participants, RR 0.65, 95% CI 0.46 to 0.93); 10% Australian lemon myrtle oil more effective than olive oil (1 study, 31 participants, RR 17.88, 95% CI 1.13 to 282.72); 10% benzoyl peroxide cream more effective than 0.05% tretinoin (1 study, 30 participants, RR 2.20, 95% CI 1.01 to 4.79); 5% sodium nitrite co-applied with 5% salicylic acid more effective than 5% salicylic acid alone (1 study, 30 participants, RR 3.50, 95% CI 1.23 to 9.92); and iodine plus tea tree oil more effective than tea tree oil (1 study, 37 participants, RR 0.20, 95% CI 0.07 to 0.57) or iodine alone (1 study, 37 participants, RR 0.07, 95% CI 0.01 to 0.50). Although there is some uncertainty, 10% potassium hydroxide appears to be more effective than saline (1 study, 20 participants, RR 3.50, 95% CI 0.95 to 12.90); homeopathic calcarea carbonica appears to be more effective than placebo (1 study, 20 participants, RR 5.57, 95% CI 0.93 to 33.54); 2.5% appears to be less effective than 5% solution of potassium hydroxide (1 study, 25 participants, RR 0.35, 95% CI 0.12 to 1.01); and 10% povidone iodine solution plus 50% salicylic acid plaster appears to be more effective than salicylic acid plaster alone (1 study, 30 participants, RR 1.43, 95% CI 0.95 to 2.16).We found no statistically significant differences for other comparisons (most of which addressed two different topical treatments). We found no randomised controlled trial evidence for expressing lesions or topical hydrogen peroxide.Study limitations included no blinding, many dropouts, and no intention-to-treat analysis. Except for the severe application site reactions of imiquimod, none of the evaluated treatments described above were associated with serious adverse effects (low-quality evidence). Among the most common adverse events were pain during application, erythema, and itching. Included studies of the following comparisons did not report adverse effects: calcarea carbonica versus placebo, 10% povidone iodine plus 50% salicylic acid plaster versus salicylic acid plaster, and 10% benzoyl peroxide versus 0.05% tretinoin.We were unable to judge the risk of bias in most studies due to insufficient information, especially regarding concealment of allocation and possible selective reporting. We considered five studies to be at low risk of bias. AUTHORS' CONCLUSIONS: No single intervention has been shown to be convincingly effective in the treatment of molluscum contagiosum. We found moderate-quality evidence that topical 5% imiquimod was no more effective than vehicle in terms of clinical cure, but led to more application site reactions, and high-quality evidence that there was no difference between the treatments in terms of short-term improvement. However, high-quality evidence showed a similar number of general side effects in both groups. As the evidence found did not favour any one treatment, the natural resolution of molluscum contagiosum remains a strong method for dealing with the condition.

Stimulation of natural killer cells by homoeopathic complexes: an in vitro and in vivo pilot study in advanced cancer patients.

The present study was designed in order to evaluate the effects of five homoeopathic complex preparations on functional activity natural killer cells (NKCs) in advanced cancer patients. We examined the effects of Coenzyme Compositum®, Ubichinon Compositum®, Glyoxal Compositum®, Katalysatoren® and Traumeel® on the functional activity of NKCs. Experimental procedures included in vitro and in vivo trials. The in vitro trials were performed in NKCs isolated from 12 healthy volunteers (aged 44 ± 4 years) and incubated with the five homoeopathic complex preparations. The in vivo trials were performed in 15 advanced cancer patients (aged 55 ± 12 years) supplemented for 3 months with the homoeopathic preparations. All five homoeopathic preparations significantly increased the cytotoxic activity of the NKCs at the lowest NKCs/target cell ratio 12:1 (p < 0·05). The order of activity was: Ubichinon Compositum® > Glyoxal Compositum® > Katalysatoren® > Traumeel® > Coenzyme Compositum®. In the advanced cancer patients, the homoeopathic preparation significantly increased NKCs cytotoxic activity (p < 0·05). The homoeopathic complex preparations tested in this study can be used as an adjuvant immunotherapy in advanced cancer patients.

[Unmittelbare Remission eines mit großzelligem B-Non-Hodgkin-Lymphom befallenen inguinalen Lymphknotens unter alleiniger homöopathischer Behandlung mit Conium: Wann ist eine alleinige adjuvant-homöopathische Tumortherapie zulässig und sinnvoll?] / Immediate Remission of an Inguinal Lymph Node Afflicted with Large-Cell B-Non-Hodgkin's Lymphoma Under Sole Homeopathic Treatment with Conium: When Is a Sole Adjuvant-Homeopathic Tumor Therapy Permissible and Useful?

Bei einer 63-jährigen Patientin wird mittels Biopsie eines linksinguinalen Lymphknotens ein großzelliges B-Non-Hodgkin-Lymphom diagnostiziert. Unmittelbar nach Beginn einer homöopathischen Therapie mit Conium C 30 beginnt sich der Lymphknoten in der linken Leiste zurückzubilden. Bei Exzision des Lymphknotens vierzehn Tage nach Therapiebeginn können histologisch keine Residuen des Tumors mehr nachgewiesen werden und es darf von einer vollständigen Remission ausgegangen werden. Die Patientin bleibt in der Folge rezidivfrei. Das homöopathische Mittel Conium (Schierling) kommt in der adjuvanten homöopathischen Tumortherapie und bei vergrößerten Lymphknoten als häufig indiziertes Mittel zur Anwendung.A large-cell B-cell non-Hodgkin Lymphoma (LCBCL) was diagnosed bioptically in a female patient (age 63 years) in one left inguinal lymph node. Immediately after beginning homeopathic treatment with Conium C 30, the lymph node started to show a reduction in size. Two weeks after starting homeopathic therapy, histological examination of the excised lymph node showed no evidence of a residual tumor ­ suggestive of a complete remission. The patient remains disease free until now. The homeopathic remedy Conium (hemlock) is frequently applied for adjuvant homeopathic tumor therapy as well as for the treatment of enlarged lymph nodes.

Hospital clinical trial: Homeopathy (Agraphis nutans 5CH, Thuya occidentalis 5CH, Kalium muriaticum 9CH and Arsenicum iodatum 9CH) as adjuvant, in children with otitis media with effusion.

BACKGROUND: Otitis media with effusion (OME) is the most common cause of paediatric hearing loss. No single treatment has proved its effectiveness. There is a lack of evidence-based medicine studies in the area of homeopathy. METHOD: A prospective randomized, double blinded interventional placebo control study was conducted. Patients, from 2 months to 12 years, with OME diagnosed by pneumatic otoscopy (PNO) and tympanometry, were randomized into two groups. Both groups received aerosol therapy (mucolytics and corticosteroids). In addition, the experimental group (EG) received homeopathy (Agraphis nutans 5CH, Thuya Occidentalis 5CH, Kalium muriaticum 9CH and Arsenicum iodatum), and the placebo group (PG) placebo, both of them for 3 months. Patients were evaluated by PNO examination and tympanometry at baseline, at 45 and 90 days. RESULTS: 97 patients were enrolled. In the EG, 61.9% of individuals were cured (PNO went from negative in the 1st visit to positive in the 3rd visit) compared with 56.8% of patients treated with placebo. 4.8% of patients in the EG suffered a recurrence (positive PNO in the 2nd visit changed to negative in the 3rd visit) while 11.4% did in the PG. No significant difference was found. Adverse events were distributed similarly, except in the case of upper respiratory tract infections, which were less frequent in EG (3 vs. 13, p: 0.009). CONCLUSION: The homeopathic scheme used as adjuvant treatment cannot be claimed to be an effective treatment in children with OME. TRIAL REGISTRATION: EUDRACT number: 2011-006086-17, PROTOCOL code: 55005646.

AnergiX.RA Corixa.

Corixa (formerly Anergen), in collaboration with Organon, is developing AnergiX.RA, a complex of solubilized HLA DRB1-0401(a) together with a specific peptide from the human cartilage glycoprotein HCgp39, for the potential treatment of rheumatoid arthritis (RA) [307156]. Phase I/II trials were completed in April 2000 and the final results from the randomized, blinded, placebo-controlled dose-escalation study are expected later this year [363409]. The product utilizes Anergen's AnergiX technology, and combines an MHC-derived protein with an Organon autoantigen peptide, derived from myelin basic protein and involved in the development of RA [212659,363409]. Engagement of T-cell receptors with AnergiX.RA induces apoptosis in autoreactive T-cells [227421]. Researchers at Organon identified the central component in AnergiX.RA; results from preclinical studies identifying this target protein were published in June 1997 in Arthritis & Rheumatism. Researchers demonstrated that HC (human cartilage) gp39 is recognized by T-cells from RA patients and has the potential to block arthritis in the mouse model [248543,354821].

[Warts and molluscum contagiosum: practical point of view]. / Verrues et molluscums contagiosums: mise au point pratique.

Warts and molluscums contagiosums are two benign viral skin diseases that commonly affect children. Contamination occurs by autoinoculation or during skin to skin contact. Molluscums contagiosums are more frequent in immunodeficient and atopic children. Swimming-pool practice and contact sports favour warts transmission. The choice of treatment depends upon the age of the child and the number and location of the lesions. Natural resolution can be awaited when lesions are limited. In first intent, curettage of the lesions under local anesthesia for molluscums contagiosums, salicylic acid preparation or cryotherapy according to location for warts, are the treatment of choice. In neither affection school ousting is necessary.

[The effects of Polyrhachis vicina on immunoregulation in mice].

OBJECTIVE: To study the immuno-regulatory effects of Polyrhachis vicina Roger(PVR) in mice. METHOD: By determining the immune function of normal mice and immune function-depressed or enhanced mice after the administration of PVR. RESULTS: PVR (0.25 g.kg-1.d-1 x 10 d, 0.5 g.kg-1.d-1 x 10 d, 1.5 g.kg-1.d-1 x 10 d, op) had no effects on non-specific immune function (weight of immune organs) and cell immune function (delayed type hypersensitivity, DTH) in normal mice, but could improve the non-specific immune function and fluids immune function (hemolysin assay method) in immune function-depressed mice induced with hydrocortisonun (5 x 10(-2) g.kg-1.d-1 x 5 d). Both depressed DTH and enhanced DTH induced with cyclophosphamide (Cy) at the doses of 80 mg.kg-1.d-1 x 1 d and 250 g.kg-1.d-1 x 10 d ig. respectively were regulated by PVR (1.5 g.kg-1.d-1 x 10 d). CONCLUSION: PVR has immuno-regulatory activities in mice.

[Homeopathic preparation Cheblin-CK-1 in the pathogenetic therapy of echinococcosis]. / Ispol'zovanie gomeopaticheskogo preparata Cheblin-CK-1 v patogeneticheskoi terapii ékhinokokkoza.

This study was experimental and clinical. The experiments were made on 80 cotton rats. The clinical study covered 289 patients operated on for echinococcosis. Earlier studies indicated that echinococcosis is accompanied by secondary immunodeficiency and amino acid metabolic disorders. The homeopathic drug Cheblin-CK-1 used normalized amino acid metabolism 40 days after treatment in these patients. The same properties were displayed by homeopathic drugs.

Systemic treatments for cutaneous warts: a systematic review.

BACKGROUND: Systemic therapies are routinely used for the management of cutaneous warts. However, there is a lack of evidence-based data on their effectiveness. OBJECTIVE: To assess the evidence for the efficacy of systemic treatments for cutaneous warts. METHODS: We designed a systematic review of the randomized controlled clinical trials (1962 to April 2010) investigating systemic therapies for the treatment of cutaneous warts. We obtained data from MEDLINE, PubMed, Current Contents, reference lists, and specialist textbooks, with no restriction on language. The main outcome measures were the total clearance of warts and the adverse effects. RESULTS: There was substantial heterogeneity in the design of the trials. No consistent evidence was found for the efficacy of cimetidine, levamisole or homeopathy, and only limited evidence was found for the efficacy of zinc. CONCLUSIONS: Reviewed trials of systemic treatments for cutaneous warts were highly variable in methods and quality, and there was a paucity of evidence from randomized, placebo-controlled trials on which to base the rational use of such therapies. Limited evidence is emerging that zinc may be effective in selected populations with zinc deficiency.

Effect of Traumeel S on cytokine profile in a cecal ligation and puncture (CLP) sepsis model in rats.

BACKGROUND: Sepsis results in significant morbidity and mortality, with current treatment options limited with respect to efficacy as well as safety. The complex homeopathic remedy Traumeel S has been shown to have both anti-inflammatory and immunostimulatory effects in the in vitro setting. OBJECTIVES: The objective was to explore the effects of Traumeel S in an in vivo setting, using a cecal ligation and puncture (CLP) sepsis model in rats, evaluating the effects of the medication on cytokine activity. DESIGN: Sepsis was induced in 30 rats using accepted CLP methodology. Following the procedure, rats were randomly allocated to receive an intraperitoneal injection of either Traumeel S (n=15) or normal saline (n=15). At 6 hours post-CLP, serum cytokines (interleukin [IL]-1ß, tumor necrosis factor-α, IL-6, and IL-10) were evaluated. RESULTS: IL-1ß levels were significantly higher in the treatment group (p=0.03) with no significant differences found between the groups with respect to the other cytokines tested. CONCLUSIONS: In contrast to in vitro studies, Traumeel significantly increased IL-1ß levels in an in vivo model, without influencing other cytokines. IL-1ß is a proinflammatory cytokine that has been shown to have a protective effect in the CLP rat model. Further research is warranted to examine this finding, as well as its clinical implications.

New therapeutic approaches.

Clinicians have witnessed an evolution from sulfasalazine and hydrocortisone to alternative aminosalicylates and steroids. Revolutionary changes beyond these, however, and other "nonspecific" anti-immunoinflammatory compounds require clarification of the primary events either activating inflammatory cascades or preventing the down-regulation of homeopathic inflammation. The authors remain encouraged by advances in basic research pertaining to IBD and optimistic that novel empiric observations and therapeutic trials will focus bench-side investigation as clinicians strive to improve the quality of life for patients.

[The effectiveness of paramunization for the control of feline coryza]. / Untersuchungen über die Wirksamkeit der Paramunisierung zur Bekämpfung des Katzenschnupfens.

20 cats in a cat home were treated prophylactically and therapeutically with Baypamun HK. The animals were allocated into three groups as described. 7 freshly admitted clinically healthy cats were treated prophylactically on day 1, 2 and 9 with 1 ml Baypamun HK (group I). 7 cats, who already were allocated for one year in the home and were sick of the feline respiratory disease complex were treated as described for group I (group II). 6 further cats, who also showed symptoms of the feline respiratory disease complex and had stayed for one year in the home were treated with physiol.saline solution according to group I (group III). From all cats blood samples were taken at day 1, 3, 10 and 17. The blood samples were checked for antibodies against feline calicivirus (FCV), feline herpesvirus (FHV), panleukopenia virus (PLV), feline peritonitis virus (FIPV) and feline immunodeficiency virus (FIV). Also the occurrence of the feline leukemia virus (FeLV) was evaluated. The cellular immunity was evaluated by means of the lymphocyte transformations test (LTT), nitroblue-tetrazolium reduction test (NBT) and cytochrome C-reduction test (CRT). Mean value and standard deviation was calculated from the results. The significance was determined by the t-test. The animals were examined clinically daily for 20 days for the feline respiratory disease complex. When necessary, the animals were treated by homeopathic and antibiotic products. At the time of admission to the home all cats were or had been treated with an attenuated panleukopenia vaccine. The serologic parameters were not influenced in the cats of group I.(ABSTRACT TRUNCATED AT 250 WORDS)

Mistletoe extracts standardised in terms of mistletoe lectins (ML I) in oncology: current state of clinical research.

PURPOSE: The aim of this review is to present the current state of clinical oncological research on mistletoe extracts standardised in terms of the active substance mistletoe lectin. METHODS: This review focuses on studies with clearly defined mistletoe extracts standardised in terms of mistletoe lectins I, II, and III (calculated as mistletoe lectin I, ML I) which belong to the category of rational phytotherapy. That means that studies with anthroposophic or homeopathic drugs will not be included. RESULTS: There are several preclinical studies that show a cytotoxic and immunostimulating effect of mistletoe extracts, predominantly on the cellular immune system. The clinical database, however, is not as good as the experimental results. So far, no direct anticancer action or any improvement in time to tumour progression or overall survival in cancer patients has been seen. The first results of a randomised phase III study suggest that additive administration of a mistletoe preparation may improve the quality of life. CONCLUSION: Mistletoe therapy has not gained an established place in oncology. Further, well-planned randomised clinical investigations will be necessary to verify the first positive findings with regard to an improvement of quality of life in cancer patients.

Otros fármacos y procederes en el tratamiento de las infecciones en Ortopedia / Other drugs and procedures in the treatment of orthopedic infections

Los vertiginosos avances que se vienen produciendo en el campo de la farmacología han permitido la aparición de nuevos antibióticos para tratar eficazmente las infecciones osteomioarticulares. Hoy los gérmenes más frecuentes de este tipo estafilococos, estreptococos, neiseria gonorreae, hemophilos enfluenzae, y bacilos gramnegativos entre otros, los cuales se han hecho resistentes a muchos antibióticos convencionales. En este trabajo exponemos los tratamientos idóneos en infecciones como artritis, osteomielitis, osteítis, tenosinovitis, bursitis, mordeduras y heridas; siempre se tiene en cuenta la edad del paciente y el tipo de afección en el momento de su aplicación