Preventing influenza: an overview of systematic reviews.

BACKGROUND: Many options are available for preventing people from getting infected by influenza virus, with vaccination being the most widely used. METHODS: We assessed the evidence available in Cochrane systematic reviews. We found nine reviews, five of them addressing influenza vaccination, and four addressing medication. RESULTS: Vaccination is effective in healthy adults and children, but the effect is modest in adults, and for young children few data are available. In patients with asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis, more evidence is needed to determine effectiveness. Vaccination does not result in exacerbation of asthma. Neuraminidase inhibitors may also have a place in limiting the spread of infection, at least in adults. Amantadine and rimantadine seem effective but have unfavourable adverse-effect profiles. The popularity of homoeopathic Oscillococcinum, especially in France, is not supported by current evidence. CONCLUSION: In many areas, more clinical trials are needed, as the current evidence is inconclusive. Furthermore, several other measures that may be helpful in preventing influenza that have not been addressed in Cochrane reviews.

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.

Tumor therapy with Amanita phalloides (death cap): stabilization of B-cell chronic lymphatic leukemia.

BACKGROUND: Molecular events that cause tumor formation upregulate a number of HOX genes, called switch genes, coding for RNA polymerase II transcription factors. Thus, in tumor cells, RNA polymerase II is more active than in other somatic cells. Amanita phalloides contains amanitin, inhibiting RNA polymerase II. Partial inhibition with amanitin influences tumor cell--but not normal cell--activity. OBJECTIVES: To widen the treatment spectrum, homeopathic dilutions of Amanita phalloides, containing amanitin, were given to a patient with leukemia. Monitoring the leukemic cell count, different doses of amanitin were given. RESULTS: The former duplication time of leukemic cells was 21 months. Within a period of 21 months, the cell count is stabilized to around 10(5)/µL. No leukemia-associated symptoms, liver damage, or continuous erythrocyte deprivation occur. CONCLUSIONS: This new principle of tumor therapy shows high potential to provide a gentle medical treatment.

Double-blind randomized placebo-controlled study of homoeopathic prophylaxis of migraine.

Homoeopathic remedies for migraine are widely available over the counter, statutorily offered by the national health service in the UK, and apparently popular with patients. Do they work? Sixty-three outpatients with migraine with or without aura by IHS criteria entered a 4-month randomized placebo-controlled, double-blind parallel-groups trial of individualized homoeopathic prophylaxis, the first month being baseline with all patients on placebo. Three patients (4.8%) dropped out, leaving 30 in each treatment group. There were chance differences in attack frequency and severity between the groups at baseline (attacks were more frequent but less severe in the placebo group). Both groups improved on therapy, but neither to a great extent on the primary outcome measure of attack frequency (verum: -19%; placebo: -16%). Reduction was mostly in mild attacks on placebo, more in moderate and severe attacks on homoeopathy. Few adverse events were reported. Overall, there was no significant benefit over placebo of homoeopathic treatment. The course of change differed between groups, and suggested that improvement reversed in the last month of treatment on placebo. On this evidence we cannot recommend homoeopathy for migraine prophylaxis, but cannot conclude that it is without effect.