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The Laryngoscope Jun 2015To determine the effectiveness and safety of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). The study was conducted and reported in accordance... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the effectiveness and safety of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). The study was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES
A comprehensive search strategy in MEDLINE, EMBASE, the Cochrane library, and Google Scholar was completed and limited to studies published in English. Relevant reference lists were reviewed.
STUDY SELECTION
Two independent reviewers selected prospective or retrospective studies of pediatric patients treated with interventional sialendoscopy for the management of JRP. Outcome measures included rates of successful treatment (no further episodes of parotid swelling or need for further sialendoscopy) and complications,
DATA EXTRACTION
Two reviewers appraised the level of evidence using the Oxford Clinical Evidence-based Medicine (OCEBM) guidelines, extracted data, and resolved discrepancies by consensus. Weighted pooled proportion, 95% confidence interval (CI), and test results for heterogeneity and publication bias are reported.
RESULTS
Seven studies were included. Levels of evidence varied from OCEBM level 3 to 4. The weighted pooled proportion of success rates for no further episodes by patient (n = 120) was 73% (95% CI: 64%-82%) and by gland (n = 165) 81% (95% CI: 75%-87%). The weighted pooled proportion of success rates for no further sialendoscopy by patient was 87% (95% CI: 81%-93%). Heterogeneity was low, and publication bias was not detected. There were no major complications reported. Surgical techniques and endoscopic findings are summarized.
CONCLUSIONS
The results from this analysis suggest that sialendoscopy is effective and safe for the treatment of JRP and may be offered to appropriate patients.
LEVEL OF EVIDENCE
NA
Topics: Endoscopy; Humans; Parotitis; Treatment Outcome
PubMed: 25393103
DOI: 10.1002/lary.25029 -
The Cochrane Database of Systematic... Sep 2012Mumps is an infectious disease caused by the mumps virus. Chinese physicians generally believe that Chinese medicinal herbs are effective in alleviating symptoms and... (Review)
Review
BACKGROUND
Mumps is an infectious disease caused by the mumps virus. Chinese physicians generally believe that Chinese medicinal herbs are effective in alleviating symptoms and reducing the duration of mumps. Herbalists tend to develop a treatment plan according to the individual's symptoms.
OBJECTIVES
To evaluate the effectiveness and safety of Chinese medicinal herbs for mumps.
SEARCH METHODS
We searched CENTRAL Issue 4, 2012, MEDLINE (1948 to April week 3, 2012), EMBASE (1974 to April 2012), CINAHL (1981 to April 2012), AMED (1985 to April 2012), the Chinese Biomedical Database (CBM) (1980 to May 2012), China National Knowledge Infrastructure (CNKI) (1979 to May 2012), VIP Information (1989 to May 2012), and relevant databases of ongoing trials.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of Chinese medicinal herbs for mumps (with or without complications).
DATA COLLECTION AND ANALYSIS
Two review authors (MS, ZL) independently evaluated trial quality and conducted data extraction. We contacted the trial authors for missing data regarding participant allocation. Some trials allocated participants according to the participants' admitting sequence, making it a pseudo-random allocation. None of the trials concealed participants allocation or used blinding.
MAIN RESULTS
We did not identify any eligible trials for inclusion. We identified 102 studies which claimed to use random allocation. Ninety-nine studies were excluded because the allocation methods the authors had used were not actually randomised. We were unable to contact the trial authors of the remaining three studies. These trials require further evaluation and have been allocated to the 'Studies awaiting classification' section.
AUTHORS' CONCLUSIONS
We did not find any RCTs for or against Chinese herbal medicine used in the treatment of mumps. We hope more high-quality RCTs will be conducted in the future.
Topics: Drugs, Chinese Herbal; Humans; Mumps; Phytotherapy
PubMed: 22972124
DOI: 10.1002/14651858.CD008578.pub2 -
The Cochrane Database of Systematic... Sep 2012Mumps is an acute, viral illness transmitted by respiratory droplets and saliva. A number of studies published in China have suggested that acupuncture is beneficial for... (Review)
Review
BACKGROUND
Mumps is an acute, viral illness transmitted by respiratory droplets and saliva. A number of studies published in China have suggested that acupuncture is beneficial for children with mumps but the literature reporting the benefits or harms of acupuncture for mumps has not been systematically reviewed.
OBJECTIVES
To determine the efficacy and safety of acupuncture for children with mumps.
SEARCH METHODS
We searched CENTRAL (2012, Issue 4), MEDLINE (1950 to April week 4, 2012), EMBASE (1974 to May 2012), CINAHL (1981 to May 2012), AMED (1985 to May 2012), the Chinese BioMedicine Database (CBM) (1979 to May 2012), China National Knowledge Infrastructure (CNKI) (1979 to May 2012), Chinese Technology Periodical Database (CTPD) (1989 to May 2012) and WANFANG database (1982 to May 2012). We also handsearched a number of journals (from first issue to current issue).
SELECTION CRITERIA
We included randomised controlled trials comparing acupuncture with placebo acupuncture, no management, Chinese medication, Western medication or other treatments for mumps. Acupuncture included either traditional acupuncture or contemporary acupuncture, regardless of the source of stimulation (body, electro, scalp, fire, hand, fine needle, moxibustion).
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed the quality of included studies. We calculated risk ratios (RR) with their 95% confidence intervals (CI) for the effective percentage and standardised mean differences (SMD) with 95% CIs for the time to cure.
MAIN RESULTS
Only one study with 239 participants met our inclusion criteria. There were a total of 120 participants in the acupuncture group, of which 106 recovered, with their temperature returning back to normal and no swelling or pain of the parotid gland; the condition of 14 participants improved, with a drop in temperature and alleviation of swelling or pain of the parotid gland. There were 119 participants in the Western medicine group, of which 56 recovered and the condition of 63 improved. The acupuncture group had a higher recovery rate than the control group. The relative RR of recovery was 1.88 (95% CI 1.53 to 2.30). However, the acupuncture group had a longer time to cure than the control group. The mean was 4.20 days and the standard deviation (SD) was 0.46 in the acupuncture group, while in the control group the mean was 3.78 days and the SD was 0.46.There was a potential risk of bias in the study because of low methodological quality.
AUTHORS' CONCLUSIONS
We could not reach any confident conclusions about the efficacy and safety of acupuncture based on one study. More high-quality research is needed.
Topics: Acupuncture Therapy; Child; Drugs, Chinese Herbal; Fever; Humans; Mumps; Randomized Controlled Trials as Topic
PubMed: 22972121
DOI: 10.1002/14651858.CD008400.pub2 -
The Cochrane Database of Systematic... Feb 2012Mumps, measles and rubella (MMR) are serious diseases that can lead to potentially fatal illness, disability and death. However, public debate over the safety of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mumps, measles and rubella (MMR) are serious diseases that can lead to potentially fatal illness, disability and death. However, public debate over the safety of the trivalent MMR vaccine and the resultant drop in vaccination coverage in several countries persists, despite its almost universal use and accepted effectiveness.
OBJECTIVES
To assess the effectiveness and adverse effects associated with the MMR vaccine in children up to 15 years of age.
SEARCH METHODS
For this update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, PubMed (July 2004 to May week 2, 2011) and Embase.com (July 2004 to May 2011).
SELECTION CRITERIA
We used comparative prospective or retrospective trials assessing the effects of the MMR vaccine compared to placebo, do nothing or a combination of measles, mumps and rubella antigens on healthy individuals up to 15 years of age.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed methodological quality of the included studies. One review author arbitrated in case of disagreement.
MAIN RESULTS
We included five randomised controlled trials (RCTs), one controlled clinical trial (CCT), 27 cohort studies, 17 case-control studies, five time-series trials, one case cross-over trial, two ecological studies, six self controlled case series studies involving in all about 14,700,000 children and assessing effectiveness and safety of MMR vaccine. Based on the available evidence, one MMR vaccine dose is at least 95% effective in preventing clinical measles and 92% effective in preventing secondary cases among household contacts.Effectiveness of at least one dose of MMR in preventing clinical mumps in children is estimated to be between 69% and 81% for the vaccine prepared with Jeryl Lynn mumps strain and between 70% and 75% for the vaccine containing the Urabe strain. Vaccination with MMR containing the Urabe strain has demonstrated to be 73% effective in preventing secondary mumps cases. Effectiveness of Jeryl Lynn containing MMR in preventing laboratory-confirmed mumps cases in children and adolescents was estimated to be between 64% to 66% for one dose and 83% to 88% for two vaccine doses. We did not identify any studies assessing the effectiveness of MMR in preventing rubella.The highest risk of association with aseptic meningitis was observed within the third week after immunisation with Urabe-containing MMR (risk ratio (RR) 14.28; 95% confidence interval (CI) from 7.93 to 25.71) and within the third (RR 22.5; 95% CI 11.8 to 42.9) or fifth (RR 15.6; 95% CI 10.3 to 24.2) weeks after immunisation with the vaccine prepared with the Leningrad-Zagreb strain. A significant risk of association with febrile seizures and MMR exposure during the two previous weeks (RR 1.10; 95% CI 1.05 to 1.15) was assessed in one large person-time cohort study involving 537,171 children aged between three months and five year of age. Increased risk of febrile seizure has also been observed in children aged between 12 to 23 months (relative incidence (RI) 4.09; 95% CI 3.1 to 5.33) and children aged 12 to 35 months (RI 5.68; 95% CI 2.31 to 13.97) within six to 11 days after exposure to MMR vaccine. An increased risk of thrombocytopenic purpura within six weeks after MMR immunisation in children aged 12 to 23 months was assessed in one case-control study (RR 6.3; 95% CI 1.3 to 30.1) and in one small self controlled case series (incidence rate ratio (IRR) 5.38; 95% CI 2.72 to 10.62). Increased risk of thrombocytopenic purpura within six weeks after MMR exposure was also assessed in one other case-control study involving 2311 children and adolescents between one month and 18 years (odds ratio (OR) 2.4; 95% CI 1.2 to 4.7). Exposure to the MMR vaccine was unlikely to be associated with autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn's disease, demyelinating diseases, bacterial or viral infections.
AUTHORS' CONCLUSIONS
The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with the MMR vaccine cannot be separated from its role in preventing the target diseases.
Topics: Adolescent; Age Factors; Autistic Disorder; Child; Child, Preschool; Clinical Trials as Topic; Crohn Disease; Epidemiologic Studies; Humans; Infant; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Purpura, Thrombocytopenic; Rubella; Seizures, Febrile; Vaccines, Attenuated
PubMed: 22336803
DOI: 10.1002/14651858.CD004407.pub3 -
Autoimmunity Reviews Dec 2011To analyze available evidence on vaccinations in paediatric patients with rheumatic and autoinflammatory diseases. This evidence formed the basis of the recently... (Review)
Review
Vaccination in paediatric patients with auto-immune rheumatic diseases: a systemic literature review for the European League against Rheumatism evidence-based recommendations.
OBJECTIVES
To analyze available evidence on vaccinations in paediatric patients with rheumatic and autoinflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients.
METHODS
A systematic literature review in the MEDLINE and EMBASE databases was conducted using various terms for vaccinations, paediatric rheumatic and autoinflammatory diseases and immunosuppressive drugs. Only papers on paediatric patients (<18 years of age) were selected. A panel of 13 experts in the field graded methodological quality and extracted data using predefined criteria.
RESULTS
27 papers were available. No studies were found on autoinflammatory diseases. 14 studies considered live-attenuated vaccines. Evidence so far supports the safety and immunogenicity of non-live composite vaccines, although studies were underpowered to accurately assess safety. Live-attenuated vaccines did not cause disease flares or severe adverse events, not even in patients on methotrexate and low dose glucocorticosteroids. Seven patients on anti-TNFalpha therapy were described receiving the live-attenuated measles, mumps, rubella (n=5) or varicella (n=2) booster without severe adverse events.
CONCLUSIONS
Data on safety and efficacy of vaccinations in paediatric patients with rheumatic diseases is reassuring, but too limited to draw definite conclusions. More research is needed on the safety and efficacy of especially live-attenuated vaccines in patients with rheumatic and autoinflammatory diseases using high dose immunosuppressive drugs.
Topics: Adolescent; Chickenpox; Chickenpox Vaccine; Child; Child, Preschool; Consensus; Databases, Bibliographic; Drug-Related Side Effects and Adverse Reactions; Evidence-Based Medicine; Female; Hereditary Autoinflammatory Diseases; Humans; Immunosuppressive Agents; Infant; Male; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Practice Guidelines as Topic; Rheumatic Diseases; Rubella; Vaccination; Vaccines, Attenuated
PubMed: 21896342
DOI: 10.1016/j.autrev.2011.08.010 -
BMJ Clinical Evidence Feb 2007Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding... (Review)
Review
INTRODUCTION
Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding complications in survivors. Mumps can cause neurological problems and hearing loss, orchitis with infertility, and pancreatitis. Rubella infection is usually mild, but can lead to fetal death or severe congenital abnormalities if contracted in early pregnancy. The incidence of all three infections has decreased significantly in countries with routine vaccination programmes targeted at these diseases, but decreased vaccination rates are associated with increased risks of infection.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of measles, mumps, and rubella vaccination? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 94 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: MMR vaccine, monovalent measles vaccine, monovalent mumps vaccine, and monovalent rubella vaccine.
Topics: Deafness; Hearing; Hearing Loss; Humans; Measles; Mumps; Recovery of Function; Risk Factors; Rubella; Treatment Outcome; Virus Diseases
PubMed: 19454052
DOI: No ID Found -
The Cochrane Database of Systematic... Oct 2005Public debate over the safety of the trivalent measles, mumps and rubella (MMR) vaccine, and the resultant drop in vaccination rates in several countries, persists... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Public debate over the safety of the trivalent measles, mumps and rubella (MMR) vaccine, and the resultant drop in vaccination rates in several countries, persists despite its almost universal use and accepted effectiveness.
OBJECTIVES
We carried out a systematic review to assess the evidence of effectiveness and unintended effects associated with MMR.
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2004), MEDLINE (1966 to December 2004), EMBASE (1974 to December 2004), Biological Abstracts (from 1985 to December 2004), and Science Citation Index (from 1980 to December 2004). Results from reviews, handsearching and from the consultation of manufacturers and authors were also used.
SELECTION CRITERIA
Eligible studies were comparative prospective or retrospective trials testing the effects of MMR compared to placebo, do-nothing or a combination of measles, mumps and rubella antigens on healthy individuals up to 15 years of age. These studies were carried out or published by 2004.
DATA COLLECTION AND ANALYSIS
We identified 139 articles possibly satisfying our inclusion criteria and included 31 in the review.
MAIN RESULTS
MMR was associated with a lower incidence of upper respiratory tract infections, a higher incidence of irritability, and similar incidence of other adverse effects compared to placebo. The vaccine was likely to be associated with benign thrombocytopenic purpura, parotitis, joint and limb complaints, febrile convulsions within two weeks of vaccination and aseptic meningitis (mumps) (Urabe strain-containing MMR). Exposure to MMR was unlikely to be associated with Crohn's disease, ulcerative colitis, autism or aseptic meningitis (mumps) (Jeryl-Lynn strain-containing MMR). We could not identify studies assessing the effectiveness of MMR that fulfilled our inclusion criteria even though the impact of mass immunisation on the elimination of the diseases has been largely demonstrated.
AUTHORS' CONCLUSIONS
The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with MMR cannot be separated from its role in preventing the target diseases.
Topics: Adolescent; Autistic Disorder; Child; Clinical Trials as Topic; Crohn Disease; Humans; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Rubella; Vaccines, Attenuated
PubMed: 16235361
DOI: 10.1002/14651858.CD004407.pub2 -
Vaccine Sep 2003Public debate over the safety of the trivalent measles, mumps and rubella (MMR) vaccine and the drop in vaccination rates in several countries persists despite its... (Meta-Analysis)
Meta-Analysis Review
Public debate over the safety of the trivalent measles, mumps and rubella (MMR) vaccine and the drop in vaccination rates in several countries persists despite its almost universal use and accepted effectiveness. We carried out a systematic review to assess the evidence of unintended effects (beneficial or harmful) associated with MMR and the applicability of systematic reviewing methods to the field of safety evaluation. Eligible studies were comparative prospective or retrospective on healthy individuals up to 15 years of age, carried out or published by 2003. We identified 120 articles satisfying our inclusion criteria and included 22. MMR is associated with a lower incidence of upper respiratory tract infections, a higher incidence of irritability, similar incidence of other adverse effects compared to placebo and is likely to be associated with benign thrombocytopenic purpura (TP), parotitis, joint and limb complaints and aseptic meningitis (mumps Urabe strain-containing MMR). Exposure to MMR is unlikely to be associated with Crohn's disease, ulcerative colitis, autism or aseptic meningitis (mumps Jeryl-Lynn strain-containing MMR). The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunization with MMR cannot be separated from its role in preventing the target diseases.
Topics: Bias; Case-Control Studies; Cohort Studies; Ecology; Humans; Infant, Newborn; Measles-Mumps-Rubella Vaccine; Prospective Studies; Randomized Controlled Trials as Topic; Research Design; Retrospective Studies; Twin Studies as Topic; Vaccines, Attenuated
PubMed: 12922131
DOI: 10.1016/s0264-410x(03)00271-8