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Arhiv Za Higijenu Rada I Toksikologiju Mar 2012Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide... (Review)
Review
Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fluid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management.
Topics: Aluminum Compounds; Humans; Pesticides; Phosphines
PubMed: 22450207
DOI: 10.2478/10004-1254-63-2012-2182 -
The Cochrane Database of Systematic... Oct 2009Radioactive iodine treatment for differentiated thyroid cancer possibly results in xerostomia. Amifostine has been used to prevent the effects of irradiation to salivary... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Radioactive iodine treatment for differentiated thyroid cancer possibly results in xerostomia. Amifostine has been used to prevent the effects of irradiation to salivary glands. To date, the effects of amifostine on salivary glands in radioactive iodine treated differentiated thyroid cancer remain uncertain.
OBJECTIVES
To assess the effects of amifostine on salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer.
SEARCH STRATEGY
Studies were obtained from computerized searches of MEDLINE, EMBASE, The Cochrane Library and paper collections of conferences held in Chinese.
SELECTION CRITERIA
Randomised controlled clinical trials and quasi-randomised controlled clinical trials comparing the effects of amifostine on salivary glands after radioactive iodine treatment for differentiated thyroid cancer with placebo and a duration of follow up of at least three months.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed risk of bias and extracted data.
MAIN RESULTS
Two trials with 130 patients (67 and 63 patients randomised to intervention versus control) were included. Both studies had a low risk of bias. Amifostine versus placebo showed no statistically significant differences in the incidence of xerostomia (130 patients, two studies), the decrease of scintigraphically measured uptake of technetium-99m by salivary or submandibular glands at twelve months (80 patients, one study), and the reduction of blood pressure (130 patients, two studies). Two patients in one study collapsed after initiation of amifostine therapy and had to be treated by withdrawing the infusion and volume substitution. Both patients recovered without sequelae. Meta-analysis was not performed on the function of salivary glands measured by technetium-99m scintigraphy at three months after high dose radioactive iodine treatment due to the highly inconsistent findings across studies (I(2) statistic 99%). None of the included trials investigated death from any cause, morbidity, health-related quality of life or costs.
AUTHORS' CONCLUSIONS
Results from two randomised controlled clinical trials suggest that the amifostine has no significant radioprotective effects on salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer patients. Moreover, no health-related quality of life and other patient-oriented outcomes were evaluated in the two included trials. Randomised controlled clinical trials with low risk of bias investigating patient-oriented outcomes are needed to guide treatment choice.
Topics: Adenocarcinoma, Follicular; Amifostine; Carcinoma, Papillary; Humans; Iodine Radioisotopes; Radiation Injuries; Radiation-Protective Agents; Radionuclide Imaging; Randomized Controlled Trials as Topic; Salivary Glands; Thyroid Neoplasms; Xerostomia
PubMed: 19821441
DOI: 10.1002/14651858.CD007956.pub2 -
BMJ Clinical Evidence Jan 2009Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely... (Review)
Review
INTRODUCTION
Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, and of lower socioeconomic group.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for head lice? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (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 15 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: dimeticone, herbal and essential oils, insecticide combinations, lindane, malathion, mechanical removal by combing ('bug busting'), oral trimethoprim-sulfamethoxazone (co-trimoxazole, TMP-SMX), permethrin, phenothrin, and pyrethrum.
Topics: Administration, Oral; Animals; Humans; Lice Infestations; Malathion; Pediculus; Permethrin; Scalp Dermatoses; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 19445766
DOI: No ID Found -
The Angle Orthodontist Jan 2009To evaluate the effectiveness of adhesives used to attach bands to teeth during fixed appliance treatment. (Review)
Review
OBJECTIVE
To evaluate the effectiveness of adhesives used to attach bands to teeth during fixed appliance treatment.
MATERIAL AND METHODS
Electronic databases, conference proceedings and the Internet were searched. There was no restriction with regard to publication status or language of publication. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. All review authors were involved in study selection, validity assessment, and data extraction. Disagreements were resolved by discussion. Comparisons were made between the main types of adhesive.
RESULTS
Five RCTs and three CCTs were identified, all of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light-cured compomer; and one trial compared chemically cured glass ionomer with a chemically cured glass polyphosphonate. Data analysis was often inappropriate within the studies. Meta-analysis was not feasible.
CONCLUSIONS
There is insufficient high-quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.
Topics: Compomers; Controlled Clinical Trials as Topic; Dental Cements; Glass Ionomer Cements; Humans; Light-Curing of Dental Adhesives; Molar; Organophosphates; Orthodontic Wires; Self-Curing of Dental Resins; Zinc Phosphate Cement
PubMed: 19123702
DOI: 10.2319/081307-377.1 -
BMJ Clinical Evidence Aug 2008Scabies is a common public health problem, with an estimated prevalence of 300 million cases worldwide, the majority in resource-poor countries. In industrialised... (Review)
Review
INTRODUCTION
Scabies is a common public health problem, with an estimated prevalence of 300 million cases worldwide, the majority in resource-poor countries. In industrialised countries, it is most common in institutionalised communities.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of topical treatments for scabies? What are the effects of systemic treatments for scabies? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2007 (BMJ 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 two 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: benzyl benzoate (topical), crotamiton (topical), lindane (topical), malathion (topical), ivermectin (oral), permethrin (topical), and sulphur compounds (topical).
Topics: Acute Disease; Administration, Oral; Hexachlorocyclohexane; Humans; Insecticides; Ivermectin; Malathion; Permethrin; Scabies
PubMed: 19445807
DOI: No ID Found -
The Cochrane Database of Systematic... Jul 2007Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left... (Review)
Review
BACKGROUND
Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched.
OBJECTIVES
The aim of this review was to assess the effects of interventions for head lice.
SEARCH STRATEGY
Cochrane Infectious Diseases Group specialized trials register (July 2002); The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2002); MEDLINE and TOXLINE (1966 to July 2002); EMBASE (1980 to May 2002); LILACS (July 2002); Science Citation Index (1981 to July 2002); BIOSIS (1985 to July 2002); reference lists of relevant articles; pharmaceutical companies producing pediculicides (published and unpublished trials); UK and US Regulatory Authorities.
SELECTION CRITERIA
Randomised trials (published and unpublished) or trials using alternate allocation were sought which compared pediculicides with the same and different formulations of other pediculicides, and pediculicides with physical methods.
DATA COLLECTION AND ANALYSIS
Of the 71 identified studies, only four met the inclusion criteria. Two reviewers independently assessed trial quality. One reviewer extracted the data.
MAIN RESULTS
We found no evidence that any one pediculicide has greater effect than another. The two studies comparing malathion and permethrin with their respective vehicles showed a higher cure rate for the active ingredient than the vehicle. Another study comparing synergised pyrethrins with permethrin showed their effects to be equivalent. A comparative trial of malathion lotion vs combing, showed combing to be ineffective for the cureative treatment of head lice infection. Adverse effects were reported in a number of trials and were all minor, although reporting quality varied between trials.
AUTHORS' CONCLUSIONS
Permethrin, synergised pyrethrin and malathion were effective in the treatment of head lice. However, the emergence of drug resistance since these trials were conducted means there is no direct contemporary evidence of the comparative effectiveness of these products. The 'best' choice will now depend on local resistance patterns. Physical treatment methods(BugBusting) were shown ot be ineffective to treat head lice. No evidence exists regarding other chemical control methods such as the use of herbal treatments, when used in the curative treatment of head lice. Future trials should take into account the methodological recommendations that arise from this review.
Topics: Adult; Animals; Antiparasitic Agents; Carbaryl; Health Education; Humans; Hygiene; Lice Infestations; Malathion; Pediculus; Permethrin; Phytotherapy; Pyrethrins; Randomized Controlled Trials as Topic; Scalp Dermatoses
PubMed: 17636657
DOI: 10.1002/14651858.CD001165.pub2 -
BMJ (Clinical Research Ed.) Sep 1995To collect and evaluate all trials on clinical efficacy of topical treatments for head lice. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To collect and evaluate all trials on clinical efficacy of topical treatments for head lice.
DESIGN
Systematic review of randomised trials identified from following data sources: Medline, International Pharmaceutical Abstracts, Science Citation Index, letters to key authors and companies, and hand search of journals.
SETTING
Trials in schools or communities.
SUBJECTS
Patients infested with lice.
MAIN OUTCOME MEASURE
Cure rate (absence of live lice and viable nits) on day 14 after treatment.
RESULTS
Total of 28 trials were identified and evaluated according to eight general and 18 lice specific criteria. Of the 14 trials rated as having low to moderate risk of bias, seven were selected as they used the main outcome measure. These seven trials described 21 evaluations of eight different compounds and placebo (all but two evaluations were of single applications). Only permethrin 1% creme rinse showed efficacy in more than two studies with the lower 95% confidence limit of cure rate above 90%.
CONCLUSIONS
Only for permethrin has sufficient evidence been published to show efficacy. Less expensive treatments such as malathion and carbaryl need more evidence of efficacy. Lindane and the natural pyrethrines are not sufficiently effective to justify their use.
Topics: Administration, Topical; Carbaryl; Hexachlorocyclohexane; Humans; Insecticides; Lice Infestations; Malathion; Permethrin; Pyrethrins; Randomized Controlled Trials as Topic; Scalp Dermatoses; Treatment Outcome
PubMed: 7545045
DOI: 10.1136/bmj.311.7005.604