 Title |
 Authors |
Publication |
Page(s) |
Link / File |
| Interventions for Vitiligo |
Whitton ME, Pinart M, Batchelor J, Lushey C, Leonardi-Bee J, González U. |
Cochrane Database Syst Rev. |
CD003263. |
 :
|
| BACKGROUND: Around one per cent of the world's population has vitiligo, a disease which causes white patches on the skin. There are a variety of treatments available, most of which are unsatisfactory. OBJECTIVES: To assess all interventions used to manage vitiligo. SEARCH STRATEGY: In November 2009 we updated searches of the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library (Issue 4, 2009), MEDLINE, EMBASE, AMED, PsycINFO, LILACS and ongoing trials databases. SELECTION CRITERIA: Randomised controlled trials (RCTs). DATA COLLECTION AND ANALYSIS: At least 2 review authors independently assessed study eligibility and methodological quality, and carried out data extraction. Two of the 57 included studies could be combined for meta-analysis. MAIN RESULTS: In this update, 57 trials, including 19 from the original review, were assessed with 3139 participants. Most of the RCTs, which covered a wide range of interventions, had fewer than 50 participants. All of the studies assessed repigmentation, 6 measured cessation of spread, and 5 investigated the effect of treatment on quality of life.Most of the studies assessed combination therapies which generally reported better results. New interventions include monochromatic excimer light (MEL), Polypodium leucotomos, melanocyte transplantation, oral antioxidants, Chinese zengse pill, and pimecrolimus. We analysed the data from 28 studies that met our outcome criteria of improvement in quality of life and greater than 75% repigmentation.Fifteen analyses from studies comparing various interventions showed a statistically significant difference between the proportions of participants achieving more than 75% repigmentation. The majority of analyses showing statistically significant differences were from studies that assessed combination interventions which generally included some form of light treatment.Topical preparations, in particular corticosteroids, reported most adverse effects. However, in the combination studies it was difficult to ascertain which treatment caused these effects. None of the studies was able to demonstrate long-term benefits. Very few studies were conducted on children or included segmental vitiligo. We found one study of psychological interventions and none evaluating micropigmentation, depigmentation, or cosmetic camouflage. AUTHORS' CONCLUSIONS: This review has found some evidence from individual studies to support existing therapies for vitiligo, but the usefulness of the findings is limited by the different designs and outcome measurements and lack of quality of life measures. There is a need for follow-up studies to assess permanence of repigmentation as well as high quality randomised trials using standardised measures and which also address quality of life. |
| New Guidelines Update Diagnosis and Treatment of Parkinson's Disease |
Paula Moyer, MA |
|
(nonre) |
:
|
| The updated guidelines for the diagnosis and management of Parkinson's disease are more comprehensive than any previous documents, according to a panel of experts who presented highlights of the guidelines here at the 58th annual meeting of the American Academy of Neurology. |
| Human brucellosis |
María Pía Franco, Maximilian Mulder, Robert H Gilman, Henk L Smits |
Lancet Infectious Diseases |
|
:
|
| Human brucellosis still presents scientists and clinicians with several challenges, such as the understanding of
pathogenic mechanisms of Brucella spp, the identifi cation of markers for disease severity, progression, and treatment
response, and the development of improved treatment regimens. Molecular studies have shed new light on the
pathogenesis of Brucella spp, and new technologies have permitted the development of diagnostic tools that will be
useful in developing countries, where brucellosis is still a very common but often neglected disease. However, further
studies are needed to establish optimum treatment regimens and local and international control programmes. This
Review summarises current knowledge of the pathogenic mechanisms, new diagnostic advances, therapeutic options,
and the situation of developing countries in regard to human brucellosis. |
| The treatment of amblyopia |
Holmes, Repka, Kraker & Clarke |
Strabismus |
37–42 |
|
|
| Management of postpolio syndrome |
Gonzalez H, Olsson T, Borg K. |
Lancet Neurol |
634-42. |
|
| Postpolio syndrome is characterised by the exacerbation of existing or new health problems, most often muscle weakness and fatigability, general fatigue, and pain, after a period of stability subsequent to acute polio infection. Diagnosis is based on the presence of a lower motor neuron disorder that is supported by neurophysiological findings, with exclusion of other disorders as causes of the new symptoms. The muscle-related effects of postpolio syndrome are possibly associated with an ongoing process of denervation and reinnervation, reaching a point at which denervation is no longer compensated for by reinnervation. The cause of this denervation is unknown, but an inflammatory process is possible. Rehabilitation in patients with postpolio syndrome should take a multiprofessional and multidisciplinary approach, with an emphasis on physiotherapy, including enhanced or individually modified physical activity, and muscle training. Patients with postpolio syndrome should be advised to avoid both inactivity and overuse of weak muscles. Evaluation of the need for orthoses and assistive devices is often required. |
Subject
