Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jun 2012
ReviewTreatment for POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome.
POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome is a rare cause of demyelinating and axonal mixed neuropathy with monoclonal plasma cell proliferative disorder and multiorgan involvement. The pathogenesis of POEMS syndrome is not well understood, but overproduction of vascular endothelial growth factor (VEGF), probably secreted by plasmacytomas, is likely to be responsible for most of the characteristic symptoms. POEMS syndrome is a potentially fatal disease, and patients' quality of life deteriorates because of progressive neuropathy, massive pleural effusion or ascites, or thromboembolic events. There is a need for efficacious therapy to improve prognosis. This is the first update of a review first published in 2008. ⋯ There are no randomized or quasi-randomized controlled clinical trials of treatment for POEMS syndrome on which to base practice.
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Cochrane Db Syst Rev · Jun 2012
ReviewAntifungal therapies for allergic bronchopulmonary aspergillosis in people with cystic fibrosis.
Allergic bronchopulmonary aspergillosis (ABPA) is an allergic reaction to colonisation of the lungs with the fungus Aspergillus fumigatus and affects around 10% of people with cystic fibrosis. ABPA is associated with an accelerated decline in lung function. High doses of corticosteroids are the main treatment for ABPA; although the long-term benefits are not clear, their many side effects are well-documented. A group of compounds, the azoles, have activity against Aspergillus fumigatus and have been proposed as an alternative treatment for ABPA. Of this group, itraconazole is the most active. A separate antifungal compound, amphotericin B, has been employed in aerosolised form to treat invasive infection with Aspergillus fumigatus, and may have potential for the treatment of ABPA. Antifungal therapy for ABPA in cystic fibrosis needs to be evaluated. ⋯ At present, there are no randomised controlled trials to evaluate the use of antifungal therapies for the treatment of ABPA in people with cystic fibrosis. Trials with clear outcome measures are needed to properly evaluate this potentially useful treatment for cystic fibrosis.
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Cochrane Db Syst Rev · Jun 2012
ReviewTianma Gouteng Yin Formula for treating primary hypertension.
Tianma Gouteng Yin Formula (TGYF) is widely used to treat hypertension-related symptoms in clinical practice in East Asia. It has been shown to have a blood pressure lowering effect, reducing total cholesterol, improving clinical symptoms and quality of life, and preventing the occurrence of stroke in hypertensive patients. Understanding the effect of Tianma Gouteng Yin Formula on blood pressure, quality of life and cardiovascular risk factors could be valuable for the management of high blood pressure. ⋯ As no trials could be identified, no conclusions can be made about the role of TGYF in the treatment of primary hypertension. Well-designed randomized controlled studies need to be conducted and published.