key: cord-0033707-k60qhqot
authors: Richards, Derek
title: Short summaries
date: 2009-10-24
journal: Evid Based Dent
DOI: 10.1038/sj.ebd.6400674
sha: 9a0d4bf96c4c61829f5ef2aa61048c7c0ee80ca2
doc_id: 33707
cord_uid: k60qhqot

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Lissiman E, Bhasale AL, Cohen M.

Garlic is purported to have antimicrobial and antiviral properties that relieve the common cold. A quick Google search highlights over 2 million webpages on this topic. The common cold is caused by a range of viruses including picornaviruses (notably, rhinoviruses and enteroviruses), coronaviruses, adenoviruses, parainfluenza viruses, influenza viruses, metapneumoviruses and respiratory syncytial viruses and, on average, adults get two to four colds per year with children catching six to eight. 1 The common cold is associated with significant morbidity and economic consequences, with the total annual economic impact in the US estimated at $40 billion. 2 

Cochrane review looked at the effect of garlic on the prevention and treatment of the common cold. Only one trial met the inclusion criteria, and found insufficient evidence to recommend garlic supplements as a preventative or treatment option for the common cold. The small trial suggests that garlic might reduce the frequency of symptoms of the common cold if taken continuously as a daily prophylactic, but the results require validation. Anecdotally, adverse events reported include odour and minor skin or respiratory irritation, but the frequency of adverse effects could not be determined from the evidence available.

(NSAID) have been used to treat the pain and fever associated with the common cold from many years and this Cochrane review looks at their efficacy.

The review included nine randomised controlled trials (including 1064 patients), which made 37 comparisons between them: six tested NSAID versus placebo, and three tested NSAID versus other NSAID. In a pooled analysis, NSAID did not significantly reduce the total symptom score or the duration of colds. For outcomes related to the analgesic effects of NSAID (headache, ear pain, and muscle and joint pain) there were significant benefits. There was a borderline benefit for malaise and mixed results for chills. Throat irritation was not improved, and neither were cough and nasal discharge, but the sneezing score significantly improved. There was no evidence of increased frequency of adverse effects in the NSAID treatment groups.

McCarthy B.

Melanoma of the scalp and neck is a condition that dental practitioners are able to spot in their regular attendees. This commentary in the Evidence-based Medicine journal discusses a review by Lachiewicz and colleagues, 1 the conclusion of which is that in patients with a first invasive melanoma, tumours of the scalp, neck or trunk, older age, being male, tumour thickness, and ulceration were associated with increased risk of melanoma-specific mortality.

The data from the study came from the American Surveillance, Epidemiology and End Results (SEER) program. McCarthy notes the potential problems relating to possible incompleteness of the SEER database and the risk of inadequate or incomplete followup, so he emphasises the fact that these results should be interpreted with caution. This is also mentioned by the review's authors, who highlight the need for their results to be confirmed.

• telemedicine and telecare services;

• health information networks;

• decision support tools for healthcare professionals;

• internet-based technologies and services.

Whereas some of these are in use in dentistry, none of the ten studies included in this review involved dentists and only two meas- 

Providing decision support to clinicians at the point of care is considered one of the main incentives for implementing sophisticated clinical information systems. This Cochrane review identified 28 studies (reporting a total of 32 comparisons). Computer reminders achieved a median improvement in process adherence of 4.2%

[interquartile range (IQR), 0.8-18.8%] across all reported process outcomes; 3.3% (IQR, 0.5-10.6%) for medication ordering; 3.8% (IQR, 0.5-6.6%) for vaccinations; and 3.8% (IQR, 0.4-16.3%) for test ordering. In a sensitivity analysis using the best outcome from each study, the median improvement was 5.6% (IQR, 2.0-19.2%) across all process measures and 6.2% (IQR, 3.0-28.0%) across measures of medication ordering.

The review overall showed small to modest improvements, with a minority of interventions showing larger effects, but no specific reminder or contextual features were significantly associated with effect magnitude. Consequently, future research must identify design features and contextual factors consistently associated with larger improvements in provider behaviour if computer reminders are to succeed on more than a trial and error basis. 

The common cold

The economic burden of non-influenza-related viral respiratory tract infection in the United States