Lisa Cicutto

Review: pneumococcal vaccination does not prevent pneumonia, bacteraemia, bronchitis, or mortality.

Is pneumococcal vaccination effective for various clinical outcomes in adults? Included studies compared pneumococcal polysaccharide vaccine with placebo, other vaccines, or no intervention (control). Studies of children; evaluating antibody responses only or pneumococcal polysaccharide vaccines as a booster after receipt of conjugate pneumococcal vaccine; or animal, laboratory, and observational intervention studies were excluded. Outcomes were definitive pneumococcal pneumonia, presumptive pneumococcal pneumonia, all-cause pneumonia, bacteraemia, bronchitis, all-cause mortality, pneumonia mortality, and mortality from pneumococcal infection. Medline (1966 to May 2007), EMBASE/Excerpta Medica (1974 to May 2007), Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, Indian Medlars Centre, African Index Medicus, …

Review: addition of salmeterol leads to improved lung function and fewer exacerbations in symptomatic asthma

(2000) BMJ 320, 1368. Shrewsbury S, Pyke S, Britton M. . Meta-analysis of increased dose of inhaled steroid or addition of salmeterol in symptomatic asthma (MIASMA). . May 20; . : . –73 . [OpenUrl][1][Abstract/FREE Full Text][2] 
 QUESTION: In patients with symptomatic asthma who are currently taking inhaled steroids, does adding salmeterol improve lung function and reduce symptoms and exacerbations compared with increasing the dose of inhaled corticosteroids? Studies were identified by searching EMBASE/Excerpta Medica, Medline, and GlaxoWellcome databases (1985 to Sept 1999). Studies were selected if they were randomised, double blind, controlled trials comparing the addition of salmeterol to the current dose of inhaled steroid with an increased dose (at least doubling) of the current inhaled steroid for ≥12 weeks in adolescents and adults with symptomatic asthma. Data were extracted on patient characteristics; treatment type, dose, and duration; and outcome measures based on the intention to treat population. Individual patient datasets were obtained and exacerbation severity was assessed by 2 independent reviewers. 9 trials involving 3685 patients met … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DShrewsbury%26rft.auinit1%253DS.%26rft.volume%253D320%26rft.issue%253D7246%26rft.spage%253D1368%26rft.epage%253D1373%26rft.atitle%253DMeta-analysis%2Bof%2Bincreased%2Bdose%2Bof%2Binhaled%2Bsteroid%2Bor%2Baddition%2Bof%2Bsalmeterol%2Bin%2Bsymptomatic%2Basthma%2B%2528MIASMA%2529%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.320.7246.1368%26rft_id%253Dinfo%253Apmid%252F10818025%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=320/7246/1368&atom=%2Febnurs%2F4%2F1%2F15.atom