UNIVERSAL FLU VACCINATION COSTS LESS THAN TREATMENT
Administration of the trivalent influenza vaccine to all healthy adults saves
money over treatment of those who develop influenza-like illnesses with the oral
neuraminidase inhibitor oseltamivir or supportive care alone.
COMMON HERBAL REMEDIES HAVE UNCERTAIN RISK-BENEFIT PROFILES
While many people swear by the benefits of certain herbal therapies, a review
of the medical literature provides only incomplete evidence of efficacy, making
any risk benefit assessment unreliable.
OLD CHINESE REMEDY MAY BE USEFUL IN TREATMENT OF ASTHMA
Xiao-qing-long-tang (XQLT), a traditional Chinese medicine used to treat bronchial
asthma, appears to reduce bronchoconstriction and eosinophil infiltration of the
Universal Flu Vaccination Costs Less Than Treatment
NEW YORK (Reuters Health) Dec 31 - Administration of the trivalent influenza
vaccine to all healthy adults saves money over treatment of those who develop
influenza-like illnesses with the oral neuraminidase inhibitor oseltamivir or
supportive care alone, report investigators from Cornell University and the
New School University.
In Clinical Infectious Diseases for December 1, Drs. Peter A. Muennig
and Kamran Khan define influenza-like illness as a fever of at least 37.7 degrees
Centigrade along with a cough or sore throat. Supportive care would include
rest, hydration, symptom relief and medical care as needed. Oral oseltamivir
treatment would require 75 mg b.i.d. for 5 days.
They developed a decision-analysis model that included all healthy individuals
between the ages of 15 and 65 years who lived in the US in 1997. The model assumed
that no deaths would occur, that 10% of patients with flu-like illnesses would
visit a clinician, that 95% of these would be prescribed oseltamivir, and that
the risk of hospitalization due to influenza would be reduced by 50% among those
The incidence of flu-like illnesses was the major predictor of cost savings.
At more than 24.2 cases per 100 persons, "which is well below rates quoted
in the medical literature," the authors write, vaccination would save money
compared to providing supportive care alone.
Oseltamivir would be a cost-saving intervention relative to supportive care
only if a 5-day course of the drug costs less than $15, Drs. Muennig and Khan
calculate. Even if oseltamivir were free, vaccination would save costs overall.
Clin Infect Dis 2001;33:1879-1885.
Common Herbal Remedies Have Uncertain Risk-Benefit Profiles
NEW YORK (Reuters Health) Jan 01 - While many people swear by the benefits
of certain herbal therapies, a review of the medical literature provides only
incomplete evidence of efficacy, making any risk benefit assessment unreliable,
a UK researcher reports in the Annals of Internal Medicine for January
In a review of published studies of ginkgo, St. John's wort, ginseng, Echinacea,
saw palmetto and kava, Dr. Edward Ernst from the University of Exeter, found
that what clinical trials existed were too short, too small and too few.
Data from these studies showed that ginkgo had some positive effects on dementia
and impaired circulation, but is of questionable value for memory loss and tinnitus.
St. Johns wort was effective for mild to moderate depression, but adversely
interacts with many common drugs, decreasing their effectiveness.
Echinacea may be of benefit in the prevention and treatment of upper respiratory
infection, but the data are unconvincing. Saw palmetto did reduce symptoms of
benign prostatic hyperplasia in the short-term, and kava appears effective in
reducing anxiety in the short-term. Ginseng was of no proven benefit in treating
While there are books on these remedies, Dr. Ernst finds them for the most
part useless. "According to our preliminary evaluation, these books represent
more of a risk to the health of the reader than a helpful source of knowledge,"
Dr. Ernst concludes that "dissemination of objective rather than promotional
information, stimulation of rigorous research and provision of adequate funds
are clearly the way ahead and should be of interest to all parties concerned.
Rigorous and systematic evaluation of all herbal medicinal products is urgently
Ann Intern Med 2002;136:42-35
Old Chinese Remedy May Be Useful in Treatment of Asthma
NEW YORK (Reuters Health) Jan 01 - Xiao-qing-long-tang (XQLT), a traditional
Chinese medicine used to treat bronchial asthma, appears to reduce bronchoconstriction
and eosinophil infiltration of the airway, according to the results of an animal
study by Taiwanese researchers.
Dr. Shung-Te Kao, from China Medical College, and colleagues studied the effect
of XQLT in ovalbumin-sensitized guinea pigs. Both antigen-induced immediate
asthmatic response and late asthmatic response were significantly inhibited
by XQLT, Dr. Kao's team found.
Also, XQLT produced relaxation of isolated guinea pig trachea that had been
precontracted with carbachol. This effect was reversed by a selective beta-2
When the investigators analyzed bronchoalveolar lavage fluid they found that
XQLT significantly suppressed the increase in eosinophils in the airway and
slowed the increase of eosinophils for up to 72 hours after antigen challenge,
according to their report in the December issue of Allergy.
Dr. Kao and colleagues conclude that "we show for the first time that
XQLT is effective against early and late phase airflow obstruction in conscious
sensitized guinea pigs...and we associated these changes with the number of
eosinophils in bronchoalveolar lavage fluid."
"We suggest that there may be two antiasthmatic mechanisms of XQLT, a
bronchodilator effect resulting from its stimulation of beta-2-receptors on
bronchial smooth muscles, and an ability to inhibit the eosinophil infiltration
into the airway."