Flu, chills and other ills: a wintry round-up of Cochrane evidence

This week it really feels like winter is upon us and infection is the dominant theme in this blog, which gives you a round-up of some new and updated Cochrane reviews on flu vaccination; antibiotics for colds, sore throats and for those having feeding tubes put in;  bringing down your poorly child’s temperature and whether avoiding lactose is helpful when diarrhoea strikes.

Babies, bright lights, blood-thinners and more: Cochrane evidence round-up

It’s probably best to draw a veil over many of the things done in English boarding schools by past generations and some in the name of health. The boys of Dickens’ fictional Dotheboys Hall were given brimstone and treacle from “a common wooden spoon, which might have been originally manufactured for some gigantic top, and which widened every young gentleman’s mouth considerably: they being obliged, under heavy corporal penalties, to take in the whole of the bowl at a gasp.”

Hot off the press: catch this Cochrane evidence!

New and updated Cochrane reviews are now published daily

If your idea of a present is a new or updated Cochrane review then it’s now Christmas every day with the arrival of Publish When Ready here in Cochraneland. In a huge change to the system for publishing reviews and protocols in the Cochrane Library, new arrivals appear daily, throughout the day, instead of once a month. In the time it takes me to make a cup of tea, a new review may have popped into the Library, ready for my consumption. It’s all rather exciting! It’s also rather alarming, as I have the distinct feeling that with such a rapid flow of  evidence I may miss things and fail to shout about stuff that you might like to know about. It may calm down (or I may speed up!) but with the sudden arrival of a very large amount of new evidence I thought I’d give you a bit of a round-up. So here are my picks of the week on surgery, drugs and rock’n’roll, with some talking treatment thrown in.

Can signs and symptoms guide diagnosis and treatment of community-acquired pneumonia in children? A new Cochrane diagnostic accuracy review

Key message: M. pneumoniae cannot be diagnosed reliably in children and adolescents with community-acquired pneumonia based on individual clinical symptoms and signs. Although absence of wheeze is a statistically significant diagnostic indicator, it does not have sufficient diagnostic value to guide empirical macrolide treatment. Chest pain may be a clinically useful indicator but needs further evaluation.

Preventing shingles in older adults: how effective and safe is vaccination? A new Cochrane review

Key Message:Herpes zoster vaccine is effective in preventing shingles, with people aged 60 to 69 years benefitting more than older people but also experiencing more side effects. In general, the vaccine is well tolerated and most side effects are mild to moderate reactions at the injection site.

Herpes zoster or ‘shingles’ is a painful condition, arising from the reactivation of varicella zoster virus, the virus that causes chicken pox. Older adults are particularly susceptible to shingles, which can last for weeks or months and have a significant impact on quality of life. A new review from the Cochrane Acute Respiratory Infections Group evaluated the effectiveness and safety of vaccination to prevent herpes zoster in adults aged sixty and over. The review includes eight randomized controlled trials with more than 52,000 participants but the main outcomes on effectiveness and safety come from the Shingles Prevention Study, a large trial with 38,546 participants, who were followed up for over three years.