What’s being served up in the Cochrane Library?

The reviews are flying into the Cochrane Library quicker than balls off Murray’s racquet this week and several aces have been served! Here’s my pick of the past fortnight.

It’s all strawberries and Pimms in SW19 but in WC1 the good folk of the Cochrane Heart Group are concentrating on garlic sandwiches and tea. Now I like a nice cuppa but a garlic sandwich? Even Jamie Oliver might balk at that, but the suggestion crops up in a new review on preventing cardiovascular disease (CVD) through providing fruit and vegetables to encourage people to eat more of them, or just advising them to do so. I asked heart doctor Harry Boardman to take a look.

Interferon improves survival after surgery for melanoma

Key message: interferon alpha improves both disease-free survival and overall survival of people with high-risk cutaneous melanoma. Interferon is also valid as a reference standard for future trials of other new treatments.

Cutaneous melanoma is a type of skin cancer that’s on the rise in all Western countries and carries with it a poor chance of survival for those in whom the cancer has spread, with around 10% surviving longer than five years. For those whose cancer has not spread, their outlook after surgery is variable; between 40% and 90% are alive after five years. Interferon alpha is the only drug approved for adjuvant (additional) treatment of high-risk cutaneous melanoma after surgery, but not enough has been known about its benefits for it to be offered as a standard treatment.

Evening primrose oil and borage oil no help for eczema

Key message: Oral evening primrose oil and borage oil are not effective treatments for eczema

Anyone who suffers from eczema, or is close to someone who has it, knows that this common skin condition can be a real misery. In the developed world it’s on the increase. Treatments can be very time-consuming and many people struggle to find effective relief from the itching and help for sore, weeping, cracked or bleeding skin. Some people use complementary therapies, including evening primrose oil (EPO) and borage oil (BO) taken by mouth, but to date it has been unclear whether these are effective and safe.

A sting in the tail? Venom immunotherapy may help or harm: evidence from a new Cochrane review

Key message:Venom immunotherapy is effective in preventing serious allergic reactions and large local reactions to insect stings, but it carries a risk of systemic allergic reaction.

If you’re someone who’s suffered a severe allergic reaction to a sting, or if you’re a clinician with patients who have, you’ll be interested to hear about a new review, from the Cochrane Skin Group, on the use of venom immunotherapy (VIT) for preventing future reactions to stings. As with any treatment, the potential benefits have to be weighed against the risks of harm, and this is a significant issue for this treatment.