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Results: 16

Intrarectal quinine versus intravenous or intramuscular quinine for treating Plasmodium falciparum malaria

Quinine given through the rectum may be as effective as intravenous and intramuscular quinine for treating uncomplicated Plasmodium falciparum malaria. The data reviewed also lead to the conclusion that a diluted proprietary quinine solution (made less acidic by adjustment to a pH of 4.5) given intrarectally using a syringe for two to three days has less harmful effects compared with intramuscular quinine given for the same time period. Administration of intrarectal quinine (made less acidic by adjustment to a pH of 4.5) is significantly less painful than intramuscular injection of quinine. More trials are needed for patients with severe malaria and in adults.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Initial high dose of quinine to treat severe malaria

People with severe malaria are unconscious, have difficulty breathing, may convulse, and have low blood sugar. They need treating quickly.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Quinine for muscle cramps

Muscle cramps can occur anywhere and in anyone; however, leg cramps are especially common in older people. Quinine is a medication which has been used to treat cramps for many years. There is conflicting evidence for its ability to reduce cramps. It can cause serious, even fatal adverse events, especially in overdosage. Twenty‐three trials including 1586 participants were included in this review, comparing quinine or quinine derivatives against placebo or other interventions. There is moderate quality evidence that quinine significantly reduces cramp frequency, intensity and cramp days more than placebo. There is moderate quality evidence that there is a significant increase in minor adverse events with quinine compared to placebo but not in major adverse events. Overdosage however is well documented to cause serious harm including death. There is low quality evidence from one trial that theophylline combined with quinine improves cramps more than quinine alone. Low quality evidence shows there is no significant difference between quinine and vitamin E, quinine‐vitamin E mixture, or xylocaine injections. More research is needed to clarify the optimum dose and duration of treatment, as well as alternatives to quinine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Artesunate reduces death from severe malaria

Severe malaria occurs when infection with the malaria parasite is complicated by serious failure of the body's major organs, and results in over a million deaths every year. Sometimes severe malaria is associated with coma and is known as cerebral malaria. Following cerebral malaria a small proportion of children suffer with long‐term neurological disability.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Artemisinin derivatives for treating severe malaria

Artemisinin drugs improve survival in severe malaria. Artemisinin drugs come originally from a plant that has been used since ancient times in China as a traditional medicine for fever and malaria. They are fast acting and effective against malaria parasites that have developed resistance to quinine. The review shows that treatment with artemisinin drugs may be better than quinine at preventing death in adults and children with severe and complicated malaria. There is no evidence so far against early treatment with suppositories in rural areas whilst patients are transferred to hospital. Few side effects have been reported with these drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Intramuscular arteether to treat severe malaria

People with severe malaria are unconscious, have difficulty breathing, may convulse, and have low blood sugar. They need to be treated quickly, but because of their illness cannot take drugs by mouth. Arteether, an artemisinin derivative, is a possible alternative to the standard drug quinine. There are two types, artemotil and alpha/beta arteether, both are which are given as an intramuscular injection once a day. The authors of this review wanted to compare intramuscular arteether with other drugs used to treat severe malaria. They identified two small trials with 194 participants. Both trials compared arteether with quinine in children with cerebral malaria (an unrousable coma that cannot be attributed to any other cause other than malaria). There was no difference between the drugs in the number of deaths, people with neurological symptoms, or other outcomes, but there were probably too few participants to detect differences.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Artemether injection for treating people with severe malaria

In this review, researchers from The Cochrane Collaboration examined the effects of treating people that have severe malaria with artemether injected intramuscularly, and compared it to treatment with other antimalarial drugs given intramuscularly or intravenously. After searching for relevant trials up to 9 April 2014, we included 18 randomized controlled trials that recruited 2662 adults and children and were conducted mainly in Africa and Asia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Does Nicobrevin help people to stop smoking

Nicobrevin is a proprietary product containing quinine, menthyl valerate, camphor and eucalyptus oil marketed as an aid to smoking cessation. No randomised trials with long‐term follow‐up of smoking status were identified, so there was no evidence to assess efficacy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Reliable research about the benefits and harms of treatments for malaria in pregnant women is scarce

Women are more vulnerable to malaria during pregnancy, and malaria may have harmful effects on the baby. Treatment options are becoming more limited because the malaria parasite is developing resistance to existing drugs and due to concerns about whether drugs may harm the baby. Evidence from randomized controlled trials is limited, with few drugs and drug combinations being evaluated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Non‐drug therapies for lower limb muscle cramps

Lower limb muscle cramps are a common problem that can affect any person, but cramps mostly occur during exercise, at nighttime in older people, in pregnant women, in people with a neurological disease and during kidney dialysis. Non‐drug treatments are described as being effective for the treatment of muscle cramps. Non‐drug treatments include muscle stretching, physical exercise, avoidance of physical fatigue, massage, relaxation, heat therapy, weight loss, sensory nerve stimulation, ankle splints worn while sleeping, and changes to sleeping and sitting positions. We did not include invasive interventions such as surgery, acupuncture or dry‐needling in this review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Mannitol and other osmotic diuretics as adjuncts for treating cerebral malaria

Cerebral malaria can lead to coma and death, even when the patient is given anti‐malarial drugs. Death is caused by the malaria parasites in the brain that cause brain swelling, leading to pressure in the brain. Mannitol is a drug that sometimes reduces brain swelling in other situations, such as traumatic head injury.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Atovaquone‐proguanil appears to be more effective than individual drugs for treating uncomplicated malaria, but there are few data comparing atovaquone‐proguanil to other combination therapies

Many conventional treatments for uncomplicated malaria are failing because malaria parasites develop resistance to them. This can be reduced by treating people with combination drugs such as atovaquone‐proguanil. The review found 10 trials, most of low methodological quality and most funded by a single pharmaceutical company. In addition, trials were small and had few participants thus evidence suggesting atovaquone‐proguanil as more effective than a number of single drug treatments at eliminating the Plasmodium falciparum malaria parasite from the blood was limited. There were few good quality data comparing atovaquone‐proguanil with other new combination therapies. There were not enough data to assess adverse events, but all trials recorded some adverse events.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Treatment for cramps in amyotrophic lateral sclerosis/motor neuron disease

A cramp is a sudden, involuntary painful contraction of a muscle. Many people with amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), experience cramps during the course of the disease. These range from mild cramps that do not affect daily activities and sleep, through to very severe, painful cramps. Some medications that are used to treat cramps in people with no medical condition or with conditions other than ALS have been tested in ALS clinical trials. These medicines include vitamin E, creatine, quinidine, and gabapentin. Other medications such as quinine sulfate, magnesium, lioresal, dantrolene, clonazepam, diphenylhydantoin, and gabapentin have been used to treat cramps in people with ALS but their effectiveness is unknown. In 2006 and 2010 the US Food and Drugs Administration issued warnings concerning the use of quinine sulfate, which was the previously most widely prescribed medication for cramps in the US. This review sought to find out how effective medications and physical treatments for cramps are for people with ALS. The reviewers identified 20 randomised controlled trials in people with ALS comprising a total of 4789 participants. Only one trial, of the drug tetrahydrocannabinol (THC), directly investigated the effectiveness of an intervention for cramps. Thirteen randomised controlled ALS trials investigated cramps secondarily among other variables. The medications comprised vitamin E, baclofen, riluzole, L‐threonine, xaliproden, indinavir, and memantine. Six randomised controlled ALS trials investigated cramps as adverse events. The medications comprised creatine, gabapentin, dextromethorphan, quinidine and lithium. None of the 20 studies could demonstrate any benefit, but the studies were small. Current evidence on the treatment of cramps in ALS is lacking and more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Artemisinin drugs for treating uncomplicated malaria are better used in combination therapy

Artemisinin drugs come originally from a plant that has been used since ancient times in China as a traditional medicine for fever and malaria. These drugs act quickly and few side effects have been reported. Malaria parasites have so far not developed resistance to artemisinin drugs. The review shows that artemisinin drugs clear malaria parasites from the blood more effectively than standard treatment drugs. In areas where malaria parasites are more resistant to existing drugs, such as South‐East Asia, artemisinin drugs are not better at sustained parasite clearance than standard treatment with quinine or mefloquine. Combination treatment using an artemisinin drug together with the longer‐acting antimalarial drug mefloquine improves sustained clearance of parasites, but mefloquine is associated with adverse effects. There are few studies on combination treatment with longer‐acting antimalarial drugs that are safer than mefloquine. There is no evidence from trials that any of the several artemisinin derivatives is better than the others.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Fact sheet: Tinnitus

After a loud concert, sports event or using a very noisy machine like a chainsaw, people often hear ringing in their ears – even after the outside noise has stopped. This ringing usually goes away after a short while, though. It is called tinnitus, and everyone experiences it from time to time. But 1 or 2 out of every 10 people will hear this kind of noise constantly for a while. Or they have episodes that just come and go, for no obvious reason. The tinnitus could go on for months or even years, but it is usually only mild and a bit annoying.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 11, 2013

Rectal artesunate for treating people with suspected severe malaria before transfer to hospital

Cochrane Collaboration researchers conducted a review of the effects of pre‐referral rectal artesunate for people with suspected severe malaria, living in rural areas without healthcare services. After searching for all relevant trials up to May 2014 they included only one randomized controlled trial. This trial was conducted at various sites across Ghana, Tanzania and Bangladesh, and enrolled 17,826 children and adults.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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