Do corticosteroids improve outcome in meningitis?

Drug Ther Bull. 2010 Oct;48(10):116-20

Authors:

Despite significant advances in prevention of meningitis through vaccination, and in improved antimicrobial treatment, the disease still kills around 340,000 people worldwide each year.¹ Around 75% of these deaths occur in Africa and South East Asia and around 3% in Europe.¹ The mortality rate for bacterial meningitis is 10-30% and sequelae, such as cranial nerve impairment, particularly leading to hearing loss, occur in 5-40% of patients.² Whether adjunctive corticosteroid treatment improves the outcome in bacterial meningitis through an anti-inflammatory effect has been a long-standing controversy. Here we review the role of adjunctive corticosteroids in the management of children (aged over 1 month) and adults with bacterial or tuberculous meningitis.

PMID: 20926448 [PubMed - indexed for MEDLINE]

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Management of benign paroxysmal positional vertigo.

Drug Ther Bull. 2009 Jun;47(6):62-6

Authors:

In vertigo, people experience an illusion of movement of the environment about them, or of themselves with respect to the environment. Vertigo usually originates in the peripheral nervous system (e.g. due to a disorder of the inner ear) but can, rarely, have a CNS origin (e.g. an intracranial tumour or brainstem lesion). It is commonly due to a peripheral disorder known as ‘benign paroxysmal positional vertigo’ (BPPV). Here we discuss BPPV and the management of patients with the condition, including diagnostic and therapeutic manoeuvres.

PMID: 19494342 [PubMed - indexed for MEDLINE]

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Ivabradine for stable angina?

Drug Ther Bull. 2008 Nov;46(11):84-8

Authors:

Up to 1 in 25 people in Europe and the USA have stable angina, with symptoms that may limit function and quality of life. Beta-blockers are usually used in initial symptomatic treatment, but may cause unwanted effects. They are also contraindicated in some patients (e.g. those with uncontrolled heart failure, severe peripheral vascular disease) and should be avoided in patients with asthma or a history of reversible obstructive airways disease or bronchospasm. Ivabradine (Procoralan-Servier) is the first in a new class of specific heart rate-reducing drugs and is licensed for the “symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm, who have a contra-indication or intolerance for beta-blockers”. Here we consider the place of ivabradine in the management of patients with stable angina.

PMID: 18987382 [PubMed - indexed for MEDLINE]

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