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At least 1,099 records · Page 61Linked to original sources
PubMed2005

Fat food for a bad mood. Could we treat and prevent depression in Type 2 diabetes by means of omega-3 polyunsaturated fatty acids? A review of the evidence.

AIMS: Evidence strongly suggests that depression is a common complication of Type 2 diabetes mellitus. However, there is considerable room to improve the effectiveness of pharmacological antidepressant agents, as in only 50-60% of the depressed subjects with diabetes does pharmacotherapy lead to remission of depression. The aim of the present paper was to review whether polyunsaturated fatty acids (PUFA) of the omega-3 family could be used for the prevention and treatment of depression in Type 2 diabetes. METHODS: MEDLINE database and published reference lists were used to identify studies that examined the associations between omega-3 PUFA and depression. To examine potential side-effects, such as on glycaemic control, studies regarding the use of omega-3 supplements in Type 2 diabetes were also reviewed. RESULTS: Epidemiological and clinical studies suggest that a high intake of omega-3 PUFA protects against the development of depression. There is also some evidence that a low intake of omega-3 is associated with an increased risk of Type 2 diabetes, but the results are less conclusive. Results from randomized controlled trials in non-diabetic subjects with major depression show that eicosapentaenoic acid is an effective adjunct treatment of depression in diabetes, while docosahexanoic acid is not. Moreover, consumption of omega-3 PUFA reduces the risk of cardiovascular disease and may therefore indirectly decrease depression in Type 2 diabetes, via the reduction of cardiovascular complications. CONCLUSIONS: Supplementation with omega-3 PUFA, in particular eicosapentaenoic acid, may be a safe and helpful tool to reduce the incidence of depression and to treat depression in Type 2 diabetes. Further studies are now justified to test these hypotheses in patients with Type 2 diabetes.

Adult↗
PubMed2006

The prevalence of co-morbid depression in adults with Type 1 diabetes: systematic literature review.

AIM: To review the literature estimating the cross-sectional prevalence of clinical depression in adults with Type 1 diabetes. METHODS: Electronic databases and published references were used to identify studies published between January 2000 and June 2004, with a previous meta-analysis used to identify studies before 1 January 2000. RESULTS: Between January 2000 and June 2004, a further five eligible studies were identified. Only one was a controlled study using diagnostic interviewing to determine rates of depression. Taking all of the eligible studies identified by the previous meta-analysis and this search, the prevalence of clinical depression in controlled studies was 12.0% for people with diabetes compared with 3.2% for control subjects. In studies with no control group, the prevalence of clinical depression was 13.4%. CONCLUSION: There are wide-ranging differences reported in the various studies on the prevalence of depression in Type 1 diabetes. In view of the differing methods of diagnosis and small participant numbers, the results should be viewed with caution. A controlled study using diagnostic interviewing techniques to determine levels of depression is recommended to provide a clearer picture of both the prevalence and characteristics of that depression.

Adult↗
PubMed1997

Detection of Bartonella henselae and Bartonella quintana by a simple and rapid procedure using broad-range PCR amplification and direct single-strand sequencing of part of the 16S rRNA gene.

OBJECTIVE: To detect directly Bartonella henselae and Bartonella quintana using culture-independent, molecular techniques, and to evaluate a simple and rapid procedure that allows uncultivable bacteria to be detected in usually sterile clinical specimens in a diagnostic laboratory. METHODS: From four clinical specimens proven to contain B. henselae (n=3) or B. quintana (n=1) DNA, part of the 16S rRNA gene was amplified using the polymerase chain reaction (PCR) and broad-range bacterial primers followed by reamplification and direct, single-strand sequencing. The partial 16S rRNA sequences were compared to reference sequences in databases. RESULTS: Similarities between sequences derived from clinical samples and those of B. henselae and B. quintana, respectively, were in the range 98.7--100%, indicating a strong association to the genus Bartonella. Intraspecies sequence variations within the B. henselae sequences were observed. CONCLUSIONS: The method described is a rapid, sensitive and reliable tool to generate partial 16S rRNA sequences of B. henselae and B. quintana directly from normally sterile clinical specimens. It is compatible with adequate prevention of contamination as is needed for diagnostic purposes, and it possesses the potential to detect other pathogens, including those as yet unknown.

Journal Article↗
PubMed2005

Brief report: Methadone treatment of injecting opioid users for prevention of HIV infection.

OBJECTIVE: To assess the effects of oral substitution treatment for opioid-dependent injecting drug users on HIV risk behaviors and infections. DATA SOURCES: Multiple electronic databases were searched. Reference lists of retrieved articles were checked. METHODS: Because of varying methodologies of available studies, this systematic review was limited to a descriptive summary, looking at consistency of outcomes across studies. RESULTS: Twenty-eight studies involving methadone treatment were included in the review. Methadone maintenance treatment is associated with statistically significant reductions in injecting use and sharing of injecting equipment. It is also associated with reductions in numbers of injecting drug users reporting multiple sex partners or exchanges of sex for drugs or money, but has little effect on condom use. It appears that the reductions in risk behaviors do translate into fewer cases of HIV infection. CONCLUSIONS: Methadone maintenance treatment for injecting drug users significantly reduces the risk of transmission of HIV and should be provided as a component of a strategic approach to the prevention and control of HIV infection. There is insufficient evidence to determine whether other forms of oral substitution treatment also reduce the risk of HIV transmission.

HIV Infections↗
PubMed2001

The theory of planned behavior and postpartum smoking relapse.

PURPOSE: To explore the applicability of Ajzen's theory of planned behavior to postpartum smoking relapse. ORGANIZING FRAMEWORK: The theory of planned behavior is proposed as an appropriate framework for the study of postpartum smoking relapse. METHODS: The literature on smoking cessation, postnatal smoking, and the theory of planned behavior were reviewed. References included electronic database and manual search results. CONCLUSIONS: The theory of planned behavior provides a framework for explaining, predicting, and influencing human behaviors based on modifiable factors of attitude, subjective norm, and perceived behavioral control. The inclusion of instrument development guidelines significantly strengthens the usefulness of the framework. A theoretically based understanding of postpartum smoking relapses can guide and strengthen appropriate interventions directed toward significantly reducing postpartum smoking, thereby increasing the number of women who are able to remain smoke-free for life.

Attitude↗
PubMed2002

Systematic review of mental health interventions for patients with common somatic symptoms: can research evidence from secondary care be extrapolated to primary care?

OBJECTIVES: To determine the strength of evidence for the effectiveness of mental health interventions for patients with three common somatic conditions (chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain). To assess whether results obtained in secondary care can be extrapolated to primary care and suggest how future trials should be designed to provide more rigorous evidence. DESIGN: Systematic review. DATA SOURCES: Five electronic databases, key texts, references in the articles identified, and citations from expert clinicians. STUDY SELECTION: Randomised controlled trials including participants with one of the three conditions for which no physical cause could be found. Two reviewers screened sources and independently extracted data and assessed quality. RESULTS: Sixty one studies were identified; 20 were classified as primary care and 41 as secondary care. For some interventions, such as brief psychodynamic interpersonal therapy, little research was identified. However, results of meta-analyses and of randomised controlled trials suggest that cognitive behaviour therapy and behaviour therapy are effective for chronic back pain and chronic fatigue syndrome and that antidepressants are effective for irritable bowel syndrome. Cognitive behaviour therapy and behaviour therapy were effective in both primary and secondary care in patients with back pain, although the evidence is more consistent and the effect size larger for secondary care. Antidepressants seem effective in irritable bowel syndrome in both settings but ineffective in chronic fatigue syndrome. CONCLUSIONS: Treatment seems to be more effective in patients in secondary care than in primary care. This may be because secondary care patients have more severe disease, they receive a different treatment regimen, or the intervention is more closely supervised. However, conclusions of effectiveness should be considered in the light of the methodological weaknesses of the studies. Large pragmatic trials are needed of interventions delivered in primary care by appropriately trained primary care staff.

Antidepressive Agents↗
PubMed2004

Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials.

OBJECTIVE: To assess the relative effectiveness of interventions to prevent falls in older adults to either a usual care group or control group. DESIGN: Systematic review and meta-analyses. DATA SOURCES: Medline, HealthSTAR, Embase, the Cochrane Library, other health related databases, and the reference lists from review articles and systematic reviews. DATA EXTRACTION: Components of falls intervention: multifactorial falls risk assessment with management programme, exercise, environmental modifications, or education. RESULTS: 40 trials were identified. A random effects analysis combining trials with risk ratio data showed a reduction in the risk of falling (risk ratio 0.88, 95% confidence interval 0.82 to 0.95), whereas combining trials with incidence rate data showed a reduction in the monthly rate of falling (incidence rate ratio 0.80, 0.72 to 0.88). The effect of individual components was assessed by meta-regression. A multifactorial falls risk assessment and management programme was the most effective component on risk of falling (0.82, 0.72 to 0.94, number needed to treat 11) and monthly fall rate (0.63, 0.49 to 0.83; 11.8 fewer falls in treatment group per 100 patients per month). Exercise interventions also had a beneficial effect on the risk of falling (0.86, 0.75 to 0.99, number needed to treat 16) and monthly fall rate (0.86, 0.73 to 1.01; 2.7). CONCLUSIONS: Interventions to prevent falls in older adults are effective in reducing both the risk of falling and the monthly rate of falling. The most effective intervention was a multifactorial falls risk assessment and management programme. Exercise programmes were also effective in reducing the risk of falling.

Accident Prevention↗
PubMed2005

Social capital and mental illness: a systematic review.

STUDY OBJECTIVE: The concept of social capital has influenced mental health policies of nations and international organisations despite its limited evidence base. This papers aims to systematically review quantitative studies examining the association between social capital and mental illness. DESIGN AND SETTING: Twenty electronic databases and the reference sections of papers were searched to identify published studies. Authors of papers were contacted for unpublished work. Anonymised papers were reviewed by the authors of this paper. Papers with a validated mental illness outcome and an exposure variable agreed as measuring social capital were included. No limitations were put on date or language of publication. MAIN RESULTS: Twenty one studies met the inclusion criteria for the review. Fourteen measured social capital at the individual level and seven at an ecological level. The former offered evidence for an inverse relation between cognitive social capital and common mental disorders. There was moderate evidence for an inverse relation between cognitive social capital and child mental illness, and combined measures of social capital and common mental disorders. The seven ecological studies were diverse in methodology, populations investigated, and mental illness outcomes, making them difficult to summarise. CONCLUSIONS: Individual and ecological social capital may measure different aspects of the social environment. Current evidence is inadequate to inform the development of specific social capital interventions to combat mental illness.

Cognition↗
PubMedDate not supplied

Informatics in radiology (infoRAD): survey of personal digital assistant use in radiology.

There has been widespread adoption of personal digital assistants (PDAs) within medicine in recent years. However, information on the prevalence and usage of these devices among radiologists is limited. A survey was designed and mailed to randomly selected members of the Radiological Society of North America to determine the percentage of PDA users, their use patterns, and the types of applications that they would like to see in the future. The use patterns of attending radiologists were compared with those of trainees (residents and fellows). Overall usage was also compared with the relevant findings in two surveys of internal medicine users. It was found that slightly less than one-half of respondents used PDAs on a daily basis, a finding that was comparable to that in the internal medicine surveys. However, less than one-quarter of PDA users had radiology-specific applications installed on their devices, whereas a greater percentage of internal medicine users had software such as drug databases and clinical references on their PDAs. Radiology trainees had a higher rate of both PDA ownership and radiology application usage than did attending radiologists. It is likely that, as PDA hardware becomes more powerful, with higher display resolution, better wireless networking capabilities, and greater memory capacity, PDA ownership as well as radiology application usage will increase.

Computers, Handheld↗
PubMed2006

Prevalence of chronic atrophic gastritis in different parts of the world.

Chronic atrophic gastritis (CAG) is a well-established precursor of intestinal gastric cancer, but epidemiologic data about its occurrence are sparse. We provide an overview on studies that examined the prevalence of CAG in different parts of the world. Articles containing data about the prevalence of chronic atrophic gastritis in unselected population samples and published until November 2005 were identified by searching the MEDLINE database. Furthermore, the references in the identified publications were screened for additional suitable studies. Studies comprising at least 50 subjects were included. Forty-one studies providing data on the prevalence of CAG in unselected population samples could be identified. CAG was determined by gastroscopy in 15 studies and by pepsinogen serum levels in 26 studies. Although results are difficult to compare due to the various definitions of CAG used, a strong increase with age, the lack of major gender differences, and strong variations between populations and population groups (in particular, relatively high rates in certain Asian populations) could be observed quite consistently. We conclude that CAG is relatively common among older adults in different parts of the world, but large variations exist. Large-scale international comparative studies with standardized methodology to determine CAG are needed to provide a coherent picture of the epidemiology of CAG in various populations. Noninvasive measurements of CAG by pepsinogen levels may be particularly suited for that purpose.

Adolescent↗
PubMed2006

Traditional Chinese medicine (phytotherapy): Health Technology Assessment report - selected aspects.

OBJECTIVE: A summary of main aspects from a Health Technology Assessment report on Traditional Chinese Medicine (TCM) in Switzerland concerning effectiveness and safety is given. MATERIALS AND METHODS: Literature search was performed through 13 databases, by scanning reference lists of articles and by contacting experts. Assessed were quality of documentation, internal and external validity. RESULTS: Effectiveness: 43 articles concerning 'gastrointestinal tract and liver' were assessed. The studies covering 7,436 patients were undertaken in China (35), Japan (3), USA (2) and Australia (3); 33/43 being controlled studies. 34/40 show significantly better results in the TCM-treated group. A comparison of studies on results of treatment based on a diagnosis according to TCM criteria and studies on results of treatment according to Western diagnosis shows that treatment based on TCM diagnosis improves the result. The comparison of treatment by individual medication and standard medication showed a trend in favor of individual medication. SAFETY: TCM training and practice for physicians in Switzerland are officially regulated. Side effects occur, but no severe effects have been registered up to now in Switzerland. TCM medicinals are imported; admission regulations are being installed. Problems due to production abroad, Internet trade, self-medication or admixtures are possible. CONCLUSION: The evaluation of the literature search provides evidence for a basic clinical effectiveness of TCM therapy. Severe side effects were not observed in Switzerland. Regulations for trading and use of medicinals prevent treatment risks. Further clinical studies in a Western context are required.

Drugs, Chinese Herbal↗
PubMed1991

Body dysmorphic disorder: the distress of imagined ugliness.

OBJECTIVE: Body dysmorphic disorder, a preoccupation with an imagined defect in physical appearance, has a rich tradition in European psychiatry but has been largely neglected in the United States. Because this little-known disorder is probably more common than is generally realized and can have profound consequences, the author reviews its history, clinical features, and possible relationship to other psychiatric disorders. DATA COLLECTION: Data sources consisted of the MEDLINE database and relevant references in articles obtained from this search. Of 145 articles and books obtained, 100 were selected for inclusion in this review on the basis of how closely they conformed to the concept of body dysmorphic disorder as defined in DSM-III-R and how substantially they contributed to an understanding of the disorder's history, clinical features, or nosologic status. FINDINGS: Body dysmorphic disorder has been colorfully described in the European literature for more than a century. Although its concerns might sound trivial, this disorder can lead to social isolation (including being housebound), occupational dysfunction, unnecessary cosmetic surgery, and suicide. The most commonly associated psychiatric disorder appears to be depression. Although a definitive treatment does not exist, preliminary evidence suggests that serotonergic antidepressant medications may be useful. Whether body dysmorphic disorder is related to other psychiatric disorders, such as psychosis, mood disorder, social phobia, or obsessive-compulsive disorder, is unclear at this time. CONCLUSIONS: More research on the nosology, clinical features, and treatment response of body dysmorphic disorder is important, given the distress and impairment this often secret disorder can cause.

Antidepressive Agents↗
PubMed2005

Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis.

OBJECTIVE: Mortality risk in offspring of parents with psychotic disorders is a sensitive and important topic, but evidence on which to base plans for preventive services is limited. The authors synthesized evidence for mortality risk among offspring of parents with psychotic disorders and examined potential modifiers of risk such as offspring age and parental diagnosis. METHOD: Electronic reference and citation databases were searched. Secondary analyses were carried out to generate relative risk estimates and perform post hoc statistical power calculations. A meta-analysis of the association between maternal psychotic disorder and fetal death/stillbirth was conducted. RESULTS: Most of the relevant studies investigated the relationship between exposure to maternal schizophrenia and perinatal or infant mortality outcomes but were not truly population-based and lacked adequate power. Studies published since 1960 generally indicated higher than expected mortality risk in exposed offspring. Meta-analysis indicated an almost twofold higher risk of fetal death/stillbirth among offspring of women with psychoses. Notable gaps in the existing evidence include outcome beyond the first year of life, cause-specific mortality, and effects of exposure to specific parental conditions other than schizophrenia and of exposure to paternal versus maternal disorder. Etiological mechanisms are not fully understood. CONCLUSIONS: Large-scale population-based studies are needed to understand mortality risk in offspring of parents with psychoses. In the absence of etiological evidence, only general preventive measures can be taken. Prevention of offspring mortality at an early age is most likely to be achieved by identification and treatment of maternal disorder and greater provision of support to these vulnerable families.

Adolescent↗
PubMedDate not supplied

Nutrition support in acute pancreatitis: a systematic review of the literature.

BACKGROUND: Failure to use the gastrointestinal (GI) tract in patients with acute pancreatitis may exacerbate the stress response and disease severity, leading to greater incidence of complications and prolonged hospitalization. The objectives of this study were to determine the optimum route for nutrition support, whether nutrition therapy is better than no artificial nutrition support, whether specific additives to enteral or parenteral therapy can further enhance their efficacy, and whether methodologic differences in delivery of enteral nutrition (EN) influence tolerance. METHODS: A computerized search was performed of MEDLINE, Cochrane database, EMBASE, and reference lists of pertinent review articles for prospective randomized trials in adult patients with acute pancreatitis that evaluated interventions with nutrition therapy. Primary outcome data and surrogate endpoint parameters (for nutrition indices, stress markers, and measures of the inflammatory/immune response) were extracted in duplicate independently. Where appropriate, meta-analysis was performed by random-effects model. RESULTS: From 119 articles screened, 27 randomized controlled trials were included and analyzed. In patients admitted for acute pancreatitis, meta-analysis of 7 trials showed that use of EN was associated with a significant reduction in infectious morbidity (risk ratio [RR] = 0.46; 95% confidence interval [CI], 0.29 - 0.74; p = .001) and hospital length of stay (LOS; weighted mean difference [WMD] = -3.94; 95% CI, -5.86 to -2.02; p < .0001), a trend toward reduced organ failure (RR = 0.59; 95% CI, 0.28-1.27; p = .18), with no effect on mortality (RR = 0.88; 95% CI, 0.43-1.79; p = .72) when compared with use of parenteral nutrition (PN). Results from individual studies suggest that EN in comparison to PN reduces oxidative stress, hastens resolution of the disease process, and costs less. Insufficient data exist to determine whether EN improves outcome over standard therapy (no artificial nutrition support) in patients admitted for acute pancreatitis. However, in those patients requiring surgery for complications of acute pancreatitis, meta-analysis of 2 trials indicates that provision of EN postoperatively may reduce mortality (RR = 0.26; 95% CI, 0.06 - 1.09; p = .06) compared with standard therapy. PN provided early within 24 hours of admission was shown to worsen outcome, whereas PN provided later after full-volume resuscitation appeared to improve outcome when compared with standard therapy. In early individual studies, specific supplements added to EN, such as arginine, glutamine, omega-3 polyunsaturated fatty acids, and probiotics, may be associated with a positive impact on patient outcome in acute pancreatitis, compared with EN alone without the supplements, but studies are too few to make strong treatment recommendations. Supplementation of PN with parenteral glutamine was shown to reduce oxidative stress and improve patient outcome (reduced duration of nutrition therapy and decreased hospital LOS) compared with PN alone in patients with acute pancreatis. A wide range of tolerance to EN exists, irrespective of known influences such as mode (continuous vs bolus) and level of infusion within the GI tract (gastric vs postpyloric). CONCLUSIONS: Patients with acute severe pancreatitis should begin EN early because such therapy modulates the stress response, promotes more rapid resolution of the disease process, and results in better outcome. In this sense, EN is the preferred route and has eclipsed PN as the new "gold standard" of nutrition therapy. When PN is used, it should be initiated after 5 days. The favorable effect of both EN and PN on patient outcome may be further enhanced by supplementation with modulators of inflammation and systemic immunity. Individual variability allows for a wide range of tolerance to EN, even in severe pancreatitis.

Acute Disease↗
PubMed2003

Avoiding inadvertent epidural injection of drugs intended for non-epidural use.

Inadvertent administration of non-epidural medications into the epidural space has the potential for serious morbidity and mortality. The aim of this study was to collate reported incidents of this type, describe the potential mechanisms of occurrence and identify possible solutions. We searched medical databases and reviewed reference lists of papers retrieved, covering a period of 35 years, regarding this type of medication incident. The 31 reports of 37 cases found is likely to represent a gross underestimation of the actual number of incidents that occur. "Syringe swap", "ampoule error", and epidural/intravenous line confusion were the main sources of error in 36/37 cases (97%). Given that no effective treatment for such errors has been identified, prevention should be the main defence strategy. Despite all the precautions that are currently undertaken, accidents will inevitably occur. We have identified areas for systemwide change that may prevent these types of incidents from occurring in future.

Drug Labeling↗
PubMed2000

EEG operant conditioning (biofeedback) and traumatic brain injury.

A review is presented of the currently sparse literature about EEG operant conditioning or biofeedback as a treatment to reduce symptomology and patient complaints following a traumatic brain injury. The paper also evaluates the general use of quantitative EEG (QEEG) to assess traumatic brain injury and to facilitate EEG biofeedback treatment. The use of an age matched reference normative QEEG database and QEEG discriminant function are presented as a method to evaluate the nature or neurological basis of a patient's complaints as well as to individualize an efficient and optimal feedback protocol and to help evaluate the efficacy of the biofeedback therapy. Univariate and multivariate statistical issues are discussed, different classes of experimental designs are described and then a "double blind" research study is proposed in an effort to encourage future research in the area of EEG biofeedback for the treatment and rehabilitation of traumatic brain injury.

Analysis of Variance↗
PubMed2004

The association of Alu repeats with the generation of potential AU-rich elements (ARE) at 3' untranslated regions.

BACKGROUND: A significant portion (about 8% in the human genome) of mammalian mRNA sequences contains AU (Adenine and Uracil) rich elements or AREs at their 3' untranslated regions (UTR). These mRNA sequences are usually stable. However, an increasing number of observations have been made of unstable species, possibly depending on certain elements such as Alu repeats. ARE motifs are repeats of the tetramer AUUU and a monomer A at the end of the repeats ((AUUU)nA). The importance of AREs in biology is that they make certain mRNA unstable. Proto-oncogene, such as c-fos, c-myc, and c-jun in humans, are associated with AREs. Although it has been known that the increased number of ARE motifs caused the decrease of the half-life of mRNA containing ARE repeats, the exact mechanism is as of yet unknown. We analyzed the occurrences of AREs and Alu and propose a possible mechanism for how human mRNA could acquire and keep AREs at its 3' UTR originating from Alu repeats. RESULTS: Interspersed in the human genome, Alu repeats occupy 5% of the 3' UTR of mRNA sequences. Alu has poly-adenine (poly-A) regions at its end, which lead to poly-thymine (poly-T) regions at the end of its complementary Alu. It has been found that AREs are present at the poly-T regions. From the 3' UTR of the NCBI's reference mRNA sequence database, we found nearly 40% (38.5%) of ARE (Class I) were associated with Alu sequences (Table 1) within one mismatch allowance in ARE sequences. Other ARE classes had statistically significant associations as well. This is far from a random occurrence given their limited quantity. At each ARE class, random distribution was simulated 1,000 times, and it was shown that there is a special relationship between ARE patterns and the Alu repeats. CONCLUSION: AREs are mediating sequence elements affecting the stabilization or degradation of mRNA at the 3' untranslated regions. However, AREs' mechanism and origins are unknown. We report that Alu is a source of ARE. We found that half of the longest AREs were derived from the poly-T regions of the complementary Alu.

3' Untranslated Regions↗
PubMed2001

Systematic review of the use of honey as a wound dressing.

OBJECTIVE: To investigate topical honey in superficial burns and wounds though a systematic review of randomised controlled trials. DATA SOURCES: Cochrane Library, MEDLINE, EMBASE, PubMed, reference lists and databases were used to seek randomised controlled trials. Seven randomised trials involved superficial burns, partial thickness burns, moderate to severe burns that included full thickness injury, and infected postoperative wounds. REVIEW METHODS: Studies were randomised trials using honey, published papers, with a comparator. Main outcomes were relative benefit and number-needed-to-treat to prevent an outcome relating to wound healing time or infection rate. RESULTS: One study in infected postoperative wounds compared honey with antiseptics plus systemic antibiotics. The number needed to treat with honey for good wound healing compared with antiseptic was 2.9 (95% confidence interval 1.7 to 9.7). Five studies in patients with partial thickness or superficial burns involved less than 40% of the body surface. Comparators were polyurethane film, amniotic membrane, potato peel and silver sulphadiazine. The number needed to treat for seven days with honey to produce one patient with a healed burn was 2.6 (2.1 to 3.4) compared with any other treatment and 2.7 (2.0 to 4.1) compared with potato and amniotic membrane. For some or all outcomes honey was superior to all these treatments. Time for healing was significantly shorter for honey than all these treatments. The quality of studies was low. CONCLUSION: Confidence in a conclusion that honey is a useful treatment for superficial wounds or burns is low. There is biological plausibility.

Anti-Bacterial Agents↗