sábado, 2 de julho de 2011

New Cochrane meta-analysis sparks controversy about bronchiolitis

Bronchiolitis is the most common disease of the lower respiratory tract during the first year of life. Respiratory syncytial virus is the underlying cause of most bronchiolitis and this infection is associated with substantial
morbidity in young children. Research has shown its burden in developed and developing countries and a lack of
clear evidence for its therapeutic management, including
the use of different bronchodilators (β2 agonists, adrenaline (epinephrine), anticholinergics) and steroids. Several systematic reviews have failed to provide convincing evidence to support any
of these treatments in the acute management of bronchiolitis,
and their routine use is not
recommended by current clinical practice guidelines. Scholars disagree about the use of corticosteroids and common scientific belief is that they are useless and may be even harmful in children with bronchiolitis. Now, a recent meta-analysis published in the British Medical Journal has found evidence that inhaled adrenaline and systemic corticosteroids may indeed have a role in the treatment of bronchiolitis. The study has been criticized by many. One critic say the study is "flawed" and he "read with disappointment the use of a Cochrane review to promote
the use of adrenaline and steroids." Read the study and one of the critics.

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