“Zinc gluconate in the form and dosage studied significantly reduced the duration of symptoms of the common cold.”
Mossad et al., "Zinc Gluconate Lozenges for Treating the Common
A Randomized, Double-Blind, Placebo-Controlled Study." Annals of Internal Medicine Vol. 125, No. 2 (July 15, 1996): Page 81. Print.
The document appears to be a slide presentation on hepatitis C. It discusses epidemiology and transmission routes of hepatitis C virus globally and in Brazil. It provides treatment guidelines for hepatitis C, including protocols for protease inhibitor-based regimens with boceprevir or telaprevir in addition to pegylated interferon and ribavirin. It summarizes clinical trial results showing improved sustained virologic response rates with protease inhibitor regimens compared to pegylated interferon and ribavirin alone. It also notes ongoing challenges in treating hepatitis C.
Treatment of Influenza with Convalescent Plasma - Professor Ivan Hung Sara Berlanda
This document discusses the treatment of H1N1 influenza infection with convalescent plasma therapy. It summarizes several studies that found convalescent plasma treatment reduced mortality rates and viral loads in patients with severe H1N1 infections. Specifically, one study found mortality was reduced from 54.8% in controls to 20% in patients receiving convalescent plasma treatment. Another study found convalescent plasma reduced viral loads and levels of inflammatory cytokines. While convalescent plasma shows promise, there are also practical challenges to collecting enough plasma during a pandemic.
This document summarizes a morbidity meeting discussing a case of a 14-year-old female patient presenting with multifocal disseminated osteomyelitis and underlying abscesses. Key details include a history of fever, backache, and hip pain for 25 days. Imaging revealed abscesses in the right psoas muscle and illiac bone. The patient underwent drainage procedures and was treated with various antibiotics. Her condition remained unstable with ongoing fever and drainage. The meeting involved discussing her treatment plan and lessons learned for improving management of such complex cases of osteomyelitis.
1) A randomized clinical trial of 576 adults with acute sore throat found that a single dose of oral dexamethasone did not increase the proportion of patients with complete resolution of symptoms at 24 hours compared to placebo.
2) However, at 48 hours significantly more patients in the dexamethasone group experienced complete resolution of symptoms than those in the placebo group.
3) The study found no other significant differences between the dexamethasone and placebo groups in secondary outcomes such as duration of symptoms, health care use, time off work, or medication use.
- The study compared the effects of beractant and poractant surfactants in treating 58 premature infants with respiratory distress syndrome (RDS).
- Infants who received poractant had a lower oxygen requirement in the first 48 hours compared to beractant. They also had fewer cases of patent ductus arteriosus.
- There were no significant differences between the groups in outcomes like time to extubation, total ventilation time, or rates of bronchopulmonary dysplasia.
Each month, join us as we highlight and discuss hot topics ranging from the future of higher education to wearable technology, best productivity hacks and secrets to hiring top talent. Upload your SlideShares, and share your expertise with the world!
Not sure what to share on SlideShare?
SlideShares that inform, inspire and educate attract the most views. Beyond that, ideas for what you can upload are limitless. We’ve selected a few popular examples to get your creative juices flowing.
SlideShare is a global platform for sharing presentations, infographics, videos and documents. It has over 18 million pieces of professional content uploaded by experts like Eric Schmidt and Guy Kawasaki. The document provides tips for setting up an account on SlideShare, uploading content, optimizing it for searchability, and sharing it on social media to build an audience and reputation as a subject matter expert.
The document appears to be a slide presentation on hepatitis C. It discusses epidemiology and transmission routes of hepatitis C virus globally and in Brazil. It provides treatment guidelines for hepatitis C, including protocols for protease inhibitor-based regimens with boceprevir or telaprevir in addition to pegylated interferon and ribavirin. It summarizes clinical trial results showing improved sustained virologic response rates with protease inhibitor regimens compared to pegylated interferon and ribavirin alone. It also notes ongoing challenges in treating hepatitis C.
Treatment of Influenza with Convalescent Plasma - Professor Ivan Hung Sara Berlanda
This document discusses the treatment of H1N1 influenza infection with convalescent plasma therapy. It summarizes several studies that found convalescent plasma treatment reduced mortality rates and viral loads in patients with severe H1N1 infections. Specifically, one study found mortality was reduced from 54.8% in controls to 20% in patients receiving convalescent plasma treatment. Another study found convalescent plasma reduced viral loads and levels of inflammatory cytokines. While convalescent plasma shows promise, there are also practical challenges to collecting enough plasma during a pandemic.
This document summarizes a morbidity meeting discussing a case of a 14-year-old female patient presenting with multifocal disseminated osteomyelitis and underlying abscesses. Key details include a history of fever, backache, and hip pain for 25 days. Imaging revealed abscesses in the right psoas muscle and illiac bone. The patient underwent drainage procedures and was treated with various antibiotics. Her condition remained unstable with ongoing fever and drainage. The meeting involved discussing her treatment plan and lessons learned for improving management of such complex cases of osteomyelitis.
1) A randomized clinical trial of 576 adults with acute sore throat found that a single dose of oral dexamethasone did not increase the proportion of patients with complete resolution of symptoms at 24 hours compared to placebo.
2) However, at 48 hours significantly more patients in the dexamethasone group experienced complete resolution of symptoms than those in the placebo group.
3) The study found no other significant differences between the dexamethasone and placebo groups in secondary outcomes such as duration of symptoms, health care use, time off work, or medication use.
- The study compared the effects of beractant and poractant surfactants in treating 58 premature infants with respiratory distress syndrome (RDS).
- Infants who received poractant had a lower oxygen requirement in the first 48 hours compared to beractant. They also had fewer cases of patent ductus arteriosus.
- There were no significant differences between the groups in outcomes like time to extubation, total ventilation time, or rates of bronchopulmonary dysplasia.
Each month, join us as we highlight and discuss hot topics ranging from the future of higher education to wearable technology, best productivity hacks and secrets to hiring top talent. Upload your SlideShares, and share your expertise with the world!
Not sure what to share on SlideShare?
SlideShares that inform, inspire and educate attract the most views. Beyond that, ideas for what you can upload are limitless. We’ve selected a few popular examples to get your creative juices flowing.
SlideShare is a global platform for sharing presentations, infographics, videos and documents. It has over 18 million pieces of professional content uploaded by experts like Eric Schmidt and Guy Kawasaki. The document provides tips for setting up an account on SlideShare, uploading content, optimizing it for searchability, and sharing it on social media to build an audience and reputation as a subject matter expert.
Reducing the Incidence of 131I Induced Sialadenitis - The Role of PilocarpineXiu Srithammasit
My presentation
Reducing the Incidence of 131I Induced Sialadenitis - The Role of Pilocarpine.
THE JOURNAL OF NUCLEAR MEDICINE Vol. 49 No. 4 April 2008 by Edward B. Silberstein from Department of Nuclear Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio
My Blog : http://ImagingSing.wordpress.com
This document describes Flu Terminator, a homeopathic formulation for treating influenza. It contains 10 homeopathic ingredients including Gelsemium, Zincum, Aconitum, and Eupatorium. Conventional flu treatments have limitations and side effects. Homeopathy is based on the principle of "like cures like" and stimulates the immune system rather than directly attacking viruses. A study found Flu Terminator activates white blood cells to release cytokines. It is manufactured according to FDA regulations and has no reported side effects. The recommended dosage is 10 drops every 10 minutes at onset then 10 drops 3 times daily.
When does one use zinc alone - Dr Vinay GoyalSanjeev Kumar
This document discusses the use of zinc alone in treating Wilson's disease. Zinc is the preferred initial treatment as it is nontoxic and prevents copper absorption in the intestine. It works by inducing intestinal metallothionein and blocking copper absorption and resorption from the gastrointestinal tract. Zinc can be used long-term for maintenance therapy in Wilson's disease patients, including during pregnancy where it has been shown to be safe. The document also discusses combinations of zinc and penicillamine, noting some studies have found higher mortality with this combination compared to other therapies.
Microbial Flora in Chronic Rhinosinusitis with and without Nasalpolyps by José Gameirodos Santos in Experiments in Rhinology & Otolaryngology
The most common microbial agents in the etiology of chronic rhinosinusitis are defined in the literature as Staphylococcus aureus, Staphylococcus coagulase-negative and Streptococcus spp. In healthy individuals these same microorganisms are also the most frequent (mainly Staphylococcus coagulase negative) ascolonizing flora agents. We often encounter a poly microbial colonization of the nose and sinuses. The contribution of the different pathogens for the disease remains sun certain. The aim of this study is to compare the microbial flora found in patients with chronic rhinosinusitis with and without nasal polyps.
Case Studies (Clinical Pharmacy Assignment)
Case Studies
Case Study 1. Drug Related Problem
Case Study 2. Alcohol Toxicity
Case Study 3. Patient Counseling
Case Study 4. Peptic Ulcer
Case Study 5. Drug and the Newborn
Case Study 6. Night time Anxiety
Case Study 7. Clostridium Difficile
Case Study 8. Epilepsy and Pregnancy
Case Study 9. Parkinsonism
Case Study 10. Treatment May Be Worse Than Condition
Bronchiolitis is an acute viral infection that commonly affects infants under 2 years old. The document discusses recent advances in managing bronchiolitis, including supportive care with oxygen and hydration. Nebulized epinephrine may reduce admissions. Hypertonic saline reduces hospital stay compared to normal saline. Antibiotics generally are not beneficial except possibly clarithromycin. Palivizumab prevents RSV infections in high-risk infants. Overall, bronchiolitis typically resolves with supportive care alone.
This document discusses evidence-based medicine (EBM), which involves integrating clinical expertise with the best available external clinical evidence from systematic research. EBM aims to improve decision making in areas like diagnosis, treatment, prevention, and prognosis. It emphasizes using relevant clinical research studies, especially patient-oriented research, to evaluate diagnostic tests, treatments, and preventive measures. The history of the drug flecainide illustrates how reliance on proposed mechanisms of action rather than outcomes from clinical trials can lead to widespread use of treatments that end up doing more harm than good when better evidence emerges.
AllTrials AAAS 2015 - Closing the Loop: Towards Claim-Evidence Networks in C...SenseAboutSci
The document discusses improving connections between clinical claims and evidence. It presents examples where claims in guidelines or drug marketing are not well supported by available evidence from clinical trials. Better systems are needed to link claims directly to supporting evidence, such as those used by Cancer Commons and Cochrane Collaboration, which connect websites, case reports, and trials. Tools to identify the strength and source of claims in research papers can also help form more rigorous claim-evidence networks in clinical practice.
1. The document discusses nucleic acids, their structures and functions. It describes nucleosides, nucleotides, DNA, RNA and their components.
2. Synthetic nucleotide analogs are discussed that are used as chemotherapy drugs and antivirals by interfering with DNA replication. Zidovudine and 5-fluorouracil are highlighted as examples.
3. The clinical cases provided are used to explain how zidovudine works against HIV and how 5-fluorouracil inhibits cancer cell proliferation.
Drug repurposing involves finding new uses for existing drugs to treat rare diseases. It has advantages over developing new drugs including being faster, cheaper, and leveraging existing safety and use data. Opportunities for repurposing can be identified through screening compound libraries, literature mining, and 'omics approaches. A example is using the epilepsy drug sodium valproate identified from screening as a potential treatment for Wolfram syndrome, which is now in clinical trials.
The Laryngoscope - 2009 - Tomooka - Clinical Study and Literature Review of N...ManIPN
This study evaluated the efficacy of nasal irrigation with hypertonic saline delivered by a Water Pik device for treatment of sinus diseases. 211 patients with sinus diseases like rhinitis used the irrigation method for 3-6 weeks. Patients reported statistically significant improvements in 23 of 30 nasal symptoms measured. They also showed improved scores on a quality of life assessment. Nasal irrigation was found to be an effective treatment for improving symptoms and health status in patients with sinus diseases.
The document summarizes several new drugs approved by the FDA in 2014 to treat various medical conditions, including:
1) Zerbaxa and Rapivab, approved to treat infections. Saxenda was approved to treat obesity. Namzaric was approved to treat Alzheimer's disease.
2) Viekira Pak was approved to treat hepatitis C. Kitabis Pak was approved to treat cystic fibrosis. Xigduo XR was approved to treat diabetes.
3) Sotylize was approved to treat arrhythmias. Several studies on new drugs and treatments for COPD, emphysema, influenza, and other conditions were summarized.
This document summarizes several new drugs and medical issues from 2014. It describes new drugs approved for treating infections (Zerbaxa, Rapivab), obesity (Saxenda), Alzheimer's disease (Namzaric), hepatitis C (Viekira Pak), cystic fibrosis (Kitabis Pak), diabetes (Xigduo XR), and arrhythmias (Sotylize). It also summarizes studies on treating COPD, emphysema, liver failure, ICU infections, anemia, nutrition, and more.
The document summarizes several new drugs approved by the FDA in 2014 to treat various medical conditions such as infections, obesity, Alzheimer's disease, hepatitis C, cystic fibrosis, diabetes, arrhythmias, COPD, emphysema, and cancer. It also discusses clinical trials on topics like the use of statins for COPD, prophylactic antibiotics for liver failure, antibiotic decontamination of the digestive tract, transfusion thresholds, enteral nutrition, immune modulatory enteral feeds, palliative ICU care, intraoperative PEEP, stem cell therapy for scleroderma, and chemotherapy for small cell lung cancer.
Upper respiratory infections in children 2015 Khaled Saad
Streptococcus infection causing inflammation of the throat and tonsils. Treatment involves supportive care with analgesics and anesthetics for viral infections. For bacterial Streptococcus infections, antibiotics are prescribed to prevent complications like rheumatic fever, with amoxicillin being a first line treatment. Sinusitis is usually caused by bacteria following a viral upper respiratory infection. Symptoms include nasal discharge and facial pain. Antibiotics like amoxicillin-clavulanate are prescribed. Acute otitis media is an ear infection that can be preceded by upper respiratory infections. It is usually treated with antibiotics like amoxicillin.
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Cold-EEZE Cold Remedy Testimonial - Kim SCold-EEZE
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
More Related Content
Similar to Zinc Gluconate Lozenges for Treating the Common Cold: a Randomized, Double-Blind, Placebo-Controlled Study
Reducing the Incidence of 131I Induced Sialadenitis - The Role of PilocarpineXiu Srithammasit
My presentation
Reducing the Incidence of 131I Induced Sialadenitis - The Role of Pilocarpine.
THE JOURNAL OF NUCLEAR MEDICINE Vol. 49 No. 4 April 2008 by Edward B. Silberstein from Department of Nuclear Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio
My Blog : http://ImagingSing.wordpress.com
This document describes Flu Terminator, a homeopathic formulation for treating influenza. It contains 10 homeopathic ingredients including Gelsemium, Zincum, Aconitum, and Eupatorium. Conventional flu treatments have limitations and side effects. Homeopathy is based on the principle of "like cures like" and stimulates the immune system rather than directly attacking viruses. A study found Flu Terminator activates white blood cells to release cytokines. It is manufactured according to FDA regulations and has no reported side effects. The recommended dosage is 10 drops every 10 minutes at onset then 10 drops 3 times daily.
When does one use zinc alone - Dr Vinay GoyalSanjeev Kumar
This document discusses the use of zinc alone in treating Wilson's disease. Zinc is the preferred initial treatment as it is nontoxic and prevents copper absorption in the intestine. It works by inducing intestinal metallothionein and blocking copper absorption and resorption from the gastrointestinal tract. Zinc can be used long-term for maintenance therapy in Wilson's disease patients, including during pregnancy where it has been shown to be safe. The document also discusses combinations of zinc and penicillamine, noting some studies have found higher mortality with this combination compared to other therapies.
Microbial Flora in Chronic Rhinosinusitis with and without Nasalpolyps by José Gameirodos Santos in Experiments in Rhinology & Otolaryngology
The most common microbial agents in the etiology of chronic rhinosinusitis are defined in the literature as Staphylococcus aureus, Staphylococcus coagulase-negative and Streptococcus spp. In healthy individuals these same microorganisms are also the most frequent (mainly Staphylococcus coagulase negative) ascolonizing flora agents. We often encounter a poly microbial colonization of the nose and sinuses. The contribution of the different pathogens for the disease remains sun certain. The aim of this study is to compare the microbial flora found in patients with chronic rhinosinusitis with and without nasal polyps.
Case Studies (Clinical Pharmacy Assignment)
Case Studies
Case Study 1. Drug Related Problem
Case Study 2. Alcohol Toxicity
Case Study 3. Patient Counseling
Case Study 4. Peptic Ulcer
Case Study 5. Drug and the Newborn
Case Study 6. Night time Anxiety
Case Study 7. Clostridium Difficile
Case Study 8. Epilepsy and Pregnancy
Case Study 9. Parkinsonism
Case Study 10. Treatment May Be Worse Than Condition
Bronchiolitis is an acute viral infection that commonly affects infants under 2 years old. The document discusses recent advances in managing bronchiolitis, including supportive care with oxygen and hydration. Nebulized epinephrine may reduce admissions. Hypertonic saline reduces hospital stay compared to normal saline. Antibiotics generally are not beneficial except possibly clarithromycin. Palivizumab prevents RSV infections in high-risk infants. Overall, bronchiolitis typically resolves with supportive care alone.
This document discusses evidence-based medicine (EBM), which involves integrating clinical expertise with the best available external clinical evidence from systematic research. EBM aims to improve decision making in areas like diagnosis, treatment, prevention, and prognosis. It emphasizes using relevant clinical research studies, especially patient-oriented research, to evaluate diagnostic tests, treatments, and preventive measures. The history of the drug flecainide illustrates how reliance on proposed mechanisms of action rather than outcomes from clinical trials can lead to widespread use of treatments that end up doing more harm than good when better evidence emerges.
AllTrials AAAS 2015 - Closing the Loop: Towards Claim-Evidence Networks in C...SenseAboutSci
The document discusses improving connections between clinical claims and evidence. It presents examples where claims in guidelines or drug marketing are not well supported by available evidence from clinical trials. Better systems are needed to link claims directly to supporting evidence, such as those used by Cancer Commons and Cochrane Collaboration, which connect websites, case reports, and trials. Tools to identify the strength and source of claims in research papers can also help form more rigorous claim-evidence networks in clinical practice.
1. The document discusses nucleic acids, their structures and functions. It describes nucleosides, nucleotides, DNA, RNA and their components.
2. Synthetic nucleotide analogs are discussed that are used as chemotherapy drugs and antivirals by interfering with DNA replication. Zidovudine and 5-fluorouracil are highlighted as examples.
3. The clinical cases provided are used to explain how zidovudine works against HIV and how 5-fluorouracil inhibits cancer cell proliferation.
Drug repurposing involves finding new uses for existing drugs to treat rare diseases. It has advantages over developing new drugs including being faster, cheaper, and leveraging existing safety and use data. Opportunities for repurposing can be identified through screening compound libraries, literature mining, and 'omics approaches. A example is using the epilepsy drug sodium valproate identified from screening as a potential treatment for Wolfram syndrome, which is now in clinical trials.
The Laryngoscope - 2009 - Tomooka - Clinical Study and Literature Review of N...ManIPN
This study evaluated the efficacy of nasal irrigation with hypertonic saline delivered by a Water Pik device for treatment of sinus diseases. 211 patients with sinus diseases like rhinitis used the irrigation method for 3-6 weeks. Patients reported statistically significant improvements in 23 of 30 nasal symptoms measured. They also showed improved scores on a quality of life assessment. Nasal irrigation was found to be an effective treatment for improving symptoms and health status in patients with sinus diseases.
The document summarizes several new drugs approved by the FDA in 2014 to treat various medical conditions, including:
1) Zerbaxa and Rapivab, approved to treat infections. Saxenda was approved to treat obesity. Namzaric was approved to treat Alzheimer's disease.
2) Viekira Pak was approved to treat hepatitis C. Kitabis Pak was approved to treat cystic fibrosis. Xigduo XR was approved to treat diabetes.
3) Sotylize was approved to treat arrhythmias. Several studies on new drugs and treatments for COPD, emphysema, influenza, and other conditions were summarized.
This document summarizes several new drugs and medical issues from 2014. It describes new drugs approved for treating infections (Zerbaxa, Rapivab), obesity (Saxenda), Alzheimer's disease (Namzaric), hepatitis C (Viekira Pak), cystic fibrosis (Kitabis Pak), diabetes (Xigduo XR), and arrhythmias (Sotylize). It also summarizes studies on treating COPD, emphysema, liver failure, ICU infections, anemia, nutrition, and more.
The document summarizes several new drugs approved by the FDA in 2014 to treat various medical conditions such as infections, obesity, Alzheimer's disease, hepatitis C, cystic fibrosis, diabetes, arrhythmias, COPD, emphysema, and cancer. It also discusses clinical trials on topics like the use of statins for COPD, prophylactic antibiotics for liver failure, antibiotic decontamination of the digestive tract, transfusion thresholds, enteral nutrition, immune modulatory enteral feeds, palliative ICU care, intraoperative PEEP, stem cell therapy for scleroderma, and chemotherapy for small cell lung cancer.
Upper respiratory infections in children 2015 Khaled Saad
Streptococcus infection causing inflammation of the throat and tonsils. Treatment involves supportive care with analgesics and anesthetics for viral infections. For bacterial Streptococcus infections, antibiotics are prescribed to prevent complications like rheumatic fever, with amoxicillin being a first line treatment. Sinusitis is usually caused by bacteria following a viral upper respiratory infection. Symptoms include nasal discharge and facial pain. Antibiotics like amoxicillin-clavulanate are prescribed. Acute otitis media is an ear infection that can be preceded by upper respiratory infections. It is usually treated with antibiotics like amoxicillin.
Similar to Zinc Gluconate Lozenges for Treating the Common Cold: a Randomized, Double-Blind, Placebo-Controlled Study (20)
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Cold-EEZE Cold Remedy Testimonial - Kim SCold-EEZE
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Cold-EEZE Cold Remedy Testimonial - Joe RCold-EEZE
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Cold-EEZE Cold Remedy Testimonial - Jo Ann SCold-EEZE
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Cold-EEZE Cold Remedy Testimonial - Jim LCold-EEZE
Our fans love our Cold-EEZE Cold Remedy zinc lozenges, oral spray and QuickMelts! See how they've learned to shorten the duration of their cold by almost half by using Cold-EEZE at the first sign of the common cold. Have you tried Cold-EEZE to shorten your cold? What do you think? Share your story with us here: http://bit.ly/coldeezetestimonials
To learn more, visit our website http://bit.ly/coldeeze for information on Cold-EEZE products and join our community of fans on Facebook: http://on.fb.me/xeegkL and Twitter: http://bit.ly/xaSDMr
Zinc Gluconate and the Common Cold: a Controlled Clinical StudyCold-EEZE
The present study was carried out to test the hypothesis that pleasant-tasting zinc gluconate glycine lozenges that release 93% of the ionic zinc into saliva may produce similar efficacy to that originally reported by Eby et al in 1984, which successfully reduced the duration of the common cold using zinc gluconate.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Zinc Gluconate Lozenges for Treating the Common Cold: a Randomized, Double-Blind, Placebo-Controlled Study
1. Reprinted from ANNALS OF INTERNAL MEDICINE Vol.125;No.2, 15 July 1996
Printedin U.S.A.
15July 1996 Votume 125 Number 2
Annalsof InternalMedicine
Zinc Gluconate Lozengesfor Treating the Common Cold
A Randomized,Double-Blind, Placebo-ControlledStudy
Sherif B. Mossad,MD; Michael L. Macknin, MD; Sharon V. Medendorp, MPH;
and PamelaMason, BSN, MBA
Background: The common cold is one of the most fre- P < 0.001),nausea(20% compared with 4%; P "" 0.02), and
quent human illnessesand is responsible for substantial bad-taste reactions (SO%compared with 30%; P < 0.001).
morbidity and economic loss. No consistently effective Conclusion: Zinc gluconate in the form and dosagestud-
therapy for the common cold has been well documented, ied significantly reduced the duration of symptomsof the
but evidence suggeststhat several possible mechanisms common cold. The mechanism of action of this substance
may make zinc an effective treatment. in treating the common cold remains unknown. Individual
Objectl".: To test the efficacy of zinc gluconate lozenges patients must decide whether the possible beneficial ef-
in reducing the duration of symptoms causedby the com- fects of zinc gluconate on cold symptoms outweigh the
mon cold. possibleadverseeffects.
Design: Randomized, double-blind, placebo-controlled AM Inlml M«l. 1996;12S:81-88.
study. From the OevelandOinic Foundation,aeveland, Ohio. For
Setting: Outpatientdepartmentof a largetertiary care current author addresses, see end of text.
center.
The common cold is one of the most frequently
Patients: 100 employeesof the Cleveland Clinic who de-
.1. occurring human illnesses in the world. More
veloped symptoms of the common cold within 24 hours
than 200 viruses can cause common colds in adults,
before enrollment.
including rhinoviruses (the most frequent cause),
Intervention: Patients in the zinc group (n - SO) received coronaviruses,adenoviruses,respiratory syncytial vi-
lozenges (one lozenge every 2 hours while awake) con- rus, and parainfluenza viruses. In the United States
taining 13.3mg of zinc from zinc gluconate as long asthey each year, adults develop an averageof two to four
had cold symptoms. Patients in the placebo group (n - SO) colds and children develop an average of six to
received similarly administered lozenges that contained eight colds (1, 2). The morbidity resulting from this
5% calcium lactate penta hydrate instead of zinc glu-
diseaseand the subsequentfinancial loss in terms of
conate.
working hours are substantial (3). Many previously
M.in Outcome MHsures: Subjective daily symptom described treatments have not provided consistent
scores cough, headache,hoarseness,
for muscleache,nasal or well-documented relief of symptoms. Even a
drainage, nasal congestion, scratchy throat. sore throat, treatment that is only partially effective in relieving
sneezing,and fever (assessed oral temperature).
by cold symptomscould markedly reduce physical mal-
Results: The time to complete resolution of symptoms aise and economic lossesin a large population.
was significantly shorter in the zinc group than in the The medical literature describes many possible
placebo group (median, 4.4 days compared with 7.6 days; mechanismsby which zinc may treat the common
P < 0.001). The zinc group had significantly fewer days cold, and seven controlled trials have studied the
with coughing (median, 2.0 days compared with 4.5 days; use of zinc for this purpose. All sevenwere double-
P = 0.04), headache (2.0 days and 3.0 days; P = 0.02),
blind, placebo-controlled studies, but each used dif-
hoarseness daysand 3.0 days; P = 0.02), nasal conges-
(2.0 ferent formulations and dosagesof zinc. Three of
tion (4.0 daysand 6.0 days;P = 0.002), nasal drainage (4.0
daysand 7.0 days;P < 0.001),and sore throat (1.0 day and
3.0 days;P < 0.001).The groups did not differ significantly
in the resolution of fever, muscleache, scratchythroat, or
sneezing. More patients in the zinc group than In the
placebo group had side effects (90% compared with 62%;
2. thesestudiesshowedthat zinc had a beneficialef::-
these studies showed that zinc had a beneficial ef::- the studyas specified the protocolwere enrolled
by
feet (4-6) and four did not (7-10). In the studies'
fect (4-6) and four did not (7-10). In the studies in a ramefor one of two prizes:dinner for two or
that examined
that examinedvirus shedding 7), zinc treatment
virus shedding (5, 7), zinc treatment
(5, a trip for two to the Bahamas. The Institutional
had no elect on this shedding.
had no elect on this shedding. ReviewBoard at the aeveland ainic Foundation
We designed studysimilar to that of Godfrey
We designeda study similar to that of Godfrey
a approved study,and participants
the gaveinformed
and colleagues and used the symptomscore
and colleagues (6) and used the symptom score
(6) consent the time of enrollment.Participants
at were
developedby these researchers.
developed by these researchers. We emphasized
We emphasized informed of the placebo-controlled, double-blind
startingtreatment
starting treatment within 24 hoursafter the onsetof
within 24 hours after the onset of natureof the study.
symptoms,
symptoms,because
because Godfrey and colleagues
Godfrey and colleagues found
found Patients who volunteered the studywere en-
for
that early treatmentwas most elective. We used
that early treatment was most elective. We used rolled only if they had had cold symptoms 24 for
zinc gluconate
zinc gluconate lozenges,
lozenges,which appeared be well
which appeared to be well
to hoursor less.Patients musthavehad at leasttwo of
toleratedand had the best bioavailability
tolerated and had the best bioavailability profile in
profile in the following10 symptoms: cough,headache, hoarse-
previousstudies.Other studies(4-7, 9) used loz-
previous studies. Other studies (4-7, 9) used loz- ness,muscleache,nasaldrainage, nasalcongestion,
engescontaining 23 mg of zinc. To improvepalat-
engescontaining23 mg of zinc. To improve palat- scratchy throat,sorethroat,sneezing, an oral tem-
or
ability, lozenges our studycontained13.3mg of
ability, lozengesin our study contained 13.3 mg of
in perature greater than 37.7°c. Patientswere ex-
zinc. This provided a local concentrationof zinc
zinc. This provided a local concentration of zinc cludedif theywere pregnant, had a knownimmune
ions of about4.4 mmo1/L, amountgreaterthan
ions of about 4.4 mmoVL, an amount greater than
an deficiency, had had symptoms the common
or of
that necessary suppress
that necessaryto suppressrhinovirus(0.1 mmoVL)
to rhinovirus (0.1 mmol/L) cold for more than 24 hours.
(11, 12).The placebo
(11, 12). The placebo lozenge
lozengecontained calcium
contained 5% calcium
5% The zinc gluconate-glycine placebo
and lozenges
lactateso that it had a medicinaltaste similar to
lactate so that it had a medicinal taste similar to were supplied by the Quigley Corporation of
that of the zinc gluconatelozenge.
that of the zinc gluconate lozenge. Doylestown, Pennsylvania. zinc lozenges
The con-
Ours was a pragmaticstudy designedto deter-
Ours was a pragmatic study designed to deter- sistedof a boiled hard-candy base preparedwith
mine the efficacyof zinc gluconatelozenges re-
mine the efficacy of zinc gluconate lozengesin re-
in approximatelyequal proportions of sucroseand
Jcing clinical symptomscores under conditions
lcing clinical symptom scores under conditions com syrup,zinc gluconatetrihydrate (AKZO Che-
'1t reflectedusual medicalcare for the common
"it reflected usual medical care for the common mie, Amersfoort,the Netherlands), molar propor-
a
cold (13, 14).We did not seekto define the mech-
cold (13, 14). We did not seek to define the mech- tion of glycine(aminoacetic acid), and lemon and
anismof any zinc elect. Althoughvirus culturesor
anism of any zinc elect. Although virus cultures or lime flavoring oils. The mixture was formed into
serologictests might have been desirable,we de-
serologic tests might have been desirable, we de- lozenges weighed4.4 g and contained13.3mg
that
cidednot to do thesetestsbecause
cided not to do these tests becausethey are almost
they are almost of zinc. Placebo lozenges, weighing4.4 g, were
also
neverdonein the courseof standardcare.
never done in the course of standard care. preparedfrom the sameflavoredhard-candy base
and contained5.0% calcium lactate pentahydrate.
Placebo and active lozengeswere identical in
weight,appearance, flavoringcontent,and texture.
Methods
Methods The zinc lozenges, however,were more astringent
. than the placebo lozenges.
StudyDesign A statisticalconsultant prepared computer-gen-
a
We determined that a 50% reductionin the du- erated randomizationcode and the packages of
ration of symptoms(in days) would representa medication. The packages were identicalin appear-
significantclinical elect. A previousstudy of zinc ance exceptfor the randomizationnumbers.The
gluconate given during the first day of cold symp- studymedication distnDuted the studynurse,
was by
tomssuggested the duration of illnesswas re-
that who wasmasked treatmentassignments.
to Patients
ducedfrom approximately days to 4 daysafter
8 weregiven 120lozenges were askedto dissolve
and
treatmentbegan(6). Our previousresearch pa- on 1 lozenge their mouthsevery2 hourswhile awake
in
tients with colds who were seen at the Oeveland for as long as they had cold symptoms. The study
Clinic suggested the mean ~uration(:tSD) of
that nurseadministered first lozenge assess
the to initial
cold symptoms was approximately :t 6 days (15,
7 tolerability.Participantswereasked takeno other
to
16).We chosea sample sizeof 100patientsso that cold preparationsduring the study period. Acet-
we coulddetecta dilerence in the meannumberof aminophen samplesand oral digital thermometers
daysof symptoms from 8 daysin the placebo group weregivento the patientsat the time of enrollment.
to 4 daysin the zinc group with a standarddevia- All patientswere calledon the second of med-
day
tion of 6 days,a two-sided value of 0.05,and an
P ication useto makesure that they were not devel-
approximate powerof 90%. oping a more seriousillnessand to assess ade-
the
Patientswere recruited from amongthe Cleve- quacy of the masking through responses a to
land ainic staft'throughannouncements internal
in questionnaire. assessing adequacy the pla-
By the of
Oinic publications by word of mouth.One hun-
and cebo on the secondday of treatmentrather than
dred volunteers were enrolled between3 October only at the end of treatment, hopedto decrease
we
and 4 November 1994.All patientswho completed the likelihoodthat a rapid curewould help patients
82 .
15July 1996 An1Ul1s InlenuUMediciM
of . Volume 125 . Number2
3. in the zinc group correctly determine that they were '_b'. 1. DemographicCharacteristics 99 Volunteers
of
ReceivingZinc or PlaceboLozenges
for
receiving the active medication. This questionnaire Treatmentof the CommonCold
was also administered at the end of treatment with
the addition of questions about the occurrence of
specific, previously described side elects of zinc
therapy.
Patients returned to the ainic for the final visit
".1
M81~SD 37.5 :t 1.5
MedlIn (minlmum-mlXimum) 36.1 (22.3-54.6)
within 1 day of noting that their cold symptomshad Sex.n~
resolved. At this visit, they returned unused loz- Men
enges so that adherence to the protocol could be women
RIce. ~
n
checked through lozenge counts, and the study White
nurse confirmed that cold symptoms had resolved. Blick
Other
Patients were asked to complete a daily log doc- ~
Smokers. n /%)
umenting the severity of symptoms and the medica- PMients with iIIefgies. n ttW
tions taken throughout the duration of their cold
for as long as 18 days. Every day, patients graded
each symptom as 0 for none, 1 for mild, 2 for
moderate, or 3 for severe. Total symptom scores
)tom four or more lozengesper day for the first 4 daysof
were calculated by summing the scores of the 10
s the study (16 lozenges) and if they took no antibi-
symptomsfor each day. Cold resolution was defined otic agents.
as resolution of all symptoms (a total symptom
iii
score of 0) or resolution of all but one mild symp-
tom (a total symptom score of 1). Results
Statistical Analysis One hundred patients were enrolled in the study;
The time to cold resolution was calculated as the
llated SOwere assigned to the zinc group, and SOwere
number of days from study entry. Resolution rates
Ilution assigned to the placebo group. All patients were
were estimated using the Kaplan-Meier method,
ier Oeveland Clinic employees older than 18 years of
and resolution profiles were compared between
~d age. One patient in the zinc group withdrew from
groups using the log-rank test (17, 18). We esti-
:). the study on the first day because she could not
mated median resolution times using the method tolerate the lozenges; she did not complete the
suggestedby Lee (19). The elect of treatment on
'eatment symptom diary. All other patients, as directly ob-
individual symptoms was examined by comparing served by the study nurse, indicated that they had
the number of days with each symptom using the
n good tolerance of the first lozenge. Demographic
Wilcoxon rank-sum test. For analysis of treatment
If characteristicsof the groups are given in Table 1.
effect, we combined hoarseness,sore throat, and The mean (~ SD) and median symptom scoresat
scratchythroat into a category called "throat symp-
hroat baseline (the first measurement)were 8.6 ~ 3.3 and
toms" and nasal drainage and congestion into a
tion 8 for the entire sample, 9.3:t 3.6 and 8 for the
category called "nasal symptoms." Plots i of individ- placebo group, and 7.9 ~ 2.8 and 8 for the zinc
ual patient symptoms give the percentage of the
tage group. In practice, an increase in score from 8 to 9
baselinetotal severity score (sum of symptom scores
ptom entails scoring one symptom one grade higher or
for all patients) by assignmentgroup and study day.
:I developing another mild symptom. Six hours after
When appropriate, we used the Fisher exact test
r the study began, the mean symptom scores for the
and the chi-square test to analyze associationsbe-
ciations placebo group (9.3 ~ 4.2; median, 9) and the zinc
tween the side effects and assignedgroups. Patient
LIpS. group (8.7 ~ 4.0; median, 8) were closer.
adherence was examined by cOmparing the total
g The incidence of individual symptomsat baseline
lozenge counts between the two groups using the
s was similar in the two groups for all but two symp-
Wilcoxon rank-sum test. toms: sneezing (31 of SO placebo recipients [62%]
ntention-to-
These analyseswere done using an intention-to- and 38 of 49 zinc recipients [77.5%]; P = 0.09) and
treat framework, regardless of patient adherence sore throat (39 of SOplacebo recipients [78%] and
(20-22). Before the randomization code was bro-
Ie was bro- 2S of 49 zinc recipients [51%]; P = 0.005). No pa-
ken, patients who received antibiotic therapy or tients had fever at baseline.
whosecondition was diagnosedby a physicianas an
sician Eight patients (six in the placebo group and two
illnessother than the common cold were considered in the zinc group) had colds that did not resolve
nonadherent. Patients who wrote their diaries from
liaries while they remained in the study. Two of these
memory were also considerednonadherent. Patients
:nt. patients (both were placebo recipients) completed
wereconsidered adherent they took an averageof
if I average the 18 daysof the study, and the remaining six (four
.
15 July 1996 AnM/sof Intunlll Medicine. Volume125. Number
2 83
4. signrnent (P > 0.2). Even when the 17 nonadherent
. patients were excluded, symptoms in the zinc group
l still resolved significantly faster according to both
definitions of symptom resolution (P < 0.001). The
median duration of symptoms for the adherent pa-
I tients in the placebo and zinc groups was 7.2 and
i 3.9 days, respectively, for complete resolution and
t 5.7 and 3.4 days, respectively, for near-complete
resolution.
J Figures 2 and 3 show the percentageof the orig-
inal symptom score (each day by group assignment)
for nasal symptoms and throat symptoms.The zinc
group had significantly fewer days with any symp-
tom, nasal symptoms, throat symptoms, coughing,
headache,hoarseness, nasal congestion,nasal drain-
age,and sore throat. The groups did not differ signif-
were placebo recipients and two were zinc recipi- icantly in the resolution of muscle ache, scratchy
ents) dropped out after 7 to 16 days. In addition, throat, sneezing, fever (Table 2).
or
one patient recorded his symptoms for 18 days but We calculated the total number of lozengesfrom
indicated that his cold resolved on day 19. counts of returned lozenges and from patient dia-
We used the Kaplan-Meier method to estimate ries. When we found discrepancies,we used actual
the percentage of patients whose colds completely lozengecounts. During the entire study, the placebo
rf"solved(Figure 1) and almost completely resolved group took a mean of 49 :t 30 lozenges(median, 42
"n each day of the study. The median time to lozenges) and the zinc group took a mean of
rt:solution of all symptoms was 7.6 days in the pla- 36:t 22 lozenges(median, 28 lozenges)(P = 0.03).
cebo group and 4.4 days in the zinc group; the The placebo group took an average of 5 :t 2 loz-
median time to resolution of all but one mild symp- enges per day (median, 5 lozenges per day),
tom (data not shown) was 7.5 days in the placebo whereas the zinc group took an average of 6 :t 2
group and 3.7 days in the zinc group. The results of lozengesper day (median, 5 lozengesper day) (P =
the log-rank test and the plot of these distributions 0.20). Becausetheir colds lasted longer, the placebo
indicate that symptoms resolved significantly faster group used significantly more lozengesthan the zinc
in the zinc group than in the placebo group (P < group, but the number of lozengesper day of symp-
0.001). This effect was also seen when the end of toms did not differ between the two groups.
the cold was defined as almost complete resolution Use of acetaminophen not differ significantly
> did
(P < 0.001). The study nurse directly observed betweenthe two groups (P = 0.10); the placebo
whether the patients who returned their study forms group took a median of 6 acetaminophen tablets,
and unused medication within 1 day of reported and the zinc group took a median of 4 tablets.
resolution of symptomswere free of symptoms. Despite instructions to the contrary, 15 patients (10
Seventeenof the 100 patients (10 in the zinc placebo recipients and 5 zinc recipients) took other
group and 7 in the placebo group) were considered cold medications during the study (P = 0.17).
nonadherent.Of these 17, 6 (2 zinc recipients, 1 of
whom also took antibiotic agents, and 4 placebo
recipients) did not take enough medication for rea-
sons that were not stated; 5 (all zinc recipients)
stopped taking the lozengesbecauseof adverse ef-
fects (bad taste in 3 patients, sore mouth in 1 pa-
tient, and a "lump in back of throat" in 1 patient);
4 (2 zinc recipients, 1 of whom also could not
tolerate the taste of the medicine, and 2 placebo
recipients) took antibiotic agents; 2 (both zinc re-
cipients) reconstructed their diaries from memory;
and 2 (1 zinc recipient and 1 placebo recipient)
stopped keeping a record for reasonsthat were not
stated. When data were analyzed after these 17
nonadherentpatients were excluded, the study con-
clusions remained the same. No significant relation:
was seen between adherence status and group as- ~
84 .
IS July 1996 A1IIUIU of Inlmull Medicine. Volume 125 Number2
5. cipients (16%) and 12 zinc recipients (25%) re-
- . ported that the lozenges tasted sour; 6 placebo
(12%) and 20 zinc (41%) recipients reported a bit-
ter taste; and 4 placebo (8%) and 4 zinc (8%)
recipients reported a salty taste. Many patients re-
ported that the lozenges had an aftertaste. Thirty-
four of 50 placebo recipients (68%) and 6 of 49 zinc
recipients (12%) reported no aftertaste (P < 0.001).
Twelve placebo recipients (24%) and 22 zinc recip-
"0.. ients (45%) reported a mild aftertaste;2 placebo
u"o.. (4%) and 17zinc (35%) recipientsreporteda mod-
, , , :..;..~ erate aftertaste; and 1 placebo recipient (2%) and 3
3 .'5'5,715 zinc (6%) recipients reported a severe aftertaste.
Two patients (1 in the placebo group and 1 in the
Figure J. Percent8ge origin_I thl'Ollt symptoms,:- :::. d8y
of - 88dI ~ zinc group) did not answer the question.
by trutment group. Throat symptomswere hoal'Seness. throat. and
sore
cebo group.
scratchythroat. Solid hne = zinc group; dotted line = placebo group. We ascertained side effects in two ways. During
the study, we asked patients to list all of the side
effects of their medication. This open-ended ques-
Questions to evaluate the efficacy of masking to tion was the only one asked during the study period.
group assignmentwere asked after the first day of Seventeen of 49 zinc recipients reported that no
treatment and at the end of the study. Patientswere
atients side effects developed with their medication before
asked to guesstheir assignmentfrom among seven
mong the conclusion of the study. In these patients, the
cebo, possi-
choices: certainly placebo, probably placebo, mean (4.7) and median (4.0) numbers of days until
bly placebo, do not know, certainly active, probably
ve, only one mild symptom remained was the same as
active, or possibly active. By assigning all guesses
aU the Dumber in the 32 patients with identified side
that mentioned "placebo" as placebo and all
)() aU effects. The zinc recipients with and without identi-
guesses that mentioned "active" as zinc, the follow-
, fled side effects also had a similar mean (5.1 days
ing results were obtained. On the initial question-
al and 5.5 days, respectively) and median (4.5 daysand
naire, 50% of the placebo recipients (25 of SO)and
i 50) 6.0 days, respectively) time until symptoms com-
55.2% of the zinc recipients (27 of 49) correctly
9) pletely resolved (P > 0.2).
guessedtheir study assignment.At the end of the The second method used to determine side ef-
study, 54% of the placebo recipients (27 of SO)aDd
r 50) and fects entailed listing all of the common side effects
53.1 of the zinc recipients (20 of 49) correctly
% 9) of zinc and asking patients at the end of the study
guessed their treatment assignment.Sixty-five of the
y-five whether these or other side effects developed while
99 patients (65.7%) maintained their original guess
'iginal they were taking the study medication (Table 3). As
at the end of the study. Becauseno clear pattern of
Ir expected, patients described more side effects in
movement of guesses was seen between the groups,
masking appears to have been maintained during
ined
the study. T8bIe2. Duration individual
of Symptoms the
of
After the first day of treatment, 46% of the pla-
, of the pla- Common Cold
cebo recipients and 59% of the zinc recipients said
;ipieDts
I . h. Symptom Duration in Duration
in PVIIue*
that the study medication had helped alleviate t elr
evlate their Placebo
Group Zinc
Group
symptoms(P = 0.19). At the end of the study, 44%
study, 44% (n- SO) (n - 49)
of the placebo recipients and 59% of the zinc re-
the zinc re- dt
cipients said that the study medication had helped
had helped
improve the cold symptoms (P =
0.13).When the
. When the
d . h
NISIIsyrnptOmS*
ThroItsymptoms§
7.0(4. 13)
4.0 (3.9)
4.0(3.~
3.0(t, 5)
<0.001
0.004
zinc and placebo groups were subdivided IOto t e
e into the Cough 4.5(1.10) 2.0(1.~ 0.04
seven subgroups on the basis of how certain the
certain th
the HNdKhe 3.0(1.5) 2.0(0.3) 0.02
HoIrseness 3.0 (0. 8) 2.0 to. 3) 0.G2
patients were about their group assignmenton the
Rent on e NISII
congtStion 6.0(3.12) 4.0(2,6) 0.002
first day of treatment, the mean and median dura-
edian dura- ~ draiNgl 7.0(4.II) 4.0(2.5) <0.001
Iw Sorethroat 3.0(1. 6) 1.0(0. 3) <O.OCI1
tions of symptoms in the zinc group were a ays
were always Muscleache 2.0 (1, 5) 1.0(0. 3) 0.11
shorter than those in the placebo group. ). Saatchythrolt 3.0(1,5) 3.00,4) 0.17
(76%) d Sneezing 3.0(1,5) 2.0(1,.t) 0.20
Thirty-eight of 50 placebo recipients (76%) an and fMr 0 (0.0) 0 to.O) G.15t
28 of 49 zinc recipients (57%) describedthe taste of
the lozengesas sweet. Patients were also as
ked t
so asked to 0
.v-- ..
t
WIIaJIIan
rri-
upmsed
IIeSl
.. tht mediIn125m,15mpttCtntiles).
chooseother tastesthat applied to their medication ,
medication, ,
. ~
-nwo.t~
-- nasal
-- ~ dr.,. 8IIdnasal scrM(hy IhroIt
S(Q
~
IIvoaI. 8IId
including sour, bitter, and salty. Eight placebo re-
placebo re- , IIy FtWr -
ttw euct
. Medicine Volume 125 Number
IS July 1996 AnMls of /1IlemaJ 2 . . 85
85
6. .-- iI. .>'U'" ""...~ n...pun... UJ ~ YUIUn_n ~"'IiI preVIous studJes that showed a beneficial effect of
T8bI. 3. Sideor Placebo I.ozenges 99 Volunteen Receiving
Zinc
EffectsReportedby for Trutment of the - .. t: .
Zincor PlaceboLozenges Treatment of the -
for
h
Id
'
Common
Cold.
.
usmg
zmc
lor
treatIDg
t
e
common
co
,
partlCU
I
ar
I
y
CommonColde when zinc is started within the first 24 hours of
Variable PIIcebo Group ZIncGroup onset of symptoms.Of the four studies that did not
Variable Placebo
In.. Group
50) ZIncGroup
In.. 49) show a beneficial effect, three (7-9) were criticized
(II .. 50) In .. 49)
n'" for using a lozenge formulation that inactivated the
ntIW
zinc (24-26) and one (10) used a possiblyineffective
-
CI' 0.O2)t
" .. 0.O2)t
2 (4.CJt
2 (44
10(20.4)
10(20.4)
dose of 4.5 mg of zinc per lozenge. Of the three
VomIting
=:'PIin I 12,
~g:0) 0
~(&.1) studies that did show a beneficial effect, one (4)
AbdomNI PIin
DiaIThN . 1 (2.0)
2(4.0) 3 (&.1)
2(4.1) reported a strong treatment effect (P < 0.001)at 7
DiIntI8I 2(4.0) 2«'.1)
Constipation
~(P>0.2)t (P> 0.2>* 0
Ig(20.01 1 12.0)
,~g:>.5) days (14% of zinc recipients compared with 54% of
Mouthirritation
Bad.tIste 0.001>*
(P 0.0011*
< 10(20.0)
15 (30.0) 1212..5)
39(79.6) placebo recipients had symptomsat 7 days) but also
e.d tIstt (P< 15(30.0) 39 (79.6)
Dizziness
=:e 0
g 0
g noted a high rate of side effects in the zinc group.
HeiIdache 0 0
Dlymou1h 6(12.0) 6(12.2) This finding caused some investigators to question
DrymouIt1
Other > 0.2)"
CI' 6 (12.0)
2 (4.0)
Numberofsideefects(p<O.OOI)"2 (..0)
Other > 0.2)"
(P
6 (12.2)
5 (10.2)
5 (10.2) t he vaIIdity 0f t he mas ng and therelore the valId
'
lei t: ' -
Number of Side efects (P < 0.001)e
0 19 (38.0) 5 (10.2) ity of the study results (27). AI-Nakib and coi-
0
l 26(38.0)
19 (52.0) 19(10.2)
5
2
1 2 (4.0)
26 (52.0) 17(38.8)
(34.7)
19(38.8) .
Ieagues (5) used ZinC gluconate Iozenges In persons
.
2
3 2 (4.0)
3 (6.0) 17(304.7)
8 (16.3) with experimentally induced colds and found no
3
" St8IIcIII8Sting
. StIMaI tilling -
t ., the FiIIw 8IId ..
- done
when
3(6.0)
01
done when adequIW numb8n 01 ~
t ... II» fisher 8IIICt lISt.
8(16.3)
aqu,te numb8n pIIiInIs"PO'I8d tIects.
IIdI
/IIIOftId licit Ifects.
benefit
note a
in giving
reduction
zinc prophylactically,
in mean daily clinical
but they did
scores com-
..,thecN1quft-.
""II»~_. d .h . I bo ..
pare WIt scores In p ace recipients on days 4
(P < 0.01) and 5 (P < 0.05) of treatment. The treat-
response to this question than in response to the ment was well tolerated, and the placebo lozenge
response to this question than in response to the
open-ended question alone. Patients in the zinc was not distinguished from the zinc lozengeby taste
open-ended question alone. Patients in the zinc
group reported more side effects per person (25 or appearance.
group reported more side effects per person (25
zinc recipients and 5 placebo recipients had two or Godfrey and colleagues (6) compared a nonche-
zinc recipients and 5 placebo recipients had two or
more side effects; P < 0.001), significantly more
more side effects; P < 0.001), significantly more lating formulation, zinc gluconate-glycine, which re-
nausea (10 patients compared with 2 patients;
2
nausea (10 patients compared with (39patients; leases93% of contained zinc in saliva, with a pia-
P = 0.02), and more bad-taste reactions (39 patients
P = 0.02), and more bad-taste reactions patients cebo containing highly astringent tannic acid and
compared with 15 patients; P < 0.001). The other
with 15 patients; P < 0.001), The other saccharin. They reported a 26% reduction in the
compared
symptomsdescribed(vomiting, abdominal pain, diar-
symptomsdescribed(vomiting, abdominal pain, diar- duration of colds when treatment was begun during
rhea, constipation, mouth irritation, and dry mouth) the second day of symptoms and a 42% reduction
rhea, constipation, mouth irritation, and dry mouth)
did not differ significantly between the two groups,
did not differ significantly between the two groups. (from 9.1 days to 5.3 days) when treatment was
begun on the first day of symptoms.Our study was
similar to that of Godfrey and colleagues;we used
Discussion the same symptom score, emphasizedstarting treat-
Discussion
ment within 24 hours after onset of symptoms,and
The common cold still has no definitive cure. At used a reduced dose of zinc to improve the palat-
best, available over-the-counter medications mini- ability of the lozenge.
mally alleviate cold symptoms (23). Our study The mechanismsthrough which zinc affects the
showed that the time to resolution of all symptoms common cold remain to be determined, but several
was significantly shorter in the zinc group. The zinc possibilities have been described. Zinc prevents the
group had significantly fewer days with coughing, formation of viral capsid proteins, thereby inhibiting
headache,hoarseness, nasal congestion,nasal drain- in vitro replication of several viruses, including rhi-
age,and sore throat but had more patients with side novirus (11, 12, 28-30). Zinc combines with the
effects. The fact that zinc recipients and placebo carboxyl termini (negatively charged canyons) of
recipients did not differ significantly in their subjec- rhinovirus coat proteins, which may prevent the vi-
live overall impression of whether the study medi- rus from combining with the tissue-surfaceprotein
cation had helped alleviate their cold symptoms is (intracellular adhesion molecule type 1) and enter-
somewhatsurprising. However, global assessment by iog the cell. This processstops further reproduction
patients may be based largely on subjective esti- (31, 32), Extracellular zinc may exert antiviral ef-
mates of how long a cold "should" last rather than fects by stabilizing and protecting cell membranes
on objective knowledge of the duration; this created by uncertain means (30, 33-36). In vitro studies
much variation in subjective estimates of whether have suggestedthat zinc may induce production of
the actual duration of the patients' cold symptoms interferon (37), Zinc ions also have human prosta-
were or were not "improved" with either treatment. glandin metabolite-inhibiting properties at 0.01 to
The results of our study are similar to those of 0.1 mmol (38), which may also account for the
86 .
15July 1996 Annals of InlmuJl MediciM . Volume 125 . Number2
7. ability of zinc to help relievesymptoms the com- - fects in the dosesused in our study.Thus, we do
of
mon cold. not believethat our resultsreflectan adverse
effect
Our study has some limitations. First,, we did not
we did not of the placebo administration.
the
establisha microbiological diagnosisof the common In our study, the only statistically significant ad-
ective infor-
cold. We relied solely on patients' subjective infor- verse effects of zinc therapy were bad taste and
study nurse.
mation and clinical evaluation by the study nurse. nausea.Although the incidence of mouth irritation
We elected not to do microbiological studies of
I studies did not differ significantly between the two groups,
rhinovirus because the expense of such studies is
:h is mouth irritation may still be a clinically significant
prohibitive, and our goal was only to ) determine
determine adverse effect because the placebo may also have
whether zinc helped to relieve cold symptoms.The
lpt~ms. The been irritating. We assessed possibility that pa-
the
he inftuenza
fact that the study was done early in the influenza tients withdrew from the study becauseof side ef-
ad
season,when no cases of influenza had been re- re- fects before their colds had completely resolved.We
~rts
ported at the Oeveland Oinic, supports the as- as- hypothesized that patients who recognized side ef-
ave ~comf-
sumption that most of our patients did have a com- fects of medication before the end of the study may
mon cold. Doing the study at a di1ferent time of
'ent time 0 h d .d d ' I th I d d' .
f . ave ecl e to VlOate e protoco an IscontIDue
~
year could have involved di1ferent types of viruses,
0 VIrUSeS
b ' their medications before they were completely well,
which might have altered the results. The absence
(lie a sence . h . .
II
(beca
f
h
.
of fever at baseline in all patients suggests that
ts
th
t
elt
er
IDtentlona
y
use
0
t
e
perceIVe
d
uD-
~~~
certain viruses,such as influenza, parainfluenza,and
anad pleasantnessof the side effects) or unintentionally
.mon ~Id in (because the side effects masked their cold symp-
adenovirus,were unlikely causesof common cold in
~ patients in
our patients. Second,the fact that more patients in toms). No statistically significant association was
up had sore
the zinc group than in the placebo group had sore seen between the presence or absenceof medica-
different vi-
throats at baseline could suggest that di1ferent vi- tion side effects recognizedbefore the conclusion of
ruseswere responsiblefor common cold in the two
:I in the two the study and the duration of the patients' illnesses.
ished within
groups. This difference, however, diminished within This is further evidencethat patients adhered to the
we assessed
the first 12 hours of the study. Third, we assessed protocol and did not prematurely stop taking their
t by review-
compliance with the assignedtreatment by review- assignedmedication becauseof side effects. Individ-
We did not
ing patients' diaries and lozenge count. We did not ual patients must decide whether the possible ben-
it difficult
check zinc or calcium blood levels, but it is difficult eficial effects of zinc on their cold symptoms out-
have
to predict whether these levels would have been weigh the possible adverse effects.
~ave several
meaningful, given tbat these elements have several Our data suggestthat zincgluconate in tile fQrm
other dietary sources. and dosage tested was helpful in reducing the du-
is
The fourth limitation of our study is that our our ration of common cold symptoms. Although we
results cannot be applied to immunocompromised
ompromised used a lower dose of zinc, our results were nearly
or pregnant patients, because neither group was
group was identical to those reported by Godfrey and col-
not provide
included in our study. Fifth, we did not provide leagues in their subset of 44 patients who were
:he repeated
information on the cumulative effect of the repeated randomly assigned to a treatment similar to ours
use of zinc or explore the possibility of development
levelopment after fewer than 24 hours of symptoms.In addition,
of resistance. We emphasize that we. used only used ~nly multi-institution studies that obtain virologic data
~. Habitual
short-term zinc therapy for common colds. Habitual on the infecting organisms are needed to confirm
or long-term ingestion of large dosesof zinc may be
ZInc be our findings.
hazardousby causingimbalancesin levels of copper
Is of copper
(39) and possibly other nutrients. We also avoided
Ilso avoided Acknowledgments: authorsthankBectonDiclcinson
The (Ruther-
which have
zinc dosages greater than 150 mgld, which have ford, New Jersey)for supplyingthe digilal thermometers, the
) S' Oui&Iey Corp, (Doylestown.Pennsylvania) supplyina ac-
for the
been associatedwith adverse effec,ts(40). Sixth, al-
). ixth, al- live andplacebo medication,
McNeil (Fort Washington, Pennsyt-
though our results indicated clinical improvement
nprovement vania) for supplyingacetaminophen, aassia Restaurant
and
on cold, we
when zinc was used to treat the common cold, we (aeveland,Ohio) for donatinga dinner for two for a raJJe to
do not know the actual mechanism by, which this
which this encourage patients to enroU in the study. The authors also thank
' ed ' th h Jobn C, Godfrey,PhD, and NIDC)'J, Godfrey,PhD, for their
occurred. Finally, if patients had complied with the
I WI t e help in designing studyand reviewing manUlCript,
this the Tom
protocol (one lozenge every 2 hours while awake),
~ile awake), Langfor medical editing,and CharleneMahovlicfor typingthe
they would have taken sevenor eight lozengeseach
zenges each manuscript.
day. Zinc lozengeswere actually taken about four to
bout ~our GI'fIIII
Support: the GeneralPediatrics
By Researd1Fundandthe
). ThIS may
eight times daily (median, five lozenges).This may Departments InfectiousDiseases GeneralPediatrics
of and of
~ number of
raise concernsabout compliance, but the number of the aeveland Clinic Foundation,
lozenges taken appears to have been effective. A
effective. A &qums for &prints: MichaelL Macknin,MD, Departmentof
recent review (41) and a MEDLINE search showed
arch showed Pediatricsand AdolescentMedicine,A 120,OevelaodOink
no evidencethat calcium lactate causesadverse ef-
adverse ef- Foundation,9500Euclid Avenue,aeveland,OH 44195.
IS July 1996 . A1INJi.J llllmlill Medidne . Volume 125 . Number2
of 87
87
8. Cunmi Author Addrusu: DR. Mosaad and Macknin, Ms. Med. 19. lft ET. Statistical Methods for SurviYiI 0... ~. 2d Iditian NIw York:
endorp, and Ms. Muon: The ~Iand Oinic Foundation, 9SOO. Wiley; 1992:77.
Euclid Avenue, Oeveland, OH 44195. 20. Gr8nt A. ~ controlled trials. 8r J Obslltl GynecGI. t--:397-400.
21. The st.andIrds of reporting trials group. A ptOpOMI fof structurtd reporting of
randomized controlled trills. lAMA. 1994;272:1926-3t.
22. SchuIIICF. C1IIIm8n I. ...,.. IU. AhIMn DG. Empiric8 evidtnct of biIs
dimensions~
of ~ 8OCiIIed wilt! ~ of tNIImInt
References ~ects in controlledtnals lAMA. 1995;273:408-12.
n. SmIItI
-. W.();er.~ midrnecIUIion:
I cri1icIImiIW
1. DInfIe JH, Gf, JonI8n W5 II. IInessin 1M Home:5tudv 0125.000 of clinicaltrills ~ 1950and 1991.JAMA..1993;269:2258-63.
1IIn4!s~ a Groupof CIMand Families.
in C~nd: Press Western~
of :M. GodfIwr JC. Zinc fof tht common cold (~~ AntimIcrobAgentseM-
Univ; 1964 mother. 1988;32:60S-6.
2. Gw8l1ner JM Jr, Hendley 10, Simon G. .IonI8n WS Jr. Rhinovltu$ inlte- 25. u., GA. StabiIiIy conslantS of zonecornpiIIIrs .thct common mid tlWtmlnl
III - """..lat"", " ..n.. n«, ,.. - --- .. ~ . .~_.
linn< an IIViIl<lrU1
1966;275":',261.., I ..- ", -.. III I UM results[Lener].AntimicrobAgentsehemolher. 1988;32:606-7.
X. Z8Nmbo JE. Godhy JC. CicIdfNr IIU. Tone in NhI: deeInnination
(I) of
" ,,-- -
.. ." _W"-' - -_. ~...u. , .L..L.-
"'- or~..~
...~. ~~ '~.'~.'V'-'J. n
concenllationsproducedby diflerenl formulations zincgIuconaIe
of IoangIs
4. Ibr CiA. D8WiI DII. H8IaIInb WW. Reduction in durMion of common cold cont.1ri1gcommonexcipients. PNrm SO.1992;81:128-30.
I
by zinc glucanate lozenges in a doubIHIind study. Antimicrob Agents CIw- 27. ,., ... fG. Gw8Itn8rJM Jr. StabIIty
consunts zinccom-
of
-
modIer. 1984;25:20-4. pII!JIe5anea common COk/trNtment !@SUItS
I~~J. Anllmlcrob Agents CI1e-
- - on. -
5. AI.fWdb
W. I'G,--- .. G,1'yrNIDA.I'ropI¥IIIIs mocher. 1918;32:607.
and trN1ment of rhinovirus colds wi1h zinc gIuconate lozenges. J Antimiaob - CionIDn /IIIfIrf6 IIedC8r ~
YJ. Y, Y. Inhibition herpes
01 sAmpltx virus
- -..
..
Chemother. 1987;20:893-901.
... -
.- . .. '-".. . ... -- -
.. -- -- ...
u -..,
- ..
MI. Zinc gkjcOlllte IIId the common cold: I controlled diNC11study. J Int Med
repIOtion in 8S(-1 eels by zinc ions Antimiaob AgentsChemoIher.19~;
8:377.80.
21. firpo EJ. EL Inhibition01foot and moudI ell.- virusand proaIp5Id
Res. 1992;20:234-46. synthesis Zincions. ~
by r@pOrt. Arch ViroI. 1979;61:175-81.
7. '- -, c- EM,I8tts Itf', 0I8Ib J, Mlnnefcw Gw8ltn8y Jr.
A. .. .. Its*- II. L8dI8MwIII. ~ C. IC8rInIU. K8dI GoI'OIicMM-
TwornbniDd controIedtrills of ZincgIuconMrIozengt thlflpy of e.per-
imentJllymduc8drllincMruscolds.AntimicrobAgentsChernother.1987;31: assoa.tedproItin kinase: desUbiliulion of the virus capsid and sIimWtion
1183-7. of the ~ INCtion by Zn2'. J Viral 1989;63:~.
I. DougI8II1M, HI. Mo«e IW. lIyan '. I'InnodI Q. Flilure of 31. Motf8t As. Going back to the fulln wi1h SINII ~ compounds
tftervesant Zinc ICNte Iozengts 10 III« the courseof uppet"respAIiOry (Newsl Scienc».1993;26Ct91 0-2.
trlet infectionin Austrabn ldults. AntimicrobAgentsChemoth8r.1987;31: 32. NovIdc SG.GodfNr J(. GodfNr NJ, ... How doesme: mocify the
1263.5. commoncold?CIinicJI observations implications
and regilding mechanism of
t. SmIth DS, Hellner Ic, Nuttlln a Jr, Collins M. RofwwIIA. GInIb8rg 1CtJon. ~
Med 1996;46:29S-302.
U. membr- protectionby Cal .
CA. A novetform of host defence:
D. .. ... Flilurt of ZincgIuconMr in trNtment of ICUII!uppet"repiriIIOr'f
Irlet infections.AntimicrobAgentsChemother.1989;33:646-8. and W'. Iiosd Rep. 1987;7:81-91.
10.WeIInIaM JIIIoIII8II *b
Ie. ". JE.
"- UM..., SM. M. I8Ihfard a. AId8r GM. M8ne1rfn8G. MIcId8M MurphyJJ,,..
IU,
H- I, .. 81. Zinc gluconate lozenges for common cokl. A cfou~-blind -- CA.~ dimagtby~ viruses, (Qj,IpIe...e<1t,
tains.
clirWo1Ilrio1Inan Uod III. 1--.17.77<l-1li1
- -- - -- ----.-------- and oth« cytoloxic '91"15. A common m«hmsm bIocUcI by dMIInt Qt.
n. lCorent 10. ~ IE. InNbition by zinc of rhincMrusprOIIIn dNv- ions J BioI Chem. 1986;261:9300-8.
.: interaction zincwith apsid polypeptides. VWoI.
of I 1976;18:298-306. 35. H8riIdI Ii. 1CretIch- M. ~ aspectS of a non--- elect 01 zinc ions
12.G8Ist ---
Fe. JA.H8yIIen N. In vitro IC1MIyof zinc SIlls IgIinst on the histamine ~ from ral peritonNl mast ails. ~ (ommun (hem
'-- rlln7<inMS. Antimlcrob
AgentsChemott1er.
1987;31:62H. Pathol and Phannacol. 1987;55:39-46.
13. ~~ D, ~!'-~~ .,.j pr~ attitudes lheripeUtlc
In JI. --- Ii. fInII8y sa. LIch8IIIin LM. ModuIMions 01 basophil histamine
,... s;;.;G..w';';E:'~~M. Cost-eflectivenm compIri5ons using
r.- byzinc
(Abstta<tL J AIIttgy Clin 1mmunoI. 1979;65:171
37. 58181 M. IOrdIIw H. Induction 0I1n~1jiIMIa in human leutcocy18
"n!a wOOd"randomized triaI5:the caseof new antidepressant drugs.J CUn
cu/1ures slimu1a1edby W'. (Iin 1mmunoI1mmunopIIhoI. 1987;45:139-42.
EpidemioIl996;48:363.7)
15. ML. M8thew S. ..a.anclorp $V. Efleetof inhaledhNted vapor .. Ie" 1M. Abel MH. C~ and Zinc inhibit the metabolism of pro51agIan-
on symptoms the commoncold. JAMA. 1990;264:~'.
01 din by the human uterus. BioI RIprod. 1983;28:183-9
". Font8II GJ, M8ckn1nML. Y8II-lIeb8nn8n .. MIl"'" SV. Elled of ft. ~ cc. ""'.'lInnou .. IoIII8r A. EtItct at cMInic zinc intaIIicJIion
inhaled~aled vapor on Symptoms the commoncold. JAMA. i994;2":
of on COpper
IewIs.bloodfomIItion IIId poIytmines. ~
0rttI0m0I '
11W-!I I. 1980;9:79-89,
17. IC8pIIn El. P. NonparIIMIric I'5IiIMIion fftIm incDmpIeee ~ .. ~ lilt. bcesM inUh of Zinc impIirs inIIIIuM mpoIIws, lAMA,
lions. ~ of the AmeriQn StItisIbI AssodItion. 1937;32:675-701. 1984;252: 144306-
1L .. J. AsympIoIiaIIydiciInt ra ~ leStprocedures.Jour- .,. Optimal t*ium intake, NIH COIISIfISUS Confertnce, lAMA, 1994;272:
nal of I~ Ro¥,1 Swlistiul Society Series A. 1972; 135: 185-98. 1942-8
88 IS July 1996 . Annals of Inlemal Medk:iM . Volume125 . Number 2