Research reviews

Asthma that starts in childhood and persists throughout adult life tends to be more severe and is associated with poorer lung function compared with adult-onset asthma, a study from Japan has concluded. The difference in clinical characteristics points to a distinct phenotype.

Errors in prescribing, supervised or non-supervised dispensing, and monitoring and communication, were responsible for patient safety incidents in opioid substitution treatment, a study from England and Wales has shown.

An observational study using clinical case records has found a ten-fold increased risk of sudden unexpected death in infancy (SUDI) in siblings of SUDI cases.

More than a third of smokers who completed a pilot study of e-cigarettes as a smoking cessation aid quit smoking.

Abdominal obesity is an independent risk factor for a further myocardial infarction (MI) or stroke in patients who have already suffered a first MI, an observational cohort study from Sweden has shown. A total of 22,882 MI patients from the SWEDEHEART registry (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) were recruited to the study.

Ceasing treatment with opioids is associated with an increased risk of death from overdose and suicide, an observational study from the United States has found.

Intrauterine exposure to maternal smoking is associated with an increased risk of fractures in the first year of life, a national cohort study from Sweden has found. The study cohort comprised 1,680,307 live born singletons in Sweden, born between 1 January 1983 and 31 December 2000, followed up until 31 December 2014.

Physiotherapy to improve ankle strength and balance produced sustained improvements in functional status in patients with diabetic peripheral neuropathy, in a study from Singapore.

There has been a significant increase in the use of long-acting reversible contraception in women under 25 over the past decade, a national survey has found. However, condoms and the oral contraceptive pill are still the most commonly used methods.

A smartwatch-based patient device demonstrated only moderate diagnostic accuracy in detecting atrial fibrillation (AF) when compared with a 12-lead ECG, in a study from Australia. Accuracy was improved if the automated device diagnosis was combined with specialist interpretation of unclassified tracings.

One in five young people have steatosis, one in ten severe steatosis, and one in forty liver fibrosis, a recent UK study has found.

Overweight teenagers are more likely to consult their GP for asthma, and other respiratory symptoms, than those of normal weight, a study from the Netherlands has found. A total of 617 children, aged 2 to 18 years, were recruited to a prospective cohort study from 71 GP practices across the country. Height and weight were measured at recruitment and other health and social data collated from questionnaires sent to patients/parents. Children with disabilities or conditions affecting their weight were excluded. Details of subsequent consultations were obtained from the medical records.

Effectiveness of smoking cessation aids varies between different types of smokers, a survey-based UK study has found. The data presented in this large, representative sample may provide useful information for GPs and other treatment providers in tailoring quit smoking advice to individual patients.

Analysis of cough sounds captured on a smartphone can potentially be used to help diagnose common respiratory conditions in children, a study from Western Australia has shown. The study authors conclude: ‘We have demonstrated that automated cough analysis delivers good diagnostic accuracy in detecting common childhood respiratory diseases including pneumonia, RAD, croup, bronchiolitis, upper and lower respiratory tract disorders. It can be used as a diagnostic aid for childhood respiratory disorders.’

Abnormal spirometry and FeNO results are common in children with asthma managed in primary care and relate poorly to symptom scores, a UK study has shown.

The majority of patients with genitourinary (GU) symptoms do not attend sexual health clinic (SHCs), although many would consult their GP, an analysis of Natsal-3 survey data has shown. Natsal-3 is a probability sample survey of sexual behaviour involving 15,162 women and men in Britain aged 16-74 years.

Middle-aged individuals with a high body mass index (BMI) and those whose BMI had significantly increased since the age of 20 had an increased prevalence of breathlessness, a population-based study has found.

Men who have sex with men (MSM) may transmit oropharyngeal gonorrhoea to partners by kissing, a cross-sectional study from Australia has found.

Nearly 40% of smokers and former smokers believe it is the nicotine in cigarettes that causes cancer, a UK study has found.

Adults with type 2 diabetes who had received intensive glucose lowering therapy for nearly six years had a lower risk of cardiovascular events than those who received standard therapy only during the prolonged period in which the HbA_1C curves were separated, a study from the US has found. There was no evidence of a legacy effect or a mortality benefit with intensive glucose control 15 years after commencement of the study.

Current guidelines advise treating paroxysmal AF in the same way as sustained AF but the evidence is weak, with only one retrospective analysis comparing the risk of stroke in patients with paroxysmal AF vs chronic AF (analysis of the SPAF trials, performed 15 years ago and limited to patients treated with aspirin). The ACTIVE W trial showed that warfarin is more effective than aspirin plus clopidogrel for the prevention of vascular events (stroke, embolism, MI and vascular death) in patients with AF. A recent substudy of this trial looked at the risk of stroke in 1,202 patients with paroxysmal AF compared with 5,495 with sustained AF, and the effectiveness of thromboprophylaxis in these patients. ' This substudy has shown that the risk of stroke is similar, irrespective of whether AF is paroxysmal or sustained, and that anticoagulation therapy is equally effective in both groups. Other factors, such as age and cardiovascular comorbidity, remain central to the ultimate choice of thromboprophylaxis in these patients.'