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Gestational diabetes is on the increase

23 May 2017Paid-up subscribers

The prevalence of gestational diabetes mellitus (GDM) has been increasing over the past three decades, a large retrospective cohort study from the US has shown.

Heavy drinkers and teetotallers at increased risk of wide range of cardiovascular diseases

23 May 2017Registered users

Both high levels of alcohol consumption and abstinence raise the risk of a broad spectrum of cardiovascular disorders, a UK study has shown.

Insulin pumps vs multiple injections in adults with type 1 diabetes

23 May 2017Registered users

A randomised controlled trial comparing insulin pump use with multiple daily injections suggests that when patients are engaged with intensive self-management, insulin pump therapy may not add significant extra benefits in adults.

Non-major bleeds less frequent in AF patients on apixaban

23 May 2017Paid-up subscribers

Non-major bleeding was substantially less in patients on apixaban compared with those on warfarin in the Apixaban for Reduction in Stroke and other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. 

Gene variants associated with increased risk of congenital heart defects with SSRI use

24 Apr 2017Paid-up subscribers

Common variants in genes related to folic acid, homocysteine and glutathione/transsulfuration metabolic pathways are associated with an increased risk of congenital heart disease in the offspring of women who take SSRIs in the periconceptual period, a US case control study has found.

Benzodiazepine and opioid co-prescribing raises risk of opioid overdose

24 Apr 2017Paid-up subscribers

Stopping concurrent benzodiazepine and opioid prescribing could reduce the risk of inpatient admissions for opioid overdose and attendance at emergency departments by 15%, a study from the US has found.

Uncomplicated menorrhagia can be effectively managed in primary care

24 Apr 2017Paid-up subscribers

A UK primary care study comparing the use of the levonorgestrel-IUS (LNG-IUS) with usual medical treatments for heavy menstrual bleeding (HMB) showed both to have very good outcomes.

Stress echo has good diagnostic accuracy in elderly patients

24 Apr 2017Paid-up subscribers

Stress echocardiography is a safe and effective first-line test for suspected coronary artery disease in patients over 80, a UK study, published in Heart, has found.

Early catheter ablation improves outcomes in paroxysmal AF

22 Mar 2017Registered users

Patients with paroxysmal atrial fibrillation (AF) treated with catheter ablation first line showed significantly better improvement than those treated initially with drug therapy in a multicentre, randomised, unblinded trial. The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial compared radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment for paroxysmal AF.

GP vs clinic care for people living with HIV

22 Mar 2017Registered users

Around 60% of people living with HIV would choose GP care in preference to an HIV clinic, a UK study has found.

E-cigarette use linked to successful quit attempts

22 Mar 2017Paid-up subscribers

The rise in the use of e-cigarettes in England has been associated with an improvement in the success of quit attempts, a study in the BMJ has found.

Risk factors for antepartum stillbirth

22 Mar 2017Paid-up subscribers

Antepartum stillbirth is a complex syndrome associated with a range of risk factors, a prospective observational study has concluded.

How accurate are screening tests for pre-diabetes?

22 Feb 2017Paid-up subscribers

A recent meta-analysis has confirmed that interventions in patients with pre-diabetes reduce the rate of progression to overt diabetes, but found that the screening tests used to identify pre-diabetes are inaccurate. The study was commissioned by policy makers in a London borough who wanted to identify an effective screen and treat policy in an area of high diabetes prevalence. The UK investigators trawled through Medline, PreMedline and Embase for eligible papers evaluating the accuracy of tests for pre-diabetes, and controlled studies of interventions (lifestyle changes or metformin) in pre-diabetes patients identified by screening. A total of 2,874 titles were scanned and 148 eligible papers reviewed. The final analysis included 49 studies of screening tests and 50 intervention trials.

Depression common in patients with mild cognitive impairment

22 Feb 2017Paid-up subscribers

A third of patients with mild cognitive impairment also suffer from depression, a meta-analysis has found.

Cardiovascular risk factors in middle age linked to heart failure later on

22 Feb 2017Paid-up subscribers

Preventing hypertension, obesity and diabetes in middle age improves morbidity and mortality related to heart failure, a pooled analysis of data from the United States has shown.

Exploring risk-taking behaviour for STIs in middle age

22 Feb 2017Paid-up subscribers

Sexually transmitted infection (STI) rates are increasing in the over 45 age group. However, feelings of guilt, embarrassment about age and stigma attached to STIs may deter middle-aged people from consulting sexual health services, a UK study has found.

Low BP in elderly patients treated for hypertension associated with increased mortality

23 Jan 2017Registered users

Systolic blood pressure (BP) below 135 mmHg was associated with greater mortality in patients, aged 80 and over treated for hypertension, in an observational primary care study.

Blood pressure and risk of cardiovascular events in type 2 diabetes

23 Jan 2017Registered users

A large cohort study has found that lower systolic blood pressure (BP) is associated with reduced cardiovascular risk in type 2 diabetes patients with no previous cardiovascular disease (CVD). However, there was evidence of a J-shaped relationship between systolic BP and heart failure, and also all cause mortality.

Is frequent self-monitoring and on-line reporting of blood glucose worthwhile?

23 Jan 2017Registered users

Frequent self-monitoring of blood glucose had a significant effect on HbA1c only when combined with frequent on-line reporting, in a study from Canada.

Women on hormonal contraception at raised risk of depression

23 Jan 2017Registered users

Women who use hormonal contraception are more likely to become depressed, a large Danish prospective cohort study has found. The cohort comprised all adolescents and women aged between 15 and 34 who were resident in Denmark and without a previous history of depression, antidepressant use, other major psychiatric diagnosis, cancer, venous thrombosis or infertility treatment. Data were obtained from national registers of dispensed prescriptions and secondary care psychiatric diagnoses.

Saliva may be a vehicle for gonorrhoea transmission.

15 Dec 2016Registered users

Almost half of men who have sex with men (MSM) with positive cultures for gonorrhoea from the pharnyx also had positive saliva samples, in a study from Australia, suggesting that saliva may act as a vehicle for transmission of the infection.

Use of infant simulators does not reduce teenage pregnancies

15 Dec 2016Paid-up subscribers

Providing teenage girls with an infant simulator doll for a few days appeared to increase rather than decrease the risk of pregnancy, in a study from Western Australia.

Will a cup of tea a day keep the cardiologist away?

15 Dec 2016Paid-up subscribers

Moderate tea consumption was associated with a slower progression of coronary artery calcium and lower incidence of major cardiovascular events, a study published in the American Journal of Medicine has found. Regular coffee consumption had neither protective nor adverse effects.

Drinking levels in young women are approaching those of men

15 Dec 2016Paid-up subscribers

The traditional gender difference in alcohol misuse and alcohol-related harm, where men have been at much higher risk than women is changing, a recent study has confirmed.

Whole body hyperthermia for depression

15 Dec 2016Paid-up subscribers

Whole body hyperthermia (WBH) shows promise as an effective treatment for depression, a randomised double-blind,sham-controlled trial, published in JAMA Psychiatry, has concluded.

A diagnosis of cancer can affect mental health

24 Oct 2016Registered users

Cancer patients have an increased risk of developing common mental health disorders from 10 months prior to their cancer diagnosis, with a peak incidence during the first week after diagnosis,a Swedish study has found.

Homelessness is an independent risk factor for mortality

01 Jun 2009Registered users

Although the higher mortality risk associated with homelessness can partly be explained by an increased prevalence of morbidity, homelessness itself confers an additional risk, a retrospective cohort study has shown. 'In this study, homelessness itself has been shown to be an independent risk factor for the high mortality seen in this group. In addition to interventions addressing morbidity in homeless people, intensive targeted social interventions directed to homelessness itself may be needed to lower mortality in this highly disadvantaged social group.'

Stroke risk similar in paroxysmal and sustained AF

23 Jan 2008Registered users

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.'