Login:
 
 

 

Exercise can improve functional status in diabetic neuropathy

24 Mar 2020Paid-up subscribers

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

Weight gain associated with accelerated lung function decline

24 Mar 2020Paid-up subscribers

Adults who put on weight over a 20-year period had a more rapid decline in FVC and FEV1, a large international population-based study has shown. However, weight loss was found to attenuate the decline.

LARC uptake increases in young women

24 Mar 2020Paid-up subscribers

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.

Are psychological techniques effective in patients at high risk of CVD?

24 Mar 2020Paid-up subscribers

Enhanced motivational interviewing with additional behaviour change techniques was not effective in reducing weight or increasing physical activity in patients at high risk of cardiovascular disease, a primary care study has shown.

How accurate are wearable electronic devices for monitoring atrial fibrillation?

24 Feb 2020Paid-up subscribers

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.

Diabetes during pregnancy raises risk of early CVD in offspring

24 Feb 2020Paid-up subscribers

Diabetes of any type in pregnant women increases the risk of early onset cardiovascular disease (CVD) in their childen, a study from Denmark has found.

High rates of steatosis detected in young adults

24 Feb 2020Paid-up subscribers

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

Varicella exposure only partially protective against herpes zoster infection

23 Jan 2020Registered users

Household exposure to varicella infection only offers modest protection against herpes zoster infection in adults, a large self-controlled case series study has shown. Data were derived from the Clinical Practice Research Datalink (CPRD) which covers 9% of the UK population registered at more than 700 general practices. A total of 9,604 adults  with a diagnosis of herpes zoster, documented in primary care or hospital records, between 1997 and 2018, and who had lived with a child with a diagnosis of varicella were identified for the study.

Overweight adolescents consult more frequently for respiratory symptoms

23 Jan 2020Paid-up subscribers

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.

Most deaths in patients on methadone are not drug related

23 Jan 2020Paid-up subscribers

Non drug-related morbidities are the most common cause of death as methadone-treated opioid dependent patients age, a study from Scotland has found. The study authors used information from the Community Health Index and data on methadone prescriptions held within the Scottish National Prescribing Information System for 36,606 patients who had received one or more methadone prescriptions between 2009 and 2015.

Tailor smoking cessation advice to the patient

20 Dec 2019Paid-up subscribers

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.

Antihypertensive drugs most effective when taken at bedtime

20 Dec 2019Paid-up subscribers

Patients who took their blood pressure medication at bedtime had improved blood pressure control and lower risk of major cardiovascular disease events compared with those who took their drugs in the morning, a primary care study has shown.

Automated cough sound analysis shows promise as a diagnostic tool

20 Dec 2019Paid-up subscribers

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.’

Quitting smoking in pregnancy lowers risk of preterm birth

25 Nov 2019Paid-up subscribers

Smoking cessation in pregnant women is associated with a reduced risk of preterm birth, a large study from the United States has shown. Information was obtained from live birth certificates issued between 2011 and 2017 as part of the US National Vital Statistics System. Overall, 25,233,503 pregnant women who delivered live neonates and had data recorded on pre-pregnancy and trimester-specific cigarette smoking frequency were included in the analysis.

Symptoms based approach to asthma may miss children at risk

25 Nov 2019Registered users

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.

Is the incidence of diabetes declining?

25 Nov 2019Paid-up subscribers

A recent systematic review, published in the BMJ, has concluded that in countries where data is available the incidence of diabetes has been stable or falling since 2006.

Where do patients seek help for genitourinary symptoms?

25 Nov 2019Paid-up subscribers

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.

Flu vaccination reduces all-cause mortality in heart failure patients

24 Oct 2019Paid-up subscribers

Influenza vaccination was associated with a significantly lower risk of all-cause mortality in patients with heart failure, a meta-analysis has found. However, the effect on cardiovascular deaths and hospitalisations was not significant.

Breathlessness independently associated with obesity and weight gain in adult life

24 Oct 2019Paid-up subscribers

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.

Incidence of type 2 diabetes varies markedly between occupations

24 Oct 2019Paid-up subscribers

Men employed as professional drivers, and manufacturing or agricultural workers were three times more likely to develop type 2 diabetes compared with university teachers and architects, in a national study from Sweden.

Gonorrhoea may be transmitted by kissing in men who have sex with men

24 Oct 2019Paid-up subscribers

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

Bundle branch block an indicator of heart failure risk

25 Sep 2019Paid-up subscribers

Opportunistic finding of bundle branch block (BBB) in primary care patients without major cardiovascular disease should be considered a warning of future heart failure, a retrospective cohort study from Denmark concludes.

Many smokers and former smokers have misconceptions about nicotine

25 Sep 2019Paid-up subscribers

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

Omega-3 fatty acid supplements do not prevent or improve type 2 diabetes

25 Sep 2019Paid-up subscribers

Supplementary long chain polyunsaturated fatty acids (PUFA) such as omega-3 have no effect on the prevention of diabetes or on glucose metabolism, a large meta-analysis commissioned by the World Health Organization (WHO) has found.

Lack of legacy effect from tight glycaemic control in type 2 diabetes

07 Aug 2019Paid-up subscribers

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 HbA1C 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.

Gabapentinoids may increase risk of suicidal behaviour in young patients

07 Aug 2019Paid-up subscribers

A large Swedish study has suggested that gabapentinoid medications are associated with an increased risk of suicidal behaviour and unintentional overdose in adolescents and young adults.

How does weight change affect risk of atrial fibrillation?

07 Aug 2019Paid-up subscribers

Putting on weight appears to raise the risk of developing atrial fibrillation (AF), a meta-analysis  by investigators in Oxford, UK, has concluded. However, no clear evidence emerged as to whether weight loss reduces the risk.

High levels of cardiorespiratory fitness associated with reduced risk of COPD

07 Aug 2019Paid-up subscribers

Good cardiorespiratory fitness in midlife may lower the risk of developing and dying from COPD, a prospective cohort study from Denmark has found.

Antiretroviral treatment in gay men minimises risk of HIV transmission

24 Jun 2019Registered users

There is effectively zero risk of HIV transmission in gay men through condomless sex when HIV viral load is adequately suppressed, the findings of the PARTNER2 study, published in the Lancet, suggest.

Benefits of quitting smoking outweigh the risks of weight gain

24 Jun 2019Paid-up subscribers

The cardiovascular and overall mortality benefits of stopping smoking far outweigh the risks of weight gain and acquiring type 2 diabetes, a study from the United States has shown.

Controlling risk factors in type 2 diabetes reduces excess risk

24 Jun 2019Paid-up subscribers

Patients with type 2 diabetes who have well controlled risk factors have little or no excess risk of stroke, myocardial infarction or death, a retrospective cohort study has found.

Tramadol associated with longer use of opioids after surgery

24 Jun 2019Paid-up subscribers

A study from the United States has found that patients prescribed tramadol for postoperative pain have a higher risk of prolonged opioid use relative to those given other short-acting opioids.

Do 5 alpha-reductase inhibitors raise the risk of type 2 diabetes?

22 May 2019Registered users

Finasteride and dutasteride appear to be associated with a modest increase in the risk of developing type 2 diabetes, according to the findings of a retrospective cohort study.

Does paternal age affect perinatal outcomes?

22 May 2019Paid-up subscribers

A retrospective population based cohort study from the United States has found a modest correlation between older paternal age and adverse perinatal outcomes.

Sitting time linked to raised mortality risk in inactive adults

22 May 2019Paid-up subscribers

Sitting for long periods is associated with an increased risk of all cause and cardiovascular disease (CVD) mortality among the least physically active adults. However, moderate to vigorous physical activity equivalent to public health recommendations can attenuate or effectively eliminate such associations, a study from Australia has found.

Adolescents face barriers to accessing sexual health information online

22 May 2019Paid-up subscribers

Teenagers are reticent to search for sexual health information online, a small qualitative study has found.

Regular cannabis use raises risk of psychosis

24 Apr 2019Registered users

Daily cannabis use is associated with a three-fold increased risk of psychotic disorder, a multicentre, international case-control study has shown.

Continuous ECG vs loop recording for AF detection post stroke

24 Apr 2019Registered users

Automatic external loop recording (ELR) is not suitable as a single monitoring device for AF screening following stroke, a prospective cohort study from Denmark has concluded.

SGLT2 inhibitor produces good glycaemic control in everyday practice

24 Apr 2019Registered users

An observational study from Scotland has shown that dapagliflozin produced equivalent improvements in glycaemic control in patients with type 2 diabetes in general practice to those reported in clinical trials.

Educational intervention encourages smokers to consult with respiratory symptoms

24 Apr 2019Registered users

Although an educational intervention increased respiratory consultations in smokers it did not improve detection of lung cancer, in a randomised controlled trial from Australia.

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.'