Research reviews

In older patients hospitalised for acute decompensated heart failure an early tailored rehabilitation programme resulted in a greater improvement in physical function compared with usual care together with a reduction in falls and improvement in mood. However, the programme did not result in a significant reduction in readmissions or deaths.

Hospitalisation rates for asthma in preschool children have significantly declined since the ban on smoking in vehicles carrying children in Scotland, a study has found.

A history of maternal asthma was significantly associated with the development of atopic dermatitis, as well as asthma and wheeze, in children, a cohort study from the USA has found.

Patients with non-consensus transient ischaemic attack (TIA) have a raised seven-day risk of stroke, the Oxford Vascular Study (OXVASC) has found. The ten-year risk of all major vascular events was similar for non-consensus and classic TIAs.

Parents of children facing terminal or life-threatening illnesses require timely information about their child’s prognosis from healthcare professionals and an opportunity to provide input into the discussion, a qualitative study from the Netherlands has found.

Rates of cerebral palsy and moderate and severe neurodevelopmental problems in five year olds were higher in children born prematurely compared with those born at full term, a large study from France has found.

Oral prednisolone had little effect on respiratory parameters at 24 hours in young children attending an emergency department with acute wheeze, in a study from New Zealand. However, admission rates, and the need for additional oral prednisolone and intravenous medication were lower in children in the prednisolone group.

A history of one or more miscarriages appears to be associated with an increased risk of dying before the age of 70, an analysis of data from the US Nurses’ Health Study II has found. When the cause of death was examined, the strongest association was with cardiovascular disease.

Although hospital admissions for food anaphylaxis increased over the past 20 years in the UK the case fatality rate more than halved, an analysis of national data has shown.

Tailoring choice of antihypertensives to the patient rather than using strict age criteria might be more beneficial, the authors of a UK observational cohort study suggest.

Men and women, under the age of 25, with problem gambling are at increased risk of trying to take their own lives, a UK study has found.

Acamprosate was the only intervention with evidence that it was better than placebo in maintaining alcohol abstinence for up to 12 months, following detoxification, in a network meta-analysis.

A study based on the English Longitudinal Study of Ageing (ELSA) suggests that loneliness is an independent risk factor for diabetes.

Consensually nonmonogamous partnerships, including open relationships, comprise a substantial proportion of sexual relationships in the USA, a national population-based survey has concluded. It is important to be non-judgemental when eliciting sexual histories, to discuss risks and offer the right tests to the right people to minimise STI/HIV transmission.

Between 2008 and 2017 smokers appear to have become less dependent on cigarettes but also less likely to try to quit or cut down. For those who tried to quit, fewer used behavioural support and more used pharmacological support, a study has found.

Use of oral or inhaled corticosteroids appears to be an independent risk factor for osteoporosis and fragility fractures in patients with asthma, a UK population-based study has found.

Engagement with hepatitis C treatment by people who inject drugs is associated with a lower risk of all-cause mortality and drug-related death, a study set in Scotland has found.

A nationwide case-control study from Denmark has strengthened the evidence that parental asthma and smoking in pregnancy are risk factors for onset of asthma and persistent wheezing in children. The results also suggest that exposure to ambient small particles < 2.5 µm (PM_2.5) may be a potential risk factor. However, this finding needs to be substantiated in future studies, the authors say.

Loneliness but not social isolation appears to be an independent risk factor for cardiovascular disease, an analysis of data from the English Longitudinal Study of Ageing suggests.

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.

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.'