Research reviews

Taking a hot bath every day or most days may lower the risk of cardiovascular disease (CVD), a study from Japan has suggested.

Introduction of the quadrivalent human papilloma virus (HPV) vaccination programme in girls and young women in Sweden has led to a substantially reduced risk of invasive cervical cancer at population level, a national study has shown.

Regular use of proton pump inhibitors (PPIs) increased the risk of type 2 diabetes in a cohort analysis of three large American population studies. The risk increased with longer duration of use.

A meta-analysis has shown an association between prediabetes and raised risk of all-cause mortality and incident cardiovascular disease in the general population as well as patients with atherosclerotic heart disease.

Nausea during the first few weeks of varenicline therapy may reduce adherence, a study from North America has found. The authors analysed data on 870 adults receiving varenicline in two smoking cessation trials conducted at multiple sites in Canada and the USA.

Higher consumption of total whole grain foods, such as oatmeal, dark bread, brown rice or whole grain cereals can reduce the risk of developing type 2 diabetes, analysis of data from three large prospective cohort studies in the USA has shown.

Patients aged 65 years and over with coronary artery disease benefitted at least as much as younger patients in improving lifestyle risk factors in a community-based trial from the Netherlands. Older patients were more likely to achieve the weight loss target and stop smoking.

Fluoxetine, either alone or in combination with cognitive behaviour therapy, appears to be the most effective treatment for children and adolescents with moderate to severe depression, a systematic review and network meta-analysis has concluded. NICE recommends that antidepressants should not be initiated in primary care.

A large cohort study has demonstrated that a healthy lifestyle in midlife can increase life expectancy free of type 2 diabetes, as well as cardiovascular disease (CVD) and cancer.

An electronic algorithm integrated with primary care clinical database systems achieved a modest increase in hepatitis C (HCV) case finding, a UK general practice-based study has found.

Daily emollient use for the first 12 months of life did not protect against the development of eczema in high-risk children, a UK study has found. Infants born at full term were recruited to a randomised controlled trial carried out at 12 hospitals and four primary care sites across the UK between 2014 and 2016. All the infants were deemed at high risk of developing eczema because of a family history of atopic disease i.e. at least one first-degree relative with parent reported eczema, allergic rhinitis, or asthma diagnosed by a doctor.

A Scandinavian observational study has shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors are associated with a significant reduction in serious renal events compared with dipeptidyl peptidase-4 (DPP-4) inhibitors. The study used Scandinavian disease registry data to compare population outcomes in the general diabetic population rather than selected groups of high-risk patients.

A largely home-based exercise intervention improved grip strength, mobility, daily activities and quality of life in older patients after acute coronary syndrome, an Italian study has shown. Hospitalisation and death rates were also reduced by the intervention. A total of 235 patients, median age 76 years, range 73-81 years, were recruited to the trial conducted at three sites in Italy. They were randomised one month after their ACS event to the exercise or control group. All had reduced physical performance defined by the short physical performance battery with scores of 4-9.

Recent or current substance use disorder is associated with treatment resistance in patients who receive prescription treatment for depression, a nested case control study has found.

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.

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.

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.

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.

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.

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.’

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.'