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Steroid plus lidocaine injection improves pain and function in hip OA

25 Apr 2022Registered users

Addition of a single ultrasound guided intra-articular injection of triamcinolone and lidocaine to advice and education for hip osteoarthritis was associated with greater improvement in hip pain and function over six months compared with advice and education alone, a UK study has found.

Asthma education reduces hospitalisations in children

25 Apr 2022Registered users

Asthma education reduces the frequency of hospitalisation and visits to emergency departments and clinics in children, a meta-analysis has found. Education involving both children and parents/guardians was more effective than that involving only children.

Concomitant steroid therapy raises GI bleeding risk in AF patients on DOACs

25 Apr 2022Registered users

Oral glucocorticoids are associated with an increased risk of gastrointestinal bleeding in patients with atrial fibrillation concomitantly treated with direct acting oral anticoagulants, a nationwide study from Denmark has found.

Novel bleeding risk score for atrial fibrillation patients treated with DOACs

25 Mar 2022Registered users

A new, simple risk score for predicting major bleeding in patients with nonvalvular atrial fibrillation treated with direct acting oral anticoagulants (DOACs) has been developed by researchers in Israel.

Changes in health-related quality of life scores in COPD predict prognosis

25 Mar 2022Registered users

Impairment of health-related quality of life is a marker for risk of hospitalisation and death in patients with chronic obstructive pulmonary disease (COPD), a study from Spain has found.

Risk of HCC falls over time after hepatitis C cure

25 Mar 2022Registered users

The incidence of hepatocellular carcinoma (HCC) decreases with time in patients cured of hepatitis C virus infection and is lowest in younger patients and in those with compensated cirrhosis, a systematic review and meta-analysis has found.

Chronic use of prescription opioids and initiation of injecting drug use

24 Feb 2022Registered users

The risk of initiating injecting drug use is eight times higher for patients who receive long-term prescription opioid medication for non-cancer pain compared with that of opioid naïve patients, a large retrospective cohort study from Canada has found. However, the five-year cumulative probability of injecting drug use initiation in this group was only 4%.

E-cigarettes fail to help smokers quit

24 Feb 2022Registered users

Using e-cigarettes for smoking cessation neither improved the chance of quitting successfully nor helped to improve relapse rates, in a large nationally representative cohort study from the USA.

Do inhaled corticosteroids in the early years affect growth?

24 Feb 2022Registered users

Use of inhaled corticosteroids (ICS) in young children was associated with a slightly reduced height at the age of six but only in those who continued treatment into their sixth year, in a prospective study from Denmark.

Sex differences identified in cardiovascular outcomes

24 Jan 2022Registered users

Women who had survived a first coronary event had a significantly lower risk of major adverse cardiovascular events and recurrent coronary heart disease than men, a population-based cohort study has found. However, women had a higher risk of stroke, heart failure, and all-cause mortality compared with men.

Raised FeNO predicts asthma attacks in children

24 Jan 2022Registered users

High FeNO levels were independently associated with an increased risk of future asthma attacks in children, in a prospective observational cohort study from the UK. Other risk factors identified included a recent history of asthma attacks, and a reduction in the asthma medication ratio.

Early life factors associated with spirometric restriction in adulthood

24 Jan 2022Registered users

Poor growth and nutritional deficits in utero and in childhood are associated with spirometric restriction in adult life, a longitudinal, multicohort population-based study has shown.

UK drinking levels rose during the pandemic

20 Dec 2021Registered users

Alcohol consumption increased in the UK during the first months of the COVID-19 pandemic. However, in most countries in Europe it declined, a panEuropean study has found.

Young adults most likely to become overweight or obese

20 Dec 2021Registered users

Individuals aged 18-24 years are at greatest risk of becoming overweight or obese over the following decade, a longitudinal, large-scale, population-based cohort study has found.

NAFLD increases risk of all-cause mortality

20 Dec 2021Registered users

In patients with non-alcoholic fatty liver disease (NAFLD), fibrosis stages F3 and F4 are associated with an increased risk of liver-related health problems and death from all causes, a large prospective study from the USA has found.

Can choice of anticoagulant for AF influence risk of incident dementia?

20 Dec 2021Registered users

Dementia and mild cognitive impairment were less common among patients prescribed direct oral anticoagulants for newly diagnosed atrial fibrillation (AF) compared with those prescribed vitamin K antagonists, in a UK cohort study.

Depression questionnaires fail to reflect patients’ own views of mood changes

20 Dec 2021Registered users

Changes in depression questionnaire scores often disagree markedly with patients’ own ratings of changes in their mood, a prospective cohort study has found.

ECG-based tool aids rapid risk assessment for a cardiac cause of syncope

20 Dec 2021Registered users

In patients with a syncopal event, a combination of seven ECG criteria enabled a rapid assessment of the likelihood that the event was due to a cardiac cause, in a prospective multicentre trial.

When should antibiotics be prescribed for LRTIs in children?

27 Oct 2021Registered users

Amoxicillin for uncomplicated chest infections in children is unlikely to be clinically effective, a double-blind, randomised, placebo-controlled trial in primary care has found. The study authors recommend that unless pneumonia is suspected, clinicians should provide safety-netting advice but not prescribe antibiotics for most children presenting with chest infections.

Discontinuing antidepressants too early raises risk of relapse

27 Oct 2021Registered users

Patients who had been taking antidepressants for at least 9 months and felt well enough to stop were more likely to relapse by 52 weeks if their treatment was discontinued compared with those who carried on with their current therapy, a UK primary care study has found.

Naltrexone lowers hospital admissions in alcohol use disorder

27 Oct 2021Registered users

The risk of hospitalisation for an alcohol-related or other cause is lower when patients with alcohol use disorder are treated with naltrexone alone or in combination with disulfiram or acamprosate, a nationwide Swedish study has found. However, acamprosate monotherapy was associated with an increased risk of hospital admission for an alcohol-related cause.

Rehabilitation improves physical function in older heart failure patients

25 Sep 2021Registered users

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.

Simple algorithm helps identify patients with NAFLD in primary care

24 Sep 2021Registered users

Using a multistep algorithm based on risk factors and noninvasive testing followed by targeted transient elastography can identify patients with non-alcoholic fatty liver disease (NAFLD) in primary care, a study from the United States has found.

Asthma admissions in under 5s fall following smoking ban in vehicles

24 Sep 2021Registered users

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.

Evaluating interventions to help smokers quit

09 Aug 2021Registered users

Varenicline and a combination of pharmacological and behavioural interventions were the two most effective methods for smoking cessation, a systematic review by the US Preventive Services Task Force has found. Data on the effectiveness and safety of e-cigarettes for smoking cessation in adults were limited and study results inconsistent.

Maternal asthma associated with atopic dermatitis in offspring

26 Jul 2021Registered users

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.

Does BPH raise the risk of dementia?

26 Jul 2021Registered users

Men with benign prostatic hyperplasia (BPH) may be at increased risk of developing Alzheimer’s disease and other dementias, the findings of a Danish population-based cohort study suggest.

Non-consensus TIA raises early and long-term risk of stroke

25 Jun 2021Registered users

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.

Even smoking some days increases risk of premature death

25 Jun 2021Registered users

Individuals who do not smoke every day have a significantly higher risk of all-cause mortality compared with those who have never smoked. For those who smoke daily, the mortality risk increases as the number of cigarettes smoked increases, a large study from the USA has found.

Breaking bad news to parents about their child’s prognosis

25 Jun 2021Registered users

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.

Raised NT-proBNP predicts poor outcomes in AF without heart failure

25 May 2021Registered users

High NT-proBNP levels appear to be an independent predictor of adverse outcomes in patients with atrial fibrillation (AF) in the absence of heart failure, a study from Japan has found. Raised NT-proBNP levels were significantly associated with higher incidences of stroke/systemic embolism, all-cause death and hospitalisation for heart failure during a median follow-up period of five years.

Preterm birth associated with raised risk of developmental problems at age five

25 May 2021Registered users

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.

Pattern of heavy drinking with bingeing linked to depression

25 May 2021Registered users

Patterns of alcohol consumption in particular frequent use plus frequent bingeing have positive associations with symptoms of depression such as depressed mood, poor appetite or overeating, feelings of worthlessness or guilt and psychomotor agitation or retardation, a German study has found.

Do oral steroids improve respiratory outcomes in preschool children with acute wheeze?

22 Apr 2021Registered users

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.

Recreational substance use raises risk of early onset CVD

22 Apr 2021Registered users

Use of illicit drugs, as well as tobacco and alcohol, is associated with an increased risk of premature atherosclerotic cardiovascular disease (CVD), especially in women, a study from the US has shown. Those with multiple substance use had a graded response with the highest risk of premature CVD among individuals who used four or more recreational substances.

Miscarriage associated with raised risk of premature death

22 Apr 2021Registered users

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.

Sex differences remain in the prevalence and treatment of CVD risk factors

22 Mar 2021Registered users

Differences persist in the prevalence, treatment and control of risk factors for cardiovascular disease between men and women, an analysis of data from the Health Survey for England 2012-2017 has found. Men were more likely to have one or more risk factors than women. However, figures for both treatment and control of dyslipidaemia were significantly lower in women than men.

Are prescription opioids safe to use in pregnancy?

22 Mar 2021Registered users

Prescription opioids used in early pregnancy are not associated with a substantial increase in the risk of most congenital malformations, although a small increase in the risk of oral clefts associated with their use is possible, a large US 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.'