Research reviews

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.'