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.

Food anaphylaxis admissions rise but case fatality rates fall

22 Mar 2021Registered users

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.

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.

Which drugs should be used first line for hypertension?

21 Feb 2021Registered users

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.

Preterm birth associated with shorter life span

21 Feb 2021Registered users

Individuals born even slightly prematurely have an increased risk of early death in adult life, a Nordic population-based study has found.

Increased risk of attempted suicide in young problem gamblers

21 Feb 2021Registered users

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.

Prematurity associated with higher hospital admission rates in childhood

25 Jan 2021Registered users

Children born preterm, even at 38 and 39 weeks’ gestation, have increased hospital admission rates in the first ten years of life, a large population-based study has found.

Which treatments are effective for maintaining abstinence from alcohol in primary care?

25 Jan 2021Registered users

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.

Childhood cancer survivors at increased risk of cardiac ischaemia

25 Jan 2021Registered users

Children who have survived cancer, particularly those treated with chemotherapy and/or radiotherapy, have a higher risk of adverse cardiac events later on, a pan-European study has found.

Loneliness associated with increased risk of type 2 diabetes

21 Dec 2020

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

Can a hot bath a day keep the cardiologist away?

21 Dec 2020Registered users

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

Relationship structure and sexual health

21 Dec 2020Registered users

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.

HPV vaccination lowers risk of invasive cervical cancer

24 Nov 2020Registered users

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.

Smokers’ dependence on cigarettes has decreased over the past decade

24 Nov 2020Registered users

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.

Long-term PPI use associated with increased risk of type 2 diabetes

24 Nov 2020Registered users

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.

Corticosteroid therapy for asthma raises risk of osteoporosis and fragility fractures

27 Oct 2020Registered users

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.

Prediabetes associated with increased risk of CVD and all-cause mortality

27 Oct 2020Registered users

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.

Engagement with HCV therapy linked to lower deaths from all causes in injecting drug users

27 Oct 2020Registered users

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.

Nausea may affect adherence to varenicline

24 Sep 2020Registered users

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.

Is air pollution associated with onset of asthma in childhood?

24 Sep 2020Registered users

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 (PM2.5) may be a potential risk factor. However, this finding needs to be substantiated in future studies, the authors say.

Diet rich in whole grain foods may lower risk of diabetes

24 Sep 2020Registered users

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.

Loneliness a risk factor for cardiovascular disease

24 Sep 2020Registered users

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.

Lifestyle intervention reduces risk factors in older patients with coronary artery disease

24 Jul 2020Registered users

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.

Asthma persisting from childhood to adulthood presents a distinct phenotype

24 Jul 2020Registered users

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.

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.'