Azithromycin beneficial in nonsmoking COPD patients who suffer exacerbations

20 Dec 2022Registered users

Long-term azithromycin confers a net benefit in COPD patients who are former smokers with a recent history of exacerbations, a model-based benefit-harm analysis has shown. The benefit is likely to be larger in those patients who suffer frequent exacerbations, the study found.

Bariatric surgery lowers CVD risk in severely obese patients with NAFLD

20 Dec 2022Registered users

Compared with nonsurgical management bariatric surgery is associated with a significant reduction in cardiovascular disease (CVD) risk in individuals with severe obesity and nonalcoholic fatty liver disease (NAFLD), a large, population-based retrospective cohort study from the United States has found.

Diabetes raises risk of cardiovascular mortality in severe aortic stenosis

20 Dec 2022Registered users

Diabetes mellitus is strongly associated with death from heart failure and sudden death in patients with severe aortic stenosis (AS), a study from France has found. No such association was seen in patients with mild/moderate AS.

Low muscle mass linked to more rapid decline in executive function

25 Oct 2022Registered users

Low appendicular lean soft tissue mass is significantly and independently associated with subsequent faster decline in executive function in patients aged 65 and older, a longitudinal study from Canada has found. 

How useful is smartphone technology for detecting AF?

25 Oct 2022Registered users

Smartphone applications can allow self-detection of arrhythmias in patients with atrial fibrillation. However, current evidence of their usefulness is based on small low-quality studies, a systematic review and meta-analysis has found.

Can the Ages and Stages Questionnaire identify developmental delay?

25 Oct 2022Registered users

If a child aged 12-60 months passes the Ages and Stages Questionnaire in all domains there is a moderate probability that there is no severe developmental delay, a systematic review and meta-analysis has found.

Loud noise at work and night shifts may raise risk of IHD

26 Sep 2022Registered users

Occupational exposure to high levels of noise, greater than 90?dBA, and night shift work appear to be associated with an increased risk of ischaemic heart disease, a population-based study from New Zealand has found. However, no such association was seen for long working hours and sedentary work.

Bronchiolitis as a predictor of increased risk of future asthma

26 Sep 2022Registered users

Infants with bronchiolitis characterised by a history of breathing problems, eczema and rhinovirus infection are at increased risk of developing asthma by age 6-7 years, an analysis of three prospective cohort studies has found.

How do genetic factors influence lung cancer risk in smokers and non-smokers?

26 Sep 2022Registered users

The presence of genetic risk factors significantly increases the probability of developing lung cancer in smokers, particularly heavy smokers. However, even with a high genetic risk for lung cancer, individuals who never smoke do not have a significantly increased risk of developing the condition, a prospective cohort study has found. 

Do indirect unscheduled care pathways affect outcomes in myocardial infarction?

27 Jul 2022Registered users

Indirect unscheduled care pathways were associated with higher mortality in patients admitted with myocardial infarction compared with direct pathways, a retrospective population-based study from Scotland has found.

Examining adolescents’ concerns about their food allergy

27 Jul 2022Registered users

Using adrenaline auto-injectors, difficulties in choosing allergen-free foods, lack of understanding in peers and others, and fear of stigmatisation were among the main concerns voiced by adolescents with food allergies, a systematic review has found.

Lowering blood pressure may prevent the onset of diabetes

27 Jul 2022Registered users

Antihypertensive therapy with ACE inhibitors and angiotensin ll receptor blockers lowers the risk of developing type 2 diabetes, a meta-analysis has shown.

NAFLD associated with raised risk of heart failure

27 Jul 2022Registered users

Non-alcoholic fatty liver disease (NAFLD) is associated with a 1.5 times higher risk of new-onset heart failure, independent of the presence of diabetes, hypertension and other common cardiovascular risk factors, a large meta-analysis has found.

Novel model predicts risk factors for mortality in COPD

27 Jul 2022Registered users

Heart failure and current smoking were the strongest risk factors for predicting ten-year mortality in COPD patients, a risk prediction model based on primary care data has found.

OCD associated with increased risk of substance use disorder

24 Jun 2022Registered users

Patients with obsessive-compulsive disorder (OCD) are nearly four times more likely to develop substance use disorder than those without OCD, a Swedish cohort study has found. This association may be partially attributed to genetic factors, but environmental factors may also be involved.

Why do patients with COPD delay seeking medical care for exacerbations?

24 Jun 2022Registered users

Reluctance to seek care is a common response to exacerbations in patients with COPD. Excessive self-reliance, not wanting to bother healthcare professionals and waiting for a tipping point when the exacerbation became more severe were reasons cited by COPD patients for not seeking medical care sooner, in a qualitative study from the USA.

All grades of aortic stenosis raise risk of death

24 Jun 2022Registered users

Even mild aortic stenosis is associated with an increased risk of mortality, a large study from Australia has found.

Younger age at onset of overweight associated with higher risk of hypertension

25 May 2022Registered users

Becoming overweight before the age of 60 was associated with a raised risk of hypertension, in a prospective cohort study. The risk was greatest in those who became overweight between the ages of 18 and 39.

Physical activity reduces mobility disability in frail older people

25 May 2022Registered users

A multicomponent intervention based on regular moderate intensity physical activity was associated with a lower incidence of mobility disability in frail older adults, in a large European study.

Adolescent risk factors accelerate biological ageing at midlife

25 May 2022Registered users

Smoking, obesity, and psychological disorders during adolescence are associated with older biological age at 45, a large cohort study has found.

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.

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.

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.'