Research reviews

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.

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. 

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.

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.

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.

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

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.

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.

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.

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

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.

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.

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.'