Clinical news

Zinc supplements shorten the duration of cold symptoms in adults, but not children, according to a meta-analysis of evidence.

Intrauterine devices are a ‘highly effective’ method of emergency contraception, concludes an analysis of recent evidence by a group of international researchers.

The NICE threshold above which drugs are considered too expensive for NHS could be lowered to £13,000 for some diseases, academics have suggested.

Probiotics are an effective therapy for treating and preventing antibiotic-associated diarrhoea, says results of a new meta-analysis.

GPs will be tasked with going through their records to find anyone aged over 35 who may have COPD, under Government guidance issued to CCG leaders.

Breast-fed babies gain less weight than those fed by bottle, even if mostly expressed breast milk is used, conclude US researchers.

A switch to a ‘more accurate' equation to work out eGFR would reclassify the kidney function of a quarter of the general population, conclude researchers.

The Department of Health has successfully resolved supply problems with the shingles vaccine, paving the way for a national immunisation programme in the elderly.

Swapping a GP for a nurse is an effective way of eradicating white-coat hypertension, because it relaxes patients and lowers their blood-pressure readings, new research reveals.

Long-acting GLP-1 receptor agonist injections are more effective at reducing HbA1c levels in diabetes patients than gliptins when added to metformin, say European researchers.

Exclusive GPs will be benchmarked on the laboratory tests they order under Government plans to cut the cost of pathology services by 20% over three years, Pulse can reveal.

The NHS could save £85m annually if it switched to using an alternative treatment for macular degeneration, according to a new study that has sparked a debate on the off-label use of medicines.

A leading adviser to NICE has called for restrictions on the use of atorvastatin to be thrown aside after its price tumbled by 93% today, following the expiry of its patent.

GPs could be faced with ‘mopping up’ after a programme of meningitis C booster vaccination is rolled out in schools, say DH immunisation experts.

Women are much less likely to develop a mood disorder if they are taking a combined contraceptive pill, conclude researchers.

Weekly text messages are a easy and effective way of encouraging patients to take their medication, say researchers.

Educating patients to self-manage their diabetes has little effect long-term on their lifestyle choices or their health outcomes, concludes a major UK study.

Mindfulness training produces clinically significant improvements in quality of life and stress that are equivalent to those seen with inhalers in patients with asthma, a US trial has found.

QOF indicators for anticoagulation therapy will overlook a ‘significant proportion’ of older people with atrial fibrillation unless pulse checks are routinely carried out by practices, say experts.

The UK medicines regulator has called for GPs to check the magnesium levels of all patients on proton-pump inhibitors, in advice GPs have warned represents a ‘massive undertaking’ for primary care.

GPs are being urged to ramp up diabetes treatment within just three months if they do not reach their glycaemic goals on metformin alone, under a radical update of guidelines issued by European and American diabetes societies.

Botox injections show ‘small to modest’ benefits in preventing migraine and headache, say US researchers.

GPs have called for an urgent review of ‘outdated’ NICE guidelines on hyperlipidaemia after an analysis showed a 12-fold increased risk of severe muscle damage with simvastatin 80mg.

Treating subclinical hypothyroidism can dramatically reduce the risk of cardiovascular disease in the under-70s, but may increase the risk of events in older patients say UK researchers.

NICE advisers have recommended a radical change to the way QOF is drawn up, with incentives paid to GP practices under the scheme determined by the magnitude of the expected ‘health gain’.

HbA1c levels rise rapidly in the year before a diagnosis of type 2 diabetes, say Japanese researchers.

Parents can be taught a simple physical intervention to reduce pain in infants undergoing routine immunisations, say US researchers.

Exclusive The Department of Health is preparing to trial giving GPs access to primary care risk calculators as part of its initiative to diagnose cancer earlier, Pulse can reveal.

GPs should either initiate or switch patients to varenicline after 12-weeks to prevent relapse, a QIPP analysis by the Cochrane Collaboration has concluded.

Tricyclic antidepressants and alosetron are associated with a significant number needed to harm in the treatment of individuals with irritable bowel syndrome, a US analysis has found.

Although metformin is the ‘gold standard’ treatment for diabetes, it has little effect on reducing the risk of death or cardiovascular disease, say the authors of two new analyses.

Angotensin receptor blockers are no more effective than ACE inhibitors, and have a greater risk of diabetes say researchers.

GPs should advise patients that no treatment is needed for most insect bites, as most over-the-counter treatment ‘show little efficacy’, say experts.

GPs should inform patients with osteoporosis about the symptoms of inflammatory eye disease, say researchers who found up to a 50% increase in risk with bisphosphonate treatment.

Including ECGs in routine cardiovascular risk assessments of older people would identify more patients at high risk of a coronary event, say US researchers.

GPs should advise obese patients to set daily targets and weigh themselves twice a day if they want to lose weight, say researchers.

Delays in diagnosing ovarian cancer are a common source of medical negligence claims against GPs, and have led to damages payouts of up to £550,000, an analysis by the Medical Defence Union has found.

GPs have been urged to delay anti-fungal treatment until they have laboratory results on infections, and encourage more self-care, by Health Protection Agency researchers.

GPs should consider carefully the increased risk of bleeding and stroke with newer antidepressants before prescribing them, say US researchers.

Measles-containing vaccines do not result in any significantly increased risk of febrile seizures in toddlers, a major analysis has found.

GPs should be ‘in no hurry’ to switch patients from warfarin to newer anticoagulants say experts, after an analysis showed long-term use of the drug had led to a significant reduction in stroke rates.

GPs should check job-related causes of asthma to catch occupational asthma early, say guidelines from the Royal College of Physicians have recommended.

Up to a quarter of women diagnosed with breast tumour under mammography screening will never develop a malignancy, report US researchers.

GPs should target older people and those going on ‘winter sun’ holidays to Africa for pre-travel advice on malaria vaccination, a BMJ study reports

The manufacturer of new anticoagulant dabigatran has reduced its price by 13% amid concerns GP commissioners were set to place a series of restrictions on use of the drug to prevent it busting prescribing budgets.

GPs are referring patients to falls prevention programmes that are not evidence-based, a new analysis claims.

The Department of Health has warned GP practices will face an increase in patients presenting with concerns about lung cancer, following the roll out of a national awareness campaign for the disease.

QOF questions designed to screen for depression are providing substandard results when used for people with diabetes, researchers have claimed.

The osteoporosis treatment strontium ranelate has also been shown to slow the progression of osteoarthritis in knees, researchers have found.

GPs have called for restrictions on bariatric surgery to be revised after a major study showed the intervention resulted in the remission of diabetes in up to 95% of severely obese patients.

Lifestyle interventions for patients at risk of developing diabetes are costly, but good value for money in the long-term say the authors of a new cost-effectiveness analysis.

GPs should monitor older patients with dementia closely during in the first month of antipsychotic treatment, say researchers who found the drugs double the risk of a heart attack.

Shisha smoking poses a greater threat to patients than pandemic flu and is making a ‘mockery’ of attempts to reduce smoking in young people, a senior GP has warned.

GPs are to spearhead a major Government drive to increase dementia diagnosis rates, by providing five-yearly checks on risk factors and referring patients to memory clinics.

Adverse reactions to anti-infectives, NSAIDs and anti-epileptics are the most frequent causes of children being admitted to hospital, a large UK review has discovered.

GPs should closely monitor patients with diabetes after initiating statin treatment as the risk of discontinuation is around 70%, say researchers.

Pharmacist and nurse prescribers will be able to prescribe controlled drugs from next month, the Home Office has revealed.

A ketogenic diet can have a similar effect to drug treatment in children with epilepsy, a Cochrane review has found.

Gliptins should be used more widely in patients with diabetes as they are associated with less weight gain and fewer hypoglycaemic episodes than sulfonylureas, say researchers.

Just over a third of stroke patients are still being admitted to non-specialist units, four years after a Department of Health strategy ordered trusts to ensure everyone received the best care.

Women who use antidepressants during pregnancy have an increased risk of gestational hypertension of up to 80%, a case-control study has found.

Long-term aspirin treatment is associated with a reduced risk of cancer and should be considered for primary prevention of malignancy, say UK researchers.

Exclusive GPs face restrictions on their use of the first alternative to warfarin to be approved on the NHS in 50 years, after PCTs and clinical commissioning groups began frantically drawing up prescribing policies to soften the financial impact.

GPs should assess the risk of pancreatic and gastro-oesophageal cancer in patients who present with heartburn and indigestion, say UK researchers.

GPs will pilot a major screening programme for early-stage lung cancer in all high risk smokers, the Scottish Government has announced.

Cognitive-behavioural therapy has a ‘modest’ effect on reducing the level of anxiety in asthma patients, conclude UK researchers.

A major NHS study into whether exercise can improve depression has failed to show any clinical benefit at all from increasing activity levels, UK researchers claim.

Rheumatoid arthritis is associated with an increased incidence of atrial fibrillation and stroke, a Danish study has found.

An alternative anticoagulant to warfarin has been approved by NICE for the prevention of stroke, despite major concerns over the cost implications for the NHS.

The UK medicines regulator is proposing to scrap a controversial scheme to approve indications for the marketing of homeopathic remedies, after only one treatment was approved in five and a half years.

GPs should follow up all patients with a mildly raised alanine aminotransferase level to rule out hidden hepatitis C infection, say researchers.

An alginate is an effective alternative to proton pump inhibitors in patients with regular heartburn, conclude the authors of a primary care study.

GPs in Merseyside have launched an urgent MMR vaccination drive after a measles outbreak.

The GPC has written to the chief medical officer calling on her to retract instructions that GPs should carry out annual checks on women who have had PIP breast implants.

Practices are leaving themselves open to legal action because GPs are carrying out cervical smear tests without ‘visualising the cervix’, the GPC has claimed.

GPs may be missing a ‘significant proportion’ of diabetes and impaired glucose tolerance cases because they are being encouraged to use the wrong test in women who have had gestational diabetes, UK researchers have warned.

Patients prescribed oral steroids are nearly seven times as likely to commit or attempt suicide, say researchers.

GPs should advise patients with chronic fatigue to wait and see if their tiredness resolves itself with six months, recommend UK researchers who looked at the time course of symptoms.

GPs should use behavioural support in pregnant women wanting to give up smoking as nicotine replacement therapy has little effect on quit rates, a UK trial has found.

Nitroglycerine is not a reliable test for the diagnosis of coronary artery disease and it should not be used to triage patients, a systematic review has found.

Endometriosis is linked to an increased risk of certain types of ovarian cancer, say international researchers.

Repeated dieting leads to increased risk of osteoporotic fracture in older women, a Norwegian study finds.

A targeted exercise strategy improves shoulder function and reduces the number of patients subacromial impingement going on to have surgery, finds a Swedish study.

GPs should receive hospital discharge summaries for all elderly patients and should review their care arrangements six-weeks after they are discharged, a new report suggests.

A specialist clinic for patients with medically unexplained symptoms (MUS) in primary care can have a ‘clinically meaningful’ improvement on their quality of life, say UK researchers.

The use of some antipsychotics to elderly patients is ‘not justified’ because of the risk of harm to patients, researchers have concluded, after a major new study found the risk of death with different medications varies two-fold.

UK researchers have called for better training and support for GPs after they uncovered ‘large variation’ in the number of pre-referral consultations for certain cancers.

Pharmacists should collate information on elderly patients’ recent falls and report the results to GPs under new recommendations to health ministers on preventing fractures.

The US drugs regulator has advised patients to contact their GP if they take proton-pump inhibitors and develop diarrhoea that does not improve.

NICE guidance on hypertension is too expensive to implement, and is prompting practices to encourage patients to buy their own blood pressure monitors to use at home, cardiology expert has claimed.

Questionnaires detailing family history of cardiovascular disease can help GPs identify a further 5% of their patients who are at high risk, a UK study reveals.

PCT managers have appealed against a NICE appraisal of the oral anticoagulant dabigatran, claiming the guidance will have ‘one of the largest impacts on the NHS to date’.

Pharmacists will be invited into GP practices to conduct regular medicine reviews and tackle ‘hazardous’ prescribing, under a new scheme ministers have urged clinical commissioning groups to implement.

Exclusive GPs are set to be handed a guarantee they can access NICE- approved treatments under a Government clampdown on postcode lotteries in drug formularies.

Guidelines on skin cancer should be re-evaluated after a study showed GPs were just as good at excising squamous cell carcinomas as specialists, say UK researchers.

The risk of bleeding among older warfarin users doubles with concurrent antibiotic use, finds a large study.