The contribution of genetics and environment to obesity
AbstractBackgroundObesity is a global health problem mainly attributed to lifestyle changes such as diet, low physical activity or socioeconomics factors. However, several evidences consistently showed that genetics contributes significantly to the weight-gain susceptibility.Sources of dataA systematic literature search of most relevant original, review and meta-analysis, restricted to English was conducted in PubMed, Web of Science and Google scholar up to May 2017 concerning the contribution of genetics and environmental factors to obesity.Areas of agreementSeveral evidences suggest that obesogenic environments contribut...
Source: British Medical Bulletin - July 7, 2017 Category: General Medicine Source Type: research
Dystonia
AbstractIntroductionDystonia is a clinically heterogeneous group of hyperkinetic movement disorders. Recent advances have provided a better understanding of these conditions with significant clinical impact.Sources of dataPeer reviewed journals and reviews. PubMed.gov.Areas of agreementA recent consensus classification, including the assessment of phenomenology and identification of the dystonia syndromes, has provided a helpful tool for the clinical assessment. New forms of monogenic dystonia have been recently identified.Areas of controversyDespite recent advances in the understanding of dystonia, treatment remains sympt...
Source: British Medical Bulletin - July 4, 2017 Category: General Medicine Source Type: research
Anticoagulation after coronary stenting: a systemic review
AbstractIntroduction or backgroundAnticoagulant therapy is mainly used to prevent patients from suffering coronary and systemic thromboembolism after stenting. Many studies have been done to formulate an optimized regimen of a post-PCI or long-time anticoagulant therapy. Recent advances in the selection and duration of anticoagulant agents will be conducive to the management of patients who are considered to need anticoagulant therapy after stenting.Sources of dataKey recent published literature, including international guidelines and relevant reviews.Areas of agreementAnticoagulant therapy has been acknowledged to improve...
Source: British Medical Bulletin - July 1, 2017 Category: General Medicine Source Type: research
Is elimination of hepatitis C from the UK by 2030 a realistic goal?
AbstractIntroductionHighly effective, combination therapy for chronic hepatitis C virus (HCV) infection is now available. Current cure rates are close to 100% and applicable to all patients irrespective of race, age, severity of liver disease or viral genotype. Remarkably for persistent infection, current treatment is recommended for as little as 12 weeks; recent studies suggest even shorter courses. In contrast to interferon-based therapy, present regimens have few side effects and serious adverse events are rare. The success and safety of these regimens has stimulated interest in the possible eventual elimination of HCV....
Source: British Medical Bulletin - June 9, 2017 Category: General Medicine Source Type: research
Sudden cardiac death and Ethical issues of CRISPR technology
(Source: British Medical Bulletin)
Source: British Medical Bulletin - June 1, 2017 Category: General Medicine Source Type: research
Management of combined injuries of the posterior cruciate ligament and posterolateral corner of the knee: a systematic review
AbstractBackgroundApproximately 60% of posterior cruciate ligament (PCL) injury are associated with a posterolateral corner (PLC) tear.Sources of dataWe performed a systematic review of the literature according to the PRISMA guidelines. The following key words were searched on Medline, Cochrane, EMBASE, Google Scholar, and Ovid: ‘posterior cruciate ligament’ or ‘PCL’ with ‘posterolateral corner’ or ‘PLC’ and ‘chronic’; ‘injury’; ‘management’; ‘reconstruction’; ‘outcomes’; ‘complications’.Areas of agreementThere was a statistically significant improvement of all clinical scores after ...
Source: British Medical Bulletin - May 10, 2017 Category: General Medicine Source Type: research
Targeted therapy and maintenance in myeloma
AbstractIntroductionMaintenance therapy aims to extend progression-free survival (PFS) and overall survival (OS), but the convenience of administration, tolerability and toxicity are essentials.Source of dataA search was conducted to identify published literature and clinical studies about maintenance for multiple myeloma using PubMed and ClinicalTrials.gov.Areas of agreementThere are different drug classes able to ensure durable responses previously achieved after induction followed or not by transplant, translating into a significant benefit in PFS and OS.Areas of controversyIt is not well established the optimal mainten...
Source: British Medical Bulletin - May 10, 2017 Category: General Medicine Source Type: research
Physiotherapy management of lower limb osteoarthritis
AbstractBackgroundOsteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition.Sources of dataEvidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK.Areas of agreementThere is strongest evidence to support the use of exercise to improve pain, function and quality of life.Areas of controversyThere is limited evidence to support the use of some commonly utilized physiothera...
Source: British Medical Bulletin - May 3, 2017 Category: General Medicine Source Type: research
Sudden cardiac death
AbstractIntroductionSudden cardiac arrest continues to be the leading cause of death in the industrialized world.Sources of dataOriginal papers, reviews and guidelines.Areas of agreementCommunity programs for lay bystander cardiopulmonary resuscitation (CPR) and automatic external defibrillation improve outcomes. Post-arrest care, including targeted temperature management (TTM) combined with early coronary angiography and percutaneous coronary intervention, is helpful for those suffering cardiac arrest during an ST-segment elevation myocardial infarction.Areas of controversy(1) The optimal approach to encourage lay bystand...
Source: British Medical Bulletin - April 24, 2017 Category: General Medicine Source Type: research
Return to sport following stress fractures of the great toe sesamoids: a systematic review
AbstractIntroductionThis review aims to provide information on return rates and times to sport following stress fractures of the great toe sesamoids (SFGTSs).Sources of dataA systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, Medline, PEDro, Scopus, SPORTDiscus and Web of Science was performed using the keywords ‘stress’, ‘fractures’, ‘great’, ‘toe’, ‘sesamoid’, ‘athletes’, ‘sports’, ‘non-operative’, ‘conservative’, ‘operative’ and ‘return to sport’.Areas of agreementFourteen studies were included: three studies reported on the outcome of conservatively-managed SFGTS...
Source: British Medical Bulletin - April 24, 2017 Category: General Medicine Source Type: research
