Intensive lifestyle interventions can help obese young people lose weight
Obese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact time, with less than 25 hours ineffective. The control group gained weight.
Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-i...
Self-guided therapy for people with obsessive-compulsive disorder did not improve symptoms
Offering people book-based or computer-based cognitive behavioural therapy (CBT) whilst on a waiting list for therapist-led therapy did not improve their obsessive-compulsive symptoms when assessed after three or 12 months. However, these low-intensity interventions may reduce the likelihood of people taking up therapist-led CBT.
This NIHR-funded trial included 473 adults with moderate to severe obsessive-compulsive disorder who were already waiting to receive CBT. Issues with the uptake of the...
Heel casts do not improve heel ulcers in diabetes
Fibreglass casts moulded to the heel did not improve heel ulcers in people with diabetes when added to usual ulcer care. Ulcers healed within six months in 44% of people using casts compared with 37% without which was not a statistically significant difference.
Foot ulcers are a common complication of diabetes, and heel ulcers are particularly difficult to treat. Based on the success of casts for treating ulcers elsewhere on the foot this trial was designed to test the effect and cost-effective...
52-week programme leads to more weight loss than 12-week
Obese people referred to a 52-week group weight management programme lost about 2kg more weight on average by one and two years compared to those referred for the standard 12 weeks. These modest health gains were also more likely to be sustained over time in the long programme. A brief intervention led to 3kg weight loss at 12 months, but the 12- and 52-week more intensive programmes led to 23% and 46% more weight loss respectively.
The number of people who are obese or overweight continues to ...
Group rehabilitation activities improve walking after stroke
Group-based circuit class therapy (CCT) focused on repetitive mobility, and functional tasks improved walking ability in people after stroke. People walked on average 61m further during six minutes than those receiving comparison interventions. CCT involves stroke survivors practising different activities at workstations in sight of each other.
This Cochrane review identified 17 trials of group-based CCT, given at least weekly for four weeks, compared with other physical therapies or no interve...
A range of anti-epilepsy drugs are effective as first-line treatment
Lamotrigine and levetiracetam are emerging as first-line treatments for epilepsy, which people may be more likely to keep taking than carbamazepine. Reducing the risk of adverse events and treatment withdrawal is important when selecting an anti-epilepsy drug as it usually will need to be taken long-term.
This study reviewed evidence on anti-epilepsy drugs in adults and children. The drugs were compared directly or indirectly with each other. The main outcome of interest was time to withdrawal ...
Blood test and ECG may safely rule out heart attack
A high sensitivity troponin test accurately ruled out a heart attack amongst a third of patients presenting to the emergency department with chest pain. A patient with no detectable troponin and normal electrocardiogram was almost certain not to have had a heart attack.
Many people come to hospital with chest pain, but more than 75% of them have not had a heart attack. The two tests accurately ruled out heart attack in 30% of all chest pain presentations, but more than a third of people who did...
Use of public defibrillators linked to out-of-hospital cardiac arrest survival
Providing a shock using a defibrillator to people with out-of-hospital cardiac arrest before the arrival of emergency medical services increases their chance of survival.
The UK survival rate is around 8%, which is lower than in other developed countries. This review found that bystander assistance through cardiopulmonary resuscitation and attaching a defibrillator increased it to 32%, compared to 12% for police or firefighters. Survival rates were even higher for people who had a rhythm that c...
Comprehensive assessment may reduce risk of delirium after hip fracture
Comprehensive geriatric assessment reduced the risk of delirium by 20% in patients having hip fracture surgery. Forty-three percent developed delirium on average compared with 53% who didn’t receive these assessments.
The assessment of the older persons’ medical condition was typically undertaken by a team of healthcare professionals who assessed functional ability, living circumstances and risk factors in order to develop a tailored plan for prevention and treatment of delirium aft...
Resistance training may prevent obese older people becoming frail when losing weight
Combining resistance training with aerobic exercise increased physical function in older, obese adults who were following a weight loss programme. Functional improvements, such as the speed to stand from a chair or to climb stairs, were greater with combination training (21%) than with either type of exercise performed alone (14%).
This randomised controlled trial assigned 160 obese adults in the USA (aged over 65, mostly educated white females) to the different types of exercise for six months...