Adverse effects of antidepressants in younger adults

  SSRIs might have higher rates of fracture than tricyclic antidepressants but lower mortality and adverse reactions. Carl Heneghan Antidepressants are commonly prescribed. Yet, in those under 65, there is scant evidence on the risks associated with their use. A recent publication in BMC  looked at these risks in a cohort of 20 to 64-year […]

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Do I need the drugs, doc? Heart failure drugs with preserved ejection fraction.

Evidence suggests heart failure patients with preserved ejection fraction could benefit from beta-blocker treatment, guidelines do not. Jack O’Sullivan   There is a well-established list of medications that work in heart failure with a reduced ejection fraction. However, it is unclear if these drugs are clinically effective in patients with heart failure with a preserved […]

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Crystalloids or saline?

  Use of resuscitation fluids has largely been based on physiological principles rather than evidence. Carl Heneghan The debate over when to use crystalloids versus saline in unwell adults shows there has been considerable uncertainty about what to do in practice. Use of resuscitation fluids has largely been based on physiological principles rather than evidence. […]

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Why I am confused about lung cancer screening

  Should findings from a single trial inform decision making about lung cancer screening? Carl Heneghan, Editor in Chief   A recent cost-effective analysis of low-dose computed tomography for lung cancer screening targeted in those at highest risk of lung cancer suggests only modest benefits. The conclusion is based on a cost-effectiveness analysis of risk-targeted screening […]

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Evidence Watch: uncertainties with the evidence for influenza vaccination

  This week’s Evidence Watch highlights serious uncertainties with the current evidence-base for influenza vaccination Carl Heneghan, Editor in Chief  A systematic review of vaccines in the elderly [1] highlights the difference vaccination makes in a single season (lowers risk of influenza from 6% to 2.4%); but adds caution, in that we have very little […]

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Evidence Watch: Carl Heneghan’s view on evidence that impacts practice

  This week’s Evidence Watch highlights preoperative physio, the risk of heart disease in relation to the number of cigarettes smoked per day, use of antipsychotics in hospital and risk of pneumonia, the effect of exercise across 17 countries and the impact of having a large preterm baby.   Carl Heneghan, Editor in Chief Does a single […]

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Evidence Watch: Carl Heneghan’s selection of evidence that impacts on practice

  This week’s Evidence Watch highlights the risk of pre-eclampsia with metformin, the role of repeated influenza vaccination, de-prescribing medications and assessing harms in the elderly at the time of elective surgery. Carl Heneghan, Editor in Chief A meta-analysis evaluating the risk of pre-eclampsia in women taking metformin before, or during pregnancy found that there […]

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