Author summary Why was this study done? New national guidance was introduced in the United Kingdom with recommendations for the care and surveillance of people with endometrial hyperplasia (EH). Comparing patterns of care with these recommendations has identified opportunities for improvement. What did the researchers do and find? After the guidance, medical treatment of non-atypical hyperplasia increased and more patients achieved histological regression, avoiding hysterectomy. Surveillance of hyperplasia for those who do not undergo hysterectomy could be improved. A greater proportion of women with atypia diagnosed in 2020 commenced medical management and fewer underwent hysterectomy; the impact of the pandemic on care must be considered as a contributory factor towards this. What do these findings mean? This work has identified where the care of patients with EH diverged from recommended guidance. Clinicians may use these findings to review their local care pathways and qu
Objective To evaluate the comparative efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on glycaemic control, body weight, and lipid profile in adults with type 2 diabetes.
Design Systematic review and network meta-analysis.
Data sources PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase from database inception to 19 August 2023.
Eligibility criteria for selecting studies Eligible randomised controlled trials enrolled adults with type 2 diabetes who received GLP-1RA treatments and compared effects with placebo or any GLP-1RA drug, with a follow-up duration of at least 12 weeks. Trials with a crossover design, non-inferiority studies comparing GLP-1RA and other drug classes without a placebo group, using withdrawn drugs, and non-English studies were deemed ineligible.
Results 76 eligible trials involving 15 GLP-1RA drugs and 39 246 participants were included in this network meta-analysis; all subsequent estimates
In a population-based, sibling-controlled cohort study Jiangwei Sun and colleagues explore the long-term risk of arrhythmias in patients with inflammatory bowel disease.
Objective To investigate whether supplementing older adults with monthly doses of vitamin D alters the incidence of major cardiovascular events.
Design Randomised, double blind, placebo controlled trial of monthly vitamin D (the D-Health Trial). Computer generated permuted block randomisation was used to allocate treatments.
Setting Australia from 2014 to 2020.
Participants 21 315 participants aged 60-84 years at enrolment. Exclusion criteria were self-reported hypercalcaemia, hyperparathyroidism, kidney stones, osteomalacia, sarcoidosis, taking >500 IU/day supplemental vitamin D, or unable to give consent because of language or cognitive impairment.
Intervention 60 000 IU/month vitamin D3 (n=10 662) or placebo (n=10 653) taken orally for up to five years. 16 882 participants completed the intervention period: placebo 8270 (77.6%); vitamin D 8552 (80.2%).
Main outcome measures The main outcome for this analysis was the occurrence of a major cardiovascular event, inclu
Space spraying of insecticides is still an important means of controlling Aedes and Culex mosquitoes and arboviral diseases. This study evaluated the space spray efficacy of Fludora Co-Max EW, (water-based insecticide space spray combining flupyradifurone and transfluthrin with film forming aqueous spray technology (FFAST)), against wild insecticide-resistant Aedes aegypti and Culex quinquefasciatus mosquitoes from Abidjan, Côte d’Ivoire, compared with K-Othrine EC (deltamethrin-only product), in small-scale field trials. Wild Ae. aegypti and Cx. quinquefasciatus mosquito larvae were collected in Abidjan, Côte d’Ivoire from August to December 2020. Mosquito larvae were reared in the laboratory until the adult stage. Fludora Co-Max EW and K-Othrine EC were tested against emerged adult females (F0 generation) using ultra-low volume cold fogging (ULV) and thermal fogging (TF) delivery technology, both outdoors and indoors in Agboville, Côte d’Ivoi