NHS Evidence - Eyes on Evidence April 2013

. . . providing easy access to a comprehensive evidence base for everyone in health and social care who takes decisions about treatments or the use of resources. A monthly bulletin is produced, Eyes on Evidence; the issue for April includes:

Infectious diseases among homeless populations. The prevalence of infectious diseases, such as tuberculosis, HIV and hepatitis C, in homeless populations is significantly higher than in the general population. However, figures show much local variation raising questions about the need for a more locally-based response.
Risk of abuse in disabled children. A systematic review of studies from across the world suggests that more than a quarter of children with disabilities will experience abuse within their lifetimes and that children with disabilities are 3 to 4 times more likely to be victims of abuse than their peers without disabilities.
Rheumatoid factor and risk of future rheumatoid arthritis. A cohort study reports that raised levels of rheumatoid factor are associated with an increased risk of developing rheumatoid arthritis. Although treating pre-rheumatoid is currently of unproven value, this study suggests it might be possible in the future.
Heart failure: effects of aldosterone antagonists and renin-angiotensin antagonists on mortality. An observational study in people admitted to hospital with heart failure (HF) with reduced ejection fraction finds that aldosterone antagonists reduce readmissions for HF but have no effect on mortality and increase the risk of admission with hyperkalaemia. Another observational study in people with HF with preserved ejection fraction finds that angiotensin converting enzyme inhibitors or angiotensin receptor blockers reduced all-cause mortality.
Grapefruit–drug interactions. A review article details the evidence for a pharmacokinetic interaction between grapefruit and certain drugs, and the potential clinical consequences of this.

Website: NHS Eyes on Evidence