Evidence
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The weekly break from dialysis is harmful to patients with kidney failure

The way that dialysis is normally scheduled in hospitals leaves a gap that may be harmful to the health of kidney patients. If, in addition, patients miss a scheduled session, the risks of hospital admission or death increase dramatically. When someone’s kidneys are not working properly, waste products and fluid can build up to dangerous ...

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Longer duration of urinary catheter placement associated with an increase in urinary infection

The risk of urinary infection appears low with very short-term use but increases with the time that a patient has a catheter. Women and patients with paraplegia or cerebrovascular disease are at increased risk. This US-based retrospective analysis of electronic health records identified 148,361 indwelling catheterisations, of which 61,047 were for three or more days, ...

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Length of steroid course for childhood nephrotic syndrome makes little difference to later recurrences

For children with a first presentation of nephrotic syndrome, an extended sixteen-week treatment regimen with prednisolone does not reduce the risk of relapse compared with the standard eight-week course. Most children will experience a relapse with either regimen, but the longer course may delay it by a month or so which may, in turn, reduce ...

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New insights into how fatigue affects the lives of people on dialysis

Feelings of profound and relentless exhaustion while undergoing haemodialysis impact on patients’ ability to lead a normal life. This overwhelming fatigue is different from the immediate symptoms of post-dialysis fatigue observable in a clinical setting and can pervade all aspects of a patient’s life. This review of 65 international studies, including 1,713 participants, found that ...

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Iron deficiency in people with chronic kidney disease can be managed with either oral or IV therapy

For people with chronic kidney disease who are also iron deficient, intravenous iron improves haemoglobin levels and iron stores faster than oral iron. However, the evidence is inconclusive about whether it influences survival, cardiovascular death, or quality of life. Adverse effects and such as allergic reactions or gastrointestinal side effects and other practicalities are likely ...

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Pelvic floor muscle training can improve symptoms of urinary incontinence

Two-thirds of women with any type of urinary incontinence who have pelvic floor muscle training see improvement or cure compared with only a third of women who receive no treatment or inactive treatments. It is even more effective for women with stress incontinence, with three-quarters of women reporting improvement or resolution of symptoms, such as ...

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MRI scan does not help to find the cause of pelvic pain in women

MRI scans are not sufficiently accurate to find the cause of chronic pelvic pain in women and should not replace laparoscopy (keyhole surgery), which can be used for diagnosis and often treatment. MRI only correctly ruled out a gynaecological condition in half of women judged to have no obvious cause and missed half of women ...

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Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise

People who perform clean intermittent self-catheterisation can reduce symptomatic urinary tract infections from two per year to one by taking daily low-dose antibiotics. This NIHR-funded trial randomised 404 adults in the UK who perform the procedure for a variety of reasons to either daily oral low-dose antibiotics or no prophylaxis. All had a recent history ...

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Gallbladder surgery through a single-incision is more risky than a multiple incision technique

Single-incision keyhole gallbladder removal surgery carries increased risk of adverse events, such as puncturing the gallbladder, compared with the more standard multiple-incision procedures. However, in experienced hands, there may be benefits such as reduced pain and less scarring after the operation. Current guidance recognises that using a single incision for laparoscopic cholecystectomy is more complex ...

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Alternative sedative reduces the risk of acute kidney injury following cardiac surgery

The sedative drug dexmedetomidine can reduce the risk of acute kidney injury when given during non-emergency cardiac surgery. Trial participants who received dexmedetomidine were a third less likely to develop acute kidney injury than those receiving placebo or other treatments. There was no difference in mortality or length of hospital stay. This systematic review identified ...

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