More than 80% of total knee replacements can last for 25 years An NIHR-funded study showed that about 82% of total knee replacements and 70% of partial (unicompartmental) knee replacements last for 25 years. In 2017 there were 106,334 knee replacement procedures carried out in England, Wales and Northern Ireland. This research suggests people could be …

Services providing holistic health care can improve the psychological well-being of people who are living with breathlessness associated with chronic or advanced lung disease, such as lung cancer or chronic obstructive pulmonary disease. Breathlessness is a distressing symptom in which feelings of fear and helplessness, social isolation, high levels of anxiety and significant carer burden …

In adults with mild to moderate asthma, budesonide-formoterol used as needed for symptom relief was more effective at preventing severe exacerbations than maintenance low-dose budesonide plus as-needed terbutaline. In this trial involving 885 adults, those using the combination inhaler as required had fewer severe asthma attacks, with similar levels of general symptom control, and overall …

People with bronchiectasis (not caused by cystic fibrosis) who take long-term macrolide antibiotics are around 50% less likely to experience acute worsening of symptoms like cough and sputum production (an exacerbation) than people taking a placebo. Bronchiectasis guidelines only recommend preventative macrolide antibiotics in people with frequent exacerbations who do not carry a bacterium (Pseudomonas …

Implied parental expectation of antibiotic prescription does not appear to affect clinician prescribing for childhood respiratory tract infection in primary care. Parents typically accept clinicians’ treatment recommendations based on symptoms and signs, with a minority seeking further home care advice. This NIHR-funded analysis of 56 videoed primary care consultations is the first such study to …

In My Signals, health and social care staff and service users tell us what research is important to them and why they feel others need to know about it. In this collection, we asked seven occupational therapists to tell us which Signals have interested them most and explain why they feel the findings are worth …

In adults after major surgery, high-flow nasal oxygen decreases by about two-thirds the need for reintubation compared with conventional oxygen therapy. In this study, only about four in every 100 patients needed reintubation with high-flow nasal oxygen, compared with about 11 in every 100 patients receiving conventional oxygen therapy. This review evaluated seven randomised and …

Use of a rapid C-reactive protein (CRP) blood test in general practice for people with a flare-up of COPD reduces the proportion who take antibiotics over the next month by about 20 percentage points compared with usual care alone. The reduction in antibiotic use does not lead to worse health, more visits to the doctor …

Care bundles for COPD are difficult to implement, and their introduction in NHS hospitals does not reduce repeat admissions, deaths or use of resources when used on or after admission. Care bundles are packages of interventions which, in other situations, can improve care. COPD care bundles include: checking inhaler technique and medication use providing a …

Surgery for adults who have a deviation, or bend, in the wall running through the centre of their nose improves quality of life more than non-surgical alternatives. The benefit was maintained for at least two years. The surgery, a septoplasty, also improves airflow through the nose. The trial compared septoplasty to non-surgical alternatives, such as just …