Evidence
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Bespoke shoes and insoles could prevent foot ulcers in people with diabetes

Shoes and insoles which are custom-made to relieve pressure on the foot could prevent ulcers in people with diabetes. Foot ulcers are a serious complication of the disease and can lead to amputation if they are not managed appropriately. Even a mild injury can cause a foot ulcer. Researchers wanted to identify design features of ...

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Two commonly used pressure redistributing mattresses are similar for preventing pressure ulcers but differ on price

The choice of mattress used in hospital makes no difference to whether adults develop pressure ulcers, or how quickly, but differ on price. This large NIHR-funded trial included 2,029 participants at high risk of developing pressure ulcers and found fewer pressure ulcers overall than expected (7.9%). Half of about 2,000 participants in this large NIHR-funded ...

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Antimicrobial central venous catheters do not reduce infections in pre-term babies

Central venous catheters (CVCs) impregnated with antimicrobial agents are no better than standard CVCs for avoiding bloodstream infection in pre-term babies. This NIHR-funded trial compared peripherally inserted CVCs that had been impregnated with a combination of the antifungal miconazole and the broad-spectrum antibiotic rifampicin, against standard non-antimicrobial-impregnated CVCs for preterm babies in intensive care. Rates ...

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5% fluorouracil cream is the best first-line treatment for actinic keratosis skin lesions

Comparison of four common treatment regimens for actinic keratosis found that twice daily 5% fluorouracil cream was the most effective and least expensive. It was also found to be convenient and well tolerated by patients. Actinic keratosis, also known as solar keratosis, is a scaly skin lesion that develops following long-term sun exposure. It is ...

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Dermoscopy plus visual inspection aids melanoma diagnosis

Dermoscopy, using a relatively cheap handheld magnifying device alongside naked eye observation, is more accurate in the diagnosis of melanoma than visual inspection alone. It can also provide a photographic record which can be used for reference during follow-up. This NIHR-funded review included 104 studies of skin lesions in the dermatology clinic that looked suspicious ...

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Adding emollients to the bath unlikely to help children with eczema

Adding emollients to children’s bath water does not significantly improve their eczema. Prescriptions should focus on emollients applied directly to the skin or used as a soap substitute. Using emollients to lock in moisture is the standard treatment for childhood eczema. These can be applied in a number of ways, but there is uncertainty surrounding ...

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Biological therapies for psoriasis do not increase serious infection risk

People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies. There are fears that these biological therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting ...

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Terbinafine is probably first choice oral drug for fungal toenail infection

The oral antifungal drug terbinafine appears to be slightly better than alternative ‘azole’ drugs for treating fungal toenail infection. Fifty-eight percent of people had a normal nail appearance after a treatment course compared with 47% taking ‘azoles’. Both drug classes were more effective than placebo and had similar side effects. Current guidelines recommend terbinafine or ...

Collection

Childhood eczema

Eczema is an inflammatory skin condition, characterised by dry, itchy and red skin. It can affect both children and adults, and is very individual in nature. Childhood eczema is usually the ‘atopic’ type, which commonly starts in childhood, often runs in families, and is linked to allergies and other allergic conditions like asthma and hay ...

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Molluscum contagiosum is best left to clear by itself

Molluscum contagiosum, the viral skin infection, is best left alone to heal by itself rather than being treated with medication, destructive treatments or creams. When comparing imiquimod (a skin cream that activates the immune system) with nothing, about 40% of people were clinically clear by 6 months in either group. Treatment increased the chance of ...

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