Evidence
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Tranexamic acid is safe to use following mild-to-moderate traumatic brain injury and reduces deaths

In people with mild-to-moderate traumatic brain injury, tranexamic acid (a drug which reduces bleeding) given within three hours of injury reduces the risk of death by 22%. This effect is seen in a subgroup of those who are less severely affected. This NIHR-funded multi-centre international trial randomised 12,737 adults with intracranial bleeding to receive either …

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On balance, antiplatelet drugs may be restarted for stroke survivors who have bled into the brain

Early research suggests that antiplatelet drugs, such as aspirin, can provide more benefit than harm if restarted at about 2 to 3 months after a brain bleed. The results seem to apply best to those patients with a good prognosis who survive with less disability. Antiplatelet drugs are of proven benefit to those with a …

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Robot-assisted training offers little useful improvement in severe arm weakness and function after stroke

People who have severe arm weakness following stroke have no better function after robot-assisted training or enhanced upper limb therapy than those who have usual NHS care. This large multicentre trial, funded by the NIHR, randomised 770 adult stroke patients to robot-assisted training using the MIT-Manus robotic gym, to an enhanced therapy programme or to …

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Centralising stroke services can save lives

Changing access to more specialised stroke centre care in one city (London) was estimated to save an additional 96 lives per year (1%) compared to the reductions occurring in the rest of England. These improvements were sustained over time. Other cities did well on quality of care indicators, including time to admission in a stroke …

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Transcutaneous electrical stimulation (TENS) may help lower limb spasticity after stroke

Transcutaneous electrical stimulation (TENS) delivered alongside standard physical therapies could reduce spasticity in the lower limbs following a stroke. Spasticity is a muscle control disorder characterised by tight muscles. It is common after stroke and accounts for significant disability. TENS is often used to treat pain and can affect nervous stimulation of the muscles. The …

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A commonly-used antidepressant doesn’t improve recovery after stroke

The antidepressant fluoxetine works no better than placebo to reduce disability after a stroke, lowering hopes that had been raised by other smaller studies. After a six month trial including more than 3,000 adult stroke patients recruited at 103 UK hospitals, researchers concluded that fluoxetine should not be used to promote recovery from stroke-related disability, …

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Robot-assisted arm training after stroke helps people regain some strength and independence

People who have electromechanical or robot-assisted arm rehabilitation after stroke have better arm function and strength as well as finding it easier to complete activities of daily living. Although moderate, the improvements suggest it may be worth considering these interventions as an adjunct to usual therapy. Many people have impaired arm function after a stroke …

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Omega-3 supplements do not prevent heart disease, stroke or death

Omega-3 fatty acid supplements from fish oils or plants have little or no effect on the risk of heart disease, stroke or overall death rates. This finding contradicts a widespread belief that omega-3 supplements are protective. Previous evidence in favour of omega-3 supplements is mainly derived from trials at high risk of bias. The better …

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Two antiplatelet drugs may prevent further strokes but increase major bleeds

People experiencing a minor stroke or a transient ischaemic attack have a lower risk of further stroke within 90 days if given clopidogrel and aspirin, rather than aspirin alone. However, taking both drugs doubles the risk of bleeding over the same period. Current UK guidelines recommend using clopidogrel alone. In this major international trial of …

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Varicose vein injections help new venous leg ulcers heal

For patients with leg ulcers caused by varicose veins, early intervention to treat the veins results in faster healing of ulcers than standard compression therapy alone. Researchers studied 450 people with open venous leg ulcers of 6 weeks to 6 months duration and varicose veins. Those assigned to have their veins treated within two weeks …

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