Evidence
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Providing pressurised air through a mask may improve outcomes for people with deteriorating heart failure

Non-invasive positive pressure ventilation may help people with rapidly deteriorating heart failure who become short of breath due to fluid build-up in the lungs. For people not requiring immediate mechanical ventilation using an endotracheal tube, this approach may reduce the risk of death in hospital and the need for intubation. This review evaluated 24 trials ...

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More than 50% of hip replacements appear to last 25 years

Data from national registries and large case series show that in those countries, around 85% of total hip replacements last for 15 years, with 58% lasting for 25 years. This means that those hip replacements have lasted last longer than was first thought. It is good news for an ageing population, as it should mean that ...

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Psychological therapies may improve parenting skills in parents of children with chronic illness

Psychological therapies appear to show promise in helping improve self-reported parenting behaviour of parents of children and adolescents with cancer, chronic pain, diabetes or traumatic brain injury. Cognitive behavioural therapy (CBT) and problem-solving therapy (PST) appear particularly valuable in supporting this. Psychological therapies also seemed beneficial in improving the mental health of parents who have ...

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Steps to better understanding resistant behaviours and the culture of bedside dementia care in hospitals

High levels of resistance to care by people with dementia can be exacerbated by responses by staff on the wards. This study sought to understand the interactions and culture underlying care by closely observing and documenting what was actually happening on ten wards in five UK hospitals, and through interviews with carers and families. This ...

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Smartphones instead of direct supervision can improve adherence rates for TB treatment

People who need supervision take their medication for tuberculosis (TB) more reliably when using a smartphone to send video evidence instead of direct observations; for example, by attending a clinic appointment. Almost double the number of observations was completed in the video-supervised arm at six months than when people were directly observed. Ensuring the effectiveness of ...

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More than 80% of total knee replacements can last for 25 years

Large data sets from national registries and case series show that about 82% of total knee replacements and 70% of partial (unicompartmental) knee replacements last for 25 years. This NIHR-funded review of that data is the first to demonstrate longer-term effectiveness of these procedures. This means that the operation, which aims to relieve pain for ...

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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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A laser eye procedure can be effective and safe if used early as treatment for glaucoma

Using a laser to improve drainage of fluid within the eye showed similar results to eye drops as a first-line treatment for adults with open angle glaucoma or ocular hypertension (raised pressure in the eye). It improved vision without increasing the risk of adverse events. It was preferred by patients and also associated with lower ...

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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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A traditional implant is as effective as more expensive newer types for people over 65 having a hip replacement

A commonly used, cheaper implant used in total hip replacement surgery is as effective as more expensive options for over-65s, a new study has found. A range of prosthetic implants is used for hip replacement, including newer and more expensive options, with different surface materials and some that do not require cement. They may wear ...

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