Evidence
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A care package to increase awareness of fetal movements does not reduce risk of stillbirth

A care package to increase awareness of fetal movements, and allow identification and delivery of high-risk babies, did not reduce the risk of stillbirth. The incidence of stillbirth varies across high-income countries suggesting that many could be preventable. The AFFIRM trial is the largest to date to assess whether interventions that increase awareness of fetal ...

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Standing desks with a support package reduce time sitting at work

An office-based intervention involving a height-adjustable workstation and instruction package reduced the amount of time spent sitting. Workers sat for around 60 to 90 minutes less per day at six and 12 months compared with the control group. Sitting for long periods is a risk factor for ill health even in people meeting recommended levels ...

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Warfarin and newer anticoagulants equally effective for long-term treatment of blood clots

Warfarin and newer anticoagulants work equally well to prevent blood clots in extended treatment after venous thromboembolism. One clot is prevented for every 15 people receiving either anticoagulant. Aspirin is ineffective. Following venous thromboembolism – a blood clot in the deep leg veins (deep vein thrombosis) or lungs (pulmonary embolism) – anticoagulant treatment is given ...

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Early cooling provides no benefit following traumatic brain injury

Deliberate cooling (prophylactic hypothermia) in the early management of traumatic brain injury does not improve neurological outcomes at six months. Inducing hypothermia may also increase the risk of pneumonia. Hypothermia (33-35oC) is sometimes induced to try and limit brain damage in people with severe head injuries. However, evidence for its safety and effectiveness has been ...

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Aerobic exercise is an effective treatment for depression

A systematic review shows aerobic exercise improves clinically diagnosed major depression compared with antidepressants or treatment as usual. Previous reviews found conflicting evidence of benefit. The new review only included the trials thought to have the most applicable results. This meant that trials recruiting people who might not have a clinical diagnosis of depression or ...

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Reviewing inhaler technique for older people with COPD can improve disease control

Educating older adults with chronic obstructive pulmonary disease or asthma about the correct way to use their inhalers, as part of disease management, can reduce their risk of exacerbations. Either a demonstration using a placebo inhaler or written information appears effective for this. This review pooled the results of four trials, with a total of ...

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Lifestyle changes may be more important than drugs for mild hypertension

Consideration of wider risk factors may be important when treating adults with low-risk mild hypertension (raised blood pressure). A large NIHR-funded UK study compared rates of mortality and risk of cardiovascular disease between patients who received antihypertensive treatment and those who did not. There was an increased risk of adverse effects, like low blood pressure. ...

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Premature babies have fewer complications if a lower platelet count is accepted

Fewer premature babies die or have major bleeding if platelet transfusions are withheld until platelet numbers drop to a lower level. At 28 days, death or new major bleeding occurred in 19% of neonates transfused when they had less than 25,000/mm3 platelets compared to 26% of neonates transfused when they had less than 50,000/mm3 platelets. ...

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Antibiotics may be an alternative first-line treatment for uncomplicated appendicitis

Appendicectomy surgery could potentially be avoided for around 60% of adults with uncomplicated appendicitis if they receive antibiotics first. Adults in Finland with appendicitis were randomised to have appendicectomy or a course of antibiotics. In 6 out of 10 the appendicitis settled and did not return over the five years they were followed. Of those ...

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Radiotherapy benefits some men whose prostate cancer has spread to their bones

Adding radiotherapy directed at the prostate to hormone treatment for all men with metastatic prostate cancer makes no difference to overall survival. However, when men with a limited number of metastases confined to the bones of the pelvis and spine are treated with radiotherapy to the prostate, their survival improves. The standard treatment for men ...

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