Evidence
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Following programmes to improve recovery after surgery linked to shorter hospital stays

Reduced compliance with enhanced recovery protocols was associated with more days in hospital after keyhole bowel surgery, an increased likelihood of readmission and complications. Enhanced recovery, also known as fast track access, is considered standard practice but there is considerable variation in what this means and how this is implemented locally. This systematic review included ...

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Young children from deprived areas are more at risk of serious burns and scalds

Five in every 1,000 children under four are injured by burns and scalds each year in England, although these injuries are becoming less common. Serious injuries needing hospital treatment happen more often to children from deprived areas than wealthy areas. The study looked at general practice data from 1998 to 2013. It showed a steady ...

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Nine different drug classes reviewed for type 2 diabetes

Metformin worked best at keeping blood sugar levels under control and remains a good first choice as single therapy. Overall, the nine classes of blood sugar-lowering drugs had similar effect on risk of death from cardiovascular causes and overall mortality, though estimates are imprecise because so few people died in these studies. Risk of other ...

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Propranolol generally safe in treating childhood haemangioma birthmarks

Treating ‘infantile haemangioma’ strawberry birthmarks with oral propranolol is known to be effective and in this review was associated with low levels of adverse events. The most common adverse events included coldness in the hands and feet, diarrhoea, sleep disorders and upper respiratory infections. More serious problems such as low blood pressure, slow heart rate, ...

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General surgery is mostly safe during pregnancy

Routine data from English hospitals show that general surgery during pregnancy, such as removing the appendix or gallbladder, does not commonly harm mother or baby. This suggests that surgery in pregnant women is generally safe, but that mothers could be provided with more specific estimates of the risks. This large observational study assessed the “real ...

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Whole brain radiotherapy provides little benefit for lung cancer that has spread

Radiotherapy to the whole brain makes little difference to people with the commonest type of lung cancer that has spread to the brain and cannot be operated on. This mainly UK-based trial found no difference in overall survival and quality of life among people who had whole brain radiotherapy plus usual supportive care compared with ...

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Drug coated balloons have some short-term benefits for peripheral arterial disease

Widening damaged blood vessels using balloons coated in a drug called paclitaxel improves blood flow and reduces the risk of a further operation within a year compared to cheaper, uncoated balloons. Rates of amputation and death were no different between groups, though there were few of these events. This review of 11 studies included over ...

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The nitric oxide breath test offers little benefit when monitoring asthma

Using exhaled nitric oxide levels to guide the dose of asthma medication at regular clinic visits may reduce flare-ups but does not improve overall symptoms or quality of life. In this review hospitalisations and the total inhaled steroid doses were unaffected by the intervention. Measuring the amount of fractional exhaled nitric oxide (FeNO) in the ...

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No clear “best” treatment of mild or severe sickness in pregnancy

Pregnant women could benefit from simple, cheap, “self-help” remedies for mild nausea and vomiting. Ginger, vitamin B6 and possibly acupressure wrist-bands might relieve symptoms for some women, according to a recent overview of research in this area. The review has identified some promising areas for future research. For sickness that doesn’t respond to “self-help” remedies, ...

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Low-dose sedative reduces sudden confusion after major surgery in older adults

Giving a low-dose sedative to older adults in intensive care after surgery reduces sudden confusion, also known as delirium, without increasing the risk of adverse effects. In this Chinese trial, adults aged 65 or over were given an intravenous drip of the sedative dexmedetomidine on their first day in intensive care following non-heart surgery. Nine ...

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