Evidence
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Short-term dual antiplatelet treatment may be best for most patients after receiving a drug-eluting stent

For patients who have had a drug-eluting stent inserted into the coronary arteries, there is no difference in mortality or cardiovascular outcomes between the standard 12-month dual antiplatelet therapy and shorter six-month courses. Longer courses above 12 months increased risk of bleeding and non-cardiac death compared with short courses. It has been debated whether longer …

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Early suppression of male hormones is better than delayed therapy for advanced prostate cancer on balance

Offering early hormone suppression therapy to men with advanced prostate cancer that is causing no symptoms improves outcomes compared with waiting until symptoms of cancer spread arise. Early treatment is associated with 23 to 57 fewer deaths per 1,000 men over five years, depending on the men’s baseline risk. However, this comes with an increased …

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Better strategies are needed to reduce preventable patient harm in healthcare

About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death. Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm …

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‘Last resort’ antipsychotic remains the gold standard for treatment-resistant schizophrenia

Among patients with schizophrenia that has not responded to other drugs, the antipsychotic drug clozapine cuts the chances of hospital admissions and drug discontinuation. Recent trials have questioned the superior efficacy of clozapine compared with other standard antipsychotic drugs. However, a review of real-world data from observational studies confirms its place as a drug that may …

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Partial knee replacement ‘could be first choice’ for suitable patients with osteoarthritis

Partial knee replacement surgery improves pain and function similarly to total knee replacement in people with osteoarthritis that affects only a single compartment of the knee. Partial knee replacement surgery is also cheaper. In this NIHR-funded trial of 528 people with osteoarthritis affecting only one compartment of the knee, those who had partial knee replacement saw …

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Diagnosis of delirium in hospitals can be improved by the 4 A’s test

A new shorter test for delirium appears helpful in assessing older people in hospital who may have the condition. A normal score on the 4 A’s test effectively rules out delirium while an abnormal score is reasonably useful for detecting the condition. People detected by the test would still need a full assessment to confirm …

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Enhanced communication and staff training could improve the experience of maternity services for asylum-seeking women

Pregnant asylum seekers experience significant barriers to accessing maternity services in the UK. A review found that these barriers often relate to language differences and practical challenges associated with their status. Provision of interpreter services and training for health care professionals could improve maternity support for these women. Pregnant women seeking asylum have often experienced …

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C-reactive protein testing in general practice safely reduces antibiotic use for COPD flare-ups

Use of a rapid C-reactive protein (CRP) blood test in general practice for people with a flare-up of COPD reduces the proportion who take antibiotics over the next month by about 20 percentage points compared with usual care alone. The reduction in antibiotic use does not lead to worse health, more visits to the doctor …

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Text message reminders increase attendance at NHS health checks

Sending text messages reminding people to book their NHS health check following their invitation letter increases attendance. There is little evidence to support pre-notification text messages telling people an invitation would soon be sent. NHS health checks are offered to adults aged 40 to 74 years. Identification and management of cardiovascular risk factors has been …

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Diet and physical activity interventions targeting children and youth have different, yet small, effects on preventing obesity

Obesity prevention interventions which include both diet and physical activity may reduce the risk of obesity in pre-school children. Once at school, physical activity appears to be more effective for weight loss than diet alone. Resulting weight loss form any intervention, if any, has been very small with unclear benefits to the individual or population. …

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