Evidence
Alert

A statin drug during admission for heart surgery did not prevent an irregular heart beat

The statin, rosuvastatin, taken by adults before and after heart surgery, did not prevent atrial fibrillation or heart muscle injury compared to placebo. Acute kidney injury was more common for adults who received rosuvastatin. Atrial fibrillation (AF) is a type of irregular heart rhythm which is relatively common after heart surgery. A previous review of ...

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Better evaluation of physical health services for people with severe mental illness is needed

Approaches to improve the integration of physical health services for people with severe mental illness are generally poorly described, and most evaluations are small in scale and poorly reported. Better descriptions and evaluations are needed to help identify and replicate best practice in the UK. About 1% of the UK population have severe mental illness, ...

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Early aspirin reduces stroke recurrence following warning symptoms

Aspirin taken as soon as possible after a stroke or symptoms of a stroke reduces the risk of further stroke within the next six weeks by about 60%. This is much better than the 13% reduction previously estimated. People with warning strokes, where symptoms resolve within 24 hours, stand to benefit by self-administering aspirin even ...

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Intravenous nutrition is more costly than feeding by stomach tube, with few added benefits

Critically ill people need some form of feeding to give them protein and energy. The NIHR funded this multicentre trial to compare the costs and effects of early intravenous nutritional support with enteral feeding, feeding by tube into the stomach or the intestine. Death rates and other important outcomes were similar when using either route. ...

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Mobile phone support helps smokers quit

This review found that mobile phone based support is effective at helping people quit smoking for at least six months. Support was mainly via text messages, although some packages combined this with personalised assessment. Mobile phone support was usually compared with standard cessation advice and treatment, or online support that was not tailored to the ...

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Depression and anxiety common in people with heart disease

This multi-part NIHR study found that depression and anxiety were more common in people with coronary heart disease, than the general population. Anxiety increased people’s risk of a future heart attack. The people included in the study were generally older, white males, so the findings may not apply to everyone. Patients considered a nurse-led intervention ...

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Nexgen found to be best value for total knee replacement

This economic analysis, using routinely collected National Joint Registry data from 2003 to 2012, found that Nexgen was the most cost-effective brand of prosthesis for total knee replacement. The cheapest brand was AGC Biomet, but Nexgen gave greater quality of life improvement, and the additional cost for the benefit - £2,300 per quality-adjusted life-year - ...

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A newer sedative agent may shorten length of stay in intensive care units

Adults needing mechanical ventilation who were sedated with dexmedetomidine had reduced length of stay in intensive care and reduced duration of ventilation. Various sedative drugs are available for use in England although it is unclear if one is better than the others. This review compared two alpha-2 agonist drugs (clonidine and dexmedetomidine) to other commonly ...

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Single therapy an option for adults with suppressed HIV

For adults with HIV who have achieved a low level of the HIV virus after initial treatment, further treatment with a protease inhibitor alone instead of standard triple drug therapy does not reduce future drug options. It is also cost-effective for long-term management of HIV. In this large NIHR funded trial, switching to single therapy ...

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Mechanical clot removal may offer better outcomes for people with stroke

Mechanical clot removal alongside standard clot-busting drug treatment may offer better functional outcomes for people who have suffered a stroke caused by a blood clot than drug treatment alone. This review found that 44% of patients receiving mechanical clot removal had a good functional outcome after 90 days, compared to 33% of those who didn’t. ...

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