Evidence
Alert

Self-monitoring of warfarin is safe and cost-effective

This NIHR-funded systematic review investigated the clinical and cost-effectiveness of self-monitoring by people receiving long-term anticoagulation using vitamin K antagonists, most commonly, warfarin. People receiving warfarin require regular blood tests to see how their blood is clotting and to adjust their dose to avoid bleeding from too high a dose or thrombosis (clots) if the ...

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Resveratrol supplements do not improve cardiovascular risk markers

This systematic review of trials found that resveratrol supplements do not improve the results of tests that indicate risk of heart disease, including levels of blood pressure, blood glucose, cholesterol or C-reactive protein. Resveratrol is found naturally in red grapes, other fruits, and nuts. Some researchers think resveratrol in red wine may lower the risk ...

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Occupational therapy several years after stroke does not improve function in severely ill care home residents

This trial found that a three-month individualised occupational therapy programme did not significantly improve the daily functioning (dressing, using the toilet and overall mobility) of severely physically and cognitively impaired people living in residential care who had a stroke on average three years before. About a quarter of stroke survivors in the UK cannot return ...

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Treatment of mother-child interaction might be of value for childhood anxiety disorder

Child cognitive behavioural therapy helps children with anxiety disorders. But children of mothers with anxiety disorder are less likely to improve. This trial (MaCH) found that treating maternal anxiety disorder at the same time as the child’s provided no additional treatment benefit. The treatments tested were maternal cognitive behavioural therapy or a new treatment focused ...

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Pre-hospital non-invasive ventilation for people with acute respiratory failure

This NIHR-funded systematic review and cost-effectiveness study found that pre-hospital (i.e. in the ambulance) non-invasive ventilation in the form of continuous positive airway pressure for people with acute respiratory failure, can reduce both the risk of dying and the need for ventilation in intensive care. The small device used by trained ambulance personnel was more ...

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Continuous positive airway pressure led to less daytime sleepiness in older adults with sleep apnoea

This NIHR trial found that continuous positive airway pressure for obstructive sleep apnoea in people aged 65 and over led to less daytime sleepiness and was reasonable value for money. Obstructive sleep apnoea causes the airway to close intermittently overnight leading to daytime sleepiness. It is most common in older people, but previous studies have ...

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Very early mobilisation following a stroke is no better than usual care

The AVERT trial found very early mobilisation - such as out-of-bed sitting, standing and walking - within 24 hours of stroke onset and at increased intensity, led to 4% fewer people with good recovery than usual care. No differences were found in death rates, overall disability scores, or in the time to be able to ...

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Paracetamol may be ineffective in treating lower back pain

This systematic review found that paracetamol as a first-line treatment did not reduce pain, disability, or improve quality of life in the short-term (up to 8 weeks) for people with low back pain. There was a very small effect in reducing pain and disability in the short-term for people with osteoarthritis of the hip or ...

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Two common drugs do not help more people pass kidney stones

This large, high quality trial found that people with a single kidney stone taking tamsulosin or nifedipine drugs for up to four weeks were no more likely to pass the stone spontaneously than those taking a placebo. This suggests that these drugs should not be offered to people with renal colic who are managed with ...

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Laser treatment is the preferred treatment for troublesome varicose veins

Initial results from this trial (CLASS) found that the three main treatments for varicose veins all improved symptoms and quality of life six months after treatment. On a balance of scores, laser treatment was more effective than foam treatment or surgery. Laser involved fewest complications six weeks after the procedure and may be the most ...

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