Evidence
Alert

A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers

Contrary to a previous review of trials, this large, NIHR-funded trial found that probiotic treatment did not prevent two common life-threatening conditions in very premature babies. The conditions were necrotising enterocolitis, which is a severe gut inflammation/infection that can result in the death of intestinal tissue, and sepsis (blood poisoning) from bacteria that have crossed ...

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Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis

The authors of this systematic review found that high-volume saline irrigation and corticosteroid nasal sprays were effective at reducing symptoms of sinusitis. They recommend a combination of these two therapies as the first line treatment of choice, in accordance with guidelines from the Royal College of Surgeons and ENT UK. In addition they found that, ...

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Lack of evidence on whether collagenase or surgery is more clinically or cost effective in managing Dupuytren’s contracture

This review aimed to compare injections of collagenase clostridium histolyticum with standard surgical treatments for Dupuytren’s contracture. Unfortunately existing trials are small and there are no head to head trials of surgery vs collagenase, so it is not possible to determine which therapy is more effective in the short or longer term - nor which ...

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A new tool may help identify more patients at risk of developing pressure ulcers

This was an NIHR-funded study to develop and evaluate a new pressure ulcer assessment tool, called PURPOSE-T. The tool, developed as part of a five year NIHR research programme, is used by following a manual and assesses eight risk factors: mobility; skin; previous pressure ulcer; sensory perception; perfusion (blood flow); nutrition; moisture; and diabetes. Field testing ...

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Protocol-led therapy for septic shock did not reduce mortality compared to usual resuscitation care

This NIHR funded randomised controlled trial found that early goal-directed therapy for people with septic shock offered no benefit over usual resuscitation care. About three in ten people died in both groups. Early goal-directed therapy differed from routine care in that it involved rigorous monitoring with use of a central venous “oximetry” catheter to manage ...

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Evidence is growing that early mechanical removal of clots from blocked brain arteries may improve recovery after stroke

Restoring blood flow to the brain within a few hours of having a stroke improves a person’s chances of recovery. Early use of drugs to dissolve clots (thrombolysis) has been the mainstay of management in recent years and there has also been rapid development of devices to remove clots. Using evidence from trials published in ...

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Noradrenaline confirmed as first-choice vasopressor for septic shock

This review supports current guidance that noradrenaline should be used as the first-choice vasopressor for adults with septic shock. Noradrenaline reduced mortality by 11% and major adverse events by two-thirds compared to dopamine. However, evidence of its effectiveness compared to the other vasopressors remains limited. Septic shock accounts for nearly one in ten admissions to ...

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Workplace interventions may support return to work after sick leave

This systematic review finds that interventions based in the workplace can help to support employees’ return to work following illness or disability. There is evidence indicating that the longer period of sick leave someone takes, the less likely they are to return to work. This review identified interventions to improve return to work, with support ...

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One size does not fit all – evaluating the move to a hospital with 100% single rooms

This was a well-designed NIHR funded mixed methods evaluation of a move to a new build NHS hospital in England with 100% single inpatient rooms. The study found that while two thirds of patients preferred single rooms, a number reported feeling isolated. There were differences of opinions across groups, for example half of the men ...

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Stopping Donepezil may be linked to nursing home placement for people with Alzheimer’s disease, but a “cause and effect” not conclusive

This follow up study examined whether the drugs donepezil or memantine affected the chance that people with Alzheimer’s disease could continue to live in the community, rather than move permanently to a nursing home. One or both of the drugs was taken for a year and then participants could have any treatment thereafter. The study ...

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