Evidence
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Wound complications remain a concern for CABG surgery using both mammary arteries

Rates of death, heart attack and stroke were similar at five years for people who underwent coronary artery bypass graft (CABG) using one or both mammary arteries. Bypass surgery involves grafting another blood vessel to bypass the narrowed or blocked artery to improve blood flow to the heart muscle. The left mammary (internal thoracic) artery ...

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Delaying chemotherapy after breast cancer surgery may reduce survival chances

Delaying chemotherapy after breast cancer surgery may slightly decrease a woman’s chances of survival. A review found about a 5% increase in the relative risk of death. Many women are offered chemotherapy soon after breast cancer surgery, called adjuvant chemotherapy. Chemotherapy is usually started after the surgical wounds have healed but the effect of any delay to ...

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Excision is probably better than stapling in the long-term for haemorrhoids

Recurrences of haemorrhoids (piles) are three times less likely if they are surgically removed rather than treated with a relatively new stapling procedure. There are now a wide range of techniques to tackle this common, distressing condition. Some, such as stapling, have become more popular despite a lack of evidence about improved long-term outcomes. This ...

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Mortality benefits from minimally invasive aneurysm repair aren’t sustained in the long term

Minimally invasive surgery to repair abdominal aortic aneurysm (AAA) was associated with fewer aneurysm-related deaths in the short-term, up to six months. From eight years onwards the open surgical procedures were associated with fewer aneurysm-related deaths, suggesting on-going monitoring is required. An AAA is a swelling due to weakness in the main blood vessel running ...

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Stricter alcohol licensing policies were linked to declines in crime rates

Local authorities with stricter alcohol licensing policies saw the greatest decline in alcohol-related crime between 2009 and 2013, but from a higher base. Violent crime reduced from 6.1 to 4.9 per 1000 people, compared to a reduction from 3.9 to 3.3 per 1000 in areas with more “passive” policies. Reporting of offences did rise again ...

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Specialist hip fracture services linked to fewer deaths in South Central region

Following a hip fracture, nurse-led fracture liaison services or specialist consultant (orthogeriatrician) input both reduce deaths. They did not reduce the small number of people having a second hip fracture within two years of the first. Both models of care were cost effective, although the orthogeriatric model was favoured. Despite national guidance recommending both use ...

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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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Daily aspirin reduces pre-eclampsia for ‘at-risk’ women

Starting daily low-dose aspirin before 16 weeks of pregnancy in women at risk reduces pre-eclampsia, severe pre-eclampsia and foetal growth restriction. Aspirin started after 16 weeks is less beneficial, giving smaller risk reduction for pre-eclampsia and no effect on other outcomes. Defining who is ‘at risk’ remains challenging. Pre-eclampsia is a rare pregnancy complication, but ...

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Eye surgery to remove the lens shows promise for treating early glaucoma

Lens extraction, a procedure usually used to remove cataracts, could be a better first choice for some people with one type of glaucoma than laser treatment. Glaucoma is a group of eye conditions which damage the optic nerve and eventually lead to blindness. Commonly the pressure within the eye is raised and nerve damage can ...

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Long-term oxygen therapy shows no benefit for moderate lung disease

Long-term oxygen therapy for 16 hours per day did not lengthen life or the time until hospital admission for people with stable chronic obstructive pulmonary disease (COPD) who experience a moderate drop in blood oxygen levels with exercise or at rest. Nor did it improve their quality of life, lung function or anxiety and depression ...

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