Evidence
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The blood-thinner apixaban is less likely to cause major bleeding than warfarin

People who take apixaban to prevent blood clots are less likely to suffer major bleeding complications than those taking warfarin. Findings are similar in different groups of people, such as those with irregular heart rhythm (atrial fibrillation) and those who have had joint replacement surgery. Warfarin has long been used as an anticoagulant but needs ...

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A football programme for overweight men achieves sustained weight loss

A 12-week weight management programme for men, centred on football, achieved 4.9kg weight loss at 12 months. Modest weight loss of 2.9kg was maintained at 3.5 years. Rates of overweight and obesity are higher for men than women in the UK, and there is little evidence that interventions are effective in the longer term. This ...

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Financial incentives may help workers quit smoking

Financial incentives, when given alongside free smoking cessation aids, improved abstinence rates compared with free cessation aids or motivational information alone. This workplace-based US trial assigned 6,000 smokers, unselected for willingness to quit, to information only, free e-cigarettes, free nicotine replacement or drug therapy, or free cessation aids with a $600 reward in one of ...

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Negative pressure dressings are no better than standard dressings for open fractures

Negative pressure wound dressings are neither more nor less effective than standard wound dressings for severe open fractures of the lower leg. Any difference between groups was neither clinically important nor statistically significant. The outcomes included self-rated disability at one year, quality of life and deep surgical site infections at one month which occurred in ...

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No benefit from monitoring antiepileptic drug levels in pregnancy

Regular monitoring of antiepileptic drug levels in pregnant women with epilepsy does not improve seizure control compared with clinical features-based monitoring. This NIHR-funded study was conducted across 50 UK hospitals and is the largest randomised trial in pregnant women with epilepsy. Just over 260 pregnant women with unstable antiepileptic drug levels were assigned to ongoing ...

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Non-urgent attendances to emergency departments are more common among younger adults

Adults aged 16 to 44 years are more likely to attend emergency departments for non-urgent presentations than older adults. They were more than three times more likely to present for non-urgent reasons than those over 65 years. Non-urgent attendances are also more common during out-of-hours periods, especially at night. Emergency departments are consistently under high pressure ...

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Better pain relief for women in labour

Women in labour, who had the short acting strong painkiller remifentanil, rather than pethidine, had less need for further pain relief. Only 19% of women given remifentanil received a subsequent epidural compared with 41% given pethidine. Remifentanil was given intravenously, using a patient-controlled delivery device, and pethidine given by intramuscular injection. This NIHR-funded study is ...

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Patient-centred care for multimorbidity improves patient experience, but quality of life is unchanged

A patient-centred intervention in general practice for people with multiple chronic conditions, based on recommended best practice, had no effect on patient quality of life or burden of illness and treatment. Patients were, however, more likely to report being satisfied with their care. An increasing number of people in the UK are living with multimorbidity, ...

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Keyhole surgery is more effective than physiotherapy for hip impingement

Keyhole surgery to reshape the joint surfaces in people with hip impingement improves hip-related quality of life more than physiotherapy. In hip impingement, there is a painful restriction of the smooth movement of the ball of the femur inside the cup (acetabulum) of the pelvis. It mainly affects younger, active people. Observational studies have supported ...

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Routine measurement of grip strength can help assess frailty in hospital

Training clinical staff to routinely measure grip strength can help identify frail older hospital inpatients. This could help tailor their care. This NIHR-funded study was conducted across five acute medical wards in one hospital in England over a nine-month period. Nursing staff were trained to measure grip strength of people aged over 80 years. They ...

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