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NIHR Signal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children
Intravenous lorazepam is as effective as intravenous diazepam for stopping children’s tonic-clonic seizures in hospital. Lorazepam also results in fewer breathing problems than diazepam. Giving antiepileptic drugs intravenously generally stops seizures more quickly than giving the drugs buccally (in the cheek), intranasally (in the nose) or rectally. However, this effect can be cancelled out if administering the drug into the veins takes too long. Two of the 18 included trials were carrie...
NIHR Signal Atraumatic needles reduce headaches following lumbar puncture
Use of atraumatic needles rather than conventional needles for lumbar puncture more than halves the rate of post-procedure headache. Moreover, this improvement does not come at the expense of procedure success rates. Lumbar puncture involves inserting a needle in the lower back into the spinal canal to collect cerebrospinal fluid for diagnosis, or to inject a treatment or anaesthetic into it. A common side effect is a headache, often from leakage of fluid from the puncture. Atraumatic needles ...
NIHR Signal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis
Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus. It increased the risk of adverse reactions requiring a change in treatment and the chances of drug interactions. This NIHR-funded trial is the largest to date on adding rifampicin to standard antibiotic therapy. The study included 770 people in 29 UK hospitals. Half were assigned to 14 days of treatment with rifampicin on top of their existing ...
NIHR Signal Swimming in seawater is linked with an increased chance of some illnesses
People who swim in seawater have almost double the odds of experiencing any illness than people who avoid it. The specific illnesses linked to seawater exposure were ear and gastrointestinal illnesses, but the exact or absolute rates of infection are not available. Many people enjoy coastal waters for sport and recreation, and it's important that they can access relevant risk information. This is the first systematic review to look at infection risk from swimming in seawater. It gathered da...
NIHR Signal A school-based obesity prevention programme was ineffective
A school-based healthy lifestyle programme delivered to 6-7-year-old children and their parents made no difference to children’s weight, diet or activity levels. Around 1 in 4 remained overweight or obese. The NIHR-funded year-long programme was delivered in 54 primary schools in one region of England. Teachers were trained to provide an additional 30 minutes of physical activity a day and deliver cookery workshops with parents each term. It also included activities with a local football ...
NIHR Signal Exercise improves intermittent claudication leg pain on walking
People with intermittent claudication who participate in structured exercise programmes can walk about 80 metres further without experiencing leg pain than those who do not do the programme. They can also walk about 120 metres further overall. Intermittent claudication is a cramp-like pain in the legs caused by narrowing of the arteries, which restricts blood flow to the muscles. There’s increasing evidence that maintaining physical activity can help. This updated systematic review combin...
NIHR Signal The most effective antidepressants for adults revealed in major review
Antidepressants are effective to treat moderate to severe depression in adults. Five antidepressants appear more effective and better tolerated than others. A major review of 522 antidepressant trials found that all of the 21 drugs studied performed better than placebo, in short-term trials measuring response to treatment. However, effectiveness varied widely. Researchers ranked drugs by effectiveness and acceptability after eight weeks of treatment. Several drugs were more effective and were ...
NIHR Signal Physiotherapy education before major abdominal surgery reduces lung complications
A physiotherapy session before planned abdominal surgery, explaining the importance of breathing exercises and sitting out of bed as soon after surgery as possible, halves the risk of pneumonia. This trial compared the physiotherapy session with usual care which was provided to all 432 participants. This consisted of a leaflet given in the pre-operative outpatient clinic outlining the exercises, and physiotherapy input in the days after surgery. Just seven people would need to receive the addit...
NIHR Signal Self-care support for children with long-term conditions may reduce emergency costs
Helping children and parents to manage long-term conditions like asthma may reduce their need for emergency care, and is unlikely to reduce children’s quality of life. This NIHR review found that structured professional help with self-care, including online support, provision of care plans, case management and face-to-face education, was linked to small increases in quality of life scores and fewer emergency department visits. However, there was no clear evidence that supported self-care ...
NIHR Signal A third of health practitioners do not get vaccinated against flu
Flu vaccination uptake amongst healthcare workers in England is below the NHS target of 75%. Reasons may include mixed views on the vaccine’s effectiveness, side effects and belief they are unlikely to catch or transmit flu. Surprisingly, practical barriers such as time and access to vaccination were not mentioned in this systematic review of qualitative studies for the Department of Health. Though it included mainly North American studies, the findings are consistent with issues raised i...
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