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NIHR Signal Boosting omega-3 fatty acid intake is unlikely to prevent type 2 diabetes
Increasing the intake of polyunsaturated fats in the diet with supplements of omega-3 fatty acids, for example, is unlikely to affect people’s risk of developing type 2 diabetes. However, this review only looked at the effect of supplements on diabetes, not wider health. This large systematic review included 83 long-term trials comparing higher and lower intake of omega-3 and omega-6 fatty acids and total polyunsaturated fats in healthy adults and those with existing diabetes. It found no...
NIHR Signal Herpes zoster vaccine reduces chances of shingles after stem cell transplants
A non-live vaccine against herpes zoster provides good, though partial protection for adults undergoing autologous (using the patient’s own) stem cell transplant for treatment of blood cancers. These people cannot use the usual live vaccine, because of their suppressed immune system. An industry-funded trial of the vaccine involved 1,846 patients from 28 countries, including the UK. Two doses of the vaccine resulted in a 68% reduction in cases of shingles over 21 months of follow-up. Shin...
NIHR Signal Keyhole hysterectomy is effective for women with heavy menstrual bleeding
When surgical treatment was needed, almost all women with heavy menstrual bleeding were satisfied and had a good quality of life following keyhole surgery to remove the uterus. Slightly fewer achieve this with ablation to remove the uterine lining. In a UK randomised trial, women given one or other treatment in NHS hospitals reported good benefits after both interventions, which also had similar, low rates of adverse effects. In total, 97% were satisfied with the effects a year after laparoscop...
NIHR Signal Significant risk of another thrombosis remains if anticoagulation is stopped
Unprovoked venous thromboembolism (VTE), including deep vein thrombosis in the leg and pulmonary embolism, are clots within veins that occur spontaneously in people without risk factors and are treated with anticoagulant drugs. If those drugs are stopped after three months or more, the risk of another clot appears to be on average 10% in the first year, 16% by two years, 25% by five years and 36% by 10 years. This systematic review and meta-analysis of 18 studies included a total of 7,515 patie...
NIHR Signal Long-term macrolide antibiotics reduce risk of exacerbations of bronchiectasis
People with bronchiectasis (not caused by cystic fibrosis) who take long-term macrolide antibiotics are around 50% less likely to experience acute worsening of symptoms like cough and sputum production (an exacerbation) than people taking a placebo. Bronchiectasis guidelines only recommend preventative macrolide antibiotics in people with frequent exacerbations who do not carry a bacterium (Pseudomonas aeruginosa). This review pooled data from three trials in 341 patients where erythromycin or ...
NIHR Signal High-flow nasal oxygen reduces reintubation after major surgery compared with conventional oxygen therapy
In adults after major surgery, high-flow nasal oxygen decreases by about two-thirds the need for reintubation compared with conventional oxygen therapy. In this study, only about four in every 100 patients needed reintubation with high-flow nasal oxygen, compared with about 11 in every 100 patients receiving conventional oxygen therapy. This review evaluated seven randomised and three non-randomised studies in 1,327 adult patients recovering from surgery under a general anaesthetic. Most of the...
NIHR Signal Short-term dual antiplatelet treatment may be best for most patients after receiving a drug-eluting stent
For patients who have had a drug-eluting stent inserted into the coronary arteries, there is no difference in mortality or cardiovascular outcomes between the standard 12-month dual antiplatelet therapy and shorter six-month courses. Longer courses above 12 months increased risk of bleeding and non-cardiac death compared with short courses. It has been debated whether longer treatment might decrease complications, but similarly, it is unclear if shorter treatment might be as effective while red...
NIHR Signal Early suppression of male hormones is better than delayed therapy for advanced prostate cancer on balance
Offering early hormone suppression therapy to men with advanced prostate cancer that is causing no symptoms improves outcomes compared with waiting until symptoms of cancer spread arise. Early treatment is associated with 23 to 57 fewer deaths per 1,000 men over five years, depending on the men’s baseline risk. However, this comes with an increased chance of some non-serious side effects. Hormone suppression works by lowering levels of the male sex hormones that fuel the cancer’s gr...
NIHR Signal Partial knee replacement ‘could be first choice’ for suitable patients with osteoarthritis
Partial knee replacement surgery improves pain and function similarly tototal knee replacement in people with osteoarthritis that affects only a single compartment of the knee. Partial knee replacement surgery is also cheaper. In this NIHR-funded trial of 528 people with osteoarthritis affecting only one compartment of the knee, those who had partial knee replacement saw at least as much improvement as those who had a total joint replacement. Their care also cost about £900 less over five...
NIHR Signal Better strategies are needed to reduce preventable patient harm in healthcare
About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death. Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm were seen in intensive care and surgical departments than in general hospital settings. This NIHR-funded review poole...
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