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NIHR Signal The best dose of aspirin for cardiovascular protection may depend on body weight
Low dose aspirin only appears to be effective at preventing stroke or heart attack for people weighing less than 70kg, while higher doses are better for people who weigh over 70kg. Researchers analysed data from 13 trials of aspirin for primary or secondary prevention of cardiovascular events, totalling over 115,000 participants. They found that 75 to 100mg aspirin only benefitted people who weighed less than 70kg, while only those who weighed 70kg or more benefited from doses of 325mg or above...
NIHR Signal Stool test is useful before GPs refer for possible inflammatory bowel disease
A stool test by GPs has been shown to support referral decisions for young adults, not suspected of cancer, to investigate possible inflammatory bowel disease (IBD - which includes Crohn’s Disease and Ulcerative Colitis). This study supports current NICE guidelines that the calprotectin stool test can usefully inform patient referral pathways and reduce unnecessary invasive tests such as colonoscopy. High levels of faecal calprotectin are associated with gut inflammation, as occurs in IBD...
NIHR Signal New insights into living with inflammatory bowel disease
Living with inflammatory bowel disease as a `hidden’ condition can lead to feelings of isolation and exclusion. These experiences are characterised by exhaustion, feelings of damaged body image, loss of control and living with the fear of complications. The condition can be unpredictable and have a profound impact on quality of life, disrupting social relationships and interactions with the outside world. The ongoing emotional and psychological difficulties caused by this chronic, long te...
NIHR Signal Enhanced recovery programmes after stomach cancer surgery reduce hospital stay without increasing complications
Enhanced recovery programmes reduce length of hospital stay and associated healthcare costs after stomach cancer surgery, with no impact on short-term mortality or post-operative complications. They also improvepost-operative quality of life. The enhanced recovery approach includes a range of components designed to help people to recover more quickly and have better outcomes after surgery. These include optimising people's health preoperatively, attention to detail during anaesthesia and su...
NIHR Signal Gallbladder surgery through a single-incision is more risky than a multiple incision technique
Single-incision keyhole gallbladder removal surgery carries increased risk of adverse events, such as puncturing the gallbladder, compared with the more standard multiple-incision procedures. However, in experienced hands, there may be benefits such as reduced pain and less scarring after the operation. Current guidance recognises that using a single incision for laparoscopic cholecystectomy is more complex than using multiple incisions. The risks and benefits of all options available for pat...
NIHR Signal Fewer side-effects and similar benefits from shorter chemotherapy after bowel cancer surgery
A three-month course of chemotherapy after surgery for bowel cancer seems no less effective than the standard six-month course, and half as many people suffered from nerve damage as a side-effect. Three-quarters of people survived to three years without disease progression on either treatment. This international trial, part funded by the NIHR, included over 6,000 people with high-risk stage II or III bowel cancer that had spread through the bowel wall or to nearby lymph nodes. Standard treatmen...
NIHR Signal Mesh repair of small umbilical hernias reduces recurrence compared to sutures
Repairing small umbilical hernias with surgical mesh rather than sutures reduces the chance of the hernia returning. Complications such as wound infection and pain are not affected by the type of repair. Adults with umbilical hernias need surgery to prevent serious bowel complications. There are no guidelines about how to best to treat them. In practice, larger hernias tend to be repaired with mesh, while smaller ones are repaired with sutures. This trial of adults with umbilical hernias of 1 t...
NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics
Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile (C. difficile) bacteria by 60%. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection. When antibiotics disturb healthy gut bacteria, Clostridium bacteria may multiply to toxic levels, causing diarrhoea and serious intestinal complications. ...
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 experiencingillness than people who avoid it. The specific illnesses linked to seawater exposure are 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 data fro...
NIHR Signal Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia
Post-operative vomiting is common in children. One strategy is to use an intravenous anaesthetic, which is known to cause lower rates of sickness than inhaled anaesthetics. There are disadvantages to this though, such as the need for injections before a child is asleep, slowing of the heart and difficulty in monitoring depth of the anaesthetic. This review of four trials included 558 children who had an operation to correct a squint. A third of children in each anaesthetic group had post-operat...
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