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NIHR Signal Eplerenone does not improve vision in people with central serous chorioretinopathy
Eplerenone, a drug used for people with central serous chorioretinopathy, is no more effective than placebo. Neither visual acuity nor the build-up of fluid in the eye shows an important improvement. Central serous chorioretinopathy is a serious eye condition that causes blurred and distorted vision. Fluid collects underneath the macula, which is the central area of the retina. The condition mostly affects men aged 20–45 years, although it can affect women too. A specific cause is rarely ...
NIHR Signal Plasma and blood cell injections have not shown a benefit for Achilles tendon injury
Injecting a ruptured Achilles tendon with a small sample of a person’s own plasma, without the red blood cells, has no functional or other benefit. Plasma rich in platelets and white blood cells for the acute injury was compared with placebo. The NIHR-funded trial involved 230 adults with acute Achilles tendon rupture (the tendon which connects the calf muscles to the heel). All were attending UK hospitals within 12 days of injury. The trial found no difference in function at 24 weeks aft...
NIHR Signal Melatonin shows potential for reducing delirium among older people after surgery
Taking melatonin around the time of surgery is linked with lower odds of delirium onset in older people, compared with placebo or no treatment. In a systematic review and meta-analysis, around 15% of the melatonin group developed delirium after surgery compared with around 20% of the comparison group. Delirium is an acute state of mental confusion associated with longer hospital stays and increased mortality. UK clinical guidelines do not recommend specific medications to prevent this condition...
NIHR Signal Increasing omega-3 intake does not prevent depression or anxiety
Increasing intake of polyunsaturated fats, for example with omega-3 fatty acid supplements, has little or no effect in preventing the onset of depression or anxiety symptoms in people without these conditions, but who might be at risk. These findings support dietary advice that omega-3 supplements are not needed in healthy people. This review also highlights that evidence of the effect of omega-3 in people with existing anxiety or depression is lacking or very limited. There remains not enough ...
NIHR Signal Measles vaccine still effective if given to infants under nine months old
A first vaccination dose against measles is a safe and somewhat effective option if given to infants earlier than usual, and before the age of nine months. However, vaccine effectiveness does increase when administered at older ages, as currently. Two doses of measles-containing vaccines are recommended as part of a childhood immunisation programme. In countries with ongoing measles transmission, the first dose (MCV1) is recommended at nine months. In the UK, the MCV1 is recommended at 12 month...
NIHR Signal GLP-1 drug for diabetes gives modest cardiovascular benefits compared with placebo
Taking a glucagon-like peptide-1 receptor (GLP-1) agonist drug lowers the likelihood of having a stroke, heart attack or dying due to cardiovascular causes by 12%. The drugs give a similar 12% reduction in overall mortality. They do not increase the risk of heart failure, very low blood sugar levels or pancreatic disease. Diabetes causes one in five strokes along with other cardiovascular complications. Clinicians aim to reduce these risks and lower blood sugar levels. This meta-analysis is the...
NIHR Signal Tranexamic acid is safe to use following mild-to-moderate traumatic brain injury and reduces deaths
In people with mild-to-moderate traumatic brain injury, tranexamic acid (a drug which reduces bleeding) given within three hours of injury reduces the risk of death by 22%. This effect is seen in a subgroup of those who are less severely affected. This NIHR-funded multi-centre international trial randomised 12,737 adults with intracranial bleeding to receive either tranexamic acid or a placebo. Overall, there was no difference in risk of death within 28 days between the two groups. However, whe...
NIHR Signal Fewer infections with antibiotic-impregnated shunts for hydrocephalus
Antibiotic-impregnated shunt catheters led to fewer infections than standard catheters in this study, although the overall rate of shunt revision remained about the same. In hydrocephalus, a shunt is a device consisting in part of a long catheter (a tube) that relieves the raised pressure of fluid in the ventricles of the brain. It is inserted internally and works by simply draining the fluid, most commonly, to the abdomen. These shunts may need revision because of infection or mechanical failu...
NIHR Signal ‘As-needed’ combination asthma inhalers can be more effective than regular inhaled steroids
In adults with mild to moderate asthma, budesonide-formoterol used as needed for symptom relief was more effective at preventing severe exacerbations than maintenance low-dose budesonide plus as-needed terbutaline. In this trial involving 885 adults, those using the combination inhaler as required had fewer severe asthma attacks, with similar levels of general symptom control, and overall used a lower dose of corticosteroid. The results of this trial suggest that for people with mild asthma, ex...
NIHR Signal Continuing an anticoagulant at home after abdominal surgery cuts thrombosis risk
Continuing to take low molecular weight heparin for two to four weeks after major abdominal surgery significantly reduces the risk of developing a dangerous blood clot. A review of seven studies, mainly in cancer surgery, has found that 13% of patients who received anticoagulant treatment only during their hospital stay developed a clot in the deep veins or lungs, compared with 5% of those who continued with the treatment beyond discharge. There was no increased risk of bleeding complications w...
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