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NIHR Signal Providing pressurised air through a mask may improve outcomes for people with deteriorating heart failure
Non-invasive positive pressure ventilation may help people with rapidly deteriorating heart failure who become short of breath due to fluid build-up in the lungs. For people not requiring immediate mechanical ventilation using an endotracheal tube, this approach may reduce the risk of death in hospital and the need for intubation. This review evaluated 24 trials of 2,664 adults comparing a group who received air under pressure through a mask, to a group receiving standard medical care. These ty...
NIHR Signal Psychological therapies may improve parenting skills in parents of children with chronic illness
Psychological therapies appear to show promise in helping improve self-reported parenting behaviour of parents of children and adolescents with cancer, chronic pain, diabetes or traumatic brain injury. Cognitive behavioural therapy (CBT) and problem-solving therapy (PST) appear particularly valuable in supporting this. Psychological therapies also seemed beneficial in improving the mental health of parents who have children with cancer and chronic pain, but not in studies of children with diabe...
NIHR Signal Iron deficiency in people with chronic kidney disease can be managed with either oral or IV therapy
For people with chronic kidney disease who are also iron deficient, intravenous iron improves haemoglobin levels and iron stores faster than oral iron. However, the evidence is inconclusive about whether it influences survival, cardiovascular death, or quality of life. Adverse effects and such as allergic reactions or gastrointestinal side effects and other practicalities are likely to determine the choice of a route of administration. Chronic kidney disease is a long-term condition categorised...
NIHR Signal C-reactive protein is not useful in diagnosing late-onset infection in newborns
The blood level of C-reactive protein (CRP), a marker indicating inflammation in the body, is not accurate enough alone to diagnose late-onset infection in newborn infants. Late-onset neonatal infection, occurring more than three days after birth, is potentially serious and is relatively common. Tests measuring the blood level of CRP are widely used by physicians to guide their decision on whether or not to start antibiotic treatment for suspected infection. This NIHR-funded review found 20 st...
NIHR Signal Dermoscopy plus visual inspection aids melanoma diagnosis
Dermoscopy, using a relatively cheap handheld magnifying device alongside naked eye observation, is more accurate in the diagnosis of melanoma than visual inspection alone. It can also provide a photographic record which can be used for reference during follow-up. This NIHR-funded review included 104 studies of skin lesions in the dermatology clinic that looked suspicious or were present in those at high risk of developing melanoma. Melanoma is a rare form of skin cancer. Inspection of the lesi...
NIHR Signal An ultrasound scan is not as useful as a CT scan in assessing trauma
Ultrasound scans can be a useful tool to help pinpoint internal bleeding or organ damage in the chest or abdomen, but a negative scan cannot rule out damage, especially in children. Many emergency departments use portable ultrasound scanners to assess for internal damage when someone has been subject to blunt trauma (for example, involved in a car accident or fallen from a height). Ultrasound is free from radiation, non-invasive and can be used at the bedside, making it convenient if CT is not ...
NIHR Signal Prolonging anticoagulant treatment after abdominal cancer surgery reduces clot risk
People who have low molecular weight heparin (LMWH) for between two to four weeks after abdominal or pelvic surgery, especially for cancer, have fewer blood clots in their large veins or lungs. In this review of seven trials, five per cent of people receiving extended treatment experienced a clot compared with 13% who received LMWH only while in hospital. There was no difference in bleeding complications. The optimal duration of treatment following abdominal surgery is uncertain, balancing blee...
NIHR Signal A high omega-6 fatty acid diet is unlikely to prevent cardiovascular disease or deaths
Diets or supplements that aim to increase omega-6 fatty acids have no clear effect on the risk of cardiovascular events like heart attacks or stroke, overall deaths or deaths from cardiovascular disease. Omega-6 fatty acids are poly-unsaturated oils largely derived from seeds and nuts such as sunflower oil, corn oil, soybean oil, walnuts and pumpkin seeds. The results of this Cochrane review can be looked at alongside another recent Cochrane review, which found no benefits of fish oil in omega-...
NIHR Signal Antidepressants do not help treat depression in people living with dementia
Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term. This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. P...
NIHR Signal Pelvic floor muscle training can improve symptoms of urinary incontinence
Two-thirds of women with any type of urinary incontinence who have pelvic floor muscle training see improvement or cure compared with only a third of women who receive no treatment or inactive treatments. It is even more effective for women with stress incontinence, with three-quarters of women reporting improvement or resolution of symptoms, such as episodes of leakage. This systematic review included 31 trials and 1,817 women with any type of incontinence; stress, urgency or mixed urinary inc...
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