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NIHR Signal Robot-assisted training offers little useful improvement in severe arm weakness and function after stroke
People who have severe arm weakness following stroke have no better function after robot-assisted training or enhanced upper limb therapy than those who have usual NHS care. This large multicentre trial, funded by the NIHR, randomised 770 adult stroke patients to robot-assisted training using the MIT-Manus robotic gym, to an enhanced therapy programme or to usual NHS care. All three groups had improved arm function after three months, with no significant differences between the groups. The rob...
NIHR Signal A laser eye procedure can be effective and safe if used early as treatment for glaucoma
Using a laser to improve drainage of fluid within the eye showed similar results to eye drops as a first-line treatment for adults with open angle glaucoma or ocular hypertension (raised pressure in the eye). It improved vision without increasing the risk of adverse events. It was preferred by patients and also associated with lower costs. Current guidelines recommend that eye drops are used first to lower the pressure in the eye and slow the progression of glaucoma. Many patients find eye drop...
NIHR Signal MRI scans help confirm ultrasound diagnosis of fetal brain abnormalities
If fetal brain abnormality is suspected on a pregnancy ultrasound, following this with in-utero MRI (iuMRI) improves diagnostic accuracy. This sequence could allow more informed discussions and decision-making around whether to continue with or terminate a pregnancy. The NIHR funded study included 565 women of 18 weeks’ pregnancy or more who received ultrasound followed by iuMRI. Diagnoses were confirmed either by postnatal imaging of the baby or at post-mortem examination. Overall iuMRI...
NIHR Signal Two injections are equally effective for treating flare ups of severe ulcerative colitis
There is little difference between the newer drug infliximab and the older ciclosporin for treating adults with severe ulcerative colitis that has become resistant to the usual treatment with steroids. Infliximab was more expensive. Ulcerative colitis is a chronic disease where the colon and rectum become inflamed. For severe flare-ups, the standard treatment is steroids. But these do not work for almost a third of patients. In this case, NICE recommend ciclosporin, an immunosuppressant or infl...
NIHR Signal Central lines coated with antibiotics reduce bloodstream infections in children
Children in intensive care had lower rates of infection when using antibiotic coated central lines(also called central venous catheters)compared to standard central linesor those coated with heparin – an anti-clotting agent. Antibiotic or heparin coated central lines have long been used in adults to reduce catheter-associated bloodstream infections, but evidence for benefits in children was lacking. This NIHR funded trial provides evidence that use of antibiotic coated central lines coul...
NIHR Signal A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers
Contrary to a previous review of trials, this large, NIHR-funded trial found that probiotic treatment did not prevent two common life-threatening conditions in very premature babies. The conditions were necrotising enterocolitis, which is a severe gut inflammation/infection that can result in the death of intestinal tissue, and sepsis (blood poisoning) from bacteria that have crossed from the gut into the bloodstream. This trial used a single strain of a harmless bacterium, known as a “pr...
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