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NIHR Signal Treating asymptomatic MRSA on discharge from hospital reduces risk of later infection
Use of medicated creams, mouthwash and body wash for six months after discharge from hospital led to a 30% lower risk of MRSA infection, compared with basic hygiene education. This study was carried out in the USA using 2,121 adults who had tested positive for MRSA in hospital, but who had no symptoms. Meticillin-resistant Staphylococcus aureus (MRSA) bacteria have developed resistance to widely-used antibiotics. MRSA is easily transferable within healthcare settings, and people may become colo...
NIHR Signal When is it best to start the Parkinson’s drug, levodopa?
Earlier treatment with levodopa provides symptomatic relief to those with symptoms but does not appear to slow Parkinson’s disease from progressing. Therefore, timing is best determined by symptoms. The treatment of Parkinson’s disease is complex. Levodopa is the main drug used to reduce tremors and muscle stiffness. Whether it modifies the course of the disease or becomes less effective over time is debated, and it can have side effects, so patients and clinicians sometimes prefer ...
NIHR Signal One gram a day of omega-3 supplements does not reduce the risk of cancer or cardiovascular disease
A trial of omega-3 fatty acid supplements showed they have little or no effect on the risk of cancer or cardiovascular disease in the general population. The finding contradicts the widespread belief that these supplements at usual doses protect the heart. A large trial of 25,871 men and women in the United States compared the impact of taking about 1g a day of omega-3 fatty acid supplements with placebo on major cardiovascular events and invasive cancer. The results are consistent with a recen...
NIHR Signal Premature babies have fewer complications if a lower platelet count is accepted
Fewer premature babies die or have major bleeding if platelet transfusions are withheld until platelet numbers drop to a lower level. At 28 days, death or new major bleeding occurred in 19% of neonates transfused when they had less than 25,000/mm3 platelets compared to 26% of neonates transfused when they had less than 50,000/mm3 platelets. This trial included 660 premature babies with low platelet counts. The results suggest that in the absence of actual bleeding, platelet transfusions may be...
NIHR Signal People leaving hospital after medical illness do not benefit from extended clot reducing treatment
Taking rivaroxaban after discharge from hospital does not significantly reduce the risk of venous thromboembolism, either blood clots in large veins or of dying from clots travelling to the lungs. People who are hospitalised with conditions such as heart failure and stroke are at an increased risk of blood clots. This risk is further increased by factors such as age, lack of mobility and previous illness or clots. These patients will usually be given anticoagulant treatment to reduce blood clot...
NIHR Signal Aspirin did not prevent deaths or disability in healthy older adults
In the ASPREE trial, older adults with no apparent cardiovascular disease who took daily aspirin saw no benefit in terms of reducing the chance of dying or having dementia or disability. Instead, it slightly increased their mortality and bleeding risk - aspirin was associated with an excess of 1.6 deaths per 1,000 people per year. Half of these deaths were due to cancer. Aspirin is an established ‘secondary’ preventative treatment for people who have known cardiovascular disease. Ho...
NIHR Signal The benefits and harms of aspirin for people with type 2 diabetes are finely balanced
Daily aspirin reduced the risk of serious vascular events among people with diabetes, while increasing the risk of major bleeding to a similar extent. Aspirin prevented one person in every 100 from having a heart attack or stroke over seven years, but an additional person per 100 experienced a major bleed. The ASCEND study is one of three large placebo-controlled trials investigating the effects of 100mg daily aspirin for primary prevention in people without established cardiovascular disease. ...
NIHR Signal Fish oil supplements do not reduce cardiovascular deaths in people with diabetes without existing vascular disease
Omega-3 fatty acid supplements make no difference to cardiovascular outcomes in people with diabetes but without established cardiovascular disease. Serious vascular events like heart attack, stroke or deaths from these occurred in about 10% of people regardless of whether they took daily omega-3 or placebo capsules for seven years. The ASCEND studyis a large UK trial assessing primary cardiovascular prevention for people with any type of diabetes. A companion publication assesses the use of as...
NIHR Signal ‘Artificial pancreas’ improves glucose control in hospital patients with type 2 diabetes
Closed-loop insulin pumps, which continuously monitor blood glucose and administer insulin accordingly, can improve blood glucose control among patients with type 2 diabetes admitted to hospital for non-critical care. Those using the system spent about six hours longer in the target range, and this could hasten their recovery and reduce staff workload. The number of hospitalised patients with type 2 diabetes is increasing. Glucose control often worsens during illness. Closed-loop pumps have bee...
NIHR Signal Sodium thiosulfate reduces hearing loss in children treated with chemotherapy
Treatment with sodium thiosulfate alongside cisplatin chemotherapy can reduce hearing loss in children with a liver tumour called hepatoblastoma. The risk of hearing loss was reduced by 48% in children who had the combination treatment compared with those who had cisplatin only. This phase 3 trial involved 109 children with standard-risk hepatoblastoma and tested the addition of sodium thiosulfate six hours after cisplatin treatment. The additional drug caused few major side effects, and there ...
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