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NIHR Signal Very small babies appear not to be affected by the rate of increasing milk feeds
A large-scale trial has found that the speed of increasing milk feed volumes in low birth weight or very low gestational age babies who are on intravenous feeding does not influence outcomes. This NIHR-funded study randomised preterm (below 32 weeks) or very low birth weight (less than 1,500g) babies to receive either daily milk feed increases in increments of 30ml per kilogram of bodyweight or 18ml per kilogram of bodyweight. After two years of follow up, there was no significant difference in...
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...
NIHR Signal Taking blood pressure medications at night seems best
People who took their blood pressure medications at bedtime were 45% less likely to experience a major cardiovascular outcome, such as heart attack or stroke, compared with people who took them in the morning. Most blood pressure medications, diuretics aside, do not have a recommended time of administration. A large trial conducted across 40 general practices in Northern Spain assigned 19,084 adults to take their blood pressure medications either in the morning or at night. Over an average of s...
NIHR Signal Stopping smoking is unlikely to worsen symptoms of ulcerative colitis
Non-smokers and people who stop smoking after being diagnosed with ulcerative colitis are unlikely to have more flare-ups or other signs of worsening disease, compared with those who continue to smoke. Smoking is linked to reduced rates of developing ulcerative colitis in some studies. Some patients also believe that smoking can also lessen the symptoms of the disease, although previous research about this has had conflicting results. This study indicates that smoking does not have a significan...
NIHR Signal A patch or eye drops are similarly effective for the treatment of “lazy eye” in children
Both the use of a patch or atropine eye drops are equally suitable methods for improving clarity of vision (visual acuity) in children and young adults with amblyopia (a “lazy eye”). Amblyopia is a cause of poor vision in childhood that usually affects only one eye, resulting in the individual relying more on the good eye. The standard methods of treatment involve training the weaker eye and promoting its use by covering the strong eye with a patch, or eye drops to blur the vision i...
NIHR Signal A nurse-led intervention did not reduce post-traumatic stress disorder symptoms in critical care patients
For adults in critical care, a complex psychological intervention delivered by nurses did not reduce the severity of post-traumatic stress disorder (PTSD) symptoms at six months, compared with usual care. The intervention included creating a therapeutic environment, three stress support sessions, and a relaxation/recovery programme. A cost-effectiveness evaluation showed great uncertainty over whether the programme was value for money. The intervention was developed using the limited evidence t...
NIHR Signal Robotic surgery for rectal cancer produces similar results to keyhole surgery
Robotic rectal cancer surgery does not appear technically easier than standard keyhole surgery. The researchers, in this trial, judged this by measuring the need to ‘convert’ a keyhole procedure to open surgery when operating. This NIHR-funded trial also found that robotic surgery produced similar clinical results to standard laparoscopic (keyhole) surgery in treating rectal cancer. In the trial, 28 out of 230 patients (12%) who received keyhole surgery were converted to open surger...
NIHR Signal Adults who are more active live longer
People who are more physically active in middle age are less likely to die early, whether they do light or moderate to vigorous activity. The largest reductions in death are seen for those who do around 375 minutes a day of light intensity physical activity, such as walking, cooking or gardening, or 24 minutes a day of moderate to vigorous physical activity. People who did most exercise were 73% less likely to have died early than those who did the least. Whereas, people who were sedentary for...
NIHR Signal A less healthy lifestyle increases the risk of dementia
The less healthy your lifestyle, the more you are at risk of developing dementia in later life, a new systematic review has shown. Researchers analysed the results of 18 studies with over 44,000 participants. Having two or more ‘modifiable risk factors’, including smoking, high blood pressure, poor diet, inactivity, obesity and excessive alcohol consumption, puts adults at greater risk of developing dementia. The included studies followed up people without signs of cognitive declin...
NIHR Signal Losing weight following type 2 diabetes diagnosis boosts chance of remission
People who lose at least 10% of their body weight in the first year after being diagnosed with type 2 diabetes increase their chances of being in remission after five years, compared with those whose weight remains stable. Losing this achievable amount of weight over the next four years also makes remission more likely. In this study of 867 people, 257 (30%) achieved remission at five-year follow-up. The participants had been taking part in a trial but had not received intensive lifestyle inter...
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