NICE impact mental health

This report from NICE considers how evidence-based guidance can contribute to improvements in the care of people with mental health conditions. The report reviews how NICE recommendations for cost-effective care are being used in priority areas of the health and care system.  Click here to read further.

New NIHR Signal Balance of long-term benefits and risks of caesarean delivery explained

New NIHR Signal Balance of long-term benefits and risks of caesarean delivery explained
Published on 12 June 2018


Caesarean delivery has immediate known benefits and risks for those women who need help in childbirth. This review measures the long-term outcomes for the mothers’ health, the links to a higher risk of childhood illness and the chance of problems with future pregnancies.
From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-000601/balance-of-long-term-benefits-and-risks-of-caesarean-delivery-explained

New NIHR Signal Fewer side-effects and similar benefits from shorter chemotherapy after bowel cancer surgery

New NIHR Signal Fewer side-effects and similar benefits from shorter chemotherapy after bowel cancer surgery
Published on 12 June 2018


A three-month course of chemotherapy after surgery for bowel cancer seems no less effective than the standard six-month course, and half as many people suffered from nerve damage as a side-effect. Three-quarters of people survived to three years without disease progression on either treatment.
From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-000603/fewer-side-effects-and-similar-benefits-from-shorter-chemotherapy-after-bowel-cancer-surgery

New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery
Published on 5 June 2018


In a recent trial, switching to low-dose aspirin was just as effective at preventing blood clots after joint replacement surgery as continuing the anti-clotting drug rivaroxaban. Six per 1,000 people taking aspirin experienced a blood clot, compared with seven per 1,000 taking rivaroxaban. Three to five per 1,000 patients experienced major bleeding with either drug.
From the NIHR Dissemination Centrre
https://discover.dc.nihr.ac.uk/content/signal-000599/aspirin-may-be-a-follow-on-option-to-prevent-blood-clots-starting-five-days-after-surgery

New NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk

New NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk
Published on 5 June 2018


Urinary tract infection symptoms resolved by three days for 80% of women given antibiotics compared with 54% given anti-inflammatories. Anti-inflammatories reduced antibiotic use, but 5% of women developed more severe infection of the kidneys.
From the NIHR Dissemination centre
https://discover.dc.nihr.ac.uk/content/signal-000598/anti-inflammatories-for-urine-infection-reduces-antibiotic-use-but-increases-complication-risk

New NIHR Signal Plastic wraps or bags keep pre-term infants warm immediately after birth

New NIHR Signal Plastic wraps or bags keep pre-term infants warm immediately after birth
Published on 22 May 2018


Cheap and simple plastic wrapping used in the first 10 minutes after birth helps pre-term and low birth weight infants avoid hypothermia. Infants treated in this way are likely to be warmer when admitted to neonatal intensive care than those treated according to standard care. Pre-term infants are most likely to benefit.
From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00596/plastic-wraps-or-bags-keep-pre-term-infants-warm-immediately-after-birth

New NIHR Signal Cell salvage during caesarean section doesn’t reduce blood transfusions

New NIHR Signal Cell salvage during caesarean section doesn’t reduce blood transfusions
Published on 15 May 2018


In a large UK trial, cell salvage for women at risk of blood loss during caesarean did not reduce the need for donor blood transfusion, though few needed transfusion (2.5% compared with 3.5% among controls).
From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00592/cell-salvage-during-c-section-doesnt-reduce-blood-transfusions

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics
Published on 1 May 2018

Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile (C. difficile) bacteria by 60%. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection.

From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00589/probiotics-to-prevent-diarrhoea-caused-by-c-difficile

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture
Published on 17 April 2018


Use of atraumatic needles rather than conventional needles for lumbar puncture more than halves the rate of post-procedure headache. Moreover, this improvement does not come at the expense of procedure success rates.


From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00583/atraumatic-needles-reduce-headaches-following-lumbar-puncture

New NIHR Signal Swimming in seawater is linked with an increased chance of some illnesses

New NIHR Signal Swimming in seawater is linked with an increased chance of some illnesses
Published on 17 April 2018


People who swim in seawater have almost double the odds of experiencing illness than people who avoid it. The specific illnesses linked to seawater exposure are ear and gastrointestinal illnesses, but the exact or absolute rates of infection are not available.
From NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00585/swimming-in-seawater-is-linked-with-an-increased-chance-of-some-illnesses

NIHR Signal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis

NIHR Signal Adding the extra antibiotic rifampicin did not improve cure rates after sepsis
Published on 17 April 2018


Adding the antibiotic rifampicin did not improve cure rates or reduce deaths for people with bacterial blood infections caused by Staphylococcus aureus.
https://discover.dc.nihr.ac.uk/content/signal-00584/adding-the-extra-antibiotic-rifampicin-did-not-improve-cure-rates-after-sepsis


From the NIHR Dessemination Centre

Signal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children

NIHR Signal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children


Published on 17 April 2018


Intravenous lorazepam is as effective as intravenous diazepam for stopping children’s tonic-clonic seizures in hospital. https://discover.dc.nihr.ac.uk/content/signal-00586/lorazepam-confirmed-as-first-line-treatment-for-stopping-prolonged-seizures-in-children
From the NIHR Dissemination Centre

NIHR Signal Physiotherapy education before major abdominal surgery reduces lung complications

NIHR Signal Physiotherapy education before major abdominal surgery reduces lung complications


Published on 3 April 2018


A physiotherapy session before planned abdominal surgery, explaining the importance of breathing exercises and sitting out of bed as soon after surgery as possible, halves the risk of pneumonia.


https://discover.dc.nihr.ac.uk/content/signal-00579/physiotherapy-before-abdominal-surgery-helps-prevent-pneumonia


From the NIHR Dissemination Centre

Pembrolizumab for Advanced Hepatocellular Carcinoma – second line onwards

Hepatocellular Carcinoma (HCC) is the most common type of liver cancer. This type of cancer develops from the main liver cells, called hepatocytes. Treatment and survival depends on the stage at which the cancer is diagnosed. HCC is more common in people who have long‐term damage to the liver (cirrhosis) due to a viral infection or excessive alcohol intake.


http://www.io.nihr.ac.uk/report/pembrolizumab-for-advanced-hepatocellular-carcinoma-second-line-onwards/


From the NIHR Innovation Centre

Lenabasum for Diffuse Cutaneous Systemic Sclerosis

Systemic Sclerosis (SS) is a rare disease caused by the immune system attacking the tissue which lines underneath the skin and internal organs (connective tissue). The exact cause of SS is not known but it is thought to happen when immune cells attack the body’s own tissues leading to the cells in the connective tissue producing too much collagen which causes scaring and thickening of the tissue. There are 2 types of SS; limited cutaneous SS (a milder form of SS affecting only parts of the body) and diffuse cutaneous SS (a more severe form of SS which can affect the whole body). The main symptoms of diffuse cutaneous SS are hardening of the skin, acid reflux, vomiting and diarrhoea, muscular pain, weakness and cramps. The outlook for people with diffuse cutaneous SS is generally poor due to high risk of life threatening complications such as heart, lung and kidney problems.


http://www.io.nihr.ac.uk/report/lenabasum-for-diffuse-cutaneous-systemic-sclerosis/


from the NIHR Innovation Centre

Enasidenib for Relapsed or Refractory Acute Myeloid Leukaemia (AML) with an Isocitrate Dehydrogenase 2 (IDH2) Mutation

Acute myeloid leukaemia (AML) is a type of cancer that causes the bone marrow to produce lots of immature white blood cells. It is most common in people aged 60 years and over. Symptoms of AML may include weakness, fatigue, shortness of breath, recurrent infections, prolonged bleeding, loss in appetite and unintended weight loss. Most patients with AML are treated with standard
chemotherapy.


http://www.io.nihr.ac.uk/report/enasidenib-for-relapsed-or-refractory-acute-myeloid-leukaemia-aml-with-an-isocitrate-dehydrogenase-2-idh2-mutation/


From the NIHR Innovation centre

Rigerimod plus Standard of Care for Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a long-term condition causing inflammation to the joints, skin and other organs. Symptoms presented are usually very general, including fever, joint pain and skin rash but can progress to the most severe, e.g. kidney failure. SLE typically has patterns of flare-ups where the condition gets worse for a period of time. The disease is likely to be caused by a combination of genetic and lifestyle factors and most commonly affects middle-aged women and those of African-Caribbean ethnicity.


http://www.io.nihr.ac.uk/report/rigerimod-plus-standard-of-care-for-systemic-lupus-erythematosus/




From the NIHR Innovation Centre

Axitinib for Patients at High Risk of Recurrence of Renal Cell Carcinoma – Adjuvant

Renal cell carcinoma (RCC) is the most common type of kidney cancer. RCC affects the lining of tiny tubes within the kidney which filter waste from the blood, making urine. Symptoms include blood in urine, feeling of lump or mass in the kidney area, weight loss, raised temperature and sweating, back pain on one side (below the ribs), tiredness, loss of appetite and a general feeling of poor health. The main treatment for RCC is surgery to remove the cancer by partly or totally removing the kidney


http://www.io.nihr.ac.uk/report/axitinib-for-patients-at-high-risk-of-recurrence-of-renal-cell-carcinoma-adjuvant/


From the NIHR Innovation Centre

How commissioners use research evidence

Researchers want their work to be used and useful, but may not always understand the context in which decisions are made. Most health and care organisations aim to base decisions on the best available evidence, but accessing and interpreting the right evidence at the right time is hard. Researchers need to do what they can to make their research as useful as possible to those making decisions under pressure


https://www.dc.nihr.ac.uk/highlights/health-commissioners-research-evidence/


From the NIHR dissemination Centre

NIHR Signal Hospital admission rates and costs increase in line with BMI

Each 2kg/m² rise in body mass index (BMI) above the normal-weight threshold in women aged 55-79 leads to a 5% rise in annual hospital admissions and 7% rise in healthcare costs. In England, £662 million of the annual hospital admission costs in 2013 could be attributed to overweight or obesity in women of this age group. 


https://discover.dc.nihr.ac.uk/content/signal-00575/hospital-admission-rates-and-costs-increase-in-line-with-bmi


From the NIHR Dissemination Centre