Irritable bowel syndrome: low dose antidepressant improves symptoms.

The studyFord AC, Wright-Hughes A, Alderson SL, et al. Amitriptyline at low-dose and titrated for irritable bowel syndrome as second-line treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2023;402:1773-85.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/irritable-bowel-syndrome-low-dose-antidepressant-improves-symptoms/.

Surgery is better than nasal sprays for people with severely blocked airways caused by septal deviation.

The studyCarrie S, O'Hara J, Fouweather T, et al. Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial. BMJ 2023;383:e075445.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/surgery-is-better-than-nasal-sprays-for-people-with-severely-blocked-airways/.

Weights, resistance bands, and rest days are best for tendinopathy.

The studyPavlova AV, Shim JSC, Moss R, et al. Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis. Br J Sports Med 2023;57:1327-34.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/weights-resistance-bands-rest-days-best-tendinopathy/.

What are the chances of having a second epileptic seizure?

The studyNeligan A, Adan G, Nevitt SJ, et al. Prognosis of adults and children following a first unprovoked seizure. Cochrane Database Syst Rev 2023;1:1-75.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/epilepsy-what-are-the-chances-of-having-a-second-seizure/.

Online support improved eczema symptoms in children and young people.

The studySanter M, Muller I, Becque T. Eczema Care Online behavioural interventions to support self-care for children and young people: two independent, pragmatic, randomised controlled trials. BMJ 2022;379:e072007.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/online-support-improved-eczema-symptoms-in-children-and-young-people/.

How to reduce medications for people with multiple long term conditions.

The studyReeve J, Maden M, Hill R, et al. Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis. Health Technol Assess 2022;26:1-148.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/how-to-safely-deprescribe-medications-for-people-with-multiple-long-term-conditions/.

Early, intense therapy for language problems after a stroke is linked to the greatest benefits.

The studyBrady MC, Ali M, VandenBerg K, et al. Complex speech-language therapy interventions for stroke-related aphasia: the RELEASE study incorporating a systematic review and individual participant data network meta-analysis. Health Social Care Delivery Res 2022;10.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/therapy-for-language-problems-after-a-stroke-is-most-effective-when-given-early-and-intensively/.

Preventing cervical cancer: what are the risks and benefits of different treatments?

The studyKyrgiou M, Athanasiou A, Cieslak-Jones D. Comparative effectiveness and risk of preterm birth of local treatments for cervical intraepithelial neoplasia and stage IA1 cervical cancer: a systematic review and network meta-analysis. Lancet Oncol 2022;23:1097-108.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/prevention-of-cervical-cancer-what-are-the-risks-and-benefits-of-different-treatments/.

Online cognitive behavioural therapy for post-traumatic stress disorder is as effective as face-to-face therapy.

The studyBisson JI, Ariti C, Cullen K, et al. Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID). BMJ 2022;377:e069405.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/online-cbt-for-ptsd-is-as-effective-as-face-to-face-therapy/.

Methenamine is as effective as antibiotics at preventing urinary tract infections.

The studyHarding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/methenamine-as-good-as-antibiotics-preventing-urinary-tract-infections/.

One-stage hip revisions are as good as two-stage surgery to replace infected artificial hips.

The studyBlom AW, Lenguerrand, Strange S, et al. Clinical and cost effectiveness of single stage compared with two stage revision for hip prosthetic joint infection (INFORM): pragmatic, parallel group, open label, randomised controlled trial. BMJ 2022;379:e071281.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/one-stage-hip-revisions-are-as-good-as-2-stage-surgery-to-replace-infected-artificial-hips/.

Assisted vaginal births: women who tear or have a surgical cut need prompt antibiotics.

The studyHumphries ABC, Linsell L, Knight M. Factors associated with infection after operative vaginal birth-a secondary analysis of a randomized controlled trial of prophylactic antibiotics for the prevention of infection following operative vaginal birth. AJOG 2023;228:328.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/assisted-vaginal-births-women-need-prompt-antibiotics/.

Male sling is as good as more complex surgery for incontinence after prostate surgery.

The studyConstable L, Abrams P, Cooper D, et. Synthetic sling or artificial urinary sphincter for men with urodynamic stress incontinence after prostate surgery: the MASTER non-inferiority RCT. Health Technol Assess 2022;26:1-152To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/male-sling-is-as-good-as-more-complex-surgery-for-incontinence-after-prostate-surgery/.

Routine follow-up may not be needed for people undergoing joint replacement surgery.

The studyKingsbury SR, Smith LK, Czoski Murray CJ, et al. Safety of disinvestment in mid- to late-term follow-up post primary hip and knee replacement: the UK SAFE evidence synthesis and recommendations. Health Soc Care Deliv Res 2022;10. doi:10.3310/KODQ0769To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/joint-replacement-many-people-can-safely-wait-10-years-for-follow-up/.

Associations between neuroticism, subjective sleep quality, and depressive symptoms across the first year of college.

OBJECTIVE: Examine neuroticism's impact on the relationship between depressive symptoms and sleep quality during the college transition. PARTICIPANTS: First-year students (N = 302) from a southeastern university in the USA. METHODS: A longitudinal cross-lagged panel model assessed direct and indirect effects between self-reported sleep and depressed mood. RESULTS: Higher neuroticism was directly associated with both greater depressed mood and sleep quality. Poorer sleep quality was associated with depressive symptoms at baseline (ß = 0.250, [95% CI = 0.123,0.362]) and during spring semester (ß = 0.261, [95% CI = 0.126,0.383]). Baseline depressive symptoms predicted sleep quality during fall semester (ß = 0.140, [95% CI = 0.031, 0.247]), and fall semester sleep quality predicted spring semester depression symptoms (ß = 0.106, [95% CI = 0.007,0.201]). DISCUSSION: Neuroticism is an indicator of emotional distress and disrupted sleep upon college entry. Furthermore, there was evidence for both within time-point and prospective associations between sleep quality and depression symptoms albeit at different times throughout the first year of college.

People of all ages benefit from drugs to lower blood pressure.

The studyThe Blood Pressure Lowering Treatment Trialists' Collaboration. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis. Lancet 2021;398:1053-64.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/people-of-all-ages-benefit-from-drugs-to-lower-blood-pressure/.

One in two people admitted to hospital with covid-19 develop complications and may need support.

The studyDrake TM, Riad AM, Fairfield CJ, et al. Characterisation of in-hospital complications associated with covid-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. Lancet 2021;398:10296.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/one-in-two-people-hospitalised-with-covid-19-develop-complications-may-need-support/.

Why don't children and young people engage with diabetes services?

The studySharpe D, Rajabi M, Harden A, et al. Supporting disengaged children and young people living with diabetes to self-care: a qualitative study in a socially disadvantaged and ethnically diverse urban area. BMJ Open 2021;11:e046989.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/why-dont-young-people-engage-with-diabetes-services/.

Risk of breast cancer with HRT depends on therapy type and duration.

The studyVinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases. BMJ 2020;371:m3873. To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/risk-of-breast-cancer-with-hrt-depends-therapy-type-and-duration/.

Combination inhaler is effective in mild asthma.

The studyCrossingham I, Turner S, Ramakrishnan S, et al. Combination fixed-dose ß agonist and steroid inhaler as required for adults or children with mild asthma: a Cochrane systematic review. BMJ Evid Based Med 2021; doi:10.1136/bmjebm-2021-111764To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/combination-inhaler-is-effective-in-mild-asthma/.