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In this month's Round Up there is a summary of evidence relating to the benefits of exercise in the elderly, a summary of the RSV vaccination and the use of aspirin in the prevention of colorectal cancer.
Aspirin in the prevention of colorectal cancer – is there evidence of benefit of high-dose aspirin or low-dose aspirin or both high and low doses in the prevention of colorectal cancer? Is there evidence of benefit of aspirin use in prevention of recurrence of colorectal cancer? How does the duration of aspirin use affect risk of colorectal cancer?: Aspirin as a chemoprophylaxis if previous colorectal cancer or adenoma
With respect to the use of aspirin in colorectal cancer, which statement is false?
a systematic review concluded that aspirin appears to be effective at reducing the incidence of colonic adenoma and colorectal cancer, especially if used in high doses for more than 10 years
there is evidence about the effectiveness of both low dose and high dose aspirin in the prevention of colorectal cancer
there is no evidence of benefit of aspirin in the prevention of further instance of colorectal cancer in patients with a history of prior colorectal cancer
Domperidone in the management of insufficient production of breast milk in breastfeeding – what dose of domperidone is indicated in the management of insufficient supply of breast milk? How long should domperidone be prescribed in this scenario before being reviewed? What about cardiac concerns with respect to use of domperidone in the mother and infant?: Domperidone in the management of breast feeding (insufficient milk supply)
With respect to the use of domperidone in the management of insufficient breast milk supply in breast feeding, which statement is false?
evidence for the use of domperidone in the management of insufficient milk supply during breast feeding shows a moderate short-term effect on expressed breast milk volume, increasing by around 86 to 245mL per day
duration of treatment for 28 days is in line with the maximum treatment duration for the licensed indication (nausea and vomiting), due to the increased risk of cardiac events (particularly in certain populations), and potential for psychiatric withdrawal effects
cardiac events in the infant have not been reported after domperidone exposure via breast milk
Exercise benefits in the elderly – this section of GPnotebook has been updated.: Exercise - benefits of exercise in elderly
With respect to the benefits of exercise in the elderly, which statement is false?
study evidence has shown that in an eldery population, remaining active over the eight year period of the study conferred a seven times increased chance of an individual being healthy in old age compared to his/her inactive peers
WHO guidance for exercise in people over the age of 65 years suggests muscle-strengthening activities should be done on four or more days
evidence suggest that power training (lifting weights fast and lowering under control) was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults
Read pageMethadone – this section of GPnotebook has been updated.: Methadone
With respect to methadone, which statement is false?
study evidence showed that eight weeks of acupuncture were superior to sham acupuncture in reducing methadone dose and decreasing opioid craving
in a systematic review and meta-analysis of randomised and observational studies of buprenorphine versus methadone for the treatment of opioid dependence found, at timepoints beyond 1 month, retention in treatment was better for methadone vs buprenorphine
in a systematic review and meta-analysis of randomised and observational studies of buprenorphine versus methadone for the treatment of opioid dependence found evidence of increased hospitalisation and alcohol use in people receiving methadone
RSV vaccination programme – this has been summarised on GPnotebook.: Respiratory syncytial virus (RSV) vaccination programme
With respect to the RSV vaccination programme, which statement is false?
the RSV vaccine in pregnancy boosts the maternal immune system to produce more antibodies against the virus and these antibodies then pass through the placenta to help protect the unborn child from the day they are born
women will be offered the RSV vaccination during every pregnancy
pevious RSV infection confers total immunity to RSV
Steroid injection for tennis elbow – this section has been updated.: Steroid injection in tennis elbow
With respect to the use of steroid injections in tennis elbow, which statement is false?
in tennis elbow, steroid injections have been shown to improve short-term pain relief (4 to 6 weeks) compared with both placebo and bracing
evidence suggests the long-term benefits of steroid injection for tennis elbow in comparison to physiotherapy
hydrocortisone acetate mixed with local anaesthetic may be used, and long acting steroids should be avoided as there is a risk of skin atrophy