hne health libraries linking evidence with practice

Short term exposure to fine particulate matter with diameter less than 2.5 µm (PM2.5) - bush fire smoke - has previously been associated with increased risk of mortality and hospital admissions due to cardiovascular and respiratory diseases, diabetes mellitus, neurological diseases, and deep vein thrombosis. A recent US study published in the BMJ, including data from 95,277,169 participants (aged 65 or older admitted to hospital), found short term exposure to PM2.5 was also positively associated with risks of several prevalent but rarely studied causes of hospital admissions, such as septicemia, fluid and electrolyte disorders, and acute and unspecified renal failure. These associations remained even at a daily PM2.5 concentration below the WHO 24 hour guideline. Substantial economic costs were linked to a small increase in short term PM2.5.

Find out more in the December issue of the Library’s newsletter ‘Library Lore’

READ editorial (Requires Library membership)
READ author's opinion piece
Listen to an interview with the author on Norman Swan's Health Report on the ABC

This NIHR-funded study published in the Lancet is the 24-month follow-up to an earlier publication of 12-month outcomes for 558 people with irritable bowel syndrome (IBS) receiving usual care alone or additional telephone or web-based cognitive behavioural therapy (CBT). The former paper showed that both therapies helped people deal with their IBS. This longer-term follow-up shows that CBT continues to benefit patients months after therapy sessions have stopped. IBS can be a very debilitating and difficult condition to treat. The present study helps strengthen the case for the provision of remote talking therapies, particularly telephone-based therapy (71% of study participants experienced a clinically significant improvement in their IBS symptoms), as a way to improve access and outcomes for patients.
READ NIHR review

According to a recent Cochrane review, people who receive exercise training following surgery for lung cancer can walk about 57 metres further in six minutes than controls who did not exercise. Despite being of small size (8 trials, 450 participants in total), the trials demonstrated consistent and meaningful improvements in exercise capacity. Exercise also increases leg strength and quality of life.
READ Cochrane review
READ NIHR review
VISIT 'Mater Medical Grand Rounds' on the Library website to access related resources. Scroll down to 29 October 2019 – ‘Chest physiotherapy’. (Access restricted to HNEH/Mater staff)

Guillain–Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, the authors have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline, published in Nature reviews. Neurology, is based on current literature and expert consensus, and has a ten- step structure to facilitate its use in clinical practice.
READ the consensus statement
VISIT 'John Hunter Medicine Grand Rounds' on the Library website to access related resources. Scroll down to 26 September 2019 – ‘Longer term outcomes in GBS’. (Access restricted to HNEH/Mater staff)