Julho de 2025 - Inventário do mês

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Versão esquemática de Mariana Barosa:

What multimorbidity shows us about guideline-driven evidence based medicine ou Sensible Medicine

TABELA DE CONTÉUDOS:

1. META-REVISÃO

2. REVISÕES SISTEMÁTICAS DE ENSAIOS CONTROLADOS E ALEATORIZADOS (ECAs)

3. ENSAIOS CONTROLADOS E ALEATORIZADOS (ECAs)

4. NORMAS DE ORIENTAÇÃO CLÍNICA

5. OBSERVACIONAIS

   1. Revisões Sistemáticas

   2. Primários

   3. Casos clínicos e séries

6. OPINIÃO

   1. Revisões narrativas

   2. Perspectiva

   3. Notícias

7. FOAMed

Glossário:

✔✔✔ --> Muito relevante

✔ --> Relevante

✗ --> Não eficaz mas relevante (contraria hipóteses, práticas, etc.)

(sem símbolo) --> Pouco relevante (mas eventualmente interessante)

(sem símbolo) --> Não eficaz e pouco relevante (mas eventualmente interessante)

classificação pessoal, nem todos concordarão

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REVISÕES SISTEMÁTICAS de ECAs

tabela de conteúdos ↟

Cardiovascular

✔✔✔ Early Invasive or Conservative Strategies for Older Patients With Acute Coronary Syndromes | JAMA Internal Medicine

✔ Catheter and Surgical Ablation for Atrial Fibrillation | AIM

Geral, Geriatria & Paliativos

✔✔✔ Pharmacotherapy and non-invasive neuromodulation for neuropathic pain | Lancet Neurology

✗✗✗ Intermittent fasting strategies and their effects on body weight and other cardiometabolic risk factors | BMJ

? ? ? Comparative effectiveness of interventions to facilitate deprescription of benzodiazepines and others | BMJ

? ? ? Interventions to Address Potentially Inappropriate Prescribing for Older Primary Care Patients | JAMA NO

Infecciologia, Microbiologia & Antimicrobianos

✔✔✔ Efficacy and Safety of Systematic Corticosteroids Treatment Among Patients With HIV and Tuberculosis | CID

Psiquiatria

✔ Transcranial Electrical Stimulation in Treatment of Depression | JAMA Network Open

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ENSAIOS CONTROLADOS E ALEATORIZADOS

tabela de conteúdos ↟

Cardiovascular

? ? ? Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation: PRAGUE-25 | JACC

? ? ? Lorundrostat in Uncontrolled Hypertension and Treatment-Resistant Hypertension - Launch-HTN | JAMA NO

✗ Liberal fluid intake versus fluid restriction in chronic heart failure: A randomized clinical trial | Nat Med

Cirurgia, Ortopedia & MFR

✔ Robotic vs Laparoscopic Surgery for Middle and Low Rectal Cancer: The REAL | JAMA

Doente crítico/urgente

✔ Efficacy of intranasal ketamine in controlling pain caused by bone fractures | IJCI

✗ Efficacy of targeting high mean arterial pressure for older patients with septic shock - OPTPRESS | ICM

Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients: The UK-ROX | JAMA

Augmented Enteral Protein During Critical Illness - The TARGET Protein Randomized Clinical Trial | JAMA

Gastroenterologia & Hepatologia

✔ IV induction and SC maintenance therapy with guselkumab for Crohn's disease - GALAXI-2 and GALAXI-3 | Lancet

Effect of gluten and wheat on symptoms and behaviours in adults with irritable bowel syndrome | Lancet G&H

Geral, Geriatria & Paliativos

? ? ? Serious Illness Conversations in the Emergency Department for Older Adults With Advanced Illnesses | JAMA NO

✔✔✔ Penicillin allergy assessment pathway vs usual clinical care for primary care w/ penicillin allergy record - ALABAMA | BMJ PC

Hematologia

✔ Comparison of prophylactic and therapeutic doses of anticoagulation for ACS in sickle cell disease - TASC | AJR-CCM

Imuno-mediadas

✗ Low-Dose Methotrexate for the Treatment of Inflammatory Knee Osteoarthritis | JAMA Internal Medicine

Infecciologia, Microbiologia & Antimicrobianos

✔✗? Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia | Lancet RespMed

Delpazolid w/ bedaquiline, delamanid and moxifloxacin for pulmonary tuberculosis - PanACEA-DECODE-01 | Lancet ID

Sutezolid w/ bedaquiline, delamanid, and moxifloxacin for pulmonary tuberculosis - PanACEA-SUDOCU-01 | Lancet ID

Neurologia

✔✔✔Optimal Head-of-Bed Positioning Before Thrombectomy in Large Vessel Occlusion Stroke | NEJM

Pneumologia

? ? ? Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis - ASPEN | NEJM

Psiquiatria

? ? ? Pramipexole augmentation for the acute phase of treatment-resistant, unipolar depression | Lancet Psychiatry

Immersive virtual reality targeting persistent auditory verbal hallucinations in schizophrenia | Lancet Psychiatry

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NORMAS DE ORIENTAÇÃO CLÍNICAS - GUIDELINES

tabela de conteúdos ↟

Imuno-mediadas

✔✔✔ Management and prevention of hypersensitivity reactions to radiocontrast media: ACR and the AAAAI | JACIP

Urologia

Updates to microhematuria: AUA/SUFU guideline (2025) - J Urol, AUA

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ESTUDOS OBSERVACIONAIS

REVISÕES SISTEMÁTICAS COM ESTUDOS OBSERVACIONAIS (com ou sem ECA)

tabela de conteúdos ↟

Endocrinologia

Association of gestational thyroid function and thyroid autoimmunity with gestational diabetes | Lancet D&E

Hematologia

✗ Efficacy of vitamin C with Fe supplementation in patients with iron deficiency anemia | Blood Vessel Thromb Hemost

Infecciologia, Microbiologia & Antimicrobianos

Outcome Predictors of Candida Prosthetic Joint Infections: A Systematic Review and Meta-analysis | OFID

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PRIMÁRIOS - SUB-ANÁLISE / COORTE / CASO-CONTROLO / INQUÉRITOS / A. ECONÓMICAS

tabela de conteúdos ↟

Cardiovascular

✔ Variability in implantable cardioverter-defibrillator battery longevity | Hearth Rythm

Doente crítico/urgente

✔ Clinical performance of Spo₂/Fio₂ and Pao₂/Fio₂ ratio in mechanically ventilated ARDS patients | Crit Care Med

Endocrinologia

? Implications of the European Association for the Study of Obesity’s New Framework Definition of Obesity | AIM

Gastroenterologia & Hepatologia

✔ Sodium-Glucose Cotransporter 2 Inhibitors and Serious Liver Events in Patients With Cirrhosis | JAMA Network Open

✔ Higher rate of SBP recurrence with secondary prophylaxis in 2 national cirrhosis cohorts | Am J Gastroenterol

Geral, Geriatria & Paliativos

✔ Continuity of care in general practice and patient outcomes in Denmark: population-based cohort study | Lancet PC

✗ Associations of topiramate and zonisamide use with kidney stones: A retrospective cohort study | Am J Kidney Dis

Hematologia

?✔? Comparison of prophylactic vs therapeutic doses of anticoagulation for ACS in sickle cell disease-TASC | AJR-CCM

Infecciologia, Microbiologia & Antimicrobianos

✔ Metagenomic Next-generation Sequencing Compared With Blood Culture as First-line Diagnostic Method for Bloodstream Infection in Hematologic Patients With Febrile Neutropenia: A Multicenter, Prospective Study | OFID

Performance of Diagnostic Algorithms in Patients With Invasive Pulmonary Aspergillosis | CID

Mycoplasma pneumoniae: re-emergence and beyond | Lancet Microbe

The MEFIER Score—A Risk Score to Stratify Infective Endocarditis in Patients With Enterococcus faecalis Bacteremia Based on an 11-Year Territory-Wide Cohort | OFID

Meta-investigação & MBE

✔ Differences Between Trial Populations and Approved Label Populations of New Drugs in the US/Europe (12 to 23) | AIM

Neurologia

Prognostic Factors for Multiple Sclerosis Symptoms in Radiologically Isolated Syndrome | JAMA Neurology

Prevalence of Epilepsy in Frontotemporal Dementia and Timing of Dementia Diagnosis | JAMA Neurology

Immune Checkpoint Inhibitors for Patients With Preexisting Autoimmune Neurologic Disorders | JAMA NO

✗ Computed Tomography Perfusion and Angiography for Death by Neurologic Criteria | JAMA Neurology

Oncologia

✔Long-Term Follow-Up of Patients With Multiple Myeloma Treated on Earlier Total Therapy Protocols| JAMA Oncology

✔ Early ctDNA and Survival in Metastatic Colorectal Cancer Treated With Immune Checkpoint Inhibitors | JAMA Onco

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CASOS CLÍNICOS e SÉRIES DE CASOS

tabela de conteúdos ↟

Hematologia

Unraveling Pernicious Anemia With Severe Hemolysis and Roth Spots | AIM

Neurologia

Spinocerebellar Ataxia Type 27B (SCA27B): A Hereditary Ataxia in Portugal | AMP

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OPINIÃO

REVISÃO NÃO-SISTEMÁTICA / NARRATIVA

tabela de conteúdos ↟

Cardiovascular

✔✔✔ Endovascular management of intermediate-risk pulmonary embolism: evidence, outstanding questions, drivers of utilization, and the horizon | EHJ

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PERSPECTIVA

tabela de conteúdos ↟

Cardiovascular

✔✔✔ Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca’s billion dollar drug | BMJ

Infecciologia, Microbiologia & Antimicrobianos

✔ Is More Always Better? Rethinking Monotherapy for Enterococcus faecalis Infective Endocarditis | CID

✔ Does “Toxoplasma Abscess” Properly Describe Brain Lesions Caused by Toxoplasma gondii? | CID

✔ What's Hot This Year in Infectious Diseases Clinical Science | CID

Meta-investigação & MBE

✔ Single-Arm Trials Can Provide Randomized Real-World Evidence | AIM

Nefrologia

✔✔✔ Things We Do for No Reason™: Avoiding IV iodinated contrast material in patients with AKI or chronic kidney disease

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✔✔✔ FOAMed

tabela de conteúdos ↟

Cardiovascular

✔✔✔ MDCalc Wars: HEART Score Vs. EDACS | RebelEM

Diagnóstico e Raciocínio Clínico

✔ ISBE & Cochrane Portugal nº 341: Desempenho diagnóstico da TC com contraste na deteção de cancro colorretal

Doente crítico/urgente

✔ Central Cap Refill Predicts Trauma Mortality, No Cap! | JF - SJTR

Casting Doubt: The SUSPECT Trial — Bandaging Vs. Casting for Suspected Occult Scaphoid Fracture | RebelEM

Geral, Geriatria & Paliativos

✔ #393 Avoiding the void? Mirabegron for overactive bladder | TFP

Hematologia

✔ Episode 111 – Null Neutrophils | Curious Clinicians

Pneumologia

✔✔✔ REBEL Core Cast 136.0: A Simple Approach to the Tachypneic Patient | RebelEM

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