Junho 2026 - 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. REVISÕES SISTEMÁTICAS DE ENSAIOS CONTROLADOS E ALEATORIZADOS (ECAs)

2. ENSAIOS CONTROLADOS E ALEATORIZADOS (ECAs)

3. NORMAS DE ORIENTAÇÃO CLÍNICA

4. OBSERVACIONAIS

   1. Revisões Sistemáticas

   2. Primários

   3. Casos clínicos e séries

5. OPINIÃO

   1. Revisões narrativas

   2. Perspectiva

   3. Notícias

6. FOAMed

Glossário:

✔ ✔ ✔ --> Muito relevante e reforça ou pode mudar a prática

? ? ? --> Muito relevante mas dúvidas

✗ ✗ ✗ --> Não eficaz mas muito relevante (contraria hipóteses e práticas ; valor didáctico ; etc.)

✔ --> Relevante e a favor da prática

? --> Relevante mas dúvidas

✗ --> Não eficaz mas relevante (contraria hipóteses e práticas ; valor didáctico ; etc.)

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

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

classificação pessoal, nem todos concordarão

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REVISÕES SISTEMÁTICAS de ECAs

tabela de conteúdos ↟

Cardiovascular

✔ ✔ ✔ Efficacy and Safety of Prasugrel, Ticagrelor or Clopidogrel After Percutaneous Coronary Intervention | JAMA C ✔ ✔ ✔ Dual Antiplatelet Therapy Duration in Patients at High Bleeding Risk | JAMA Cardiology

✔ ✔ ✔ AEs and Treatment Discontinuation of Blood Pressure–Lowering Drugs and Combinations | JAMA NO

Neurologia

✗ ✗ ✗ Amyloid‐beta‐targeting monoclonal antibodies for mild cognitive impairment or mild Alzheimer's dementia | Cochrane 

Oncologia

✔ PD-(L)1 Inhibitor Monotherapy vs Chemoimmunotherapy for Advanced NSCLC w/ High PD-L1 Expression | JAMA Onco

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ENSAIOS CONTROLADOS E ALEATORIZADOS

tabela de conteúdos ↟

Cardiovascular

✔ Limit of Detection in the ED (LEGEND): Rule Out AMI and Reduce Hospital Length of Stay | AEM

Cirurgia, Ortopedia & MFR

✔ Prophylactic tranexamic acid for the prevention of postpartum haemorrhage in women with placenta praevia | BMJ

✔ Hospital Policy of Tranexamic Acid to Reduce Transfusion in Major Noncardiac Surgery - TRACTION | NEJM

Diagnóstico e Raciocínio Clínico

✔ ✔ ✔ A Randomized Trial of Interval Likelihood Ratios for Clinical Decision-Making | NEJM Evidence

Doente crítico/urgente

✗ ✗ ✗ Vasopressors or Fluids in Early Septic Shock – ARISE FLUIDS | NEJM

✗ ✗ ✗ Sodium Bicarbonate for In-Hospital Cardiac Arrest - BIHCA | JAMA

✗ ✗ ✗ High-Dose Intravenous Vitamin C and Mortality and Organ Dysfunction in Severe Burn Injury - VICTORY | JAMA

✗ Conservative Oxygen for Unresponsive Patients after Cardiac Arrest - LOGICAL | NEJM

Geral, Geriatria & Paliativos

✔ ✔ ✔ Digital Self-Management of Symptoms and Quality of Life for Patients With Advanced Cancer | JAMA NetOpen

Imuno-mediadas

✔ Obinutuzumab or Tacrolimus in Primary Membranous Nephropathy - MAJESTY | NEJM

✔ Phase 3 Trial of Secukinumab in Polymyalgia Rheumatica - REPLENISH | NEJM

Infecciologia, Microbiologia & Antimicrobianos

✔ ✔ ✔ Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia - SNAP trial | NEJM

✔ ✔ ✔ Benzylpenicillin vs oxacillin for the treatment of PenicillinS Staphylococcus aureus bacteraemia - SNAP | Lancet

✔ ✔ ✔ Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women – SCOUT | Lancet

✔ ✔ ✔ Fosfomycin as Oral Transition Therapy vs Continued Intravenous β-Lactams for ITUc Caused by Extended-Spectrum β-Lactamase–Producing Enterobacterales | CID

Meta-investigação & MBE

Nefrologia

? ✗ ? Finerenone in Persons with Chronic Kidney Disease without Diabetes – FIND-CKD | NEJM

Neurologia

? ✗ ? Rituximab versus Ocrelizumab in Newly Diagnosed Relapsing Multiple Sclerosis | NEJM

Oncologia ✔ ✔ ✔ Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer - RASolute 302 | NEJM

✔ Every Six-Month versus Single-Dose Adjuvant Zoledronate in Early Breast Cancer | NEJM Evidence

Pneumologia

✗ ✗ ✗ Carbocisteine or Hypertonic Saline for Acute Respiratory Failure - MARCH | NEJM

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NORMAS DE ORIENTAÇÃO CLÍNICAS - GUIDELINES

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

ASBS, SBI & CAP 2025 guidelines for the management of infectious and inflammatory lesions of the breast | JAMA Surg

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ESTUDOS OBSERVACIONAIS

REVISÕES SISTEMÁTICAS COM ESTUDOS OBSERVACIONAIS (com ou sem ECA)

tabela de conteúdos ↟

POCUS

POCUS for CVC confirmation and complications in the ED | JIMR

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

tabela de conteúdos ↟

Cardiovascular

✔ ✔ ✔ Contemporary trends and outcomes in European ICD recipients: a 15-year analysis | EP Europace

✔ Exercise Performance w/ Aficamten vs Metoprolol in Obstructive Hypertrophic Cardiomyopathy-MAPLE-HCM | JAMAC

Endocrinologia

✔ ✔ ✔ Malignancy among incidental indeterminate adrenal nodules on contrast-enhanced CT without known cancer | AJR

IA

✔ Artificial Intelligence Note Summarization in the Emergency Department | JAMA Network Open

Infecciologia, Microbiologia & Antimicrobianos

✔ Oral Wash PCR Improves the Diagnosis of Pneumocystis Pneumonia in Immunocompromised Patients wo/ HIV | CID

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CASOS CLÍNICOS e SÉRIES DE CASOS

tabela de conteúdos ↟

Imuno-mediadas

Kikuchi-Fujimoto Disease: Etiology for Relapsing/Remitting Fevers and Lymphadenopathy in Dermatomyositis | AIM

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OPINIÃO

REVISÃO NÃO-SISTEMÁTICA / NARRATIVA

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

Acute Porphyria Screening Protocol in the Emergency Department: A Strategy for Early Diagnosis | RSPMI

Hematologia

TWDFNR™: Routine use of unfractionated heparin for initial anticoagulation in venous thromboembolism | JHM

POCUS

Point-of-Care Ultrasound for the Diagnosis of Pneumonia | JAMA Network Open

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PERSPECTIVA

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

✔ ✔ ✔ The dose of iodinated contrast required for a CT scan is below the toxicological threshold | JEM Reports

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NOTÍCIAS

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

PCOS Is Now PMOS—Will a New Name Translate to Improved Clinical Care? | JAMA

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✔✔✔ FOAMed

tabela de conteúdos ↟

Cardiovascular

Blood Pressure Measurement Technique | TFP

Diagnóstico e Raciocínio Clínico

Rentabilidade diagnóstica da ecografia vs. RM na deteção de roturas da coifa dos rotadores | NL 381

Endocrinologia

#515 Primary Aldosteronism, A Deep Dive: Easy on the Salt! - Curbsiders

Gastroenterologia & Hepatologia

#416 Mood Medicine for a Moody Gut: Antidepressants in IBS | TFP

Geral, Geriatria & Paliativos

Episode 127 – ACHOO! (The Sunlit Sneeze) | Curious Clinicians

IA

NL 383 | NL SAÚDE DIGITAL | Estudo Sugere que LLMs generalistas poderão ser comparáveis a LLMs especializados

Imuno-mediadas

EBR Journal Club: Secukinumab in Polymyalgia Rheumatica (REPLENISH) | EBRJ

HCQ+Leflunomida in SJögren (RepurpuSS-II) | Mike Putman

EBR Journal Club: Obexelimab in IgG4-Related Disease (INDIGO) | EBRJ

Heir to the Throne? Obinutuzumab in the membranous nephropathy MAJESTY trial | NephJC

Infecciologia, Microbiologia & Antimicrobianos

NephJC Short: Bayesian leash: How a prior walked the Tigris across the finish line

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