Junho de 2024 - Inventário do mês

Vide também no Substack

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

---

META-REVISÃO

Oncologia

Overall Survival and Quality-of-Life Superiority in Modern Phase 3 Oncology Trials | JAMA Oncology

---

REVISÕES SISTEMÁTICAS de ECAs

tabela de conteúdos ↟

Cardiovascular

✔✔✔ P2Y12 inhibitor or aspirin after percutaneous coronary intervention: individual patient data MA of RCT | BMJ

✔✔✔ One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST Elevation | JAMA Cardiology

Doente crítico/urgente

Effect of nebulised inhalation of antibiotics on preventing ventilator-associated pneumonia in critically ill patients: a systematic review and meta-analysis | BMJ Open

Psiquiatria

Moderate- to Long-Term Effect of Dietary Interventions for Depression and Anxiety | Annals o IM

---

ENSAIOS CONTROLADOS E ALEATORIZADOS

tabela de conteúdos ↟

Cardiovascular

✔ Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 | JAMA

Cirurgia, Ortopedia & MFR

✔ Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery - FARES-II | JAMA

Effects of a Hypotension-Avoidance Versus a Hypertension-Avoidance Strategy on Neurocognitive Outcomes After Noncardiac Surgery - cogPOISE-3 | AIM

Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity: A Randomized Clinical Trial | JAMA

Doente crítico/urgente

✗✗✗ Dexmedetomidine- or Clonidine-Based Sedation Compared With Propofol in Critically Ill Patients: The A2B Randomized Clinical Trial | JAMA

Endocrinologia

✔✔✔ Once‑weekly IcoSema versus once‑weekly insulin icodec in type 2 diabetes management (COMBINE 1): an open‑label, multicentre, treat‑to‑target, randomised, phase 3a trial

✔✔✔ Once-weekly IcoSema versus multiple daily insulin injections in type 2 diabetes management (COMBINE 3): an open-label, multicentre, treat-to-target, non-inferiority, randomised, phase 3a trial

✔ Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight - GLORY-1 | NEJM

✔ Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity | Lancet D&E

✔ Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy - QWINT-1 | NEJM

Glucose-Lowering Medications, Glycemia, and Cognitive Outcomes: The GRADE Randomized Clinical Trial | JAMA

Surgery for the treatment of arterial hypertension in patients with unilateral adrenal incidentalomas and mild autonomous cortisol secretion (CHIRACIC) | Lancet

Gastroenterologia & Hepatologia

✔✔✔ Fecal Microbiota Transplantation Versus Vancomycin for Primary Clostridioides difficile Infection | AIM

??? Pre-emptive TIPS for gastric variceal bleeding in patients with cirrhosis (GAVAPROSEC) | Lancet G&H

Geral, Geriatria & Paliativos

✔✔✔ Overall efficacy and safety of olanzapine 5 mg added to triplet antiemetics for an anthracycline-containing regimen in patients with breast cancer | Lancet Oncology

✗✗✗ A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline - FLUID | NEJM

Hematologia

✔ Intermediate-Dose Cytarabine as Postinduction AML Therapy | NEJM Evidence

✔ Graft-versus-Host Disease Prophylaxis with Cyclophosphamide and Cyclosporin | NEJM

Imuno-mediadas

Disease-associated brain activation predicts clinical response to TNF inhibition in rheumatoid arthritis - PreCePra | Lancet Rheumatology

Nefrologia

Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes - CONFIDENCE | NEJM

Neurologia

Intravenous Tenecteplase before Thrombectomy in Stroke - BRIDGE-TNK | NEJM

Oncologia

✔✔✔ Structured Exercise after Adjuvant Chemotherapy for Colon Cancer - CHALLENGE | NEJM

✔ Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy - NSABP B-51 | NEJM

Pneumologia

✔✔✔ Navigational Bronchoscopy or Transthoracic Needle Biopsy for Lung Nodules - VERITAS | NEJM

✔ As-Needed Albuterol–Budesonide in Mild Asthma - BATURA | NEJM

---

NORMAS DE ORIENTAÇÃO CLÍNICAS - GUIDELINES

tabela de conteúdos ↟

Hematologia

Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice Guidelines | JAMA

IA

Reporting guideline for the use of Generative Artificial intelligence tools in MEdical Research: the GAMER Statement | BMJ EBM

Meta-investigação & MBE

CONSORT 2025 statement: updated guideline for reporting randomised trials | BMJ

SPIRIT 2025 statement: updated guideline for protocols of randomised trials | BMJ

Neurologia

Gestão das Cefaleias em Portugal: Consenso das Sociedades Portuguesas de Cefaleias e Neurologia, Associação Portuguesa de Medicina Geral e Familiar e MiGRA | AMP

---

ESTUDOS OBSERVACIONAIS

REVISÕES SISTEMÁTICAS COM ESTUDOS OBSERVACIONAIS (com ou sem ECA)

tabela de conteúdos ↟

Cardiovascular

✔ Arm Based on LEg blood pressures (ABLE-BP): can systolic ankle blood pressure measurements predict systolic arm blood pressure? An individual participant data meta-analysis from the INTERPRESS-IPD Collaboration | BMJ Open

Endocrinologia

✔ Treatments for MEN1-associated endocrine tumours: three systematic reviews and a meta-analysis

Geral, Geriatria & Paliativos

✔ Impacts of communication type and quality on patient safety incidents: A systematic review. Ann Intern Med

Oncologia

✔ Adverse Event Costs and Cost-Effectiveness Analyses of Anticancer Drugs | JAMA

---

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

tabela de conteúdos ↟

Doente crítico/urgente

✔ Hydrocortisone and Risk Factors for Kidney Replacement Therapy in Septic Shock | JAMA NO

Cost-Effectiveness of α2 Agonists for Intravenous Sedation in Patients With Critical Illness | JAMA NO

Geral, Geriatria & Paliativos

✔ Do structured career counselling initiatives influence specialty preferences in medical students? A longitudinal observational survey study | BMJ Open

✔ Machine Learning Multimodal Model for Delirium Risk Stratification | JAMA NO

✔ Predicting Agitation Events in the Emergency Department Through Artificial Intelligence | JAMA NO

✔ Associations between patient characteristics and five-year trajectories of anticholinergic drug burden in older adults in German primary care: a prospective observational cohort study | BMJ Open

Infecciologia, Microbiologia & Antimicrobianos

✔ Universal versus targeted chlorhexidine and mupirocin decolonisation and clinical and molecular epidemiology of Staphylococcus epidermidis bloodstream infections in patients in intensive care in Scotland, UK: a controlled time-series and longitudinal genotypic study | Lancet Microbe

Derivation and Validation of an Electronic Health Record Penicillin Allergy De-Labeling Prevalence Measure | CID

Pharmacokinetics of Subcutaneous and Intravenous Ceftriaxone in an Older Population: The PhASAge Study | OFID

Meta-investigação & MBE

✔ Core GRADE 4: rating certainty of evidence—risk of bias, publication bias, and reasons for rating up certainty | BMJ

✔ Core GRADE 5: rating certainty of evidence—assessing indirectness | BMJ

Neurologia

✔ Implementation of Delirium Screening at Scale in Older Patients With Emergency Hospital Admission | JAMA IM

Risk of Parkinson Disease in Individuals With Autism Spectrum Disorder | JAMA Neurology

---

CASOS CLÍNICOS e SÉRIES DE CASOS

tabela de conteúdos ↟

Cardiovascular

Precision in Crisis: A Case Study on the Diagnostic Pitfalls in Acute Aortic Dissection | AIM

Endocrinologia

Latent Autoimmune Diabetes of Adults Due to Positive Zinc Transporter 8 Antibody | AIM

Gastroenterologia & Hepatologia

A Case of Chronic Granulomatous Pancreatitis | AIM 

Hematologia

A Young Patient With Pancytopenia and Cirrhosis: Unraveling a Telomere Biology Disorder | AIM

Imuno-mediadas

Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy | AIM

Oncologia

Immune Checkpoint Inhibitor–Induced Sicca Syndrome: Early Recognition Is Key | AIM

Pneumologia

Gluten-Induced Hemoptysis: A Case Report of Lane–Hamilton Syndrome | AIM

Necrotizing Cavitary Pneumonia by Serratia marcescens in a Patient Treated With Dupilumab: Correlation or Causation? | AIM

POCUS

Efficacy of a theoretical-practical course for the ultrasound measurement of the optic nerve diameter in different healthcare operators | USJ

---

OPINIÃO

REVISÃO NÃO-SISTEMÁTICA / NARRATIVA

tabela de conteúdos ↟

Meta-investigação & MBE

Core GRADE 6: presenting the evidence in summary of findings tables

Core GRADE 7: principles for moving from evidence to recommendations and decisions

Evidence categories in systematic assessment of cancer overdiagnosis | BMJ EBM

MetaImpact: a novel tool to enable evidence-based sample sizes for future trials | BMJ EBM

---

PERSPECTIVA

tabela de conteúdos ↟

Gastroenterologia & Hepatologia

✔ Rethinking Antibiotic Prophylaxis for Spontaneous Bacterial Peritonitis in Patients With Cirrhosis: First, Do No Harm | CID

Geral, Geriatria & Paliativos

✔✔✔ Romanticised semiology | BMJ EBM

IA

✔✔✔ Are we ready for AI-augmented generalists? | BMJ EBM

Meta-investigação & MBE

Standardised mean difference | BMJ Open

An Evidence-Based Approach to Covid-19 Vaccination | NEJM

POCUS

Efficacy of a theoretical-practical course for the ultrasound measurement of the optic nerve diameter in different healthcare operators | USJ

---

FOAMed

tabela de conteúdos ↟

Cardiovascular

✔ Advance-HTN: Return of the systolic order – Lorundrostat’s role in restoring balance | NephJC

Doente crítico/urgente

✔✔✔ ​Self-Organised Criticality: Why your ED is like a Sand Pile | St. Emlyn's

✔✔✔ REBEL Core Cast 134.0 – Acetaminophen Toxicity

✔ Top 10 trauma/resus papers for IFEM 2025 | St. Emlyn's

Ten Test – A Better Sensory Exam…Hands Down | JF - JEM

When to Terminate Resuscitation for In-Hospital Cardiac Arrest | JF - JAMA IM

Risk of Carotid Puncture During Peritonsillar Abscess Aspiration | JF - AJEM

Endocrinologia

#483: Diabetic Dilemmas in Older Adults, Pregnancy and Corticosteroid Use with Jeff Colburn, MD | Curbsiders

Geral, Geriatria & Paliativos

✔✔✔ #485: Things We Do For No Reason™Live from SHM #Converge2025 | Curbsiders

Pneumologia

REBEL Core Cast 135.0: A Simple Approach to Hypoxemia (vs. Hypoxia)

---

SE QUISERES APOIAR-NOS, SUBSCREVE (...e se te sentires generoso/a, uns trocos ajudam a manter o site...)

👇

PATREON patreon.com/esFOAMeados | SUBSTACK https://esfoameados.substack.com/

Em caso de dúvidas ou sugestões, contacta-nos (e-mail, comentário, substack, twitter, ...). Agradecemos!