Novembro 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

? ? ? --> Muito relevante mas restam dúvidas

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

✔ --> Relevante

? --> Relevante mas restam dúvidas

✗ --> 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 ↟

Doente crítico/urgente

✔✔✔ Comparative effects of early physical interventions on preventing ICU‑acquired weakness | BMJ EBM

Geral, Geriatria & Paliativos

✗ ✗ ✗ Tramadol vs placebo for chronic pain: systematic review w/ meta‑analysis & trial sequential analysis | BMJ EBM

Hematologia

✔✔✔ Reduced‑Dose vs Full‑Dose Direct Oral Anticoagulants for Extended Secondary VTE Prophylaxis in Cancer | AJH

Nefrologia

✔✔✔ Fish‑Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis — PISCES | NEJM

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ENSAIOS CONTROLADOS E ALEATORIZADOS

tabela de conteúdos ↟

Cardiovascular

✔ ✔ ✔ Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation — DECAF | JAMA

✔ Bioresorbable vs Metallic Occluders for Transcatheter ASD Closure | JAMA

Cirurgia, Ortopedia & MFR

✔ ✔ ✔ Assessing clinical and cost effectiveness of total vs partial knee replacement (TOPKAT): 10‑years | Lancet Rheum

? ? ? Minimally Invasive versus Open Pancreatoduodenectomy for Resectable Neoplasms — NEJM Evidence

Doente crítico/urgente

? ✔ ? Personalized Hemodynamic Resuscitation Targeting CRT in Early Septic Shock - ANDROMEDA‑SHOCK‑2 | JAMA

✔ Diphenhydramine, Sodium Bicarbonate, or Combination for Acute Peripheral Vertigo — JAMA Network Open

Gastroenterologia & Hepatologia

✔ ✔ ✔ The Mediterranean Diet for Irritable Bowel Syndrome — Annals of Internal Medicine

✔ Carvedilol in Cirrhosis w/ New‑Onset Uncomplicated Ascites Without HighRisk Esophageal Varices - CARVE‑AS | AJG

✗✗✗ Linerixibat in patients with primary biliary cholangitis and cholestatic pruritus – GLISTEN | Lancet G&H

Imuno-mediadas

✔ ✔ ✔ Rituximab for Relapsing Nephrotic Syndrome in Adults — JAMA

Infecciologia, Microbiologia & Antimicrobianos

✔ Oral itraconazole vs oral voriconazole for treatment‑naive chronic pulmonary aspergillosis - VICTOR‑CPA | Lancet ID

Nefrologia

✔ ✔ ✔ Fish‑Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis — PISCES | NEJM

✔ ? ✔ Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury — BICARICU‑2 | JAMA

? ✔ ? Preventive care strategy to reduce moderate or severe acute kidney injury after major surgery - BigpAK‑2 | Lancet

Neurologia

✔ ? ✔ Candesartan versus placebo for migraine prevention in episodic migraine — Lancet Neurology

✔ ? ✔ Medical Management and Revascularization for Asymptomatic Carotid Stenosis — CREST‑2 | NEJM

✗✗✗ Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation — OCEAN | NEJM

Oncologia

✔ Ten‑Year Survival after Postmastectomy Chest‑Wall Irradiation in IntermediateRisk Breast Cancer - SUPREMO | NEJM

Pneumologia

✔ Effectiveness of Nebulized Bronchodilator‑Enhanced Sputum Induction in Presumed Pulmonary TB — NeB‑TB | CID

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ESTUDOS OBSERVACIONAIS

REVISÕES SISTEMÁTICAS COM ESTUDOS OBSERVACIONAIS (com ou sem ECA)

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

✔ Instability in End-of-Life Goals and Preferences of Patients Who Are Seriously Ill | JAMA Network Open

Nefrologia

Proteinuria or Albuminuria as Markers of Kidney and Cardiovascular Disease Risk | Ann Intern Med

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

tabela de conteúdos ↟

Cardiovascular

✔ Systolic Blood Pressure & Microaxial Flow Pump–Associated Survival in Infarct-Related Cardiogenic Shock | JAMA C

Major Bleeding With Apixaban vs Aspirin — A Subanalysis of the ARTESiA Randomized Clinical Trial | JAMA Cardiol

Gastroenterologia & Hepatologia

✔ Risk of Bleeding with a Midline vs. Lateral Approach to Paracentesis | Crit Care Med

Geral, Geriatria & Paliativos

✔ Polyneuropathy in Wild‑Type Transthyretin Amyloidosis | Eur J Neurol

✗✗✗ European Study of Prostate Cancer Screening — 23‑Year Follow‑up | NEJM

IA

✔✔✔ Large Language Model Assistant for Emergency Department Discharge Documentation | JAMA Network Open

Infecciologia, Microbiologia & Antimicrobianos

✔✔✔ Are repeat blood cultures necessary after completion of infective endocarditis treatment? | Clin Infect Dis

✔✔✔ Community-Acquired Meningitis: Shift from Streptococcus pneumoniae to Klebsiella pneumoniae | IJID J

Neurologia

✔✔✔ Thrombolysis With Tenecteplase for Minor Disabling Stroke — Secondary Analysis of TEMPO-2 | JAMA Neuro

✔ Validation of 4 Risk Stratification Tools for Delirium in the Emergency Department | JAMA Net Open

Oncologia

✔ Immune Checkpoint Inhibitors as Independent and Synergistic Drivers of SJS/TEN | JAMA Oncology

POCUS

✔✔✔ The effect of Peyton’s four‑step method for teaching point‑of‑care ultrasound psychomotor skills | USJ

✔ Erector spinae plane block for acute pain management of pancreatic cancer at the emergency department | USJ

✔ Agreement of IVC Diameter Measurements via Subcostal and Transhepatic POCUS Views | POCUS Journal

Feasibility of point-of-care ultrasound during ED triage: prospective cohort | Ultrasound Journal

Measurement of systolic blood pressure using POCUS w/ color Doppler compared to intraarterial line | POCUS Journal

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CASOS CLÍNICOS e SÉRIES DE CASOS

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

Case Report of Porphyria Complicated by PRES: A Trojan Horse Presenting as Dysmenorrhea | AIM

A Case of Pancreatitis, Panniculitis, and Polyarthritis Syndrome in Pancreatic Acinar Cell Carcinoma | AIM

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OPINIÃO

PERSPECTIVA

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

Breaking free from prognostic paralysis in chronic advanced diseases | Palliative & Supportive Care 

POCUS

Traceability of point‑of‑care ultrasound: PACS integration process in a tertiary hospital | EJIM

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✔✔✔ FOAMed

tabela de conteúdos ↟

Doente crítico/urgente

SUPraclavicular Block for Emergency Reduction of Upper Limb Injuries Versus Bier Block (SUPERB Trial) | St.Emlyn's

Imuno-mediadas

Stop using steroids to pretreat contrast allergy! | First10EM

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