Setembro 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. 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

5. 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

✔✔✔ Clopidogrel versus aspirin for secondary prevention of coronary artery disease | Lancet

✔ ? ✔ Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR) | Lancet

? ? ? β blockers after myocardial infarction with mildly reduced ejection fraction | Lancet

Gastroenterologia & Hepatologia

✗✗✗ Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis | JAMA Internal Medicine

Neurologia

? ? ? Intracranial Hemorrhage in Stroke After Endovascular Treatment With or Without IV Alteplase | JAMA Neurology

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ENSAIOS CONTROLADOS E ALEATORIZADOS

tabela de conteúdos ↟

Cardiovascular

✔✔✔ Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction - DIGIT-HF | NEJM

✔✔✔ Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias – POTCAST | NEJM

✔✔✔ Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy – MAPLE-HCM | NEJM

✔ ? ✔ Vericiguat in patients with chronic heart failure and reduced ejection fraction – VICTOR | Lancet

✔ Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation - ALONE-AF | JAMA

✔ Iodinated Adhesive Drapes for Repeat Cardiac Implantable Device Implantation | JAMA Cardiology

✔ Peri-interventional Anesthesia Strategies for Transcatheter Aortic Valve Implantation – DOUBLE-CHOICE | Circulation

? ? ? Outcomes of cardiovascular screening in men aged 60–64 years: the DANCAVAS II trial | EHJ

? ? ? Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension - BaxHTN | NEJM

Blockers after Myocardial Infarction in Patients without Heart Failure – BETAMI-DANBLOCK | NEJM

Paclitaxel-coated vs uncoated devices for infrainguinal endovascular revascularisation in chronic limb-threatening ischaemia - SWEDEPAD 1 | Lancet ; Paclitaxel-coated vs uncoated devices for infrainguinal endovascular revascularisation in patients with intermittent claudication - SWEDEPAD 2 | Lancet

✗ Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy – ODISSEY-HCM | NEJM

✗✗✗ Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation — AQUATIC | NEJM

✗✗✗ Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction – REBOOT-CNIC | NEJM ; Beta-

Doente crítico/urgente

✔✔✔ Effect of lateral versus supine positioning on hypoxaemia in sedated adults – multicentre RCT | BMJ

Endocrinologia

✔ ✗ Once-weekly Semaglutide 7·2 mg in Adults with Obesity – STEP UP | The Lancet Diabetes & Endocrinology

✔ ✗ Once-weekly Semaglutide 7·2 mg in Adults with Obesity and Type 2 Diabetes – STEP UP T2D | The Lancet D&E

Gastroenterologia & Hepatologia

✔ Rifasutenizol-based triple therapy versus bismuth plus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection in China – EVEREST-HP | The Lancet Infectious Diseases

✗ Lyophilised faecal filtrate compared with lyophilised donor stool on Clostridioides difficile recurrence | Lancet G&H

Geral, Geriatria & Paliativos

✔ ? ✔ VSR Prefusion F Vaccine for Prevention of Hospitalization in Older Adults - DAN-RSV | NEJM

✔ Bacterial Decolonization With Mupirocin Ointment for Acute Radiation Oral Mucositis Prevention | JAMA Oncology

✔ Proportional Sedation for Persistent Agitated Delirium in Palliative Care | JAMA Oncology

✔ A Fall Prevention Program Integrated in Primary Health Care for Older People in Rural China – FAMILY | JAMA

Hematologia

✔✔✔ Apixaban for Extended Treatment of Provoked Venous Thromboembolism – HI-PRO | NEJM

Imuno-mediadas

✔ Once-daily icotrokinra vs placebo ± deucravacitinib – ICONIC-ADVANCE 1 & 2 | Lancet

Infecciologia, Microbiologia & Antimicrobianos

✔✔✔ One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis | NEJM

? ? ? Dalbavancin for Treatment of Staphylococcus aureus Bacteremia – DOTS | JAMA

Nefrologia

✔ Efficacy and safety of anrikefon in patients with pruritus undergoing haemodialysis | BMJ

ORL

✔ Stapokibart for Severe Uncontrolled Chronic Rhinosinusitis With Nasal Polyps – CROWNS-2 | JAMA

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NORMAS DE ORIENTAÇÃO CLÍNICAS - GUIDELINES

tabela de conteúdos ↟

Cardiovascular

✔ ? ✔ 2025 ESC/EACTS Guidelines for the management of valvular heart disease | EHJ

Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension | NEJM

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ESTUDOS OBSERVACIONAIS

REVISÕES SISTEMÁTICAS COM ESTUDOS OBSERVACIONAIS (com ou sem ECA)

tabela de conteúdos ↟

Geral, Geriatria & Paliativos

✔ Proportional Sedation for Persistent Agitated Delirium in Palliative Care | JAMA Oncology

Hematologia

✔ Rapid ADAMTS13 activity assays for thrombotic thrombocytopenic purpura | Blood

Infecciologia, Microbiologia & Antimicrobianos

✔ Fosfomycin for the treatment of patients with bacterial prostatitis: a systematic review | EJCM&ID

POCUS

✔✔✔ Chest ultrasound vs. Radiograph for pneumothorax diagnosis by emergency healthcare workers in the ED| USJ

Is remotely supervised ultrasound (tele-ultrasound) inferior to the traditional service model? | USJ

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

tabela de conteúdos ↟

Cardiovascular

✔✔✔ Low-dose digoxin improves cardiac function in patients with HFpEF and atrial fibrillation – RATE-AF | EHJ

✔ Low-density lipoprotein cholesterol and cardiovascular risk in the absence of calcifications on CT | EHJ

✔ In-Hospital Mortality in Hemorrhagic Myocardial Infarction | NEJM Evidence

✔ Estimating the Stroke Risk Threshold for Initiating NOAC in AF: Markov Decision Model Analysis | Circulation

✔ First-Line β-Blocker Use for Hypertension in the Veterans Health Administration | JAMA Network Open

Diagnóstico e Raciocínio Clínico

✔✔✔ Research Letter: Fidelity of Medical Reasoning in Large Language Models | JAMA Network Open

Hematologia

✔ Monoclonal Antibodies in the Pathogenesis of Heparin-Induced Thrombocytopenia | NEJM

Imuno-mediadas

✔ Patient outcomes from a shared decision-making aid for systemic lupus erythematosus | Lancet Rheumatology

POCUS

✔ Handheld ultrasound devices for abdominal pathology: comparison with high-end devices | The Ultrasound Journal

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✔✔✔ FOAMed

tabela de conteúdos ↟

Endocrinologia

Episode 112 – Wherefore Iodine? | Curious Clinicians

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