Clínica Médica

Revisão | Encarando o desafio da polifarmácia ao prescrever medicamentos para idosos com doença cardiovascular.

17 Out, 2022 | 14:08h

Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy – European Heart Journal – Cardiovascular Pharmacotherapy

Conteúdos relacionados:

Deprescribing in Older Adults with Cardiovascular Disease – Journal of the American College of Cardiology

Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology

Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis – Health Technology Assessment

Antihypertensive Deprescribing in Older Adults: a Practical Guide – Current Hypertension Reports

How-to guide for medication reviews in older adults with cancer: A Young International Society of Geriatric Oncology and Nursing & Allied Health Interest Group initiative – Journal of Geriatric Oncology

Deprescribing in Palliative Cancer Care – Life

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review – Kidney360

Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review – Research in Social and Administrative Pharmacy

AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review – Gastroenterology

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults – JAMA Network Open

The MedSafer Study—Electronic Decision Support for Deprescribing in Hospitalized Older Adults: A Cluster Randomized Clinical Trial – JAMA Internal Medicine

Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models – Drugs & Aging

Deprescribing in palliative patients with cancer: a concise review of tools and guidelines – Supportive Care in Cancer

Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review – Exploratory Research in Clinical and Social Pharmacy

A narrative review of evidence to guide deprescribing among older adults – Journal of General and Family Medicine

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens – The Lancet Health Longevity

Polypharmacy Management in Older Patients – Mayo Clinic Proceedings

Psychopharmacological Treatment in Older People: Avoiding Drug Interactions and Polypharmacy – Deutsches Ärzteblatt international

Eliminating Medication Overload: A National Action Plan – Lown Institute

International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): Position Statement and 10 Recommendations for Action – Drugs & Aging

Common ED Medication Errors: Polypharmacy – emDocs

Current and future perspectives on the management of polypharmacy – BMC Family Practice

Routine deprescribing of chronic medications to combat polypharmacy – Therapeutic Advances in Drug Safety

Polypharmacy—an Upward Trend with Unpredictable Effects – Deutsches Ärzteblatt international

Clinical Consequences of Polypharmacy in Elderly – Expert Opinion on Drug Safety

 

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Diretriz de posicionamento | Doença renal crônica como fator de risco cardiovascular na rotina de prática clínica.

17 Out, 2022 | 14:05h

Chronic kidney disease as cardiovascular risk factor in routine clinical practice: a position statement by the Council of the European Renal Association – Nephrology Dialysis Transplantation

 

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Diretriz de posicionamento | Monitoramento domiciliar da pressão arterial.

17 Out, 2022 | 14:04h

Home blood pressure monitoring: a position statement from the Korean Society of Hypertension Home Blood Pressure Forum – Clinical Hypertension

Conteúdos relacionados:

2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement – Journal of Hypertension

Current applications and limitations of European guidelines on blood pressure measurement: implications for clinical practice – Internal and Emergency Medicine

Randomized Diagnostic Study: home blood pressure measurements correlate better with 24-h ambulatory monitoring measurements compared to clinic, and kiosk measurements.

Study suggests a 30-second interval between automated office blood pressure measurements is as accurate and reliable as a 60-second interval.

USPSTF Statement recommends screening for hypertension in adults 18 years or older with office blood pressure measurement – diagnostic confirmation with blood pressure measurements outside of the clinical setting is advised before starting treatment

Study suggests that 7 days of home blood pressure monitoring is likely better than 24h ambulatory monitoring or 3 office measurements

 

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Diretriz ACC 2022 sobre avaliação e disposição da dor torácica aguda no departamento de emergência.

17 Out, 2022 | 13:43h

2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee – Journal of the American College of Cardiology

Comentário: Guideline Guidance: Practical Tips for Finding, Triaging Chest Pain in the ED – TCTMD

Conteúdos relacionados:

2021 AHA/ACC Guideline for the Evaluation and Diagnosis of Chest Pain.

High-sensitivity cardiac troponin and the 2021 AHA/ACC Guidelines for the evaluation and diagnosis of acute chest pain.

Navigating a Complicated World | Commentary of the new AHA/ACC Chest Pain Guidelines.

 

Comentário de um dos autores no Twitter (fio – clique para saber mais)

Now out in @JACCJournals, pleased to share our @ACCinTouch Expert Consensus Decision Pathway on the Evaluation of Acute Chest Pain in the ED led by Chair @Mikekontos1 and Vice-Chair Dr. James De Lemos.

Link: https://t.co/qFg2IGc0io

Thread👇

1/ pic.twitter.com/PFgryQE0HD

— Cian McCarthy (@CianPMcCarthy) October 12, 2022

 

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Estudo randomizado | Alopurinol não melhora os desfechos em pacientes com doença cardíaca isquêmica sem gota prévia.

17 Out, 2022 | 13:42h

Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART): a multicentre, prospective, randomised, open-label, blinded-endpoint trial – The Lancet

Comentário convidado: Xanthine oxidase inhibition for cardiovascular disease prevention – The Lancet

Conteúdo relacionado: [News release – not published yet] #ESCCongress – RCT | Allopurinol does not improve cardiovascular outcomes in ischemic heart disease patients.

 

Comentário no Twitter

Despite favorable effects on surrogate endpoints in smaller trials, in an RCT trial of 5,721 pts with CAD, allopurinol did not significantly improve cardiovascular prognosis compared to placebo https://t.co/ITW4HAwI2K @TheLancet pic.twitter.com/EggHM8flle

— Pradeep Natarajan (@pnatarajanmd) October 7, 2022

Sob licença de Creative Commons Attribution (CC BY 4.0)

 

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Incidência de miocardite/pericardite após vacinação contra COVID-19 com vacina mRNA entre crianças e jovens adultos nos EUA.

17 Out, 2022 | 13:38h

Incidence of Myocarditis/Pericarditis Following mRNA COVID-19 Vaccination Among Children and Younger Adults in the United States – Annals of Internal Medicine

Comunicado de imprensa: Incidence of myocarditis/pericarditis following mRNA COVID-19 vaccination among children, younger adults in the US – American College of Physicians

 

Comentário no Twitter (fio – clique para saber mais)

Let me me perfectly clear about the evidence for myocarditis after mRNA vaccines
1. There is a notable increased incidence, age 12-39, males, with each dose (Table)https://t.co/XXQbyeLiSP pic.twitter.com/wLTZT3fppy

— Eric Topol (@EricTopol) October 12, 2022

 

Comentário no Twitter

Let me me perfectly clear about the evidence for myocarditis after mRNA vaccines
1. There is a notable increased incidence, age 12-39, males, with each dose (Table)https://t.co/XXQbyeLiSP pic.twitter.com/wLTZT3fppy

— Eric Topol (@EricTopol) October 12, 2022

 

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Revisão | Ataque isquêmico transitório e AVC leve: diagnóstico, estratificação de risco e tratamento.

17 Out, 2022 | 13:36h

Transient ischemic attack and minor stroke: diagnosis, risk stratification and management – Canadian Medical Association Journal

 

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Séries de caso e revisão sistemática | Arritmia cardíaca ameaçadora à vida e morte súbita durante a prática de jogos eletrônicos.

17 Out, 2022 | 13:35h

Life-threatening cardiac arrhythmia and sudden death during electronic gaming: An international case series and systematic review – Heart Rhythm

Editorial: Ventricular arrhythmias during electronic gaming: Sudden victory and sudden death – Heart Rhythm

Comunicado de imprensa: Electronic gaming can trigger potentially lethal heart rhythm problems in susceptible children – Elsevier

 

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Benefícios de 15 anos do rastreamento por sigmoidoscopia na incidência e na mortalidade de câncer colorretal: análise agrupada de estudos randomizados.

17 Out, 2022 | 13:34h

15-Year Benefits of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality: A Pooled Analysis of Randomized Trials – Annals of Internal Medicine (link para o resumo – $ para o texto completo)

Comunicado de imprensa: One sigmoidoscopy significantly reduces long-term CRC incidence in both men and women – American College of Physicians

Conteúdos relacionados:

RCT | Effect of colonoscopy screening on risks of colorectal cancer and related death.

RCT: One-time flexible sigmoidoscopy screening is associated with long-term reduction in colorectal cancer incidence and mortality.

ACP Guideline: Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults

BMJ Guideline: Colorectal Cancer Screening with Fecal Immunochemical Testing, Sigmoidoscopy or Colonoscopy

Current and future colorectal cancer screening strategies – Nature Reviews Gastroenterology & Hepatology (se o acesso a este link for pago, tente este em PMC)

Consensus Statement: U.S. Multi-Society Task Force on Colorectal Cancer now suggests average-risk CRC screening begins at age 45.

USPSTF Statement: Start colorectal cancer screening at 45 years for most patients.

ACG Clinical Guidelines: Start colorectal cancer screening at 45

 

Comentário no Twitter

A pooled analysis evaluating 15-yr effect of sigmoidoscopies found that receiving 1 #sigmoidoscopy significantly reduces long-term incidence of CRC in men and women: https://t.co/QXj5VRMHeo pic.twitter.com/s82sOJmBzr

— Annals of Int Med (@AnnalsofIM) October 11, 2022

 

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Diretriz | Manejo periprocedimento de agentes antitrombóticos e trombocitopenia para procedimentos comuns em oncologia.

17 Out, 2022 | 13:31h

Peri-procedure management of antithrombotic agents and thrombocytopenia for common procedures in oncology: Guidance from the SSC of the ISTH – Journal of Thrombosis & Haemostasis

 

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