Arquivos do dia: Março 1, 2022

Diretriz atualizada da Joint British Diabetes Society for Inpatient Care | Tratamento da cetoacidose diabética em adultos.

1 Mar, 2022 | 15:41h

The management of diabetic ketoacidosis in adults—An updated guideline from the Joint British Diabetes Society for Inpatient Care

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Diretriz atualizada | Momento da cirurgia eletiva e avaliação de risco após infecção por SARS-CoV-2 – “Mantemos a orientação de que os pacientes devem evitar cirurgias eletivas dentro de 7 semanas da infecção, a menos que os benefícios superem o risco de aguardar por tal período.”

1 Mar, 2022 | 15:38h

Timing of elective surgery and risk assessment after SARS-CoV-2 infection: an update – Anaesthesia

Conteúdos relacionados:

Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of Covid-19.

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

BJS commission on surgery and perioperative care post-COVID-19.

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

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[Preprint] Estudo mostra efetividade significativamente reduzida da vacina da Pfizer em crianças de 5 a 11 anos após o surgimento da variante Ômicron.

1 Mar, 2022 | 15:36h

Effectiveness of the BNT162b2 vaccine among children 5-11 and 12-17 years in New York after the Emergence of the Omicron Variant – medRxiv

Comentários:

Pfizer Covid vaccine is less effective in kids 5 to 11, study finds – STAT

Pfizer Covid-19 vaccine effectiveness fell quickly for kids during Omicron surge but still offered some protection against severe disease – CNN

More mask mandates fall as poor COVID vaccine protection noted in young kids – CIDRAP

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Revisão sistemática sobre uso inapropriado de práticas clínicas no Canadá identificou 144 práticas subutilizadas, 109 práticas usadas em excesso e 25 práticas que atendiam a ambos os critérios.

1 Mar, 2022 | 15:32h

Inappropriate use of clinical practices in Canada: a systematic review – Canadian Medical Association Journal

Comentários: What problems in health care quality should we target as the world burns around us? – Canadian Medical Association Journal

Comunicado de imprensa: Inappropriate use of 228 clinical practices in Canada – Canadian Medical Association Journal

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Estudo randomizado | Indicação de exercício precoce e com supervisão após cirurgia de câncer de mama melhora a função do ombro e a qualidade de vida relacionada a saúde.

1 Mar, 2022 | 15:30h

Resumo: Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT – Health Technology Assessment

Relatório completo: Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT – Health Technology Assessment

Conteúdo relacionado: RCT: Prophylactic Use of Compression Sleeves Reduces the Incidence of Arm Swelling in Women at High Risk of Breast Cancer–Related Lymphedema.

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Coorte retrospectiva | Troponina cardíaca I de alta sensibilidade seriada após cirurgia de revascularização do miocárdio pode adicionar informação prognóstica e ajudar na tomada de decisão pós-cirúrgica.

1 Mar, 2022 | 15:28h

High-sensitivity cardiac troponin I after coronary artery bypass grafting for post-operative decision-making – European Journal of Cardiology

Comentário: High-Sensitivity Troponin I After CABG for Postop Decision-Making – American College of Cardiology

 

Comentário no Twitter

High-sensitivity cardiac troponin I after coronary artery bypass grafting for post-operative decision-making https://t.co/sTUfRSBeWl@escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/aYsepPazwe

— European Society of Cardiology Journals (@ESC_Journals) February 23, 2022

 

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Estudo randomizado | Melatonina profilática não reduz a incidência de delirium em pacientes em UTI.

1 Mar, 2022 | 15:27h

Prophylactic melatonin for delirium in intensive care (Pro-MEDIC): a randomized controlled trial – Intensive Care Medicine (link para o resumo – $ para o texto completo)

 

Comentários no Twitter

Enteral prophylactic melatonin initiated early (within 48h of admission) & continued throughout #ICU (MAX 14 consecutive days) do not ⬇️#delirium prevalence vs placebo, Pro-MEDIC multicentre RCT
➡️12🇦🇺ICUs
➡️841 pts
➡️delirium-free assessments 79.2% vs 80%https://t.co/Gt5o1VuRo7 pic.twitter.com/gPRWxxmhHS

— Intensive Care Medicine (@yourICM) February 28, 2022

In 841 ICU patients with expected stay >72h, 4 mg melatonin within 48h after admission for 14 days vs placebo made no sign. differences in delirium-free assessments, LoS, 90d mortality, nor quality & quantity of sleep
Good bye Melatonin, we had a good timehttps://t.co/d0dayil99W

— Peter Nydahl (@NydahlPeter) February 28, 2022

 

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Revisão | Nova geração de tratamentos psicológicos na dor crônica.

1 Mar, 2022 | 15:25h

New generation psychological treatments in chronic pain – The BMJ (gratuito por tempo limitado)

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Estudo randomizado | Uma intervenção orientada por atenção plena (mindfulness) pode reduzir a dor crônica e o uso indevido de opioides na atenção primária.

1 Mar, 2022 | 15:10h

Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial – JAMA Internal Medicine (link para o resumo – $ para o texto completo)

Comentário: Mindfulness-Based Intervention Found to Reduce Chronic Pain and Opioid Misuse – Psychiatric News Alert

 

Comentário no Twitter

A randomized clinical trial showed that #Mindfulness-Oriented Recovery Enhancement delivered in the primary care setting reduces opioid misuse by as much as 46%, while simultaneously reducing chronic pain and emotional distress. https://t.co/eNj42RBCRA @DrEricGarland pic.twitter.com/tBatMT9lkQ

— JAMA Internal Medicine (@JAMAInternalMed) February 28, 2022

 

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Câncer orofaríngeo associado ao HPV: epidemiologia, biologia molecular e tratamento clínico.

1 Mar, 2022 | 15:03h

HPV-associated oropharyngeal cancer: epidemiology, molecular biology and clinical management – Nature Reviews Clinical Oncology (se o acesso a este link for pago, tente este)

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