Selection of publications on the FEMEBA Foundation website (November 2023) – CIME

On the website of the FEMEBA Foundation (Medical Federation of the Province of Buenos Aires), you will find translated summaries of the following works:

Semaglutide and cardiovascular outcomes in patients with obesity but without diabetes. , N Engl J Med, Nov 11, 2023.
In patients who had a previous cardiovascular event and body mass index greater than 27 kg/m2 but did not have diabetes, the addition of 2.4 mg semaglutide weekly reduced the incidence of major vascular events by 1.5% after 40 months of follow-up. . NNT of 67 (95% CI 44–136). Adverse events occurred more frequently in the semaglutide group with an ANN of 12 (95% CI 11–13), leading to treatment suspension.
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Apixaban or aspirin to prevent stroke in subclinical atrial fibrillation , N Engl J Med, Nov 12, 2023.
In patients with subclinical atrial fibrillation, the use of apixaban reduced the risk of stroke or systemic embolism compared with aspirin (difference of 0.46% fewer events per patient-year), but increased the risk of major bleeding (difference of 0.77% per patient ) Year).
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Decreased effectiveness of live zoster vaccine during 10 years after vaccination , BMJ, November 8, 2023.
Live zoster vaccine was initially very effective, but the effectiveness of the vaccine declined significantly over time, although some protection remained even 10 years after vaccination. During the entire follow-up time, the overall efficacy of the vaccine was 46% (45% to 47%) against herpes zoster, 62% (59% to 65%) against postherpetic neuralgia, 45% (40% to 49%) against . Against ocular herpes zoster. and 66% (55% to 74%) were against hospitalization for herpes zoster.
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Pharmacotherapy for alcohol use disorder: a systematic review , JAMA, November 7, 2023.
In this systematic review and meta-analysis, which included 118 clinical trials and 20,976 participants, oral naltrexone and 50 mg/day of acamprosate were associated with significantly improved alcohol-related outcomes compared with placebo.
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Use of corticosteroids guided by eosinophil count in COPD exacerbation , Lancet Respir Med, November 1, 2023.
The strategy of prednisolone for COPD exacerbation only in patients with eosinophil count more than 2% allows to avoid the use of steroids in one third of the exacerbation without compromising the final outcome compared to usual care.
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Thalidomide to prevent recurrent bleeding in small bowel dysplasia , N Engl J Med, November 2, 2023.
In this placebo-controlled clinical trial, treatment with thalidomide for 4 months reduced bleeding in patients with relapsed small bowel angiodysplasia. The drug, in addition to its sedative properties, has antiangiogenic, anti-inflammatory and immunomodulatory effects.
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Effects of a multimodal primary care intervention to reduce second-line antibiotic prescriptions for urinary tract infections in women. , BMJ, November 2, 2023.
In this parallel, cluster-randomized, controlled trial, a multimodal intervention in general practice significantly reduced the proportion of second-line antibiotics and all antibiotic prescriptions for uncomplicated urinary tract infections in women.
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Impact of work accidents on the use of psychotropic drugs: the case of benzodiazepines. , Health Econ Rev, October 23, 2023.
The risk of overuse of benzodiazepines is due to an increase in the likelihood of benzodiazepine use following a work-related accident, which leads to overuse rather than an increase in the likelihood of overuse in people who use benzodiazepines. The results call for a focus on first-time prescribing to limit the risk of overuse after a work-related accident.
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Treatment outcomes with licensed and off-label stimulant supplements for adults with attention-deficit/hyperactivity disorder. , JAMA Psychiatry, October 25, 2023.
In this systematic review and meta-analysis, based on group averages, off-label doses of stimulants may not have a positive risk benefit compared with licensed doses for adults with ADHD. In general, physicians should consider off-label dosing with caution. Clinicians may try off-label doses if necessary and tolerated, but should keep in mind that additional dose increases may not result in major improvements in drug response. However, the findings are averages and will not generalize to all patients.
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Immediate prescription of antibiotics versus delayed prescription versus not prescribing them for respiratory infections , Cochrane Database of Systematic Reviews, October 4, 2023.
There were no differences between prescribed strategies in many clinical outcomes. Symptoms of acute otitis media and sore throat were marginally improved by immediate antibiotic prescription compared to delayed antibiotic prescription. There were no significant differences in complication rates. Delaying prescribing compared with immediately prescribing antibiotics did not make a significant difference in patient satisfaction levels (86% vs. 91%; moderate-certainty evidence). However, delayed prescription of antibiotics was more favorable than not prescribing antibiotics (87% vs. 82%). Delayed antibiotic prescribing yielded lower rates of antibiotic use than immediate prescribing (30% vs. 93%). The no-antibiotic strategy further reduced antibiotic use compared with delayed antibiotic prescription (13% vs. 27%).
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Safety outcomes when switching between biosimilars and reference biologics: systematic review and meta-analysis., Plus One, October 3, 2023.
This first systematic review to use statistical methods to address the risk of switching patients between reference biologics and biosimilars finds no difference in the safety profile or immunogenicity rates between patients who switched and those who switched to the reference biologic. Or remained on biosimilars.
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Incidence and risk factors of drug-induced kidney injury in children: a systematic review and meta-analysis. , Eur J Clin Pharmacol, Oct 3, 2023.
The incidence of drug-induced kidney injury (LRIF) is high in children, especially among critically ill children. Identifying high-risk groups and prescribing safe treatments is essential to reduce the incidence of LRIF in children. In clinical practice, doctors should adjust the drug regimens for high-risk pediatric groups, such as ICU admission, certain underlying diseases, combination with nephrotoxic drugs, etc., and throughout the entire period of treatment Kidney function should be evaluated periodically during treatment.
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