Novedades Bibliográficas

Omega 3 polyunsaturated fatty acids and healthy ageing

British Medical Journal - hace 13 horas 42 mins
Populations across the world are living longer.1 Between 2015 and 2050, the proportion of the population worldwide, who are aged over 60 will nearly double from 12% to 22%.2 Amid this rapid shift in...

Pre-eclampsia and risk of dementia later in life: nationwide cohort study

British Medical Journal - hace 13 horas 43 mins
AbstractObjectiveTo explore associations between pre-eclampsia and later dementia, overall and by dementia subtype and timing of onset.DesignNationwide register based cohort...

Serial circulating omega 3 polyunsaturated fatty acids and healthy ageing among older adults in the Cardiovascular Health Study: prospective cohort study

British Medical Journal - hace 13 horas 43 mins
AbstractObjectiveTo determine the longitudinal association between serial biomarker measures of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) levels and healthy ageing.DesignProspective...

Concerns about the promotion of a cardboard baby box as a place for infants to sleep

British Medical Journal - hace 13 horas 43 mins
The successful reduction in cot deaths (sudden infant death syndrome or SIDS) in England and Wales from nearly 1600 deaths in 1988 to less than 200 in 2015 stems from evidence based research.1...

US will display drug prices on TV advertisements, says health secretary

British Medical Journal - Mié, 17/10/2018 - 12:36
A legal and political battle is brewing as the US government plans to require drug advertisements on television to display the list price of a 30 day supply of their product.The US health secretary,...

Karen Kirkham: Community hub pioneer

British Medical Journal - Mié, 17/10/2018 - 11:46
bmj;363/oct17_7/k4105/FAF1faDuncan SmithBiographyKaren Kirkham, a Dorset GP who has been instrumental in creating a new care system for the county, was appointed national clinical adviser in primary...

Highlights for October 16, 2018

JAMA - Mar, 16/10/2018 - 02:00

J. Marion Sims and the Historical Aspects of Race and Medicine

JAMA - Mar, 16/10/2018 - 02:00
This Viewpoint uses controversy over the status of statues commemorating J. Marion Sims, a Southern gynecologist who developed operative techniques for vesicovaginal fistulae on enslaved women, to discuss changing the history of attitudes toward race and discrimination in medicine and society.

Race, Ancestry, and Reporting in Medical Journals

JAMA - Mar, 16/10/2018 - 02:00
This Viewpoint discusses the appropriateness of documentation of race in the medical history and record, and discusses the challenge of taking the effects of race on patient health seriously without overemphasizing it as an unalterable source of difference at the individual or population level.

The Use of Race, Ethnicity, and Ancestry Data in Biomedical Research

JAMA - Mar, 16/10/2018 - 02:00
This Viewpoint discusses the need for a consensus on how race, ethnicity, and ancestry data are reported in biomedical research to avoid inappropriately describing racial and ethnic groups as discrete population groups.

NIH Policy for Inclusion Across the Lifespan in Clinical Research

JAMA - Mar, 16/10/2018 - 02:00
This Viewpoint summarizes provisions of the National Institutes of Health’s Inclusion Across the Lifespan policy scheduled for implementation in 2019 for clinical trials, which will require written plans to recruit younger and older participants as a part of grant applications and documentation of participant age in trial progress reports.

Resistance to the Normalization of the Sadness of Patients’ Reality

JAMA - Mar, 16/10/2018 - 02:00
In this narrative medicine essay, a pediatric hospitalist resists accepting as normal the deep economic desparities among the children living in poverty even if she is at risk of burnout.

Race, Ancestry, and Medical Research

JAMA - Mar, 16/10/2018 - 02:00
The discussion of race and medicine in the United States is challenging and emotionally charged. Substantial disparities in health outcomes, based on race, ethnicity, and socioeconomic status, continue to exist; additional reports of racial bias and profound insensitivity in research continue to emerge in the popular media. A renewed discussion of race as a biological vs social construct has begun and is complicated by emerging data on genetics, race, and ancestry.

Failure of Low-Dose Theophylline to Prevent Exacerbations in Patients With COPD

JAMA - Mar, 16/10/2018 - 02:00
Exacerbations drive morbidity, mortality, and the costs of care in patients with chronic obstructive pulmonary disease (COPD). Inhaled therapy with long-acting bronchodilators, with or without inhaled glucocorticoids, can help prevent further exacerbations, but some patients continue to experience them despite optimal inhaled medical therapy. These patients are most prone to hospitalization and death with limited pharmacological alternatives to decrease future exacerbations. Long-term macrolide therapy and phosphodiesterase type 4 inhibitors may be options for some patients with recurrent exacerbations, but use of these agents can be cost prohibitive, or cannot be tolerated by all patients. This population represents a large clinical unmet need that requires additional therapeutic options.

Setting Appropriate Expectations After Bariatric Surgery

JAMA - Mar, 16/10/2018 - 02:00
Bariatric surgery is the most effective intervention available for treating obesity and its numerous associated comorbid conditions, and for improving the quality and length of life for patients with severe obesity. Given the initial cost and risk of bariatric operations, defining the long-term benefits of bariatric surgery is critical for justifying its utility as an obesity treatment. Inadequate follow-up and lack of standardization of how to define failure of bariatric operations have limited the ability to fully assess their clinical utility. In this issue of JAMA, King et al provide recommendations for how to best measure clinically important weight regain after bariatric surgery based on Longitudinal Assessment of Bariatric Surgery (LABS) study outcomes.

Preventing Macrovascular Events With Bariatric Surgery

JAMA - Mar, 16/10/2018 - 02:00
Obesity and type 2 diabetes are associated with an increased incidence of macrovascular disease events, including coronary artery and cerebrovascular disease. The mainstay for treating type 2 diabetes is lifestyle modification for weight loss and pharmaceutical control of lipids, blood pressure, and glucose. These treatments have largely been shown to reduce microvascular disease, with less effect on development of macrovascular disease. It has always been known that bariatric surgery improves microvascular disease and in this issue of JAMA, Fisher et al report that bariatric surgery is associated with substantial improvements in macrovascular disease, begging the question: why is bariatric surgery not as well accepted as medications for treatment of type 2 diabetes?

Effect of Theophylline as an Adjunct to Inhaled Corticosteroids on COPD Exacerbations

JAMA - Mar, 16/10/2018 - 02:00
This randomized clinical trial compares the effects of adding theophylline vs placebo to inhaled corticosteroids (ICS) treatment on prevention of exacerbations in patients with chronic obstructive pulmonary disease (COPD).

Comparison of Common Measures of Weight Regain With Outcomes Following Bariatric Surgery

JAMA - Mar, 16/10/2018 - 02:00
This cohort study compares associations between 13 measures of weight gain and progression of diabetes, hyperlipidemia, and hypertension 5 or more years after Roux-en-Y gastric bypass surgery.

Association Between Bariatric Surgery and 5-Year Macrovascular Outcomes in Patients With Type 2 Diabetes

JAMA - Mar, 16/10/2018 - 02:00
This cohort study investigates associations between bariatric surgery and incident macrovascular events (coronary artery and cerebrovascular diseases) in patients with type 2 diabetes.

Advances in Diagnosis and Treatment of Venous Thromboembolism

JAMA - Mar, 16/10/2018 - 02:00
This narrative review summarizes advances in diagnosis and treatment of venous thromboembolism (VTE), including use of age-adjusted D-dimer levels and rule-out criteria (PERC) to exclude the diagnosis, use of newer oral anticoagulants (NOACs) as treatment, and indications for thrombolysis.
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