Resúmenes comentados. 22/09/2008

Medciclopedia

La CDC actualiza sus guías de escrutinio para hepatitis B

Posted: 19 Sep 2008 10:22 AM PDT

El centro para el control y prevención de las enfermedades (CDC, por sus siglas en inglés) de los Estados Unidos ha actualizado sus recomendaciones para el escrutinio de hepatitis B. La enciclopedia médica – http://medciclopedia.com Ahora la CDC extiende el escrutinio para hombres que tengan sexo con hombres, usuarios de drogas intravenosas, pacientes que reciban […]

Las sibilancias en la niñez relacionados con el asma del adulto

Posted: 19 Sep 2008 10:15 AM PDT

El asma que tiene su inicio en el adulto joven deriva de factores presentes en la niñez temprana, de acuerdo con un estudio de cohortes publicado en Lancet. La enciclopedia médica – http://medciclopedia.com Los investigadores examinaron datos de una cohorte de 850 niños que fueron evaluados a los 6 años de edad y después se […]

Avances en la detección de cáncer colorrectal

Posted: 18 Sep 2008 08:58 AM PDT

La coloscopía tomográfica tiene una alta sensibilidad para detectar adenomas grandes, y un periodo de 5 años para hacerla de nuevo en pacientes que hayan salido negativos parece ser apropiado para algunos pacientes, de acuerdo a dos estudios publicados en New England Journal of Medicine. La enciclopedia médica – http://medciclopedia.com En el primer estudio, alrededor […]
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Physician’s First Watch for September
JournalWatch – Medicne taht matters

ACP Issues Guidelines for Pharmacologic Treatment of Low Bone Density, Osteoporosis

The American College of Physicians has released recommendations for the pharmacologic treatment of patients with low bone density or osteoporosis.

 

The guidelines, published in the Annals of Internal Medicine, are based on efficacy data from more than 100 randomized, controlled trials or meta-analyses, as well as safety data from nearly 500 articles.

Among the recommendations:

  • Clinicians should offer pharmacotherapy (e.g., bisphosphonates, raloxifene) to women and men who have osteoporosis or have experienced fragility fractures.
  • Providers should consider treatment for adults at risk for osteoporosis, especially those who have T scores between –1.5 and –2.5, are older than age 62, or are receiving glucocorticoids.
  • Clinicians should assess the potential benefits and risks of each drug option in each patient before deciding on treatment. (The Annals article includes a helpful table summarizing the benefits and harms of various treatments.)

    Annals of Internal Medicine article (Free)

    World Health Organization fracture risk assessment tool (Free)

    Ipratropium Associated with Higher Mortality Risk in Recently Diagnosed COPD

    Ipratropium carries a higher cardiovascular mortality risk than other drugs used to treat chronic obstructive pulmonary disease (COPD), according to an Annals of Internal Medicine report.Using a nested case-control design, researchers examined mortality risks in a 145,000-member cohort of U.S. veterans recently diagnosed with COPD. Analysis of Veterans Affairs databases revealed a higher risk for cardiovascular death among those with ipratropium exposure in the 6 months preceding their death than among matched controls who had not received ipratropium in the same 6-month period (odds ratio, 1.34).

    Inhaled corticosteroids were associated with a decrease in cardiovascular deaths.

    The authors, noting that their data suggest “a substantial number of premature deaths” due to ipratropium use, conclude that “caution is warranted” in using the drug alone in patients with a recent diagnosis of COPD.

     

    Annals of Internal Medicine article (Free)