医学新闻 2014

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  1. Findings from a retrospective analysis in the November 5, 2014 issue of JAMA support initiation of the full spectrum of preventative measures to the management of nonobstructive coronary artery disease affecting more than one vessel.
  2. In November 19, 2014 issue of JAMA, researchers compare an investigative therapy (the Watchman device, which is implanted percutaneously and seals the ostium of the left atrial appendage) with warfarin therapy in patients with nonvalvular atrial fibrillation. At 4 years, patients randomized to receive the device had lower rates of hemorrhagic stroke and cardiovascular-related death.
  3. In a controlled crossover feeding study in the December 17, 2014 issue of JAMA, researchers compared 4 diets with different carbohydrate profiles. Compared with a diet low in carbohydrate and with a low total glycemic index, the high-carbohydrate, high-glycemic index diet was associated with significantly increased level of triglycerides.
  4. In a study in the December 15, 2014 issue of Clinical Infectious Diseases, patients treated for hepatitis C infection were followed for a median of 4 years. Among patient who demonstrated spontaneous clearing of the infection or achieved a sustained virologic response, subsequent infection and with a different strain of the virus occurred in more than 25% of patients.
  5. In a study in the December 3, 2014 Journal of Bone and Joint Surgery, researchers assessed the effects of bracing in older adults with single acute thoracic or lumbar vertebral compression fractures. They found the improvement in pain and disability were equal with or without bracing.
  6. On the webside of the Annals of Internal Medicine, an evaluation (by the United States Preventative Services Task Force)of the evidence for screening asymptomatic community-dwelling adults for vitamin D deficiency reaches the conclusion that the harms of treating patients with vitamin D deficiency are small to none.
  7. In a study in the December 14 2014 Journal of Clinical Endocrinology and Metabolism, researchers evaluate the interaction of proton pump inhibitors ( PPIs) with levothyroxine therapy. Based on their findings, it appears that PPIs interfere with the absorption of tablet but not liquid formulation of levothyroxine.
  8. In a case-control study on the website of JAMA Internal Medicine, researchers compared risk for hypoglycemia in patients prescribed tramadol versus codeine for noncancer pain. After adjusting for multiple variables, the risk of hospitalization due to hypoglycemia was significantly higher with tramadol than with codeine.
  9. In a prospective cohort study in the December 2, 2014 Annals of Internal Medicine, researchers evaluated the relationship between diabetes and risk for cognitive decline. During a median follow-up of 19 years, decline in cognitive function scores a showed an association with presence of diabetes, severity and duration of diabetes.
  10. In a study in the January 1, 2015 New England Journal of Medicine, patients with documented proximal arterial occlusion in the anterior cerebral circulation were randomized either to usual care or to endovascular therapy. Rates of recanalization and functional outcomes at 3 months were better in the endovascular therapy group.

 

1.2014年11月5日JAMA一项回顾性分析结果, 支持对影响到不止一个血管的非阻塞性​​冠状动脉疾病实行全面预防措施 (JAMA 2014 Nov 5; 312:17454)。
2.在2014年11月19日的JAMA上,研究人员比较了一项新的疗法(守望装置, 经皮植入和密封左心耳口)与华法林治疗非瓣膜性房颤。4年后, 接受装置的患者出血性中风和心血管相关死亡率较低 (JAMA 2014 Nov 19; 312:1988)。

3.2014年12月17日JAMA比较了4种含不同碳水化合物的饮食。与低碳水化合物, 低总血糖生成指数饮食相比, 高碳水化合物, 高血糖指数饮食, 与甘油三酯水平增高有关 (JAMA 2014 Dec 17; 312:2531)。
4.2014年12月15日临床传染病杂志报告了丙型肝炎患者治疗后4年的随访情况。感染自发清除或实现了持续的病毒学反应的患者, 随后感染不同菌株病毒的机率为25%以上 (Clin Infect Dis 2014 Dec 15; 59:1678)。
5.201412月3日骨关节外科杂志, 评估了老年人单一急性胸腰椎椎体压缩性骨折使用支撑的疗效。结果表明, 有或无支撑对疼痛和残疾的改善都是相似的 (J Bone Joint Surg Am 2014 Dec 3; 96:1959)。
6.内科医学年刊网站上, 评估了(由美国预防服务工作组)筛查无症状的社区居住的成年人维生素D缺乏。 达到的结论是, 治疗患者的维生素D缺乏无害 (Ann Intern Med 2014 Nov 25; (e-pub ahead of print))。

7.在2014年12月14日临床内分泌与代谢杂志上, 研究人员评估了质子泵抑制剂与左甲状腺素的相互反应。结果表明, 质子泵抑制剂干扰甲状腺素片剂的吸收, 而不干扰甲状腺素液体制剂的吸收 (J Clin Endocrinol Metab 2014 Dec; 99:4481)。
8.在JAMA内科杂志网站上一项病例对照研究中, 研究人员比较了曲马多 (tramadol)与可待因治疗非癌性疼痛导致低血糖的风险。在调整多个变量后, 因低血糖住院的风险, 曲马多显著高于可待因 (JAMA Intern Med 2014 Dec 8; (e-pub ahead of print))。
9.2014年12月2日内科年刊一项前瞻性队列研究, 评估了认知功能减退与糖尿病之间的关系。在平均19年的随访里,认知功能下降分数与糖尿病的存在, 糖尿病的严重程度和糖尿病病程的长短有关 (Ann Intern Med 2014 Dec 2; 161:785)。

  1. 在2015年1月1日新英格兰医学杂志一项研究中, 大脑前循环近端动脉闭塞的患者被随机分配接受常规治疗或血管内治疗。3个月后, 血管再通和功能结果以血管内治疗组更好 (N Engl J Med 2015 Jan 1; 372:11) 。
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