1. According to an evidenced review in the October 22 and 29 issue of JAMA, 160 mg of trimethoprim and 800 mg sulfamethoxazole twice daily for 3-7 days should be used as first-line therapy for managing uncomplicated urinary tract infection in women.
2. In a population-base case-control study on the website of the BMJ, researchs found that, in patients taking angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers, the concomitant use of trimethoprim-sulfamethoxazole was associated with excessive risk for sudden death.
3. On the website of Radiology, Researchers used propensity-score matching to compare risk for kidney injury patients who underwent contrast-enhanced versus unenhanced computed tomography (CT). They found that use of intravenous contrast was associated with no significant increase in risk for dialysis or mortality in the study population.
4. In a study in the October 7 Annals of Internal Medicine, researchers tracked trends in the use of cardiac stress tests, with and without imaging, in patients without known coronary disease. They concluded that stress testing with imaging is overutilized in this population.
5. In a meta-analysis on the website of the BMJ, researchers evaluated the effect of thienopyridine treatment in patients with unstable angina or non-ST-segment elevation myocardial infarction (MI). They found that treatment with thienopyridine was associated with significantly higher risk for major bleeding events and no decrease in mortality rates.
6. In a multicenter, open-label study on the website of JAMA, older patients with hypertension, dyslipidemia or diabetes we randomized to either 100 mg per day of aspirin or no aspirin. After a median follow-up on 5 years, aspirin therapy was associated with modest decrease in risk for nonfatal events and significant increase in risk for extracranial hemorrhage requiring transfusion or hospitalization.
7. In 2 studies in the October Journal of the American Geriatric Society, researchers describe healthcare-use outcomes in older patients receiving home-based primary care. The researchers found that, compared to controls or to projected outcomes, the use of home-based primary care services was associated with fewer emergency department visits and hospitalizations, similar rates of mortality and lower overall costs.
8. In a retrospective study in the November issue of Radiology, researchers assessed whether findings on CT accurately predicted response to medical therapy in patient suspected of having adhesive small bowel obstructions. High rates of response to medical therapy were seen in patients transition zone and absence of peak signs.
9. In a multicenter study in November issue of Anesthesiology, patients with arm pain attributed to cervical radiculopathy were randomized to one of the 3 approaches to management: Epidural steroid injections, drug therapy plus physical therapy, or both interventions. In one month, arm-pain scores improved similarly in all groups.
10. In a meta-analysis on the website of The Lancet, researchers assessed weather body mass index (BMI) influenced the efficacies of various antihypertensive regimens. Their results suggest that BMI should not be used as a factor in the selection of antihypertensive therapies.

 

1. 根据在10月JAMA的研究, 160毫克的甲氧苄啶和和800毫克的复方磺胺甲恶唑, 每天两次共3-7天, 应作为女性单纯尿路感染的一线治疗 (JAMA 2014 Oct 22/29; 312: 1677)。
2. BMJ的网站上一项人群为基础的病例对照研究发现, 服用血管紧张素转换酶（ACE）抑制剂或血管紧张素受体阻断剂的患者, 同时使用复方新诺明, 突然死亡的风险增加 (BMJ 2014 Oct 30; 349:g6196)。
3. 在放射杂志网站上，研究人员使用倾向得分, 比较了接受造影增强与非增强计算机断层扫描（CT）病人肾损伤的危险。他们发现, 使用静脉造影的病人透析或死亡的风险并无显著增加 (Radiology 2014 Sep 9; (e-pub ahead of print))。
4. 10月7日年鉴内科的一项研究中, 研究人员跟踪了在已知无冠心病患者中使用心脏压力测试的趋势。他们认为, 成像压力测试 (stress test with image)在该人群中使用过度 (Ann Intern Med 2014 Oct 7; 161:482)。
5. 在BMJ网站上一项荟萃分析中, 研究人员评估了噻吩并吡啶 (thienopyridine)治疗不稳定型心绞痛或非ST段抬高心肌梗死（MI）的效果。他们发现, 噻吩并吡啶治疗, 大出血事件风险较高, 死亡率没有减少 (BMJ 2014 Oct 24; 349:g6269)。
6. JAMA的网站上一项多中心研究中, 患有高血压, 血脂异常, 糖尿病的老年患者被随机分配到阿司匹林每天100毫克或没有阿司匹林组。经过平均5年的随访, 阿司匹林治疗组非致死性事件风险适度降低, 但颅外出血需要输血或住院的风险显著增加 (JAMA 2014 Nov 17; (e-pub ahead of print))。
7. 在美国老年学会杂志十月的2项研究中, 研究人员描述了接受在家进行初级保健的老年患者的治疗结果。与对照组, 或与预测结果相比, 在家初级保健的患者急诊和住院较少, 死亡率相似, 整体成本降低 (J Am Geriatr Soc 2014 Oct; 62:1825)。
8. 放射学杂志11月号一项回顾性研究, 评估了CT检查结果能否准确预测怀疑有粘连性小肠梗阻病人对药物治疗的反应。他们发现, CT影像显示过渡区, 无鸟嘴征对药物治疗反应率高 (Radiology 2014 Nov; 273:425)。
9. 在麻醉杂志11月号的一个多中心研究中, 手臂疼痛归结为颈椎神经根型的患者被随机分配到3种治疗方法之一：硬膜外类固醇注射, 药物治疗以及理疗。一个月后，手臂疼痛改善的程度在各组均相似 (Anesthesiology 2014 Nov; 121:1045)。
10. 柳叶刀杂志网站上的一项荟萃分析, 评估了身体质量指数（BMI）对各种抗高血压药物的疗效的影响。其结果表明,身体质量指数不应作为选择抗高血压药物的一个因素 (Lancet 2014 Nov 4; (e-pub ahead of print)) 。

 

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