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

On the website of the FEMEBA Foundation (Medical Federation of the Province of Buenos Aires) you can find the following translated summaries of selected works dealing with the use of medicines:

Practical Issues in Medicinal Use: Packaging | Prescription date: September 1, 2023.
A drug is more than just an active substance mixed with excipients. There is more to consider than just its pharmacological properties or economic success. A drug is also a physical product that is part of the patient’s daily life. Its packaging components, such as boxes, blisters, bottles, vials or syringes and leaflets, are an integral part of it.
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Balancing the risks and benefits of cannabis use: an overview of a meta-analysis of randomized controlled trials and observational studies | British Medical Journal, August 30, 2023.
There is compelling or consistent evidence to support avoiding cannabis use during adolescence and early adulthood, in people who are susceptible to or suffering from mental health disorders, during pregnancy, and before and while driving. Cannabidiol is effective for people with epilepsy. Cannabis-based medicines are effective for multiple sclerosis, chronic pain, inflammatory bowel disease and palliative care patients, but are not without side effects.
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Drug treatment of gastroesophageal reflux in children | Cochrane Database Systems revision, 22 August 2023.
The quality of the evidence for improvements in symptoms and changes in pH index in infants was very low. There are no aggregated data on endoscopic changes. For babies whose symptoms remain bothersome despite non-medical intervention or parental reassurance, medications may or may not be helpful (based on very low-certainty evidence). If medications are required, there is no clear evidence that they improve symptoms (very low-certainty evidence) based on pooled data for omeprazole, esomeprazole (neonates), H2 antagonists, or alginates. More research and longer follow-up are needed.
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Two-year outcomes of minimally invasive surfactant therapy in premature infants | “Journal of the American Medical Association”, September 11, 2023.
In this follow-up study of a randomized clinical trial of premature infants with respiratory distress syndrome receiving CPAP, administration of surfactant did not reduce the risk of death or neurodevelopmental impairment at 2 years of age compared with sham treatment. incidence. However, infants treated with surfactant had fewer adverse respiratory outcomes.
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Antibiotic prophylaxis in infants with severe vesicoureteral reflux | New England Journal of Medicine, September 14, 2023.
In infants with grade III, IV, or V vesicoureteral reflux and no previous urinary tract infection (UTI), continued antibiotic prophylaxis provides a small but significant benefit in preventing a first UTI, although the incidence of non-infections is increased. benefits. E. coli and antibiotic resistance.
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Single-dose psilocybin in the treatment of major depressive disorder.randomized clinical trial | “Journal of the American Medical Association”, August 31, 2023.
Single-dose psilocybin treatment resulted in clinically significant and sustained reductions in depressive symptoms and functional impairment without serious adverse events. These findings provide further evidence that psilocybin, when used with psychological support, may hold promise as a new intervention for the treatment of major depression.
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Efficacy and Tolerability of Pharmacological Interventions in the Treatment of Acute Bipolar Depression | “The Lancet Psychiatry”, September 2023.
This network meta-analysis of pharmacotherapy for bipolar depression found that olanzapine plus fluoxetine, quetiapine, olanzapine, lurasidone, lumepirone, cariprazine, and lamotrigine were beneficial in patients with bipolar depression. It is more effective than placebo in adults with acute bipolar depression, with strong evidence and varying side effects. .
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Prenatal antidepressant exposure and morphological trajectories of offspring brains | “JAMA Psychiatry”, August 30, 2023.
Results from this cohort study suggest that exposure to selective serotonin reuptake inhibitors (SSRIs) during pregnancy may be associated with altered developmental trajectories in offspring in brain regions associated with emotion regulation. More research is needed on the functional implications of these findings.
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Hormone therapy for sexual function in perimenopausal and postmenopausal women | Cochrane Database Systems revision, 24 August 2023.
Estrogen-only hormonal therapy may slightly improve global sexual function scores, particularly in the areas of lubrication, pain, and satisfaction, in women with menopausal symptoms or early postmenopause (within five years of amenorrhea) and in unselected postmenopausal women. It is unclear whether estrogen plus progestin improves global sexual function scores in unselected postmenopausal women. The quality of the evidence relating to other hormone therapies (anabolic steroids and selective estrogen receptor modulators – SERMs -) is very low, and their impact on sexual function is unclear. Current evidence does not suggest that anabolic steroids (eg, tibolone) or SREM, alone or in combination with estrogens, have beneficial effects on sexual function.
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Venous thromboembolism caused by use of hormonal contraceptives and NSAIDs | British Medical Journal, September 6, 2023.
In this nationwide cohort study, nonsteroidal anti-inflammatory drug (NSAID) use was positively associated with the development of venous thromboembolism in women of childbearing age. The number of extravenous thromboembolic events was significantly higher with NSAID use compared with concomitant use of low/no-risk hormonal contraceptives in patients not using NSAIDs. Women should be informed accordingly of their need for hormonal contraceptives and regular use of NSAIDs.
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Comparing the effectiveness of interventions to prevent tuberculosis: a systematic review and network meta-analysis of intervention studies | eClinical Medicine, September 8, 2023.
When all available preventive interventions are considered, prophylactic antibiotic treatment may be the most effective intervention. Of the options available, isoniazid and streptomycin probably rank first. This comparative study provides important information to policymakers and stakeholders, allowing them to make informed decisions about prevention strategies taking into account local resource and capacity constraints.
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No action, no side effects: Adverse drug reactions and missed doses of anti-tuberculosis treatment, a panoramic review | Br J Clin Pharmacol, September 15, 2023.
There is good evidence that adverse effects are a key factor in missed doses of anti-tuberculosis treatment. Several articles examined specific adverse drug reactions (ADRs), but none assessed the pattern of missed doses due to ADRs, indicating a knowledge gap. Understanding why doses are and are not missed is critical to providing targeted interventions to improve treatment outcomes.
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