Hipótese Nula

META-REVISÃO

Safety of proton pump inhibitors: an overview of systematic reviews and meta-analyses | BMJ EBM

Outcome switching in cohort studies of interventions: meta-epidemiological study | BMJ

REVISÕES SISTEMÁTICAS de ECAs

Effectiveness and tolerability of pharmacological prophylaxis for migraine headaches | BMJ EBM

Lung ultrasound-guided decongestion in heart failure: systematic review and meta-analysis of RCTs | JCC

ENSAIOS CONTROLADOS E ALEATORIZADOS

Accelerated Diagnostic Pathways for Suspected ACS: 0/1-Hour vs 0/3-Hour Troponin Testing – MACROS2 | JACC + Safety and efficacy of the 0/1 h pathway for myocardial infarction in the ED — PRESC1SE-MI | Lancet

Discontinuation of statins for primary prevention of ASCVD in 75 years or older — SAGA/SITE | Lancet Healthy L

Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty - EPCAT III | NEJM

Robotic versus Open Pancreatoduodenectomy (PORTAL) | BMJ

CT followed by ASCT vs nonmyeloablative consolidation: primary CNS lymphoma - IELSG43 | Lancet Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery — MERCURI-2 | JAMA Baloxavir, favipiravir, or oseltamivir in non-severe symptomatic seasonal influenza - AD ASTRA | Lancet ID Temocillin vs carbapenems for bacteraemia due to 3GCephalosporin-res Enterobac - ASTARTÉ | Lancet Mais informação em esFOAMeados! (blogue ou substack) Lazer do mês (meses): - Demónios do Dostoievsky - Socrates Children do Peter Kreeft ...

SNAP Trial - SAMS e SAPS

• Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia - SNAP trial | NEJM

  • Benzylpenicillin vs oxacillin for the treatment of PenicillinS Staphylococcus aureus bacteraemia - SNAP | Lancet

FOSFOMICINA

• Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women – SCOUT | Lancet

• Fosfomycin as Oral Transition Therapy vs Continued Intravenous β-Lactams for ITUc Caused by Extended-Spectrum β-Lactamase–Producing Enterobacterales | CID

OUTROS

• PulmCrit: Is oseltamivir assassinating ICU patients?
• A Randomized Trial of Interval Likelihood Ratios for Clinical Decision-Making | NEJM Evidence
• Vasopressors or Fluids in Early Septic Shock – ARISE FLUIDS | NEJM
• Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer - RASolute 302 | NEJM

Ócio do mês

• Dar um mergulho conta?

REVISÕES SISTEMÁTICAS de ECAs

• Efficacy and Safety of Digitalis Glycosides in Heart Failure: A Meta-Analysis | JAMA
• Timing of Complete Revascularization in Patients w/ EAMCESST and Multivessel Disease | Circ Cardiovasc Interv
• Single-Shot Regional Anesthesia for Early Rib Fracture-Associated Pain Management | Acad Emerg Med
• Effectiveness and Tolerability of Pharmacologic Prophylaxis for Chronic Migraine | Annals of Internal Medicine
• Endovascular thrombectomy for patients w/ large-core ischaemic stroke presenting up to 24 h - ATLAS | Lancet

ENSAIOS CONTROLADOS E ALEATORIZADOS (ECAs)

• Digoxin in Patients With Symptomatic Rheumatic Heart Disease – Dig-RHD | JAMA
• L​ow-dose digoxin in patients w/ heart failure w/ reduced or mildly reduced ejection fraction-DECISION | NatMed
• Weight Loss in Older Patients With Persistent Atrial Fibrillation - LOSE-AF | JAMA
• Chronic Subdural Hematoma With Adjunctive Embolization of Middle Meningeal Artery – EMMA-Can | JAMA
• Low-Volume Polyethylene Glycol for Bowel Preparation in Hospitalized Adults - INTERPRET | Annals of IntMed
• Twenty-Three–Year Benefits of Sigmoidoscopy Screening for Colorectal Cancer - NORCCAP | AIM
• Effects of LLM -generated, patient-oriented discharge summaries on patient activation | Lancet Digital Health
• Ticagrelor with aspirin with intravenous thrombolysis in patients with ischaemic stroke in China (TAPIS) | Lancet
• Adjunctive Intra-Arterial Alteplase After Successful Thrombectomy for Acute Ischemic Stroke – CHOICE-2 | JAMA
• Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke at 4.5 - 24 H – TNK-PLUS | JAMA
• Endovascular Treatment of Medium-Vessel-Occlusion Strokes – ORIENTAL-MeVO | NEJM
• Endovascular treatment for medium or distal vessel occlusion stroke (DISTAL): 12-month outcomes|LancetNeuro
• Phase 3 Trials of Inhaled Treprostinil for Idiopathic Pulmonary Fibrosis – TETON-1+TETON-2 | NEJM
• Intensive LDL Cholesterol Targeting in Atherosclerotic Cardiovascular Disease - Ez-PAVE | NEJM

Outros ECAs/artigos

Ócio do mês

• Ler na praia no geral :) - li "Diário de um pároco de aldeia" e "Vida do Santo Condestável - Dom Nuno Álvares Pereira" e estou a ler "O Pórtico do Mistério ds Segunda Virtude"
• Mundial de futebol 2026! Sim, são muito mais equipas e jogos - por outro lado, mais países envolvidos. É sempre um entusiasmo.

Ensaios controlados aleatorizados (ECAs) discutidos: - Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism - HI-PEITHO | NEJM - Catheter-Directed vs Peripheral Lysis for PE - STRATIFY | Cardiovasc Research - Mechanical Thrombectomy vs Anticoagulation Alone for Intermediate-High Risk PE - STORM-PE | Circulation Outros comentários mencionados: - At ACC26, the HI-PEITHO Trial is in a Photo-Finish for Greatest Spin - PulmCrit: The HI-PEITHO trial on low dose alteplase - HI-PEITHO Trial: Ultrasound-facilitated, Catheter Directed Fibrinolysis for PE - REBEL EM - Emergency Medicine Blog - Higher risk PE management updates (The STRATIFY and STORM-PE trials) - First10EM - EMCrit Wee - 2026 PE Update F/u with Josh Farkas & Justin Morgenstern - Dengue Suppression by Male Wolbachia-Infected Mosquitoes | NEJM

Outros ECAs mencionados no blogue: https://www.esfoameados.pt/post/abril-2026-invent%C3%A1rio-do-m%C3%AAs

Ócio do mês

• MACAM - Museu de Arte Contemporânea Armando Martins
• Livro "Aquilo que nunca morre - Caminho de um homem" do Paulo Takashi Nagai
• Série "Billions"

Ensaios discutidos: - Initial Vancomycin Taper for the Prevention of Recurrent Clostridioides difficile Infection – TAPER-V | JAMA NetO

- Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism – COBRRA | NEJM

Blogue: https://www.esfoameados.pt/post/janeiro-de-2026-invent%C3%A1rio-do-m%C3%AAs

Lazer do mês

• Filmes "Valor Sentimental" e "Hamnet"
• Peça de teatro "Death of a Salesman" do Arthur Miller

Ensaios discutidos: - Ticagrelor vs Prasugrel in Patients With Diabetes and Multivessel Coronary Artery Disease - TUXEDO2 | JAMA Cardiology

- CYP2D6-Guided Opioid Management and Postoperative Pain Control – ADOPT PGx | JAMA Network Open

Ensaios sinalizados:

- Albumin Replacement Therapy in Septic Shock | JAMA

- Morphine Plus Acetaminophen for Acute Pain in the Emergency Department - PERCEIVE | JAMA Network Open

Blogue: https://www.esfoameados.pt/post/janeiro-de-2026-invent%C3%A1rio-do-m%C3%AAs

Lazer do mês

• Filmes "Valor Sentimental" e "Hamnet"

Ensaios discutidos: - Comparing Oral vs Parenteral Antimicrobial Therapy (COPAT) Trial | CID

-Vernakalant vs procainamide for rapid cardioversion of patients with acute atrial fibrillation (RAFF4) | BMJ

Ensaios sinalizados:

-Withdrawal of HF therapy after AF rhythm control with ejection fraction normalization - WITHDRAW-AF | EHJ

- A Randomized Trial of Tenecteplase in Acute Central Retinal Artery Occlusion

Blogue: https://www.esfoameados.pt/post/janeiro-de-2026-invent%C3%A1rio-do-m%C3%AAs

Outros: Shorter is Better

Recomendações culturais:

• Livro "Malignant" do Vinay Prasad
• Concerto Capitão Fausto no Pavilhão Atlântico (já não dá!...)
• Filmes "Life is beautiful" e "Train Dreams"

ECAs analisados:

• Deferring Arterial Catheterization in Critically Ill Patients with Shock - EVERDAC | NEJM
• Fish‑Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis — PISCES | NEJM
• Medical Management and Revascularization for Asymptomatic Carotid Stenosis — CREST‑2 | NEJM

RS analisada: Reduced‑Dose vs Full‑Dose Direct Oral Anticoagulants for Extended Secondary VTE Prophylaxis in Cancer | AJH Outros: (no blogue) RS:

Tramadol vs placebo for chronic pain: systematic review w/ meta‑analysis & trial sequential analysis | BMJ EBM

Systemic Corticosteroids, Mortality, and Infections in Pneumonia and ARDS | Annals of Internal Medicine

Risk for Cancer With Glucagon-Like Peptide‑1 Receptor Agonists and Dual Agonists | AIM

ECAs:

Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation — DECAF | JAMA

Assessing clinical and cost effectiveness of total vs partial knee replacement (TOPKAT): 10‑years | Lancet Rheum

Minimally Invasive versus Open Pancreatoduodenectomy for Resectable Neoplasms — NEJM Evidence

Personalized Hemodynamic Resuscitation Targeting CRT in Early Septic Shock - ANDROMEDA‑SHOCK‑2 | JAMA

The Mediterranean Diet for Irritable Bowel Syndrome — Annals of Internal Medicine

Carvedilol in Cirrhosis w/ New‑Onset Uncomplicated Ascites Without HighRisk Esophageal Varices - CARVE‑AS | AJG

Rituximab for Relapsing Nephrotic Syndrome in Adults — JAMA

Oral itraconazole vs oral voriconazole for treatment‑naive chronic pulmonary aspergillosis - VICTOR‑CPA | Lancet ID

Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury — BICARICU‑2 | JAMA

Preventive care strategy to reduce moderate or severe acute kidney injury after major surgery - BigpAK‑2 | Lancet

Candesartan versus placebo for migraine prevention in episodic migraine — Lancet Neurology

Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation — OCEAN | NEJM

Recomendações Culturais:

• Livros "Anxious Generation" do Jonathan Haydt e "Heretics" do Chesterton
• Filmes "A wonderful life", "Knives out 3" e "One battle after another" (este mais pelo DiCaprio que pelo filme em si...)
• Concerto 15 anos dos Capitão Fausto no Meo Arena

Artigos em inventário - blogue

Sugestões culturais:

• Música no coração (filme e livro original)
• A Christmas Carol, Charles Dickens (livro sobretudo)
• Maratona Harry Potter (filme e livro)

TEMAS (5 ECAs):

---> ✔ ? ✔ VSR Prefusion F Vaccine for Prevention of Hospitalization in Older Adults - DAN-RSV | NEJM

---> ✔ Rifasutenizol-based triple therapy versus bismuth plus clarithromycin-based triple therapy for first-line treatment of Helicobacter pylori infection in China – EVEREST-HP | The Lancet Infectious Diseases

--> ✔ Methylcobalamin on capecitabine‑induced hand‑foot syndrome in early HER2‑neg breast cancer – MEC-HFS | BMJ

---> ? ? ? Intra-arterial Tenecteplase for Acute Stroke After Successful Endovascular Therapy - ANGEL-TNK | JAMA

---> ? ? ? Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis – HYPERION | NEJM

---> ✔ Suzetrigine, a Nonopioid NaV1.8 Inhibitor for Treatment of Moderate‑to‑severe Acute Pain – NAVIGATE‑1 & NAVIGATE‑2 | Anesthesiology

---> ✔ Cardiopulmonar POCUS for Hospitalist Management of Undifferentiated Dyspnea | JAMA NO

Inventários:

• Outubro de 2025 - Inventário do mês