The session is divided into two parts: how to get interesting articles for comment and the presentation of two items.
How to get interesting articles?
tools gives us the 2D web browsing is convenient to major
publications with useful our subscription using RSS to magazines, blogs and favorite websites provide us with countless articles for comment. Google Reader and Netvibes are two tools we can use to manage our subscriptions
echoes many articles of interest to primary care can find discussed in Twiter or distribution lists as medfam .
One of the most powerful constituent services bibliográfica.Estos warning track services and selected journal articles electrónico.Uno sending mail summaries of the most useful is Updat Evidence is which classifies studies utilidad.Otros quality and services can be Amedeo and alert service National electronic Library for Medicine's
Presentation of articles
JF C year, JM Baena Diez, J. Franch, J. Vila, S. Tello, J. Chambers, R. Elosua, and J. Marrugat. Long-term Cardiovascular Risk in type 2 diabetic Compared with nondiabetic first acute myocardial infarction Patients: a population-based cohort study in southern Europe. Diabetes Care.2010 (Sep) 1933:2004-2009. Cohort
This article confirms that even in our population cardiovascular morbidity and mortality in patients with type 2 diabetes is equal to that of patients with AMI but without diabetes.This supposed equivalence between the two populations suggested by Haffner in 1998 had led to the proposal made by different "experts" to move the 2 nd prevention of AMI in diabetic patients.
A systematic review (SR) on 13 recent cohort studies (45,000 patients) comparing these two poblaciones.El risk of MI (fatal or nonfatal) in diabetic patients is 43% lower than patients with IAM.Ninguno was all by studies conducted in our country.
Article object session is a prospective cohort study conducted in Spain on 4,410 patients comparing 2260 patients with type 2 diabetes without prior myocardial infarction of 53 health centers and followed by l
group GEDAPS 2150 patients with AMI enrolled in 10 hospitals by the group REGICOR . The risk of MI (fatal or nonfatal) was significantly lower in patients with diabetes HR 0.33 (0.27-0.41) . All cardiovascular events observed, including mortality were lower in the diabetic population (see presentation) even in subgroups with higher risk of diabetes as the most evolved of the disease or Hb A1c levels. This study further confirms the non-equivalence between the two populations and the need to identify prevention 2 nd in the diabetic population.
Finally ImportNT is important to note the contribution to the generation of self-knowledge and group project REGICOR GEDAPS.
Mason L, Moore RA, Edwards JE, Derry S, McQuay HJ.Topical musculoeskeletal NSAIDs for Chronic pain: Systematic review and meta-analy sis.BMC Musculoskelet Disord.2004; 5:28
To evaluate the RS should consult previous entries on this blog critical reading of this type of study.
The RS studies the role of topical NSAIDs (diclofenac, felbinac, flufenamic, fluribuprofeno, ibuprofen, indomethacin, ketoprofen, piketoprofeno and piroxicam) in chronic musculoskeletal pain. Patients included are over 40 years with moderate chronic pain including osteoarthritis osteoarthritis but exclude avanzada.Se included 14 trials with 1500 patients. The effectiveness
is evaluated according to the percentage of patients reduced their pain by 50% baseline after 2 weeks of NSAID use and tolerance by the appearance of adverse events and cessation by mismos.La tratamaiento RS has no bias in their design and implementation and quality of RCTs incluyuidos is acceptable (see presentation)
The proportion of patients in whom 50% decreases the pain is almost Double (RR 1.9, 1.7 to 2.2) in patients with NSAIDs in those assigned to placebo with an NNT 4.6 (3.8 to 5.9) The similar effect all the diseases studied including moderate osteoarthritis (It is interesting to consider the considerable percentage of patients responding to placebo). Tolerance is similar to placebo. A subnálisis
, based on three trials (764 patients), which compares oral and topical NSAIDs in osteoarthritis (knee / hand) with no differences between the two.
Although the tolerance in this review was similar to placebo this year Afssaps French withdrew Ketoprofen gel because fotosensibilización.Este problems has been made to review the safety of this drug to the European agency he has not retired but has qualified the precautions for use and has banned its dispensing without prescription.
is worth remembering that clinical trials often are not able to detect adverse effects due to limited periods studies and the small number of patients included.
used topical NSAIDs perídos two weeks is a reasonable alternative tratmiento especially useful in patients intolerant to oral polypharmacy
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