RESUMEN
BENZODIAZEPINES REMAIN THE FIRST-LINE REGIMEN FOR ALCOHOL WITHDRAWAL SYNDROME (AWS) AND ARE THE ONLY CLASS MORE EFFECTIVE THAN PLACEBO FOR REDUCING SEIZURE (STRENGTH OF RECOMMENDATION [SOR]: B, BASED ON 3 MEDIUM-QUALITY RANDOMIZED CONTROLLED TRIALS [RCTS]). ANTICONVULSANTS ARE NO MORE EFFECTIVE THAN PLACEBO AT REDUCING SEIZURES (SOR: B, BASED ON 10 MODERATE-QUALITY RCTS). GABAPENTIN REDUCES WITHDRAWAL SYMPTOMS AND IS LESS SEDATING THAN BENZODIAZEPINES (SOR: B, BASED ON 1 MEDIUM-QUALITY RCT). CARBAMAZEPINE ALSO REDUCES WITHDRAWAL SYMPTOMS (SOR: B, BASED ON 3 RCTS). EVIDENCE OF BENZODIAZEPINE SUPERIORITY TO OTHER DRUGS WITH RESPECT TO SAFETY IS LACKING (SOR: A, BASED ON A META-ANALYSIS).
Asunto(s)
Alcoholismo/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Anticonvulsivantes/uso terapéutico , Benzodiazepinas/uso terapéutico , Carbamazepina/uso terapéutico , Gabapentina/uso terapéutico , Humanos , Revisiones Sistemáticas como AsuntoAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Antifibrinolíticos/uso terapéutico , Agentes Anticonceptivos Hormonales/uso terapéutico , Danazol/uso terapéutico , Antagonistas de Estrógenos/uso terapéutico , Levonorgestrel/uso terapéutico , Menorragia/tratamiento farmacológico , Ácido Tranexámico/uso terapéutico , Adolescente , Adulto , Femenino , Humanos , Adulto JovenAsunto(s)
Productos Biológicos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Suplementos Dietéticos , Hipertensión/tratamiento farmacológico , Hipertensión/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Arginina/uso terapéutico , Beta vulgaris , Chocolate , Ácidos Grasos Omega-3/uso terapéutico , Femenino , Ajo , Humanos , Aceite de Linaza/uso terapéutico , Masculino , Persona de Mediana Edad , OleaAsunto(s)
Anticoagulantes/uso terapéutico , Fibrilación Atrial/complicaciones , Accidente Cerebrovascular/prevención & control , Vitamina K/antagonistas & inhibidores , Warfarina/uso terapéutico , Anciano , Anciano de 80 o más Años , Anticoagulantes/efectos adversos , Aspirina/uso terapéutico , Fibrinolíticos/uso terapéutico , Hemorragia/inducido químicamente , Humanos , Metaanálisis como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Accidente Cerebrovascular/etiología , Warfarina/efectos adversosAsunto(s)
Anticoagulantes/uso terapéutico , Apéndice Atrial/cirugía , Fibrilación Atrial/cirugía , Inhibidores de Agregación Plaquetaria/uso terapéutico , Accidente Cerebrovascular/prevención & control , Administración Oral , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Esquema de Medicación , Medicina Basada en la Evidencia , Humanos , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Resultado del TratamientoRESUMEN
Yes. Cognitive behavioral therapy (CBT) administered individually, in a group setting, or on the internet is effective for treating insomnia in adults compared with control (strength of recommendation [SOR]: A, meta-analyses). CBT is comparable to pharmacotherapy for improving measures of sleep (SOR: A, comparative meta-analysis). CBT produces sustainable improvements in subjective sleep quality for adults with comorbid insomnia (SOR: A, meta-analysis).
Asunto(s)
Benzodiazepinas/uso terapéutico , Terapia Cognitivo-Conductual/métodos , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Yes for exacerbations, no for hospitalizations. Prophylactic azithro-mycin reduces the number of exacerbations by about 25%. It also extends the time between exacerbations by approximately 90 days for patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Azithromycin benefits patients who are >65 years, patients with Global Initiative for Obstructive Lung Disease (GOLD) stage II or III COPD, former smokers, and patients using long-term oxygen; it doesn't benefit patients ≤65 years, patients with GOLD stage IV COPD, current smokers, or patients not using oxygen (strength of recommendation [SOR]: B, randomized controlled trials [RCTs]). Prophylactic azithromycin doesn't reduce hospitalizations overall (SOR: B, single small RCT).
Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica/métodos , Eritromicina/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Azitromicina/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
No. Exercise doesn't decrease the frequency or severity of vasomotor menopausal symptoms in perimenopausal and postmenopausal women (strength of recommendation: A, systematic review of randomized controlled trials [RCTs] and consistent RCT).
Asunto(s)
Terapia por Ejercicio , Sofocos/prevención & control , Menopausia , Sudoración , Anciano , Antidepresivos de Segunda Generación/uso terapéutico , Citalopram/uso terapéutico , Terapia de Reemplazo de Estrógeno , Ácidos Grasos Omega-3/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Clorhidrato de Venlafaxina/uso terapéutico , YogaRESUMEN
No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).
Asunto(s)
Estimulantes del Apetito/efectos adversos , Desnutrición/tratamiento farmacológico , Acetato de Megestrol/efectos adversos , Casas de Salud , Humanos , Factores de Riesgo , Trombosis de la Vena/inducido químicamenteRESUMEN
EVIDENCE-BASED ANSWER: Topical permethrin is the most effective treatment for classic scabies (strength of recommendation [SOR]: A, meta-analyses with consistent results). Topical lindane and crotamiton are inferior to permethrin but appear equivalent to each other and benzyl benzoate, sulfur, and natural synergized pyrethrins (SOR: B, limited randomized trials). Although not as effective as topical permethrin, oral ivermectin is an effective treatment compared with placebo (SOR: B, a single small randomized trial). Oral ivermectin may reduce the prevalence of scabies at one year in populations with endemic disease more than topical permethrin (SOR: B, a single randomized trial).
Asunto(s)
Antiparasitarios/uso terapéutico , Benzoatos/uso terapéutico , Hexaclorociclohexano/uso terapéutico , Insecticidas/uso terapéutico , Escabiosis/tratamiento farmacológico , Administración Oral , Administración Tópica , Animales , Humanos , Sarcoptes scabiei/efectos de los fármacos , Azufre/uso terapéutico , Toluidinas/uso terapéuticoRESUMEN
Yes for angiotensin-converting enzyme (ACE) inhibitors, no for angiotensin receptor blockers (ARBs). A 2011 meta-analysis of 5 RCTs (total 2975 patients) that compared ACE inhibitor therapy with placebo in diabetic patients without hypertension and albuminuria found that ACE inhibitors reduced the risk of new-onset microalbuminuria or macroalbuminuria by 18% (relative risk [RR]=0.82; 95% confidence interval [CI], 0.73-0.92).
