Los 10 mejores artículos del 2016. NEJM

Top 10 General Medicine Articles of 2016: NEJM Journal Watch Editors’ Picks

Information sourced from NEJM Journal Watch:

General Medicine Year in Review 2016

Allan S. Brett, MD, NEJM JW General Medicine Associate Editors

The most important medical topics of 2016, as chosen by the editors of NEJM Journal Watch General Medicine

Each year, the editors of NEJM Journal Watch General Medicine choose the year’s most important thematic areas in clinical research. We try to strike a balance among relevance to primary care, recognition of landmark studies, and acknowledgment of media publicity and public awareness. Some of our stories emerge from one important study, and others come from several studies on a single topic. The order of these stories is not intended to reflect their relative importance.


Zika Makes Headlines

[Zika Virus Infection Without Known Risk Factors]

[Parainfectious Guillain-Barré Syndrome Linked with Zika in Colombia]

[Zika-Related Guillain-Barré Syndrome]

[Congenital Zika Virus Syndrome: Beyond Microcephaly]

[Zika Impairs In Vitro Growth of Neuronal Tissue]

[Early Findings of Zika Virus Infection Epidemiology and Birth Outcomes in Colombia]

[Congenital Zika: Updated Guidance for the Care of Infected Infants]

[Laboratory Diagnosis of Zika Virus Infection]

[Postponing Pregnancy in the Zika Era: Timing Is Everything]

[Advances in Zika Vaccine Development]

Focus on Inappropriate Opioid Use Intensifies

[New CDC Guidelines for Prescribing Opioids for Patients with Chronic Pain. Cites: Dowell D et al. CDC guideline for prescribing opioids for chronic pain — United States, 2016. JAMA 2016 Apr 19; 315:1624. Free full-text JAMA article]

[Opioid Prescribing After Nonfatal Overdose. Cites: Larochelle MR et al. Opioid prescribing after nonfatal overdose and association with repeated overdose: A cohort study. Ann Intern Med 2016 Jan 5; 164:1. PubMed® abstract]

[Mortality in Patients Taking Long-Acting Opioids for Noncancer Pain. Cites: Ray WA et al. Prescription of long-acting opioids and mortality in patients with chronic noncancer pain. JAMA 2016 Jun 14; 315:2415. Free full-text JAMA article]

[Minimal Benefit from Opioids in Patients with Chronic Low Back Pain. Cites: Abdel Shaheed C et al. Efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain: A systematic review and meta-analysis. JAMA Intern Med 2016 Jul 1; 176:958. PubMed® abstract]

[Should Naloxone Be Prescribed for Patients Taking Opioids for Chronic Pain? Cites: Coffin PO et al. Nonrandomized intervention study of naloxone coprescription for primary care patients receiving long-term opioid therapy for pain. Ann Intern Med 2016 Aug 16; 165:245. PubMed® abstract]

New Sepsis-3 Definitions Await Confirmatory Data

[Assessing New Clinical Criteria for Septic Shock]

With Oxygen, Could Less Be More?

[Home Oxygen for Patients with Chronic Obstructive Pulmonary Disease? Cites: The Long-Term Oxygen Treatment Trial Research Group. A randomized trial of long-term oxygen for COPD with moderate desaturation. N Engl J Med 2016 Oct 27; 375:1617. Free full-text N Engl J Med article]

[Oxygen in Critically Ill Patients: Too Much of a Good Thing Might Do Harm]

Does CPAP Prevent Adverse CV Events in Patients with Obstructive Sleep Apnea?

[Does CPAP Reduce Cardiovascular Risk? Cites: McEvoy RD et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 2016 Sep 8; 375:919. PubMed® abstract]

[CPAP for Nonsleepy Obstructive Sleep Apnea?]

Pulmonary Embolism as a Cause of Syncope

[Pulmonary Embolism Is Surprisingly Common in Patients with Syncope]

Randomized Comparison of Surgery, Radiotherapy, and Surveillance for Prostate Cancer

[Localized Prostate Cancer: Randomized Comparison of Surgery, Radiotherapy, and Active Surveillance. Cites: 1) Hamdy FC et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med 2016 Oct 13; 375:1415. Free full-text N Engl J Med article; and 2) Donovan JL et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med 2016 Oct 13; 375:1425. PubMed® abstract]

[Active Surveillance for Patients with Low-Risk Localized Prostate Cancer. Cites: Chen RC et al. Active surveillance for the management of localized prostate cancer (Cancer Care Ontario guideline): American Society of Clinical Oncology clinical practice guideline endorsement. J Clin Oncol 2016 Jun 20; 34:2182. Free full-text J Clin Oncol article]

Cardiovascular Outcomes with Newer Antidiabetes Drugs

[Liraglutide and Cardiovascular Outcomes in Patients with Long-Standing Type 2 Diabetes. Cites: Marso SP et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016 Jul 28; 375:311. Free full-text N Engl J Med article]

[Semaglutide Passes Cardiovascular Safety Test in Patients with Type 2 Diabetes]

[Lower Rate of Adverse Cardiovascular Events with the Diabetes Drug Empagliflozin. Cites: Zinman B et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015 Nov 26; 373:2117. Free full-text N Engl J Med article]

[Empagliflozin Is Associated with Fewer Adverse Renal Outcomes. Cites: Wanner C et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med 2016 Jul 28; 375:323. PubMed® abstract]

Racial Differences Persist in End-of-Life Care

[Racial Differences in End-of-Life Care: Hospitalization and Expenditures. Cites: 1) Cai S et al. Racial differences in hospitalizations of dying Medicare-Medicaid dually eligible nursing home residents. J Am Geriatr Soc 2016 Sep; 64:1798. PubMed® abstract; and 2) Byhoff E et al. Racial and ethnic differences in end-of-life Medicare expenditures. J Am Geriatr Soc 2016 Sep; 64:1789. PubMed® abstract]

[Racial Differences in End-of-Life Care Among Patients with Metastatic Cancer. Cites: 1) Check DK et al. Investigation of racial disparities in early supportive medication use and end-of-life care among Medicare beneficiaries with stage IV breast cancer. J Clin Oncol 2016 Jul 1; 34:2265. Free full-text J Clin Oncol article; and 2) Trevino KM et al. Accuracy of advanced cancer patients’ life expectancy estimates: The role of race and source of life expectancy information. Cancer 2016 Jun 15; 122:1905. Free full-text Cancer article]

[Substantial Decline in Tube Feeding for U.S. Nursing Home Residents with Advanced Dementia. Cites: Mitchell SL et al. Tube feeding in US nursing home residents with advanced dementia, 2000-2014. JAMA 2016 Aug 16; 316:769. JAMA research letter preview]

And Finally … Rounding Out General Medicine’s 2016 Year in Review

[Extending Aromatase Inhibitor Therapy for Early Breast Cancer]

[Aim for a Happy Medium When Lowering Blood Pressure After Acute Intracerebral Hemorrhage. Cites: Qureshi AI et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med 2016 Sep 15; 375:1033. PubMed® abstract]

[Recombinant Zoster Vaccine Works Well in Older Patients. Cites: Cunningham AL et al. Efficacy of the herpes zoster subunit vaccine in adults 70 years of age or older. N Engl J Med 2016 Sep 15; 375:1019. Free full-text N Engl J Med article]

[Herpes Zoster Subunit Vaccine in Older Adults. Cites: Lal H et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med 2015 May 28; 372:2087. Free full-text N Engl J Med article]

[Reversing Anticoagulant-Associated Bleeding with Andexanet. Cites: Connolly SJ et al. Andexanet alfa for acute major bleeding associated with factor Xa inhibitors. N Engl J Med 2016 Sep 22; 375:1131. PubMed® abstract]

[Testosterone for Older Men: A Group of Randomized Trials. Cites: Snyder PJ et al. Effects of testosterone treatment in older men. N Engl J Med 2016 Feb 18; 374:611. Free full-text N Engl J Med article PDF in PubMed® Central]

[When Should We Initiate Hemodialysis in Critically Ill Patients with Acute Kidney Injury? Cites: 1) Zarbock A et al. Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: The ELAIN randomized clinical trial. JAMA 2016 May 24/31; 315:2190. Free full-text JAMA article; and 2) Gaudry S et al. Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med 2016 Jul 14; 375:122. PubMed® abstract]

[Does Early Renal Replacement Therapy Improve Outcomes in Acute Kidney Injury? Cites: Wald R et al. Comparison of standard and accelerated initiation of renal replacement therapy in acute kidney injury. Kidney Int 2015 Oct; 88:897. Free full-text Kidney Int article]

[Pioglitazone for Stroke Prevention: An Addition to Our Toolbox? Cites: Kernan WN et al. Pioglitazone after ischemic stroke or transient ischemic attack. N Engl J Med 2016 Apr 7; 374:1321. Free full-text N Engl J Med article PDF in PubMed® Central]

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