The BMJ最新文献_第7页

Will centralisation improve the Scottish health system? 中央集权会改善苏格兰的医疗系统吗？

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100900

Ellen Stewart,David Blane

引用次数: 0

Advanced practitioners and doctor substitution: Dossier reveals “shocking” patient safety incidents 高级从业人员和替代医生：档案揭示了“令人震惊”的患者安全事件

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100948

Jacqui Wise

引用次数: 0

Daraxonrasib: How soon could the new drug for pancreatic cancer be available in the UK? Daraxonrasib：治疗胰腺癌的新药多久能在英国上市？

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100870

Katharine Lang

引用次数: 0

Wastewater surveillance: UKHSA expands programme to detect major health threats 废水监测：英国卫生服务局扩大了监测主要健康威胁的方案

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100950

Gareth Iacobucci

引用次数: 0

Scarlett McNally: We need a more nuanced approach to fixing errors in the electronic patient record 斯嘉丽·麦克纳利：我们需要一种更细致的方法来修复电子病历中的错误

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100901

Scarlett McNally

引用次数: 0

QTc changes and early major adverse cardiovascular events associated with antidepressant treatment for major depressive disorder in adults: individual participant data network meta-regression of double blind randomised trials 成人重度抑郁症抗抑郁药物治疗相关的QTc变化和早期主要不良心血管事件：双盲随机试验的个体参与者数据网络meta回归

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100600

Edoardo Giuseppe Ostinelli,Sofia Capocci,Zhenpeng Li,Claire Friederich,Giacomo Mugnai,Anton Pottegård,Flavio Luciano Ribichini,Andrea Cipriani

{"title":"QTc changes and early major adverse cardiovascular events associated with antidepressant treatment for major depressive disorder in adults: individual participant data network meta-regression of double blind randomised trials","authors":"Edoardo Giuseppe Ostinelli,Sofia Capocci,Zhenpeng Li,Claire Friederich,Giacomo Mugnai,Anton Pottegård,Flavio Luciano Ribichini,Andrea Cipriani","doi":"10.1136/bmj-2026-100600","DOIUrl":"https://doi.org/10.1136/bmj-2026-100600","url":null,"abstract":"Abstract Objective To compare the effect of specific antidepressants with placebo on heart rate corrected QT interval (QTc) during the first eight weeks of treatment for major depressive disorder in adults, and to investigate whether antidepressant use is associated with early major cardiovascular adverse events (MACE). Design Individual participant data (IPD) network meta-regression and aggregate pairwise meta-analysis. Data sources Individual and aggregate level data from randomised controlled trials identified through Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS, Medline, Medline In-Process, PsycINFO, the websites of regulatory agencies, and international registers. Methods IPD were harmonised to enhance comparability and analysed using network meta-regressions to explore the interplay with baseline QTc, age, sex assigned at birth, body mass index, serum potassium level, and estimated glomerular filtration rate. The primary outcome was changes in QTc Fridericia (QTcF) associated with specific antidepressants and placebo after taking into account modifiable and non-modifiable risk factors. Aggregate data on early MACE were analysed using pairwise meta-analysis comparing antidepressants with placebo. Eligibility criteria for selecting studies Double blind randomised trials of adults (≥18 years) with major depressive disorder diagnosed according to standardised, operationalised criteria. Results Of 130 unique randomised controlled trials identified, 35 (27%) included individual level data (8679 participants) on QTc with placebo and 10 antidepressants (amitriptyline, bupropion, duloxetine, escitalopram, fluoxetine, mirtazapine, paroxetine, trazodone, venlafaxine, vortioxetine). Compared with placebo, escitalopram and amitriptyline were associated with increased QTc intervals (8.7 milliseconds (ms), 95% credibility interval (CrI) 1.6 to 15.8, and 5.3 ms, 0.8 to 9.8, respectively). When risk factors were considered, amitriptyline and escitalopram were also associated with the highest QTc prolongations (58.8% and 21.3%, respectively), whereas venlafaxine and vortioxetine were often associated with the lowest QTc intervals (24.1% and 9.7%, respectively). Important variability of effects was observed, especially for escitalopram, fluoxetine, and mirtazapine. An aggregate analysis of 139 trials (52 398 participants) did not identify an association between antidepressant use and increased rates of early MACE and non-suicidal death compared with placebo (risk difference 0.01%, 95% CrI -0.01% to 0.02%). Conclusions The effect of specific antidepressants on QTc interval differed between adults with depression. No evidence associated antidepressant use with early MACE and non-suicidal sudden death. To support shared decision making and taking into account the trade-off between benefits and harms, individual modifiable and non-modifiable risk factors should be considered when choosing antidepressants. Systematic review registration O","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"14 1","pages":"e100600"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fireworks should be banned 应该禁止放烟花

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100868

Nicolas Faure

引用次数: 0

Antidepressants and cardiac safety 抗抑郁药和心脏安全

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100828

Scott R Beach,Christopher M Celano,Matthew Gunther,Jeff C Huffman

引用次数: 0

Eyelash extensions and mites 睫毛延伸和螨虫

The BMJ Pub Date : 2026-09-23 DOI: 10.1136/bmj-2026-100920

Jacqui Wise