2024年初级保健医师研究前20名。

IF 3.5 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
American family physician Pub Date : 2025-07-01
Roland Grad, Mark H Ebell
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引用次数: 0

摘要

本文总结了2024年被确定为POEMs(以患者为导向的证据重要)的前20项研究。基于网络荟萃分析,对社区获得性肺炎最有可能有效的口服抗生素是特利霉素(在美国不可用)、阿奇霉素、阿莫西林-克拉维酸酯和喹诺酮类左氧氟沙星和奈莫沙星(在美国不可用)。口服抗病毒药物莫努匹拉韦和尼马特利韦-利托那韦可减少COVID-19免疫功能低下患者的住院率。在平均风险婴儿中,单剂量尼西维单抗可减少因呼吸道合胞病毒引起的住院。阿莫西林加克拉维酸或不加克拉维酸治疗急性鼻窦炎患儿比安慰剂更有效。25%的苯甲酸苄酯对青少年和成人疥疮非常有效。含乳酸杆菌的益生菌可降低绝经前妇女尿路感染的发生率。小剂量阿米替林作为肠易激综合征的二线治疗有效。对于无并发症的胆结石患者,保守治疗是一种合理的选择。钠-葡萄糖共转运体-2 (SGLT-2)抑制剂和胰高血糖素样肽-1 (GLP-1)受体激动剂在改善2型糖尿病患者预后方面优于旧药物。连续或间歇血糖监测对控制2型糖尿病的效果最低,而且可能有害。芬特明-托吡酯和GLP-1受体激动剂是促进减肥最有效的药物。西马鲁肽对肥胖无糖尿病人群心血管疾病二级预防有效。SGLT-2抑制剂和GLP-1受体激动剂可降低老年2型糖尿病和心力衰竭患者的心血管死亡。在保留射血分数的患者中-受体阻滞剂不能预防心肌梗死后的后续事件。对于那些在试用了伐尼克兰或联合尼古丁替代疗法后仍未戒烟的患者,任何一种药物的高剂量都会增加戒烟率。电子烟有助于戒烟,但对一些人来说,长期吸电子烟是一个后果。口服纳曲酮和阿坎普罗酸是治疗酒精使用障碍的安全有效的方法。认知行为疗法可以减轻因长时间感染新冠病毒而引起的疲劳。针对阿尔茨海默病的新型单克隆抗体是有害的、昂贵的,而且效果最低。临床医生可能会选择亲自或通过电话告知坏消息,根据他们的判断或患者的偏好来决定哪种方式对患者最好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Top 20 Research Studies of 2024 for Primary Care Physicians.

This article summarizes the top 20 research studies of 2024 identified as POEMs (patient-oriented evidence that matters). Based on a network meta-analysis, the oral antibiotics most likely to be effective for community-acquired pneumonia are telithromycin (not available in the United States), azithromycin, amoxicillin-clavulanate, and the quinolones levofloxacin and nemonoxacin (not available in the United States). The oral antivirals molnupiravir and nirmatrelvir-ritonavir reduce hospitalizations in immunocompromised patients with COVID-19. In average-risk infants, a single dose of nirsevimab reduces hospitalizations due to respiratory syncytial virus. Amoxicillin with or without clavulanate is more effective than placebo for children with symptoms of acute sinusitis. Benzyl benzoate 25% is highly effective for scabies in adolescents and adults. Lactobacillus-containing probiotics reduce the incidence of recurrent urinary tract infections (UTIs) in premenopausal women with frequent UTIs. Low-dose amitriptyline is effective as second-line therapy for irritable bowel syndrome. For patients with uncomplicated gallstones, conservative management is a reasonable option. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are better than older drugs at improving patient-oriented outcomes for type 2 diabetes. Continuous or intermittent glucose monitoring is minimally effective for control of type 2 diabetes and can be harmful. Phentermine-topiramate and GLP-1 receptor agonists are the most effective drugs for promoting weight loss. Semaglutide is effective for secondary prevention of cardiovascular disease in people with obesity and no diabetes. SGLT-2 inhibitors and GLP-1 receptor agonists decrease cardiovascular death in older adults with type 2 diabetes and heart failure. Beta blockers do not prevent subsequent events after myocardial infarction in patients with preserved ejection fraction. For patients who do not quit smoking after a trial of varenicline or combined nicotine replacement therapy, a higher dose of either drug can increase quit rates. e-Cigarettes increase abstinence from smoking, but long-term vaping is a consequence for some. Oral naltrexone and acamprosate are safe and effective treatments for alcohol use disorder. Cognitive behavior therapy can reduce fatigue attributed to long COVID. New monoclonal antibodies for Alzheimer disease are harmful, expensive, and minimally effective. Clinicians may choose to deliver bad news in person or by telephone, using their judgment or patient preference to decide which is best for the patient.

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来源期刊
American family physician
American family physician 医学-医学:内科
CiteScore
2.80
自引率
2.50%
发文量
368
审稿时长
4-8 weeks
期刊介绍: American Family Physician is a semimonthly, editorially independent, peer-reviewed journal of the American Academy of Family Physicians. AFP’s chief objective is to provide high-quality continuing medical education for more than 190,000 family physicians and other primary care clinicians. The editors prefer original articles from experienced clinicians who write succinct, evidence-based, authoritative clinical reviews that will assist family physicians in patient care. AFP considers only manuscripts that are original, have not been published previously, and are not under consideration for publication elsewhere. Articles that demonstrate a family medicine perspective on and approach to a common clinical condition are particularly desirable.
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