盘点:2018年9月第3期BMJ研究精选

2018-09-17 zhangfan MedSci原创

BMJ

2018年9月第3期BMJ研究精选



【1】妊娠期补充叶酸不能降低先兆子痫风险


近日研究人员考察了叶酸补充对预防产妇先兆子痫的疗效。高血压、妊娠前糖尿病、双胎妊娠、先兆子痫史或体重指数≥35等高风险孕妇参与研究随机接受每日高剂量叶酸(4.0mg)或安慰剂,干预从妊娠8-16周开始,直至分娩。研究发现,叶酸预防的效果不显著:叶酸组169名孕妇以及安慰剂组156人发生先兆子痫(14.8 vs13.5%,RR=1.10)。

【2】警惕高龄老人院外血压强化治疗的风险


近日研究人员考察了在非心脏疾病住院老年高血压患者出院后接受血压强化治疗的频率。65岁以上的老年高血压住院患者参与研究,患者无心脏疾病。考察患者出院后是否接受了强化降压治疗,即接受一种新的或更大剂量的降压药物。14915名患者参与研究,2074人(14%)出院医嘱接受强化血压控制治疗,其中1082人入院前血压控制良好。研究发现,住院期间血压升高与出院后加强抗高血压治疗密切相关。在住院前血压控制良好的患者中,8%的住院期间血压未升高患者,24%的轻度升高患者以及40%的严重升高患者接受了院外强化治疗。

【3】NICE胰腺炎治疗指南


胰腺炎是一种严重影响患者生活质量的疾病,并可导致患者预期寿命降低。

胰腺炎分为急性和慢性胰腺炎,若病因未被识别和处理,急性胰腺炎会反复复发。随着时间的推移急性胰腺炎患者可能会患上慢性胰腺炎。慢性胰腺炎的早期特征包括急性恶化特征、慢性疼痛和外分泌不足,与脂肪吸收和营养不良有关。糖尿病患者是胰腺炎的高危人群。随着慢性胰腺炎的发展,患者病情加重,但慢性疼痛相对减少。

临床中复发或慢性腹部疼痛患者应考虑胰腺炎风险,并且不应采取长期阿片类药物作为止疼手段。c型糖尿病是胰腺炎相关的糖尿病,需持续治疗并接受糖化血红蛋白测试。

【4】腿部静脉溃疡的诊断及治疗


腿部静脉溃疡是最常见的腿部溃疡,在英国其患病率为0.1-0.3%,终身患病风险约1%,约53%的患者在12个月内可治愈,平均治疗周期3-4个月。

静脉腿部溃疡是由静脉高血压引起的慢性静脉疾病最严重的表现,治疗的主要方法是压迫包扎,通过改善静脉和淋巴回流、微循环和炎症来促进愈合和减少复发。早期治疗十分关键,在发病2周内接受治疗可有效的降低复发风险,压力袜、皮肤护理以及血管评估是治疗以及有助于减少溃疡复发的有效手段。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1848597, encodeId=bb0a184859e1b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 26 23:47:00 CST 2019, time=2019-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346602, encodeId=8a2534660224, content=不错,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Tue Sep 25 20:53:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346487, encodeId=243334648e77, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Mon Sep 24 21:48:02 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345388, encodeId=70db3453880c, content=学习了学习了不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Mon Sep 17 19:32:42 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345384, encodeId=ee343453846b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Mon Sep 17 17:22:09 CST 2018, time=2018-09-17, status=1, ipAttribution=)]
    2019-06-26 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1848597, encodeId=bb0a184859e1b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 26 23:47:00 CST 2019, time=2019-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346602, encodeId=8a2534660224, content=不错,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Tue Sep 25 20:53:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346487, encodeId=243334648e77, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Mon Sep 24 21:48:02 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345388, encodeId=70db3453880c, content=学习了学习了不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Mon Sep 17 19:32:42 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345384, encodeId=ee343453846b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Mon Sep 17 17:22:09 CST 2018, time=2018-09-17, status=1, ipAttribution=)]
    2018-09-25 12177770m58暂无昵称

    不错,谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1848597, encodeId=bb0a184859e1b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 26 23:47:00 CST 2019, time=2019-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346602, encodeId=8a2534660224, content=不错,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Tue Sep 25 20:53:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346487, encodeId=243334648e77, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Mon Sep 24 21:48:02 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345388, encodeId=70db3453880c, content=学习了学习了不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Mon Sep 17 19:32:42 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345384, encodeId=ee343453846b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Mon Sep 17 17:22:09 CST 2018, time=2018-09-17, status=1, ipAttribution=)]
    2018-09-24 guangyi1980

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1848597, encodeId=bb0a184859e1b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 26 23:47:00 CST 2019, time=2019-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346602, encodeId=8a2534660224, content=不错,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Tue Sep 25 20:53:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346487, encodeId=243334648e77, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Mon Sep 24 21:48:02 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345388, encodeId=70db3453880c, content=学习了学习了不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Mon Sep 17 19:32:42 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345384, encodeId=ee343453846b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Mon Sep 17 17:22:09 CST 2018, time=2018-09-17, status=1, ipAttribution=)]
    2018-09-17 苏小雨

    学习了学习了不错

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1848597, encodeId=bb0a184859e1b, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jun 26 23:47:00 CST 2019, time=2019-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346602, encodeId=8a2534660224, content=不错,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76d12257050, createdName=12177770m58暂无昵称, createdTime=Tue Sep 25 20:53:05 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=346487, encodeId=243334648e77, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Mon Sep 24 21:48:02 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345388, encodeId=70db3453880c, content=学习了学习了不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/05/22/c26524b0b4ca80000d38f0294262c002.jpg, createdBy=3cf52015303, createdName=苏小雨, createdTime=Mon Sep 17 19:32:42 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345384, encodeId=ee343453846b, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Mon Sep 17 17:22:09 CST 2018, time=2018-09-17, status=1, ipAttribution=)]
    2018-09-17 小小小麦兜

    学习了

    0

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