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Iniciativa MAPAC (Mejorar la Adecuación de la Práctica Asistencial y Clínica)

Hospital Universitari Germans Trias i Pujol

EBUS-TBNA is a minimally invasive, high-precision technique that enables real-time needle aspiration of mediastinal and hilar lymph nodes guided by ultrasound images. Since the incorporation of this technique, it has been common practice to perform a chest X-ray after EBUS-TBNA to rule out the existence of complications, basically pneumothorax. The vast majority of identified studies do not report the appearance of pneumothorax as a post-EBUS-TBNA complication and what they do report describes ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Four gliflozins are authorised in the European Union: canagliflozin (alone or combined with metformin), dapagliflozin (alone or combined with metformin or saxagliptin), empagliflozin (alone or combined with metformin or linagliptin), and ertugliflozin (alone or combined with metformin or sitagliptin). All the gliflozins have an unfavourable harm-benefit balance in the prevention of the complications of type 1or type 2 diabetes. However, limited data have shown a reduction in all-cause mortality ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International: Drugs to avoid in 2022

Topical pimecrolimus and topical tacrolimus, two immunosuppressants used in atopic eczema, can cause skin cancer and lymphoma. These adverse effects are disproportionate since their efficacy is slightly different from that of high-potency topical corticosteroids (Prescrire Int n° 101, 110, 131, 224; Rev. Prestitución n° 367, 428) (d). Rational use of a topical corticosteroid to treat flare-ups is a better option in this situation. Hardly any comparative evaluations provide available data on ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire Internationat

Piracetam, a “psychostimulant”, is authorised for use in various clinical situations, including vertigo, cognitive or neurosensory impairment in elderly patients, dyslexia in children, and myoclonus of cortical origin. Piracetam’s efficacy in these situations has not been established, but it can provoke haemorrhage, nervousness, agitation and weight gain. No drugs are known to have a favourable harm-benefit balance in vertigo, cognitive or neurosensory impairment, or dyslexia. The ...

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International: Drugs to avoid in 2022

Its neuropsychiatric side effects are common and include dissociative symptoms. Addiction and misuse are likely. In this difficult clinical situation, it is more prudent to consider other less dangerous options, even if their efficacy is uncertain: psychotherapy; increasing the dose of the initial antidepressant; switching to an antidepressant from a different pharmacological class; add a so-called atypical neuroleptic; or electroconvulsive (electroshock) therapy. The choice of treatment will ...