With the combined weight of twelve RCTs, ultrasound-guided LP was shown to be superior to landmark-guided LP in multiple ways.
This rapid review by BMJ included ADRENAL and APROCCHSS along with 40 other RCTs and made a weak recommendation to use corticosteroids (CCS) for patients with sepsis. You’ll want to pull up the free full text with some great infographics.
The physician response to an incendiary tweet by the NRA last week has been striking. It has led to the hashtag #ThisIsOurLane, as the NRA admonished physicians to “stay in their lane” regarding gun policy. This is a review of the position statement by the American College of Physicians on reducing firearm deaths and injuries that sparked it all.
Adults with cough <3weeks or 3-8 weeks with post-tussive vomiting or whooping should be treated for pertussis; those with fever or without paroxysmal cough should be considered to have an alternate diagnosis. Children with <4 weeks of cough and post-tussive vomiting may have pertussis, but it was much less clear than in adults.
Individual risk factors associated with the development of severe alcohol withdrawal syndrome (SAWS) included a history of delirium tremens and baseline BP ≥ 140mmHg but no individual symptoms or signs associated with exclusion of SAWS. Composite measures fared better, such as the Prediction of Alcohol Withdrawal Severity Scale; a score ≥ 4 had a LR of 174 (95% CI 43-696).