Alteplase for Submassive PE

Alteplase for Submassive PE

This early study of thrombolytics plus heparin for submassive PE showed no mortality benefit but did show a decrease in need for escalation of care compared with heparin alone.  Subsequent studies call lytics for submassive PE into question, so take the current evidence into account.

Just Put the Clavicle in a Sling - Not Any More

Just Put the Clavicle in a Sling - Not Any More

More patients are having operative repair for displaced midshaft clavicle fractures.  This meta-analysis of 6 RCTs found that the rate of nonunion was markedly reduced and final functional outcome was also improved (though not as strikingly) with operative management.

Coffee Could Save Your Life - New Evidence

Coffee Could Save Your Life - New Evidence

Not only is coffee not bad for you, it could save your life!  This study of over half a million people in 10 European countries found coffee consumption was associated with decreased overall mortality in men and women.

Wait-and-See Antibiotics for Otitis Media

Wait-and-See Antibiotics for Otitis Media

Allowing parents the option to wait and see if their child did not improve or worsened in 48 hours after the diagnosis of acute otitis media in the ED vs. filling the prescription right away resulted in a dramatic reduction in antibiotic use with little downside in this RCT.

How A 5-Sentence NEJM Letter Caused the Opioid Epidemic

How A 5-Sentence NEJM Letter Caused the Opioid Epidemic

A 5 sentence letter to the NEJM editor in 1980 has been cited over 600 times to support opiate prescribing, which was not even the point of the original letter.  We bought the line that opiates for legitimate pain were not addictive and didn't consider the source.