June 2016

Estrogen dose and progestogen type change PE risk

Short Attention Span Summary Ingredients and dose matter in oral contraceptives.  Lower dose estrogen –  20 vs. 30-40 micrograms  – was safer, with lower risk for PE, stroke, and MI.  Regarding the progestogen, desogestrel and gestodene, compared to levonorgestrel, were associated with ~2x the risk of PE but not stroke or MI.  Why does this matter?  The …

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Somatization pre-concussion predicts long recovery

Short Attention Span Summary If you are a little cray-cray before your concussion, you complain of symptoms longer than if you’re not.  Pre-injury somatization symptom score was the best predictor of post-concussive symptom duration. FOAM Report Twitter Facebook Med Page Today Abstract Neurology. 2016 May 17;86(20):1856-63. doi: 10.1212/WNL.0000000000002679. Epub 2016 Apr 20. Preinjury somatization symptoms …

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C. difficile reactive arthritis in kids

Short Attention Span Summary Have you ever heard of C. difficile associated reactive arthritis in pediatric patients?  Me neither!  So I thought we could learn something with this article.  After C. difficile infection, a reactive arthritis may occur that can mimic septic arthritis.  Make sure to ask about preceding antibiotics and diarrhea in your next pediatric patient with …

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Dexamethasone equals prednisolone in pediatric asthma

Short Attention Span Summary Single dose dexamethasone 0.3mg/kg, up to 12mg, was not inferior to multiple dose prednisolone in pediatric asthma exacerbation.  Fewer dex kids vomited, and more dex kids had additional steroids prescribed.  I covered this article last year. FOAM Report Emergency Medicine Cases First10EM PEM Playbook emeddoc Abstract Ann Emerg Med. 2016 May;67(5):593-601.e3. doi: …

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