Why 10,000 Die Within a Week of ER Discharge
When in doubt, err on the side of admission – even if you get push back from the hospitalist, administrator, or your own government.
March 2017
How to Stop Throwing Pills at Lumbosacral Strain
There is a growing emphasis on non-pharmacologic treatments for low back pain, and a deemphasis on using opiates.
Meds for Back Pain – What Works and What Doesn’t
Pharmacologic treatments for acute low back pain were moderately helpful, at best, and included NSAIDs, possibly muscle relaxers, and steroids, but only for radicular pain.
Peds UA Accuracy Varies with Urine Concentration
If you have dilute urine with positive LE or microscopic pyuria, it is probably a real UTI. If the urine is concentrated, it’s harder to tell.
Decision Aids Rarely Beat Clinical Judgment
Your judgment at the bedside is still the final and best decision rule.
Why We Treat Bell Palsy With Steroids
Corticosteroids are definitely beneficial in Bell palsy. Antiviral agents are not helpful if used alone but have a mild synergistic effect when added to steroids.
No Saline Before Contrast – No Problem
In patients with eGFR 30-59, there was no benefit to giving saline prior to IV contrast for CT.
IV Contrast and AKI – No Association
There was no association with IV contrast for CT and short-term acute kidney injury or progression to dialysis at 6 months, regardless of initial GFR in patients with a creatinine < 4.
Diazepam Doesn’t Help Back Pain
Diazepam doesn’t help low back pain. Here is RCT data that proves it.
Brain on Fire – Anti-NMDA Receptor Encephalitis
Early treatment of anti-NMDA receptor encephalitis improved recovery. But first, you have to make the diagnosis.