August 2023
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Aug 17 2023
Point | Counterpoint – Lytics + Heparin or Heparin Alone for Intermediate Risk PE?
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There is practice variation in the treatment of patients with intermediate-risk pulmonary embolism (PE). The treatment threshold for which fibrinolytics should be added to standard anticoagulation in hemodynamically stable patients at risk for decompensation has been a focus of PE research for the last decade.Source
Treatment of Intermediate-Risk Pulmonary Embolism. N Engl J Med. 2023 Jul 13;389(2):184-187. doi: 10.1056/NEJMclde2301330. -
Aug 16 2023
Does Early Magnesium in Pediatric Asthma Reduce PICU Admission?
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Asthma is a common disease in childhood and results in many hospital admissions. This study was aimed at evaluating whether admission (specifically to the PICU) could be avoided by early magnesium sulfate administration for severe asthma exacerbation. -
Aug 15 2023
Does Prehospital Transfusion of Pediatric Trauma Patients Save Lives?
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A reduction in both 24-hour and in-hospital mortality was seen among children who received a transfusion after traumatic injury in the prehospital setting compared to those who were transfused in the emergency department.Source
Association of Prehospital Transfusion With Mortality in Pediatric Trauma. JAMA Pediatr. 2023 Jul 1;177(7):693-699. doi: 10.1001/jamapediatrics.2023.1291. -
Aug 14 2023
SCOUT RCT | 5 or 10-day Treatment for Pediatric UTI?
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This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compared to standard-course in children diagnosed with UTI who showed clinical improvement after 5 days of antibiotics.Source
Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26:e231979. doi: 10.1001/jamapediatrics.2023.1979. Epub ahead of print. -
Aug 11 2023
OPAL RCT – No More Opioids for Back Pain
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Opioid pain medications offer no benefit compared to placebo for patients with acute back or neck pain.Source
Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023 Jun 27:S0140-6736(23)00404-X. doi: 10.1016/S0140-6736(23)00404-X. Epub ahead of print. -
Aug 10 2023
How Accurate is Physician Gestalt in Estimating Abdomen/Pelvis Injury In Blunt Trauma?
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In this prospective observational study of patients undergoing CT imaging of the abdomen/pelvis for blunt trauma, gestalt among Emergency Medicine residents/attendings and General Surgery residents was moderately accurate but not sufficiently sensitive to rule out clinically significant injuries when the acceptable miss rate was set at 2%.Source
Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients [published online ahead of print, 2023 Jun 26]. Acad Emerg Med. 2023;10.1111/acem.14768. doi:10.1111/acem.14768. -
Aug 09 2023
Thyroid Storm – Spoon-Feed Version
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Thyroid storm is a high-risk, low-prevalence disease that mimics multiple other emergent diagnoses due to its most common features being fever, altered mental status, and cardiovascular dysfunction. -
Aug 08 2023
Can We Draw Blood Cultures from an Arterial Line?
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In this multicenter prospective diagnostic study, the proportion of contaminated blood cultures obtained from arterial catheters was noninferior to blood cultures obtained via venipuncture.Source
Contamination of Blood Cultures From Arterial Catheters and Peripheral Venipuncture in Critically Ill Patients: A Prospective Multicenter Diagnostic Study. Chest. 2023 Jul;164(1):90-100. doi: 10.1016/j.chest.2023.01.030. Epub 2023 Jan 30. -
Aug 07 2023
PEN-FAST 2.0 – Directly Testing for PCN Allergy – The PALACE RCT
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Starting with the PEN-FAST Decision Tool, direct oral challenges to low-risk individuals with reported penicillin allergies is safe, effective, and can remove a majority of mislabeled instances.Source
Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med. Published online July 17, 2023. doi:10.1001/jamainternmed.2023.2986 -
Aug 04 2023
Can ChatGPT Solve the Tough Cases?
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The newest generation GPT chatbot performed similarly, if not better than, current differential diagnosis generators explicitly designed for this purpose.Source
Accuracy of a Generative Artificial Intelligence Model in a Complex Diagnostic Challenge. JAMA. 2023 Jul 3;330(1):78-80. doi: 10.1001/jama.2023.8288.