New Risk After TBI - Suicide

New Risk After TBI - Suicide

The incidence of suicide nearly doubled in patients who had traumatic brain injury (TBI) compared to baseline.  Risk increased with severity of injury, number of visits, and was highest in the first 6 months post-injury.

Pediatric Head CT - Does Vomiting Matter?

Pediatric Head CT - Does Vomiting Matter?

In pediatric patients with blunt traumatic head injury, none had clinically important traumatic brain injury or significant injury on CT if the only symptom was vomiting <3 times.  It was still extremely low if isolated vomiting 3 or more times: 3/1000 for ciTBI and 6/1000 for TBI-CT.

The Next PECARN Rule? - NEXUS II CT Rule for Kids

The Next PECARN Rule? - NEXUS II CT Rule for Kids

The NEXUS II Pediatric Head CT Decision Instrument was 100% sensitive for ruling out children with a neurosurgical outcome, but it was relatively small and had wide confidence intervals.  I don't think this will supplant PECARN.

Opioids Not Better Than Non-Opioids for Back, Hip, Knee Pain

Opioids Not Better Than Non-Opioids for Back, Hip, Knee Pain

Opioids were no better than non-opioid medicines for chronic back, hip, or knee pain. However, undesirable medication-related symptoms occurred more commonly among those taking opioids. 

Value of "Red Flag" Questions for Back Pain

Value of "Red Flag" Questions for Back Pain

Positive responses to "red flag" screening questions for back pain warranted further investigation, though the positive predictive value was poor.  Negative responses to screening "red flag" questions were useless as a screening tool for ruling out serious disease, such as fracture, infection, malignancy, or cauda equina.

Self-Reduction of Shoulder Dislocation - Like a Boss

Self-Reduction of Shoulder Dislocation - Like a Boss

The Boss-Holzach-Matter (aka Davos, self-reduction) technique was less painful than the physician-driven Spaso technique and just as successful and efficient.

Muscle Relaxers Add Nothing to Naproxen for Back Pain

Muscle Relaxers Add Nothing to Naproxen for Back Pain

Naproxen + placebo was as good as (possibly better than) naproxen plus orphenadrine or naproxen plus methocarbamol for acute low back pain.

Meds for Back Pain - What Works and What Doesn't

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.

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