Exciting news! JournalFeed and Dr. Amal Mattu's Top Picks Video Series is set to GO LIVE this week! It's free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited!

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This systematic review and meta-analysis concluded, with moderate certainty evidence, that oseltamivir has little to no effect on hospitalization but does increase nausea and vomiting. 

Source
Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza. JAMA Intern Med. 2024 Jan 1;184(1):18-27. doi: 10.1001/jamainternmed.2023.0699. Erratum in: JAMA Intern Med. 2023 Nov 20;: PMID: 37306992; PMCID: PMC10262060.

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Patients with TBI who were intubated in the prehospital setting had no difference in 30-day mortality when comparing induction with ketamine versus etomidate.

Source
Etomidate versus Ketamine as prehospital induction agent in patients with suspected severe traumatic brain injury. Anesthesiology. 2024. Jan 8. Doi: 10.1097/ALN.0000000000004894. Online ahead of print.

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This article outlines the updated 2023 guidelines for diagnosis and management of atrial fibrillation. Continue reading for ways to incorporate them into your emergency medicine practice.

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In patients hospitalized with non-severe community-acquired pneumonia (CAP), beta-lactam (BL) only antibiotic regimens have been shown to have increased mortality as compared to other first-line regimens.

Source
Comparative Effectiveness of First-Line and Alternative Antibiotic Regimens in Hospitalized Patients With Nonsevere Community-Acquired Pneumonia: A Multicenter Retrospective Cohort Study. Chest. 2024 Jan;165(1):68-78. doi: 10.1016/j.chest.2023.08.008. Epub 2023 Aug 11.

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This meta-analysis found a reduction in all-cause mortality in patients hospitalized with severe CAP who received adjunctive corticosteroid therapy.

Source
Efficacy and Safety of Corticosteroid Therapy for Community-Acquired Pneumonia: A Meta-Analysis and Meta-Regression of Randomized, Controlled Trials. Clin Infect Dis. 2023 Dec 15;77(12):1704-1713. doi: 10.1093/cid/ciad496.

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In this randomized trial of patients with chronic neck pain, patients who received lidocaine patch treatments had an equivalent pain response to patients who received placebo patches.      

Source
Multicenter, Randomized, Placebo-Controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain. Anesthesiology. Published online December 11, 2023. doi:10.1097/ALN.0000000000004857.

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High-dose nitroglycerin improves outcomes in patients with sympathetic crashing acute pulmonary edema (SCAPE) without significant side effects when compared to low-dose nitroglycerin.

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Treatment of COVID-19 with nirmatrelvir-ritonavir (N-R) was associated with virologic rebound (VR) in a prospective observational trial. Viral loads are high enough to cause transmission, though it remains unclear if certain patients may require longer insolation periods or how to identify those patients without significant retesting.

Please read this announcement about upgrades to JournalFeed (CME, Amal Mattu, new website)! We also need to do a price increase due to rising costs. Price changes started Dec. 1, 2023 for new subscribers and on Jan 1, 2024 for current subscriber auto-renewals. If cost is a barrier for you, please read the announcement. We want to help! ~Clay Smith

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This was a stratified analysis of patients according to vulnerability to complications from COVID-19; it showed clinical benefit in most extremely vulnerable groups but less benefit for healthier patients, even over age 70.

Source
Nirmatrelvir-Ritonavir and COVID-19 Mortality and Hospitalization Among Patients With Vulnerability to COVID-19 Complications. JAMA Netw Open. 2023 Oct 2;6(10):e2336678. doi: 10.1001/jamanetworkopen.2023.36678.

Please read this announcement about upgrades to JournalFeed (CME, Amal Mattu, new website)! We also need to do a price increase due to rising costs. Price changes started Dec. 1, 2023 for new subscribers and on Jan 1, 2024 for current subscriber auto-renewals. If cost is a barrier for you, please read the announcement. We want to help! ~Clay Smith

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In this retrospective cohort study of COVID-vaccinated patients aged 18-50 years old, there was a significant reduction in all cause hospital visits, hospitalization and death within 30 days among patients who received nirmatrelvir/ritonavir (NMV/r, aka Paxlovid) for symptomatic COVID-19 infection, particularly among those with cancer and/or cardiovascular disease, compared to propensity matched controls who did not receive NMV/r. 

Source
Oral Nirmatrelvir and Ritonavir for Coronavirus Disease 2019 in Vaccinated, Nonhospitalized Adults Aged 18-50 Years. Clin Infect Dis. 2023;77(9):1257-1264. doi:10.1093/cid/ciad400.