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Hearing loss related to chronic otitis media with effusion tends to resolve spontaneously – the longer you wait, the more likely it is to resolve.
Source
Natural history of otitis media with effusion-related hearing loss in children under 12 years: a systematic review. Arch Dis Child. 2024 Dec 13;110(1):38-44. doi: 10.1136/archdischild-2024-327463. PMID: 39299718
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While updates to national guidelines have not been made in the past 10 years, recent data suggest that children with mild acute bacterial rhinosinusitis (ABRS) may not need antibiotics, and that when indicated, amoxicillin has similar efficacy to amoxicillin-clavulanate.
Source
Antibiotics for Pediatric Acute Bacterial Sinusitis. JAMA. 2024 Oct 16. doi: 10.1001/jama.2024.2018. Epub ahead of print. PMID: 39412765
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Clinical practice guidelines that emphasize the use of narrow-spectrum antibiotics for preseptal cellulitis can be useful in decreasing use of broad-spectrum antibiotics, particularly those targeted at MRSA.
Source
Improving Antibiotic Use in Pediatric Preseptal Cellulitis Using a Clinical Practice Guideline. Hosp Pediatr. 2024 Oct 1;14(10):791-798. doi: 10.1542/hpeds.2023-007581. PMID: 39246158
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Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease that can be easy to miss in the emergency department setting. This article provides an overview of CST as well as some pearls for clinching this diagnosis for emergency medicine physicians.
Source
High risk and low prevalence diseases: Cavernous sinus thrombosis. Am J Emerg Med. 2024;83:47-53. doi:10.1016/j.ajem.2024.06.024.
PMID: 38959601.
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This systematic review snapshot found that when the HINTS exam is used by properly trained clinicians, it shows high sensitivity and moderate specificity to identify central causes of acute vestibular syndrome (AVS).
Source
Are the HINTS and HINTS Plus Examinations Accurate for Identifying a Central Cause of Acute Vestibular Syndrome? Ann Emerg Med. 2024 Jul;84(1):60-62. doi: 10.1016/j.annemergmed.2024.01.027. Epub 2024 Feb 22. PMID: 38385911.
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Diagnosing patients with a posterior circulation TIA who are experiencing isolated episodic dizziness can be challenging, especially when considering the difficulty in assessing individual symptoms and the small absolute number of these patients. The authors lay out a pragmatic approach for assessment and diagnosis, but the data to support a reliable clinical decision-making tool is weak.
Source
Recognizing Posterior Circulation Transient Ischemic Attacks Presenting as Episodic Isolated Dizziness. Ann Emerg Med. 2024 May 23:S0196-0644(24)00214-2. doi: 10.1016/j.annemergmed.2024.04.006. Epub ahead of print. PMID: 38795083.
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This retrospective validation study at a single site in Hong Kong found the TriAGe+ score for vertigo or dizziness would have performed reasonably well for risk-stratifying patients who presented to their ED for dizziness or vertigo when evaluating for acute stroke or TIA.
Source
The TriAGe + score for vertigo or dizziness: A validation study in a university hospital emergency department in Hong Kong. Am J Emerg Med. 2024 Mar;77:39-45. doi: 10.1016/j.ajem.2023.10.055. Epub 2023 Nov 10. PMID: 38096638.
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For pediatric patients with acute sinusitis, amoxicillin-clavulanate does not offer treatment benefit over amoxicillin alone and is more likely to be associated with gastrointestinal (GI) side effects and yeast infections than amoxicillin.
Source
Treatment Failure and Adverse Events After Amoxicillin-Clavulanate vs Amoxicillin for Pediatric Acute Sinusitis. JAMA. 2023 Sep 19;330(11):1064-1073. doi: 10.1001/jama.2023.15503.
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While it doesn’t have great specificity, the sensitivity of ultrasound makes it a viable first step in making the diagnosis of peritonsillar abscess.
Source
Test characteristics of ultrasound for the diagnosis of peritonsillar abscess: A systematic review and meta-analysis. Acad Emerg Med. 2023 Aug;30(8):859-869. doi: 10.1111/acem.14660. Epub 2023 Jan 30.
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Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.
Source
Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial. JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854