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Patients with alcohol-associated hepatitis have a high rate of complications and short-term mortality of 20-50%. Prompt recognition and treatment, including initiation of treatment for alcohol use disorder, is important to improve patient outcomes.
Source
Alcohol-Associated Hepatitis. NEJM. 2022 Dec 29; 387 (26): 2436-2448.
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In patients with a gastrointestinal bleed (GIB), CT imaging was more often diagnostic when the specific indication (GIB) was listed within the requisition order and multiphase studies were ordered.
Source
Importance of communication of CT indication for imaging yield in patients with gastrointestinal bleed. Am J Emerg Med. 2022 Dec 5;64:101-105. doi: 10.1016/j.ajem.2022.12.003. Online ahead of print.
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Esophageal bougienage is an underutilized bedside technique for managing retained esophageal coins.
Source
Esophageal Bougienage for Management of Lodged Esophageal Coins: Safe, Effective, Efficient, and Underused. Pediatr Emerg Care. 2022 Sep 30. doi: 10.1097/PEC.0000000000002849. Online ahead of print.
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Conservative fluid administration in patients with acute pancreatitis can achieve similar clinical outcomes compared with aggressive resuscitation, with less risk of volume overload.
Source
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. N Engl J Med. 2022 Sep 15;387(11):989-1000. doi: 10.1056/NEJMoa2202884.
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Legalization of cannabis in Ontario was not associated with an increase in ED visits for cannabis hyperemesis syndrome (CHS); however, after legislation passed allowing commercialization of cannabis, there was a large increase in visits for CHS.
Source
Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada. JAMA Netw Open. 2022 Sep 16. Doi:10.1001/jamanetworkopen.2022.31937
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Children with functional abdominal pain and irritable bowel syndrome taking an open-label placebo reported significantly less pain and took fewer rescue pain medications.
Source
Effect of Open-label Placebo on Children and Adolescents With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Clinical Trial. JAMA Pediatr. 2022 Apr 1;176(4):349-356. doi: 10.1001/jamapediatrics.2021.5750. Erratum in: doi: 10.1001/jamapediatrics.2022.0359.
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A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice. If you see a child with a “stomach virus” who has jaundice – check labs!
Source
Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022 May 6;377:o1156. doi: 10.1136/bmj.o1156.
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There are few studies that address the overall diagnosis and management of acute left sided colonic diverticulitis; many, over the past 3 decades, have poor strength of evidence or are largely inconclusive.
Source
Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis : A Systematic Review. Ann Intern Med. 2022 Mar;175(3):379-387. doi: 10.7326/M21-1645. Epub 2022 Jan 18.
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New research on droperidol shows that it is a safe and effective medication for a multitude of common ED presentations, despite an FDA black box warning for QTc prolongation in 2001.
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Children with acute isolated vomiting have a viral pathogen detected more than half the time.
