Should We Use Steroids in Community Acquired Pneumonia Patients?
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Corticosteroid use was associated with a prevention of progression to mechanical ventilation among inpatients with community acquired pneumonia (CAP), but it had no association with the primary outcome of mortality.
Source
Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia: A systematic review, meta-analysis, and meta-regression of randomized control trials. Chest. 2022 Sep 7;S0012-3692(22)03705-9. doi: 10.1016/j.chest.2022.08.2229. Online ahead of print.
Should We Use Plain Old Doxycycline for Pneumonia?
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Doxycycline is an accessible and effective option to treat both typical and atypical bacteria that may cause community acquired pneumonia (CAP).
Source
Efficacy of Doxycycline for Mild-to-moderate Community-acquired Pneumonia in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2022 Jul 29;ciac615. doi: 10.1093/cid/ciac615. Online ahead of print.
What Are the Racial Differences in Pulse Oximetry?
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Occult hypoxemia occurred more often in Black than White inpatients. Is 92% SpO2 actually 87% SaO2?
Source
Racial bias and reproducibility in pulse oximetry among medical and surgical inpatients in general care in the Veterans Health Administration 2013-19: multicenter, retrospective cohort study. BMJ. 2022 Jul 6;378:e069775. doi: 10.1136/bmj-2021-069775.
How to Manage Hyponatremia – Spoon-Feed Version
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Regardless of the duration or etiology of hyponatremia, patients that have severe clinical manifestations warrant rapid administration of hypertonic saline as a 100-150 mL bolus of 3% sodium chloride or continuous infusion.
Source
Diagnosis and Management of Hyponatremia: A Review. JAMA. 2022 Jul 19;328(3):280-291. doi: 10.1001/jama.2022.11176.
How to Manage Spinal Stenosis | Spoon-Feed Version
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Lumbar spinal stenosis affects more than 1 in 10 U.S. citizens and over 100 million patients worldwide. This painful condition is diagnosed clinically with confirmatory imaging. Firstline treatment is activity modification, analgesia, and physical therapy, and careful selection of surgical candidates should be done only if conservative management fails.
Source
Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921.
Does the Canadian Syncope Risk Score Work Outside of Canada?
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This external validation of the Canadian Syncope Risk Score (CSRS) demonstrated good performance in identifying patients at low risk for serious outcome and was superior to the preexisting European OESIL score.
Source
International Validation of the Canadian Syncope Risk Score : A Cohort Study. Ann Intern Med. 2022 Apr 26. doi: 10.7326/M21-2313. Online ahead of print.