Pulmonary/Allergy

PEN-FAST 2.0 – Directly Testing for PCN Allergy – The PALACE RCT

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Starting with the PEN-FAST Decision Tool, direct oral challenges to low-risk individuals with reported penicillin allergies is safe, effective, and can remove a majority of mislabeled instances.

Source
Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med. Published online July 17, 2023. doi:10.1001/jamainternmed.2023.2986

Should We Rx Inhaled Steroids for Asthma?

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In this study, only 6% of asthma patients discharged from the ED received a prescription for inhaled corticosteroids and only 14% had any outpatient follow-up within 30 days of their ED visit. Patients who were Hispanic, uninsured, and privately insured had the lowest odds of receiving an ICS prescription from the ED.

Source
Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. 2023 May;64(5):555-563. doi: 10.1016/j.jemermed.2023.02.013. Epub 2023 Mar 21.

Not Just for Kids – RSV vs Flu Impact on Adults

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Respiratory syncytial virus (RSV) is prevalent in hospitalized adults and is associated with higher odds of prolonged hospitalization and mechanical ventilation, particularly in patients with CHF and COPD.

Source
Prevalence and Clinical Outcomes of Respiratory Syncytial Virus versus Influenza in Adults Hospitalized with Acute Respiratory Illness from a Prospective Multicenter Study. Clin Infect Dis. 2023 Jan 24;ciad031. doi: 10.1093/cid/ciad031. Online ahead of print.

PARIS-2 RCT – Does High Flow Oxygen Help Hypoxic Children?

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As compared with standard oxygen therapy, high flow oxygen was associated with increased length of hospital stay in pediatric patients with hypoxemic respiratory failure.

Source
Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure: The PARIS-2 Randomized Clinical Trial. JAMA. 2023;329(3):224-234.

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