Abstracts in Urgent Care: July/August, 2014
Clinical prediction rule for ureteral stones Key point: A new clinical score may predict the presence of uncomplicated ureteral stones and reduce the need for CT scan. Citation: Moore CL, Bomann S, Daniels B, et al. Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone—the STONE score: Retrospective and prospective observational cohort studies. BMJ. 2014; 348:g2191. In this two-phase trial, five factors were identified and then prospectively validated for prediction of ureteral …
Read MoreAbstracts in Urgent Care: June, 2014
Modification of Wells criteria in cancer, previous DVT Key point: Wells criteria for deep venous thrombosis (DVT) may need modification for patients with cancer or previous DVT. Citation: Geersing GJ, Zuithoff NP, Kearon C, et al. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data metaanalysis. BMJ. 2014;348:g1340. Possible DVT is an important diagnosis to make, however, many urgent cares do not have access to ultrasound. A combination …
Read MoreAbstracts in Urgent Care: May, 2014
Signs of aging and risk of heart disease Key point: Some outward signs of aging may correlate with increased risk of heart disease including MI. Citation: Christoffersen M, Frikke-Schmidt R, Schnohr P, et al. Visible age-related signs and risk of ischemic heart disease in the general population: A prospective cohort study. Circulation. 2014;4l128(9):990-998. Investigators in Denmark in this 35-year prospective trial attempted to see if outward signs of aging (frontoparietal baldness, crown top baldness, earlobe crease, …
Read MoreAbstracts in Urgent Care: April, 2014
Prompt Treatment of Pediatric UTI Prevents Renal Scarring Key point: To avoid renal scarring, don’t wait for urine culture in pediatric patients. Treat within 3 days. Citation: Coulthard MG, Lambert HJ, Vernon SJ, et al. Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: Mixed retrospective and prospective audits. Arch Dis Child. 2013 Dec 18; [e-pub ahead of print]. Investigators in England looked at the relationship between time to treatment and …
Read MoreAbstracts in Urgent Care: March, 2014
Reconsidering antibiotics for COPD exacerbation Key point: Prescribing antibiotics to patients with mild-to-moderate COPD exacerbations who have no change in sputum probably is unnecessary. Citation: Miravitlles M, Moragas A, Hernandez S, et al. Is it possible to identify exacerbations of mild to moderate COPD that do not require antibiotic treatment? Chest. 2013;144(5): 1571-1577. The decision to prescribe antibiotics to patients with moderate to mild-to-moderate chronic obstructive pulmonary disease (COPD) exacerbations is usually based on increased …
Read MoreAbstracts in Urgent Care: February, 2014
Pyuria Poor Predictor of UTI in Nephrolithiasis Key point: Classic symptoms and urine culture are the best indicators of infection in patients with acute nephrolithiasis. Pyuria proved a poor predictor. Citation: Abrahamian FM, Krishnadasan A, Mower WR, Moran GJ, Talan DA. Association of pyuria and clinical characteristics with the presence of urinary tract infection among patients with acute nephrolithiasis. Ann Emerg Med 2013;62(5):526-533. Infection can complicate the diagnosis of acute nephrolithiasis. Patients with both a …
Read MoreAbstracts in Urgent Care: January, 2014
Metabolic Consequences of Insufficient Sleep Key point: A small, randomized, controlled crossover study demonstrates changes in a critical insulin-signaling pathway in peripheral tissue. Citations: Broussard JL, Ehrmann DA, Van Cauter E, Tasali E, Brady MJ. Impaired insulin signaling in human adipocytes after experimental sleep restriction: A randomized, crossover study. Ann Intern Med 2012;157(8):549-557. and Cappuccio FP, Miller MA. A new challenge to widely held views on the role of sleep. Ann Intern Med 2012;157(8):593-594. Small …
Read MoreAbstracts in Urgent Care: December, 2013
Long-term survival following pneumococcal pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term sur- vival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans …
Read MoreAbstracts in Urgent Care: November, 2013
Long-term Survival Following Pneumococcal Pneumonia Key point: Pneumococcal pneumonia foretold considerably higher 10-year mortality than the expected rate. Citation: Sandvall B, Rueda AM, Musher DM. Long-term survival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145-1146. Before antibiotics, pneumonia was called “the old man’s friend” for carrying the old and infirm to a swift and relatively painless death. Now that short-term survival after pneumonia is the rule, does the disease provide any long-term prognostic information? Veterans Administration …
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