Fatigue and inappropriate antibiotic prescription Key point: As the day goes on, resistance to prescribe potentially inappropriate antibiotics seems to fade. Citation: Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe antibiotics. JAMA Intern Med. 2014 Oct 6; doi: 10.1001/jamainternmed.2014.5225. [Epub ahead of print] Previous research has shown that resistance to making the easier choice tends to fade as fatigue increases. Physicians make many difficult decisions during …
Read MoreAbstracts in Urgent Care: December, 2014
Pulse oximetry and decision-making on hospitalization Key point: Use of pulse oximetry to decide on necessity of hospitalization may need to be reconsidered. Citation: Schuh, S, Freedman S, Coates A. et al. Effect of oximetry on hospitalization in bronchiolitis, JAMA. 2014; 312(7):712-718. Pulse oximetry has been used to help decide when an infant with bronchiolitis should be hospitalized. The authors of this study postulated that providers may be relying too heavily on it, resulting in …
Read MoreAbstracts in Urgent Care: November, 2014
Generic medication appearance Key point: When providing generic prescriptions, warn patients about generic medication colors and shapes. Citation: Kesselheim AS, Bykov K, Avorn J, et al. Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: Cohort and nested case–control studies. Ann Intern Med. 2014; 161:96-103. Researchers in this study attempted to determine if changes in color or shape of a generic drug led to discontinuation of that drug. Patients …
Read MoreAbstracts in Urgent Care: October, 2014
Timing of concussion symptoms Key point: Symptoms of concussion such as sleep disturbance, forgetfulness, and fatigue are late in onset. Citation: Eisenberg MA, Meehan WP 3rd, Mannix R. Duration and course of post-concussive symptoms. Pediatrics. 2014;133(6):999-1006. Estimates of the duration of concussion symptoms in children vary from 1 week to months. This study looks at previous cohorts where the median time to recovery was 13 days and considers symptoms, their duration, and clinical course. The …
Read MoreAbstracts in Urgent Care – September 2014
Antibiotics and middle ear effusion Key point: Treatment with antibiotics seems to reduce the duration of middle ear effusion. Citation: Tapiainen T, Kujala T, Renko M, et al. Effect of antimicrobial treatment of acute otitis media on the daily disappearance of middle ear effusion: A placebo-controlled trial. JAMA Pediatr. 2014;168(7):635-641. Authors in this randomized, double blind, placebo-controlled trial compared 84 children aged 6 months to 15 years with acute otitis media who were either given …
Read MoreAbstracts in Urgent Care: September, 2014
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 …
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