Clinical Decision Tool Identifies Boys at Low Risk of Testicular Torsion Key point: No child with a normal testicular lie, age <11 years, and absence of nausea or vomiting had torsion. Citation: Shah MI, Chantal CA, Mendez DR. Prospective pi- lot derivation of a decision tool for children at low risk for testicular torsion. Acad Emerg Med. 2013;20(3): 271-278. To develop a clinical decision tool for identifying children at low risk for testicular torsion, investigators …
Read MoreAbstracts in Urgent Care: June, 2006
Azithromycin: FDA Issues Cardiac Warning Key point: The antibiotic azithromycin (Zithromax and Zmax) can cause QT interval prolongation and torsades de pointes. Citation: FDA Drug Safety Communication: Azithromycin (Zithromax or Zmax) and the risk of potentially fatal heart rhythms. http://www.fda.gov/downloads/Drugs/DrugSafety/ UCM343347.pdf The agency says that healthcare providers should consider risk of fatal heart rhythms when treating patients already at high cardiovascular risk, including people with known prolon- gation of the QT interval, torsades de pointes, …
Read MoreAbstracts in Urgent Care: May, 2013
Ondansetron Safe During Pregnancy Key point: No significant association between the antiemetic on- dansetron and adverse pregnancy outcomes. Citation: Pasternak B, Svanstrom H, Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N Engl J Med 2013;368:814-823. In this retrospective cohort study, ondansetron had been prescribed for nausea and vomiting in almost 2000 of some 600,000 pregnancies. Ondansetron users were no more likely than nonusers to experience spontaneous abortion or stillbirth, or to …
Read MoreAbstracts in Urgent Care: April, 2013
Soft cast versus rigid cast for treatment of distal radius buckle fractures in children Key point: Buckle fractures of the distal radius can be safely and effectively treated with a soft cast and only a single orthopedic outpatient clinic appointment. Citation: Witney-Lagen C, Smith C, Walsh G. Soft cast versus rigid cast for treatment of distal radius buckle fractures in children. Injury. 2012 Dec 21. pii: S0020-1383(12)00516-5. doi: 10.1016/j.injury.2012.11.018 Buckle fractures are extremely common and …
Read MoreAbstracts in Urgent Care: March, 2013
Statins for Prevention of UTIs? Key point: Statin use was significantly associated with reduced risk of urinary tract infections overall and for a second episode, but not for a first episode. Citation: Pouwels KB, Visser ST, Hak E. Effect of pravastatin and fosinopril on recurrent urinary tract infections. J Antimicrob Chemother. 2012 Oct 30; doi 10.1093/jac/dks419 [e-pub ahead of print]. Recurrent urinary tract infections (UTIs) are common, especially among women. Recent research has suggested that …
Read MoreAbstracts in Urgent Care: February, 2013
Flu Activity Picks Up Nationwide Key point: CDC recommends vaccination and antiviral treat- ment against influenza Citation: http://www.cdc.gov/flu/spotlights/flu-activity-picks- up.htm. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD). Influenza activity was continuing to increase in the United States and most of the country was experiencing high levels of in- fluenza-like-illness (ILI), according to CDC’s January 4 FluView report. “Reports of influenza-like-illness (ILI) are nearing what have been peak levels during …
Read MoreAbstracts in Urgent Care: January, 2013
A Useful Marker of Invasive Disease in Well- Appearing Febrile Infants Key point: Procalcitonin is better than C-reactive protein and white blood cell count for predicting bacterial infection in well- appearing infants aged <3 months. Citation: Gomez B, Mintegi S, Da Dalt L, Blazquez D, et al. Di- agnostic value of procalcitonin in well-appearing young febrile infants. Pediatrics. 2012;130(5):815-822. Differentiating between serious bacterial infection and minor viral illness in febrile infants is often difficult. To …
Read MoreAbstracts in Urgent Care: December, 2012
OTC Topical Pain Relivers Poses Burn Risk Key point: Over-the-counter topical muscle and joint pain relivers containing capsaicin, methyl salicylate, or menthol (e.g., Bengay, Icy Hot) may cause serious chemical burns. Citation: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertforHumanMedicalProducts/ucm319353.htm A review of two adverse drug event databases, as well as the medical literature, found 43 reports of burns linked to these products. Those containing menthol were the most likely to cause second- and third-degree burns. The FDA advises clinicians to warn …
Read MoreAbstracts in Urgent Care: November, 2012
Acute Heart Failure: Hospitalize or Discharge? Key point: A new tool for estimating prognosis could facilitate rapid risk assessment. Citation: Lee DS, Stitt A, Austin PC, et al. Prediction of heart failure mortality in emergent care: A cohort study. Ann Intern Med. 2012; 156(11): 767-775. The decision to hospitalize or discharge a patient with acute heart failure (HF) is often difficult to make. To develop a prognostic model for acute HF suitable for use in …
Read MoreAbstracts in Urgent Care: October, 2012
Risk Factors for Clinical Failure in Cellulitis and Skin Abscess Key point: Hospitalized patients with obesity may experience clinical failure because of inadequate antibiotic dosing. Citation: Halilovic J, Heintz BH, Brown K. Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess. J Infect. 2012; 65(2): 128-134. Although most individuals with cellulitis or skin abscess are managed as outpatients, hospital admission is sometimes necessary. Several risk factors for hospitalization have been identified. …
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