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. …
Read MoreAbstracts in Urgent Care: September, 2012
Age-based cutoffs for D-dimer levels Key point: Age-based cutoffs for D-dimer levels can more accurately rule out deep venous thrombosis than the conventional cutoff level. Citation: Schouten HJ, Koek HL, Oudega R, et al. BMJ. 2012; 344: e2985. Researchers measured D-dimer values in some 650 patients suspected of having deep venous thrombosis but who had a low clinical probability according to their Wells score. Compression ultrasonography was used to confirm the diagnosis. Various cutoff levels …
Read MoreAbstracts in Urgent Care: July/August, 2012
Doctor Panels Recommend Fewer Tests for Patients Key point: The American Board of Internal Medicine, in partnership with nine medical specialty groups, is urging physicians to perform 45 common tests and procedures less frequently. Citation: http://www.nytimes.com/2012/04/04/health/doctor-panels-urge-fewer-routine-tests.html?_r=1 An article in the New York Times notes that unnecessary treatment accounts for an estimated one third of medical spending in the United States. The initiative, called Choosing Wisely, is aimed at both physicians and patients. Among the tests …
Read MoreAbstracts in Urgent Care: June, 2012
Is Oral Antibiotic Therapy Enough for Children with Acute Pyelonephritis? Key point: A randomized trial failed to prove the acceptability of oral antibiotic monotherapy relative to sequential intravenous and oral therapy, but evidence supporting and treatment alone as an option is accumulating. Citation: Bocquet N, Sergent AA, Jais JP, et al. Randomized trial of oral versus sequential IV/oral antibiotic for acute pyelonephritis in children. Pediatrics. 2012; 129(2): e269-275. Children with acute pyelonephritis typically receive intravenous …
Read MoreAbstracts in Urgent Care: May, 2012
ED Physicians Vary Widely in Use of Head CT Key point: ED physicians vary widely, by as much as 300% for patients who presented with atraumatic headache, in their ordering patterns for head CTs. Citation: Prevedello LM, Raja AS, Zane RD, et al. Variation in use of head computed tomography by emergency physicians. Am J Med. 2012; 125(4): 356-364. A research team led by Dr. Luciano Prevedello, a fellow at the Center for Evidence-Based Imaging …
Read MoreAbstracts in Urgent Care: April, 2012
Normalization of Vital Signs Does Not Reduce Risk for Acute Pulmonary Embolism Key point: Up to one-third of patients whose abnormal triage vital signs reverted to normal values had PE. Citation: Kline JA, Corredor DM, Hogg MM, et al. Normalization of vital signs does not reduce the probability of acute pulmonary embolism in symptomatic emergency department patients. Acad Emerg Med. 2010; 19(1): 11-17. In a prospective single-center study, researchers evaluated whether normalization of vital signs …
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