What Should We Do with the Nail? Nailbed Repair in Children Take Home Point: After nail bed repair, discarding the fingernail was associated with similar rates of infection and similar cosmetic outcomes compared to replacement of the fingernail. Citation: Jain A, Grieg A, Jones A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. BJS, 2023, 110, 432–438 https://doi.org/10.1093/bjs/znad031 Relevance: Procedures for nail bed …
Read MoreAbstracts in Urgent Care – October 2023
Which Sample is More Accurate for STIs: Vaginal or Urine? Take Home Point: Vaginal swabs are the optimal sample type for women being evaluated for chlamydia, gonorrhea, and/or trichomoniasis. Citation: Aaron K, Griner S, Footman A, et. al. Vaginal Swab vs Urine for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis: A Meta-Analysis Ann Fam Med. 2023 Mar-Apr;21(2):172-179. doi: 10.1370/afm.2942 Relevance: Many sexually transmitted infections (STI) are asymptomatic in women and can have serious …
Read MoreAbstracts in Urgent Care – September 2023
How Long Should We Prescribe Antibiotics for Pediatric UTI? Take-Home Point: Children receiving 5 days of antibiotics for urinary tract infection (UTI) had a higher rate of treatment failure that children receiving 10-day courses. However, absolute treatment failure rates were low in both groups. Citation: Zaoutis T, Shaikh N, Fisher B, et. al. Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26; e231979. Relevance: There have …
Read MoreAbstracts in Urgent Care – June 2023
Click Here to download the article PDF Ivan Koay MBChB, MRCS, FRNZCUC, MD Immersive Virtual Reality Use in Reducing Pediatric Procedural Anxiety Take-home point: Immersive virtual reality (IVR) use in pediatric patients significantly improved pain and anxiety compared with the control group. Citation: Wong C, Choi K. Effects of an immersive virtual reality intervention on pain and anxiety among pediatric patients undergoing venipuncture: a randomized clinical trial. JAMA Netw Open. 2023;6(2):e230001. Relevance: Poorly managed procedural …
Read MoreAbstracts in Urgent Care – May 2023
Click Here to download the PDF Does My Patient Have a Testicular Torsion? Take-home point: Symptoms most suggestive for testicular torsion (TT) are adolescent/pubertal age, palpated hard testicle, and the presence of nausea and vomiting associated with acute scrotal pain. Citation: Lukosiute-Urboniene A, Nekrosius D, Dekeryte I, et al. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Emerg Med J. 2023;40:134–139. Relevance: As symptoms of TT …
Read MoreAbstracts in Urgent Care – April 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Clinician Training to Optimize Antibiotic Choice and Duration for Uncomplicated Skin/Soft Tissue Infections Take-home point: Maintenance of certification (MOC) project participation was associated with improvement in evidence-based practice and was sustained after the intervention period. Citation: Wiltrakis S, Jaggi P, Lu L, et al. Optimizing antibiotic treatment of skin infections in pediatric emergency and urgent care centers. Pediatrics. 2022 Oct 1;150(4): e2021053197. Relevance: Antibiotic stewardship remains one of the …
Read MoreAbstracts in Urgent Care – March 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Are Urine Dipsticks Accurate in Diagnosing UTIs in Infants? Take-home point: Point-of-care (POC) urinalysis (ie, urine dipstick) is moderately sensitive and highly specific for diagnosing urinary tract infection in febrile infants. The optimum cut-point for excluding UTI is leucocytes (1+), and the optimum cut-point for confirming UTI is nitrites (trace). Citation: Waterfield T, Foster S, Platt R, et al. Diagnostic test accuracy of dipstick urinalysis for diagnosing urinary tract …
Read MoreAbstracts in Urgent Care – February 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Quinolone Eardrops and Achilles Tendon-Related Outcomes Take-home point: Quinolone eardrops were associated with an increased risk of all-type tendon rupture, including Achilles tendon (AT), but not AT tendinitis. Citation: Tran P, Antonelli P and Winterstein A. Quinolone ear drops and Achilles tendon rupture. Clin Infect Dis. 2022; ciac709. Epub ahead of print September 6, 2022. Relevance: Systemic quinolones have been known to increase the risk of tendon rupture. Prior …
Read MoreAbstracts in Urgent Care – January 2023
Ivan Koay MBChB, MRCS, FRNZCUC, MD Kinesiology Taping for Shoulder and Chest Wall Injuries Take-home point: Kinesiologytaping (KT) combined with standard care appears to be more effective for acute pain reduction in patients with uncomplicated traumatic injury of the shoulder or chest wall. Citation: Bakker M, Bon V, Hubrechts B, et al. Kinesiotaping for acute pain due to uncomplicated traumatic injury of the shoulder or chest wall. Am J Emerg Med. 2022;58:197-202. Relevance: KT offers …
Read MoreAbstracts in Urgent Care – December 2022
Ivan Koay MBChB, MRCS, FRNZCUC, MD Applying the Ottawa Ankle Rule to Pediatric Patients Take-home point: Application of the Ottawa Ankle Rule (OAR) limits unnecessary imaging in children without missing clinically relevant fractures. Citation: de Almeida S, Rios J, Lima S, et al. Applying the Ottawa Ankle Rule in a pediatric emergency department. Pediatr Emerg Care. 2022;38(3):e1123-e1126. Relevance: Ankles fractures in children are common.Use of the OAR, a simple clinical decision rule, by UC providers …
Read More