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: 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: 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: March, 2012
Symptoms May Say Sinusitis, But Scans Disagree Key point: Infection and even inflammation were not reliably present in the scans of patients with classic sinusitis symptoms. Citation: Ferguson BJ, Narita M, Yu VL, et al. Prospective observational study of chronic rhinosinusitis: Environment triggers and antibiotic implications. Clin Infect Dis. 2010; 54(1): 62-68. (http://dx.doi.org/10.1093/cid/cir747) Chronic sinusitis can be difficult to diagnose precisely and sometimes even more difficult to treat. Increasingly, experts are suggesting that antibiotics may …
Read MoreAbstracts in Urgent Care: February, 2012
Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Gloves Are No Substitute for Proper Hand Hygiene Key point: Healthcare workers frequently neglect hand hygiene when they use gloves. Citation: Fuller C, Savage J, Besser S, et al. “The dirty hand in the latex glove”: a study of hand hygiene compliance when gloves …
Read MoreAbstracts in Urgent Care: January, 2012
USPSTF to Advise Against Routine Prostate Cancer Screening Key point: The US Preventative Services Task Force has concluded that healthy men should not undergo routine prostate-specific antigen testing. Citation: Harris G. US panel says no to prostate screening for healthy men. New York Times website. Available at: www.ny-times.com/2011/10/07/health/07prostate.html. Accessed December 6, 2011. The recommendation was based on an analysis of five trials and applies to men of all ages. The Times quotes the task force’s …
Read MoreAbstracts in Urgent Care: November, 2011
Chinese Herbs Are as Efficient as Oseltamivir for Shortening Flu Symptoms Key point: Traditional Chinese herbal therapy resolves fever in influenza as quickly as oseltamivir. Citation: Wang C, Cao B, Liu Q-Q, et al. Oseltamivir compared with the Chinese traditional therapy maxingshigan-yinqiaosan in the treatment of H1N1 influenza: a randomized trial. Ann Int Med. 2011;155(4):217-225. Researchers studied some 400 adults and adolescents in 11 Chinese hospitals who had uncomplicated 2009 H1N1 influenza A. Patients, who …
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