Chest X-Ray Findings Among Urgent Care Patients with COVID-19 Are not Affected by Patient Age or Gender: A Retrospective Cohort Study of 636 Ambulatory Patients

Chest X-Ray Findings Among Urgent Care Patients with COVID-19 Are not Affected by Patient Age or Gender: A Retrospective Cohort Study of 636 Ambulatory Patients

Joshua Russell, MD, MSc, FACEP MD; Ana Echenique, MD, DABR; Steven R. Daugherty, PhD; and Michael Weinstock, MD Abstract Background/Objective A prior study of patients presenting to urgent care (UC) centers with COVID-191 showed that only a small proportion of these ambulatory patients demonstrated significant pathology on chest x-ray (CXR). In this secondary analysis of 636 ambulatory patients with confirmed COVID-19 from greater New York City (NYC), our primary objective was to determine whether the …

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Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Michael B. Weinstock, MD, Ana Echenique, MD, DABR, Joshua W. Russell, MD, MSc, FACEP, Ari Leib, MD, Jordan A. Miller, DO, David J. Cohen, MD, Stephen Waite, MD, Allen Frye, NP, and Frank A. Illuzzi, MD, FACEP Abstract Background/Objective Patients with COVID-19 commonly present to Urgent Care (UC) centers. Our primary objective was to determine what percentage of UC patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR). Secondarily, we aim to describe …

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A 5-Month-Old with Symptoms Beyond the Presenting Complaint

A 5-Month-Old with Symptoms Beyond the Presenting Complaint

Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …

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A 16-Week-Old Infant with Bloody Vomitus

A 16-Week-Old Infant with Bloody Vomitus

In Bouncebacks, we provide the documentation of an actual patient encounter, discuss patient safety and risk-management principles, and then reveal the patient’s bounceback diagnosis. This case is from the book Bouncebacks! Pediatrics, by Michael B. Weinstock, Kevin M. Klauer, Madeline Matar Joseph, and Gregory L. Henry, and is available at www.anadem.com and www.amazon.com. Introduction A 16-week-old infant was brought by her parents to the emergency department (ED) of a children’s hospital. Note: The following is the actual documentation by the provider. Visit …

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Nonhealing Wounds, Part 2: Treatment in the Urgent Care Center

Nonhealing Wounds, Part 2: Treatment in the Urgent Care Center

Urgent message: The etiology of nonhealing wounds is often multifactorial, with the likelihood of healing enhanced if all considerations are addressed, including evaluation and management of the blood supply in patients with peripheral arterial disease or diabetes mellitus, as well as local wound care. The diagnosis of a nonhealing wound is largely clinical, with diagnostic studies tailored to the suspected cause as well as to the underlying process. Part 1 of this article [see “Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care …

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Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care Center

Nonhealing Wounds, Part 1: Diagnosis in the Urgent Care Center

Urgent message: Nonhealing wounds not only are prevalent but also are complex in terms of wound management and treating the accompanying comorbid disease. By both recognizing the diagnosis and understanding how to treat these wounds, urgent care providers have the opportunity to differentiate life-threatening illness from lifeinhibiting disease and improve outcomes for patients. An estimated 6 million people in the United States have a nonhealing wound, with a 1% lifetime incidence for the total population.1,2 This number is expected to increase with the …

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Zika Virus—Near Pandemic Proportions?

Zika Virus—Near Pandemic Proportions?

Urgent message: The clinical manifestations of Zika virus infection are generally mild in adults; the primary concern is the potential link to microcephaly in children of infected pregnant women. There is no cure, so prevention is paramount. MIZUHO SPANGLER, DO, and MICHAEL B. WEINSTOCK, MD Introduction The Zika virus epidemic is gaining a lot of media attention, deservedly so; there have been large outbreaks of infection in Brazil, South America, and the Caribbean, with numbers …

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Sudden-Onset Severe Headache

Sudden-Onset Severe Headache

Urgent message: Patients with imminently life-threatening conditions can present to an urgent care appearing to be in good health or even with a viable alternative explanation for their symptoms. It is important to be vigilant for red flags of serious illness. ARASH MIRZAIE, MS4, and MICHAEL WEINSTOCK, MD Headache is one of the most common presenting complaints in ambulatory settings. Urgent care providers must rapidly evaluate and diagnose a variety headache types in a time-limited …

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Urgent Care Evaluation of Diarrhea

Urgent Care Evaluation of Diarrhea

Urgent message: Diarrheal illness presents with varying degrees of severity and a broad range of etiologies. The urgent care center provider’s ability to gather key information from the medical history and physical examination, determine when laboratory testing is beneficial, and recognize indications for treatment is essential for the effective and efficient treatment of this common symptom. NATHAN M. FINNERTY, MD, and MICHAEL WEINSTOCK, MD Introduction Diarrheal illness is a common presenting complaint to all urgent care centers. In the United …

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LITERATURE REVIEW: Early Administration of Azithromycin and Prevention of Severe Lower RTI

LITERATURE REVIEW: Early Administration of Azithromycin and Prevention of Severe Lower RTI

Citation: Bacharier LB, Guilbert TW, Maugeret DT, al. Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses. JAMA. 2015;314:2034-2044. Reviewed by: Michael B. Weinstock, MD Background/question: The authors wanted to know if antibiotics administered early in the course of a respiratory tract infection (RTI) in children with recurrent, severe RTIs decreased progression of disease. Study: This is a randomized, double-blind, placebo-controlled trial at …

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