New Data Measure Risks with Oral Corticosteroids Key point: Remember—all medications have risks! Citation: Waljee AK, Rogers MA, Lin P, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415. This cohort study looks at patients with short-term steroid use (<30 days) and potential complications at 30 and 90 days out. Endpoints included fracture, sepsis, and blood clot. This study included 1.5 …
Read MoreAbstracts in Urgent Care – May 2017
Consider Vitamin D Supplementation for Patients Prone to URIs Key point: Vitamin D supplementation was both safe and protective against acute respiratory tract infection. Citation: Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. An ounce of prevention would definitely be a good idea when it comes to upper respiratory infection. With the currently limited treatments for …
Read MoreAbstracts in Urgent Care March 2017
Clindamycin Reduces Resistance to Group A Strep Key point: Another use for clindamycin. Citation: Andreoni F, Zurcher C, Tamutzer A, et al. Clindamycin affects group A streptococcus virulence factors and improves clinical outcome. J Infect Dis. 2017;215(2):269-277. Necrotizing fasciitis is a life-threatening infection not frequently seen in the urgent care center, though it does occur. This article from the Infectious Diseases Society of America discusses the importance of adding clindamycin to the treatment regimen. No …
Read MoreAbstracts in Urgent Care February 2017
Earlier Return to Activities May Benefit Concussed Children Key point: Another (possibly surprising) view on rest after concussion. Citation: Grool AM, Aglipay M, Momoli F. Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents. JAMA. 2016;316(23):2504-2514. In this prospective, multicenter cohort study, approximately 2,400 children aged 5-18 years with acute concussion diagnosed at nine emergency departments across Canada were evaluated for persistent postconcussive symptoms (PPCS). Each …
Read MoreAbstracts in Urgent Care – December 2016
Sean M. McNeeley, MD Azithromycin May Not Be Helpful for Asthma Key point: There is no proven benefit from taking azithromycin for asthma. Citation: Johnston SL, Szigeti M, Cross M, et al; AZALEA Trial Team. Azithromycin for acute exacerbations of asthma: the AZALEA randomized clinical trial. JAMA Intern Med. 2016;176:1630–1637. The randomized, double-blind, placebo-controlled trial reported here focused on treatment for 3 days for 199 adults with asthma exacerbations. One group received 500 mg of …
Read MoreAbstracts in Urgent Care – September 2016
SEAN M. McNEELEY, MD The American College of Gastroenterology Publishes New Guidelines for Treating Diarrheal Disease Key point: New guidelines on treating diarrheal disease are available from the American College of Gastroenterology. Citation: Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016;111:602–622. The authors of this report note that the Centers for Disease Control and Prevention reports 47.8 million cases of …
Read MoreAbstracts In Urgent Care – July 2016
SEAN M. McNEELEY, MD Dexamethasone May Be Worthwhile in Treating Adult Asthma Key point: Dexamethasone is almost as good as prednisone in treating asthma in adults. Citation: Rehrer MW, Liu B, Rodriguez M, et al. A randomized controlled noninferiority trial of single dose of oral dexa- methasone versus 5 days of oral prednisone in acute adult asthma. Ann Emerg Med. 2016 April 22. doi: 10.1016/ j.annemergmed.2016.03.017. [Epub ahead of print.] In a randomized placebo-controlled trial …
Read MoreAbstracts In Urgent Care – June 2016
SEAN M. McNEELEY, MD Longer-Term Antibiotic Treatment and Persistent Lyme Disease Symptoms Key point: Longer therapy for Lyme disease is not helpful. Citation: Berende A, ter Hofstede HJ, Vos FJ, et al. Randomized trial of longer-term therapy for symptoms attributed to Lyme disease. N Engl J Med. 2016;374:1209–1220. Lyme disease continues to be in the news because persistent symptoms after infection are of great concern. In a double- blind, placebo-controlled study, researchers gave antibiotics for …
Read MoreAbstracts in Urgent Care – May 2016
SEAN M. McNEELEY, MD Results Unavailable for 71% of Trials Key point: Many research findings are not easily available to clinicians. Citation: Chen Ruijun, Desai NR, Ross JS, et al. Publication and reporting of clinical trial results: cross sectional analyis across academic medical centers BMJ. 2016;352:i637. Researchers investigated the amount of clinical trial findings at academic medical centers that are not published and thus not easily available to clinicians. In a cross-sectional analysis of academic …
Read MoreAbstracts in Urgent Care: April, 2016
SEAN M. McNEELEY, MD Copeptin and Troponin Together Are Useful in Diagnosing Acute Coronary Syndromes Key point: There is a new tool for ruling out myocardial infarction. Citation: Ricci F, Di Scala R, Massacesi C, et al. Ultra-sensitive copeptin and cardiac troponin in diagnosing non-ST-segment elevation acute coronary syndromes—the COPACS Study. Am J Med. 2016;129:105–114. Concern about patients with non-ST-segment elevation myocardial infarction with chest pain and normal electrocardiogram (ECG) findings frequently causes a transfer …
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