When Should Diagnostic Imaging Be Used for Patients With Low-back Pain? Key point: With low-back pain, the risks associated with X-rays and MRIs often outweigh the benefits. Citation: Daily POEM: imaging for low-back pain: rarely indicated, often harmful. Available at: www.essentialevidience- plus.com. These guidelines are based on a systematic review and meta- analysis of research investigating the usefulness of various im- aging studies in patients with low-back pain. Based on a meta- analysis of six …
Read MoreAbstracts in Urgent Care: May, 2011
Complications of Sinusitis in Children Key point: Intracranial complications of pediatric sinusitis were more severe than intraorbital complications. Citation: Goytia VK, Giannoni CM, Edwards MS. Intraorbital and intracranial extension of sinusitis: Comparative morbidity.  J Pediatr. 2011;158(3):486-491. Serious complications of sinusitis occur more often in children than in adults. Prompt diagnosis and treatment are necessary to minimize morbidity and the risk for permanent sequelae or death. In arecent study, investigators reviewed records from a large chil- …
Read MoreAbstracts in Urgent Care: April, 2011
Randomized Controlled Trial of Cephalexin Versus Clindamycin for Uncomplicated Pediatric Skin Infections Key point: When it comes to curing skin infected with MRSA (methicillin-resistant Staphylococcus aureus), timely and proper wound cleaning and draining may be more important than the choice of antibiotic. Citation: Chen AE, Carroll KC, Diener-West M, et al. Pediatrics. 2011;127(3):e573-e580. Researchers originally set out to compare the efficacy of two antibiotics commonly used to treat Staph skin infections, ran- domly giving 191 …
Read MoreAbstracts in Urgent Care: March, 2011
Not All Infectious Diseases Society of America Practice Guidelines Are Created Equal Key point: More than 1/2 of recommendations in guidelines from the Infectious Diseases Society of America rely on low-quality evidence. Citation: Lee DH, Vielemeyer O. Analysis of overall level of evidence behind Infectious Diseases Society of America practice guidelines. Arch Intern Med. 2011;171(1):18-22. Researchers examined 41 guidelines published by the Infectious Diseases Society of America (IDSA) since 1994. Of the 4,200 in- dividual …
Read MoreAbstracts in Urgent Care: February, 2011
Most Frequently Missed Fractures in the Pediatric Emergency Department Key point: The most commonly missed fractures were pha- langes of the hand and metatarsal fractures. Citation: Mounts J, Clinenpeel J, McGuire E, et al. Most frequently missed fractures in the emergency department. Clin Pediatr (Phila). 2010 Dec 2. [Epub ahead of print.] This study quantified the types of extremity fractures most commonly missed on plain radiographs by pediatric emer- gency medicine specialists after an initial …
Read MoreAbstracts in Urgent Care: January, 2011
Position Statement on Sports Concussions Key point: Sports are second only to motor vehicle accidents as the leading cause of traumatic brain injury among 15- to 24- year-olds. Citation: AAN Sports Neurology Section, Practice Committee, and Board of Directors. Position statement on sports concus- sion. October 2010 (AAN Policy 2010-36). Concussion is a common consequence of trauma to the head in contact sports, estimated by the Centers for Disease Control and Prevention to occur 3 …
Read MoreAbstracts in Urgent Care: December, 2010
Nahum Kovalski, BSc, MDCM 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. New Guidelines for Prevention of Stroke in Patients with Stoke or TIA Key point: New, evidence-based recommendations aim at reducing risk of ischemic stroke in patients who have had a stroke or transient ischemic attack. Citation: Furie KL, Kasner SE, …
Read MoreAbstracts in Urgent Care: November, 2010
On ED Visits, Corticosteroids and COPD, Intranasal Steroid in Allergic Rhinitis, Intussusception in Children Under 5, Urinary Antigen Testing, and Emergency Contraception Nahum Kovalski, BSc, MDCM 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. Emergency Department Visits on the Rise Key point: ED use in the U.S. is up dramatically; these stats …
Read MoreAbstracts in Urgent Care: October, 2010
On Imaging Head Injuries, Routine Cellulitis, Alteplase and Ischemic Stroke, Head Lice, Steroids for Pharyngitis, and Brain Injury in Children Nahum Kovalski, BSc, MDCM 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. Diagnostic Imaging Rates for Head Injury in the ED and States’ Medical Malpractice Tort Reforms Key point: The authors found …
Read MoreAbstracts in Urgent Care: September, 2010
Non-intravenous Midazolam Effectively Terminates Pediatric Seizures Key point: A meta-analysis revelas that non-IV midazolam is as effective as or superior to IV or rectal diazepam for stopping seizures in children and young adults. Citation: McMullan J, Comilla S, Panciolo A, et al. Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: A meta-analysis. Acad Emerg Med. 2010; 17(6): 575-582. Although intravenous (IV) lorazepam is considered first-line therapy for status epilepticus, …
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