Over the Counter but No Longer Under the Radar—Pediatric Cough and Cold Medications Key point: Since 1985, all six controlled studies of cough/cold preparations in children have not shown a positive effect. Over the last 7 years, poison-control centers have reported more than 750,000 calls Citation: Sharfstein JM, North M, Serwint JR. N Engl J Med. 2007;357(23):2321-2324. In recent weeks, over-the-counter cough and cold medications for children have received unprecedented attention from reg- ulators, physicians, …
Read MoreAbstracts In Urgent Care: January, 2008
NEJM Article Blames CT-Related Radiation for Up to 2% of Cancers in U.S. Key point: The growth of medical CT utilization may be re- sponsible for 1.5% to 2% of cancer cases in the U.S. Citation: Brenner DJ, Hall EJ. N Engl J Med. 2007;357:2277- 2284. A New England Journal of Medicine review article published recently targets the cancer risks of CT at the same time that hundreds of scientific presentations and new products at …
Read MoreAbstracts in Urgent Care: January, 2007
Modes of Administration of Antibiotics for Symptomatic Severe Urinary Tract Infections Key point: There is no evidence suggesting that oral antibiotic therapy is less effective for treatment of severe UTI than parenteral or initial parenteral therapy. Citation: Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Systematic Reviews. 2007, Issue 4. Urinary tract infection, worldwide, is a major source of disease in children and adults. Although standard management …
Read MoreAbstracts In Urgent Care: December, 2007
Abstracts In Urgent Care: November, 2007
Effectiveness of Oxycodone, Ibuprofen, or the Combination in the Initial Management of Orthopedic Injury-Related Pain in Children Key point: Oxycodone, ibuprofen, and the combination all provide effective and similar analgesia for mild-to-moderate orthopedic injuries in children. Ibuprofen, alone, is a legitimate and effective choice. Citation: Koller DM, Myers AB, Lorenz D, et al. Pediatr Emerg Care. 2007;23(9):627-633. Orthopedic injuries comprise a majority of the indications for analgesia in the emergency department. Oxycodone and ibuprofen have …
Read MoreAbstracts in Urgent Care: October, 2007
A Controlled Clinical Trial of Steroids forBronchiolitis Key point: One dose of oral dexamethasone was no different fromplacebo. Citation: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med. 2007;357:331-339. Bronchiolitis is the leading cause of hospitalization of infants in the U.S. Use of steroids for infants with bronchiolitis remains controversial because of the lack of high-quality, sufficiently powered studies. In a multisite, double-blind clinical trial, researchers randomized 600 infants (age range, …
Read MoreAbstracts In Urgent Care: October, 2007
Abstracts In Urgent Care: September, 2007
Evaluating Fever of Unidentifiable Source in Young Children Key point: An excellent review of the approach to the febrile child. Citation: Sur DK, Bukont EL. Am Fam Physician. 2007;75:1805- 1811. Even with a thorough history and a complete physical examination, one in five acutely ill, nontoxic-appearing children had an unidentifiable source of fever. Physicians should be cautious in their approach because of the potential for unrecognized and untreated serious bacterial infections (SBI). The review notes …
Read MoreAbstracts in Urgent Care: July/August, 2007
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Syncope Key point: Syncope is a common presentation to the emergency department. These recommendations help stratify low- versus high-risk patients. Citation: Huff JS, Decker WW, Quinn JV, et al. Ann Emerg Med. 2007;49:431-444. American College of Emergency Physicians Issues Guidelines for Treatment of Syncope Citation: Barclay L. Medscape News. April 30, 2007. URL:Â http://www.medscape.com/viewarticle/ 555843?src=mp Syncope accounts …
Read MoreAbstracts in Urgent Care: June, 2007
Evaluation of the Utility of Radiography in Acute Bronchiolitis Key point: Infants with typical bronchiolitis (clinically O2sat>92% and mild/moderate distress) do not need imaging. Citation: Schuh S, Lalani A, Allen U, et al. J Pediatr. 2007;150: 429-433. URL: http://sitemaker.umich.edu/emjournalclub/article_database/ da.data/1619753/PDF/bronchiolitis_xray_j_pediatrics.pdf The purpose of this study was to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given …
Read More