Urgent message: Vigilance for risk factors and diagnostic methods related to Paget-Schroetter syndrome in patients presenting to urgent care with relevant risk factors is essential to initiating therapy on site and timely referral to a hospital and/or vascular surgeon. Darshan Shah, MD, Shikhar Saxena, MD and Shailendra Saxena, MD, PhD Introduction Upper extremity deep venous thrombosis (UEDVT) is estimated to constitute 1% to 4% of all cases of deep venous thrombosis (DVT).1 The incidence may …
Read MoreClinical Challenge 2: June 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected] The patient is a 2 ½-year-old who presents with pain in the left ankle after receiving a blow to the lower leg. You find he is unable …
Read MoreAbstracts in Urgent Care: June, 2010
Upper Gastrointestinal Tract Hemorrhage, Warfarin, and Urinary Tract Antibiotics Key point: Ciprofloxacin increased GI hemorrhage while on coumadin by twice as much, and cotrimoxazole by four times. Citation: Fischer HD, Juurlink DN, Mamdani MM, et al. Hemorrhage during warfarin therapy associated with cotrimoxazole and other urinary tract anti-infective agents: A population-based study. Arch Intern Med. 2010; 170(7): 617-621. Hemorrhage is a well-known side effect of long-term warfarin use in older patients. Interactions between warfarin and …
Read MoreClinical Challenge: June, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 4 1/2 -year-old girl who presents with local pain and swelling in the fifth digit of her left hand. The parents report that …
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The Case of a 21-year-old Woman with Sinus Pain
I would rather have a patient with a stab wound to the chest than a patient with a serious underlying problem who just wants antibiotics and a quick evaluation. Is there a way to tease out benign- appearing patients who are “pre-crump?” This month’s case is that very patient—a raindrop in a torrent of mucus and purulent drainage.
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Asthma in the Pediatric Population: An Urgent Care Approach
Urgent message: though sometimes viewed as an easily controlled disease, asthma can become a medical emergency quickly. It is important for the urgent care clinician to be able to recognize the signs of a potentially life-threatening asthma exacerbation – and know how to treat it accordingly. Muhammad Waseem, MD, Nicholas Caputo, MD, Geeta Krishna, MD, Joel Gernsheimer, MD Introduction Asthma is an episodic and reversible airflow obstruction. It is the most common chronic disease in …
Read MoreMinding Your E’s & M’s
Nothing hurts a business more than leaving money on the table. It is hard enough to attract business; the last thing you want to do is not get paid once services are rendered. There are a number of steps in the coding and billing process, and errors at any level can lead to bad debt, missed charges, and poor reimbursement. Let’s look at a few I would call the “low-hanging fruit.” Collection at the Time …
Read MoreClinical Challenge 2: April 2010
The patient is a 26-year-old who presents to urgent care after “twisting” the right foot, complaining of local pain but able to bear weight. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge: May, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 50-year-old female who presents with pain in her right thumb after taking a fall. On examination, you not local swelling at the base …
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Here Comes the Sunburn: An Update
Urgent message: The advent of warmer weather is a reminder that many otherwise sensible Americans fail to heed warnings to use adequate protection from the sun. The urgent care clinician can expect to see more patients presenting with varying degrees of sunburn. Deepthi Samindla, MBBS, Beth Braig, BA, Mikayla L. Spangler, PharmD, Shailendra K. Saxena, MD, PhD Introduction Sunburn is an acute cutaneous inflammation to excessive exposure to solar ultraviolet (UV) radiation. About 30% to …
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