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
A 14-year-old who took a fall two hours prior to presenting to the urgent care clinic
The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise healthy. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreAbstracts 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 MoreClinical Challenge: November, 2007
Case The patient is a 10-year-old boy who experienced a direct blow to the elbow approximately six hours prior to presentation. He had incomplete range of motion with minimal local swelling and considerable pain. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Ruptured Ectopic Pregnancy with a Negative Urine Pregnancy Test
Urgent message: Ectopic pregnancy must be considered in women of childbearing age who present with abdominal pain—even if ‘ruled out’ by a negative hCG test. Yi-An A. Lee, MD, MPH, Gino Farina, MD, and Helene Lhamon, MD The incidence of ectopic pregnancy is estimated to be 19.7 per 1,000 pregnancies and is responsible for 9% of pregnancy-related deaths.1 Ectopic pregnancy is always near the top of the differential diagnosis for abdominal pain in women of …
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The Case of a 46-Year-Old Man with Neck and Upper Back Pain
This article is the second in a series that will sequentially answer the following questions: What is the incidence of bouncebacks? What is the incidence of bounceback admissions? What is the incidence of deaths in patients recently discharged from the ED? What percent of bouncebacks occur because of medical errors? How can we use this information to improve patient safety? In the September issue of JUCM, we discussed several studies which found the incidence of …
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Assessment and Management of Common Hand Infections
Urgent message: Common superficial hand infections may be managed easily by the urgent care physician. Left untreated or undertreated, however, simple hand infections may progress to disabling conditions requiring urgent sub-specialty management. Arthur R. Smolensky, MD, Samuel M. Keim, MD, MS, and Peter Rosen, MD The hand is an intricate and crucial feature of the human body. Yet, with the exception of superficial cellulitis, common hand infections require relatively simple surgical procedures—many of which can …
Read MoreDefining Urgent Care
Lee A. Resnick, MD, FAAFP In this issue of JUCM, The Journal of Urgent Care Medicine, we excerpt the landmark report, “No Appointment Needed: The Resurgence of Urgent Care Centers in the United States”. Funded by the California HealthCare Foundation, and authored by Robin M. Weinick, PhD and Renée M. Betancourt, BA, the report represents the first comprehensive look into urgent care practice and the urgent care industry. Everything from business models and staffing to …
Read MoreInsights In Images: October, 2007 -2
The patient is a 35-year-old Caucasian female who presented with dysphagia and progressively worsening neck pain. No history of injury was reported. Neurovascular exam was normal. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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