Practice Management
Urgent message: To better evaluate and treat patients with low back pain, urgent care providers need a good understanding of the anatomy of the back and they must be vigilant for “red flags” that signal a potentially serious condition. SHAILENDRA K. SAXENA, MD, PHD, MIKAYLA SPANGLER, PHARM D, BCPS, and SANJEEV K. SHARMA, MD, MBA Introduction Acute low back pain is a common condition often seen by urgent care providers. An episode of acute low …
Read More
Urgent message: Fever in pediatric patients, while frequent, is rarely the result of a serious illness. Urgent care practitioners must be able to consistently distinguish between serious and benign causes with a minimum of invasive testing. BRENDAN KILBANE, MD, FAAP Introduction Ever is one of the most common chief complaints in pediatric patients who present for urgent evaluation. A surprising number of families continue to suffer from “fever phobia,” with one study noting that 91% …
Read MoreLee A. Resnick, MD, FAAFP Carl Jung said, “We should not pretend to understand the world only by the intellect. The judgment of the intellect is only part of the truth.” In medicine, reliance on intellect alone is a significant danger. Ignorance of cultural, social, and even psychological context can mislead the clinician and risks misdiagnosis and error. Yet the very basis of medical decision-making is rooted in the rule of intellect. Evidence-based medicine is, …
Read MoreSoft cast versus rigid cast for treatment of distal radius buckle fractures in children Key point: Buckle fractures of the distal radius can be safely and effectively treated with a soft cast and only a single orthopedic outpatient clinic appointment. Citation: Witney-Lagen C, Smith C, Walsh G. Soft cast versus rigid cast for treatment of distal radius buckle fractures in children. Injury. 2012 Dec 21. pii: S0020-1383(12)00516-5. doi: 10.1016/j.injury.2012.11.018 Buckle fractures are extremely common and …
Read MoreIn 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 email the relevant materials and presenting information to [email protected]. The patient, a 37-year-old woman, presented after a blow to her left hand. View the image taken (Figure 1) and consider what your diagnosis would be.
Read More
Urgent message: Close follow up is necessary for pediatric patients with vague presentations, lest a diagnosis of childhood cancer be missed. JANET D. LITTLE, MD Introduction This case presentation reflects the challenge of diagnosing childhood cancers in a timely and accurate way. The presenting signs and symptoms are oftentimes nonspecific and can mimic those of common childhood conditions.1 The frequency of delayed diagnosis for childhood cancers is high, and reflects the importance of close follow-up …
Read MoreStatins for Prevention of UTIs? Key point: Statin use was significantly associated with reduced risk of urinary tract infections overall and for a second episode, but not for a first episode. Citation: Pouwels KB, Visser ST, Hak E. Effect of pravastatin and fosinopril on recurrent urinary tract infections. J Antimicrob Chemother. 2012 Oct 30; doi 10.1093/jac/dks419 [e-pub ahead of print]. Recurrent urinary tract infections (UTIs) are common, especially among women. Recent research has suggested that …
Read MoreLee A. Resnick, MD, FAAFP Love, politics and drugs were the subjects of Mick Jagger’s self-reflection in the 1960s rock anthem, “You Can’t Always Get What You Want.” Since then, the song’s chorus has been reproduced and repurposed into everything from parenting advice to sociology lectures. Mick’s personal struggles with drugs and other temptations are referenced frequently as the artistic purpose of the song, and while he may not have intended greater ideological meaning, I …
Read More
Urgent message: With the increasing number of drugs on the market, patients are more and more likely to be taking multiple medications. Urgent care providers need to be alert for potential interactions when changing or adding to a patient’s drug therapy. MAYA HECK, MS1, and JOHN SHUFELDT, MD, JD, MBA, FACEP Consider This Patient Scenario:A 28-year-old woman who says she is a traveling nurse currently on an assignment at a nearby hospital presents to an …
Read More
Urgent message: Runners who train too much too soon risk serious injury. Prompt and thorough evaluation is necessary to spot CECS masquerading as “shin splints.” MATTHEW SPEER and JOHN SHUFELDT, MD, JD, MBA, FACEP Overview Running is one of the world’s most popular exercises, with millions across the globe participating and training for events from 5K races to ultramarathons of over 100 miles. Despite the fact that more than 10 million people run over 100 …
Read More