Journal Club, 12/13/2017
Via Angela Yang:
Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis.
de Almeida JR, Al Khabori M, Guyatt GH, Witterick IJ, Lin VY, Nedzelski JM, Chen JM.
JAMA. 2009 Sep 2;302(9):985-93. doi: 10.1001/jama.2009.1243.
PubMed ID: 19724046
https://doi.org/10.1001/jama.2009.1243
How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature.
Murad MH, Montori VM, Ioannidis JP, Jaeschke R, Devereaux PJ, Prasad K, Neumann I, Carrasco-Labra A, Agoritsas T, Hatala R, Meade MO, Wyer P, Cook DJ, Guyatt G.
JAMA. 2014 Jul;312(2):171-9. doi: 10.1001/jama.2014.5559.
PubMed ID: 25005654
https://doi.org/10.1001/jama.2014.5559
Assessing inhalation injury in the emergency room
Non-invasive Testing Vs Clinical Eval–Low Risk Chest Pain
Quoth Paolo: “No difference”
Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain: A Secondary Analysis of the ROMICAT-II Randomized Clinical Trial.
Reinhardt SW, Lin C, Novak E, Brown DL.
JAMA Intern Med.
Published online November 14, 2017.
doi:10.1001/jamainternmed.2017.7360
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2663304
JAMA: Acute Extremity Pain in the ED, Opioid vs. Nonopoid Analgesic Pain Management
via Dr. Paolo:
Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial
Andrew K. Chang, MD, MS; Polly E. Bijur, PhD; David Esses, MD; et al Douglas P. Barnaby, MD, MS; Jesse Baer, MD
JAMA. 2017;318(17):1661-1667. doi:10.1001/jama.2017.16190
https://jamanetwork.com/journals/jama/fullarticle/2661581
Rothman adds:
The associated editorial may also be of interest.
Opioid vs Nonopioid Acute Pain Management in the Emergency Department
Demetrios N. Kyriacou, MD, PhD
JAMA. 2017;318(17):1655-1656. doi:10.1001/jama.2017.16725
https://jamanetwork.com/journals/jama/fullarticle/2661559
Please also note that popular media is reporting (about as well/poorly as usual) about this study, mostly with very minor variations on the AP story.
Examples: https://news.google.com/news/story/dzQkeDa5_L-5SFM7R-uZfHJbcff9M?hl=en
Emergency departments provide nearly half of medical care in the U.S., study finds (via W. Paolo)
The Secretive Family Making Billions From the Opioid Crisis (Esquire, via W. Paolo)
You’re aware America is under siege, fighting an opioid crisis that has exploded into a public-health emergency. You’ve heard of OxyContin, the pain medication to which countless patients have become addicted. But do you know that the company that makes Oxy and reaps the billions of dollars in profits it generates is owned by one family?
http://www.esquire.com/news-politics/a12775932/sackler-family-oxycontin/
Journal Club Article for 11/8/2017
Tissue plasminogen activator for acute ischemic stroke.
N Engl J Med. 1995 Dec 14;333(24):1581-7.
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7477192
Full text PDF: http://www.nejm.org/doi/pdf/10.1056/NEJM199512143332401
EMTALA, adjusted for inflation (via E. Shaw)
Feds Increase EMTALA Penalties against Physicians and Hospitals
The Office of Inspector General recently doubled the potential monetary penalty for violations of EMTALA, added a new physician decision-making scenario subject to the penalty, and modified the factors considered in determining the amount of the penalty.
http://epmonthly.com/article/feds-increase-emtala-penalties-physicians-hospitals/
Robert A. Bitterman, MD, JD
Emergency Physicians Monthly
October 17, 2017
The Emotional Fallout From the Culture of Blame and Shame (JAMA Peds via W. Paolo)
The Emotional Fallout From the Culture of Blame and Shame.
Ferguson CC.
JAMA Pediatr.
Published online October 09, 2017.
doi:10.1001/jamapediatrics.2017.2691
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2656305
UEM Current Awareness 