Journal Feed Weekly Wrap-Up
- Apr 29th, 2022
- Clay Smith
- categories:
We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter.
Originally published at JournalFeed, a site that provides daily or weekly literature updates.
Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here.
#1: Prevalence and Significance of Incidental Findings on CTPA
Spoon Feed
Computed tomography pulmonary angiography (CTPA) yields an alternative diagnosis to pulmonary embolism (PE) in ~40% of patients with a negative PE study. Alternative diagnoses are more likely to occur in patients with increased age and in patients referred from the hospital setting (ICU or inpatient unit).
Source
Prevalence and significance of incidental findings on computed tomography pulmonary angiograms: A retrospective cohort study. Am J Emerg Med. 2022 Apr;54:232-237. doi: 10.1016/j.ajem.2022.01.064.
#2: EPIC-HR RCT – Nirmatrelvir Highly Effective for Outpatients with COVID-19
Spoon Feed
For outpatients with mild-to-moderate Covid-19 at risk of progression to severe disease, treatment with nirmatrelvir and ritonavir within 5 days of symptom onset reduced 28-day hospitalization or death.
Source
Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med 2022 Apr 14; 386(15): 1397-1408. Doi: 10.1056/NEJMoa2118542. Epub 2022 Feb 16.
Spoon Feed
There is some evidence that bolus treatment in critically ill pediatric patients (28 days old to 18 years old) with balanced fluids (such as LR) versus unbalanced fluids (such as NS) results in improved serum bicarbonate and blood pH values. However, it’s not clear if this is clinically beneficial.
Source
Balanced Versus Unbalanced Fluid in Critically Ill Children: Systematic Review and Meta-Analysis. Pediatr Crit Care Med. 2022 Mar 1;23(3):181-191. doi: 10.1097/PCC.0000000000002890.