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I had read a different article recently talking about the AGAs recommendation change regarding uncomplicated diverticulitis; here’s another one from ACEP Now citing similar data. Perhaps another condition we can stop writing unnecessary antibiotics for. Do keep in mind this is for UNCOMPLICATED cases.
Well here is the study that has had everyone talking for a while. Good old ondansetron category B now may cause congential malformations in the fetus. This study in the journal Reproductive Toxicology retrosp of 1349 infants concludes a risk for CV defect (septum specifically) is increased to a statistically significant degree. My favorite prior study looked at 608,000 pregnancies and concluded no malformation risk. This is in the NEJM. So I am much more likely to follow the recs of the huge NEJM study.
Now we could do more prospective studies of course to see if ondansetron is causing any true effects. And we can always use the promethazine, prochlorperazine class of drugs in these patients while in the ED or even for discharge. I still love good old extremely evidence-based ginger pills, also B6, diphenhydramine, not eating crap food, etc.
Discussion is welcome.
Much has been written about ED recidivism. Ryan Radecki at EM Lit of Note has just reviewed another article about returns, this one looking at bounce backs from inpatient services as well. His conclusion is that 72 hours returns should not be used as a quality measure for ED metrics. His complaint is the nonspecific analysis of these returns. When we discuss 72 returns in our didactics, we attempt to focus on the cases from which we can learn how to prevent discharge of inappropriate patients. We are discussing shifting more toward discussing less cases with well defined take home points as we enhance didactics. Take a look at the Radecki commentary and if interested, the growing body of literature. If anyone is especially interested, a solid admin project / scholarly project would be to analyze our 72 returns over a longer period than a month. Drs Coleman and Platt presented a poster at CORD when we presented the Room9ER poster years ago.
Hey guys its that time of year again for the Spears Essay Contest. See details below. We have had some finalists in the past. Inside information: not many people submit essays, you have very good odds.
Length: 800 to 2,000 words.
Format: Do not put your name on any page of your essay. Instead,include a separate cover letter with name, entry category, essay title and contact information. This allows judges to be blinded to author names.
Submission: Send via email as an attachment to Aaron Burch ataaron.burch@glms.org. Email submissions are highly preferred, but if not possible, send entry by fax to 502-736-6341 or by mail to
101 W. Chestnut St., Louisville, KY 40202.
The winning essays and Medical Writing for the Public Award will be announced at the annual GLMS Presidents’ Celebration and published in the July issue of Louisville Medicine.