RESUMO
A short-cut review of the available medical literature was carried out to establish whether remdesivir was an effective treatment for patients with confirmed COVID-19 infection. After abstract review, five papers were found to answer this clinical question using the detailed search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that despite some recent promising studies, further well-designed and larger trials are needed to answer this specific question.
Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Monofosfato de Adenosina/administração & dosagem , Monofosfato de Adenosina/efeitos adversos , Adulto , Alanina/administração & dosagem , Alanina/efeitos adversos , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/isolamento & purificação , COVID-19 , Ensaios Clínicos como Assunto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/fisiopatologia , Prática Clínica Baseada em Evidências , Feminino , Humanos , Masculino , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , SARS-CoV-2 , Resultado do Tratamento , Tratamento Farmacológico da COVID-19Assuntos
Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Inibidores da Protease de HIV/administração & dosagem , Lopinavir/administração & dosagem , Pneumonia Viral/tratamento farmacológico , Ritonavir/administração & dosagem , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Combinação de Medicamentos , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , SARS-CoV-2 , Fatores de Tempo , Resultado do Tratamento , Eliminação de Partículas Virais/efeitos dos fármacos , Tratamento Farmacológico da COVID-19Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/administração & dosagem , Pneumonia Viral/tratamento farmacológico , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Humanos , Hidroxicloroquina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , RNA Viral/isolamento & purificação , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2 , Resultado do Tratamento , Tratamento Farmacológico da COVID-19RESUMO
A short cut review of the literature was carried out to establish whether topical phenylephrine was an effective treatment for non-traumatic epistaxis. A single paper looked at this modality comparing it to another topical treatment. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are tabulated. It is concluded that further more robust studies are needed to answer this question.
Assuntos
Epistaxe/tratamento farmacológico , Medicina de Emergência Baseada em Evidências/métodos , Fenilefrina/administração & dosagem , Vasoconstritores/administração & dosagem , Administração Tópica , Humanos , Resultado do TratamentoRESUMO
A short cut review of the literature was carried out to establish whether any risk factors would predict the need for endotracheal intubation in undifferentiated adult patients presenting with poisoning/overdose with unknown substance. Five papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that further robust studies of large cohorts are needed to answer this difficult question.
Assuntos
Overdose de Drogas/terapia , Medicina de Emergência Baseada em Evidências/métodos , Intubação Intratraqueal , Intoxicação/terapia , Adulto , Tomada de Decisão Clínica , Overdose de Drogas/diagnóstico , Humanos , Intoxicação/diagnóstico , PrognósticoRESUMO
BACKGROUND: Clinicians are increasingly using social media for professional development and education. In 2012, we developed the St.Emlyn's blog, an open access resource dedicated to providing free education in the field of emergency medicine. OBJECTIVE: To describe the development and growth of this international emergency medicine blog. METHOD: We present a narrative description of the development of St.Emlyn's blog. Data on scope, impact and engagement were extracted from WordPress, Twitter and Google Analytics. RESULTS: The St.Emlyn's blog demonstrates a sustained growth in size and user engagement. Since inception in 2012, the site has been viewed over 1.25 million times with a linear year-on-year growth. We have published over 500 blog posts, each of which attracts a mean of 2466 views (range 382-69 671). The site has been viewed in nearly every country in the world, although the majority (>75%) of visitors come from the USA, UK and Australia. SUMMARY: This case study of an emergency medicine blog quantifies the reach and engagement of social-media-enabled learning in emergency medicine.
Assuntos
Acesso à Informação , Blogging , Medicina de Emergência/educação , Aprendizagem , Mídias Sociais , Educação Médica Continuada , Educação de Pós-Graduação em Medicina , Humanos , Internato e Residência , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Mídias Sociais/estatística & dados numéricosRESUMO
BACKGROUND: Fracture and dislocation of the shoulder are usually identifiable through the use of plain radiographs in an emergency department. However, other significant soft tissue injuries can be missed at initial presentation. This study used contrast enhanced magnetic resonance arthrography (MRA) to determine the pattern of underlying soft tissue injuries in patients with traumatic shoulder injury, loss of active range of motion, and normal plain radiography. METHODS: A prospective, observational cohort study. Twenty-six patients with acute shoulder trauma and no identifiable radiograph abnormality were screened for inclusion. Those unable to actively abduction their affected arm to 90° at initial presentation and at two week's clinical review were consented for MRA. RESULTS: Twenty patients (Mean age 44 years, 4 females) proceeded to MRA. One patient had no abnormality, three patients showed minimal pathology. Four patients had an isolated bony/labral injury. Eight patients had injuries isolated to the rotator cuff. Four patients had a combination of bony and rotator cuff injury. Four patients were referred to a specialist shoulder surgeon following MRA and underwent surgery. CONCLUSIONS: Significant soft tissue pathology was common in our cohort of patients with acute shoulder trauma, despite the reassurance of normal plain radiography. These patients were unable to actively abduct to 90° both at initial presentation and at two week's post injury review. A more aggressive management and diagnostic strategy may identify those in need of early operative intervention and provide robust rehabilitation programmes.
Assuntos
Lesões do Ombro/diagnóstico por imagem , Lesões do Ombro/patologia , Lesões dos Tecidos Moles/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Amplitude de Movimento Articular , Lesões do Ombro/complicações , Lesões dos Tecidos Moles/complicações , Lesões dos Tecidos Moles/diagnóstico por imagem , Adulto JovemRESUMO
A short review was carried out to see if mixing lidocaine with propofol is a safe and effective method in reducing the commonly reported pain at the injection site. Four relevant papers were found using the described search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Although a promising idea, a paucity of good quality evidence suggests further needed research.
Assuntos
Anestésicos Locais/farmacologia , Injeções/efeitos adversos , Dor/tratamento farmacológico , Adulto , Anestésicos Locais/uso terapêutico , Humanos , Lidocaína/farmacologia , Lidocaína/uso terapêutico , Masculino , Propofol/farmacologia , Propofol/uso terapêuticoRESUMO
A shortcut review of the literature was carried out to establish whether the use of fluoroquinolones was associated with an increased risk of tendinopathy in adult patients. 10 trials were found to be directly relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is an association between the use of fluoroquinolones and a broad range of tendinopathies.
Assuntos
Antibacterianos/efeitos adversos , Fluoroquinolonas/efeitos adversos , Tendinopatia/induzido quimicamente , Adulto , Humanos , Fatores de RiscoRESUMO
A short-cut review was carried out to establish whether there was evidence to suggest that propofol should be avoided in patients with known egg allergy. Ninety-two papers were found in Medline using the reported searches, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are are shown in table 1. It is concluded that while the use of propofol in patients with simple egg allergy is likely to be safe, previous egg anaphylaxis is a contraindication.