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  • Did Emergency Provider Discuss Sensitive Topics with Adolescent?

    Protecting confidentiality is the primary consideration for emergency care providers discussing sensitive topics with adolescent patients, including documentation in the medical record, discharge papers, lab results, and billing. Confidential conversations can be protected in the medical record several ways, including using confidential notes that are not visible to all.

  • EHR Flaws Contribute to Diagnostic Errors

    Many, if not most, emergency care providers would agree there are some significant downsides to electronic health records, including usability, interoperability, and malfunctions, to name a few. But are these issues merely annoying, or do they actually contribute to diagnostic errors?

  • Vital Signs Are Unreported During Most EMS Handoffs

    EMS holds a wealth of information about a very critical time in the patient’s treatment and evaluation for that episode. Physicians, EMS agencies, and hospital leaders should collaborate to figure out what gaps exist and develop specific tools to close those gaps.

  • Multidisciplinary Initiative Leads to More Referrals, Donors, and Transplanted Organs

    Staff training and more visible public awareness helped a Georgia hospital make tremendous improvements.

  • Disease-Modifying Therapy After Natalizumab Discontinuation in Patients with Relapsing Multiple Sclerosis

    In this retrospective cohort study, the investigators found that, when compared to fingolimod and dimethyl fumarate, ocrelizumab use was associated with significantly lower annualized relapse rate and treatment discontinuation. There were no significant differences in outcomes between fingolimod and dimethyl fumarate use. Ocrelizumab use was associated with a lower rate of disability accumulation when compared to fingolimod.

  • Treatment of Psychotic Symptoms in Alzheimer’s Disease

    In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in reducing psychotic symptoms.

  • Antidepressants for Chronic Pain: Do They Work?

    Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.

  • Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?

    A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.

  • Brain Atrophy and Type 1 Diabetes

    In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.

  • Post-Exposure Rabies Prophylaxis — Shorter, Simpler, and Less Costly

    After bites by animals potentially infected with rabies, three-visit (over one week) intradermal rabies vaccination was compared to standard four-visit (over two weeks) intramuscular rabies vaccination. Both vaccine regimens prompted similarly protective neutralizing antibody and T-cell responses. While still off-label, the shorter, simpler regimen could protect patients at lower cost than the current standard regimen.