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Intrauterine Devices and Cervical Cancer
In this case-control study, levonorgestrel IUD use was associated with a slightly increased rate of CIN 2 but not CIN 3. Copper IUD use was not associated with CIN 2 or CIN 3.
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Primary HPV Screening: Ready for Prime Time?
In this randomized, controlled trial of more than 25,000 women, participants with negative high-risk human papillomavirus testing at baseline had rates of CIN 3+ at 48 months that were lower compared to negative liquid-based cytology testing.
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USPSTF Recommendation: Screening for Cervical Cancer
The U.S. Preventive Services Task Force (USPSTF) recently updated its recommendations for cervical cancer screening. Practitioners currently following guidelines published by ASCCP (and supported by ACOG) will not find any discrepancies in the new USPSTF position
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What Is Really BRUEing?
In May 2016, the American Academy of Pediatrics (AAP) published clinical practice guidelines titled Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants, suggesting a new terminology, an evaluation based on the risk of recurrent events or serious underlying causes, and key action statements (management recommendations) for patients meeting the brief resolved unexplained events (BRUE) definition for lower-risk patients. The authors review and discuss the definitions and key management strategies recommended in these new guidelines.
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Metabolic Acidosis in the ICU
Sodium bicarbonate therapy for severe metabolic acidemia did not affect a primary composite outcome of all-cause mortality at 28 days and at least one organ failure at day 7. However, in an a priori-defined stratum of patients with acute kidney injury, sodium bicarbonate therapy decreased 28-day mortality and the primary outcome.
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Severe Sepsis and Septic Shock Early Management Bundle
When the Severe Sepsis and Septic Shock Early Management Bundle was used to identify patients with severe sepsis or patients in septic shock, delays in lactate measurements for patients with abnormal lactate levels were associated with delayed initiation of antibiotic therapy and increased mortality.
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Should We Use Early Physical Therapy for Respiratory Muscles?
Mechanically ventilated patients undergoing inspiratory muscle training demonstrated significant increases in both maximum inspiratory and expiratory muscle pressures; the training was associated with reduced weaning duration of 2.3 days.
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A Novel Prediction Tool for Hypoxemia During ICU Intubation
The authors of this retrospective analysis of data from two prospective randomized trials of tracheal intubation created a new risk score calculator to identify patients who may develop severe hypoxemia during this procedure.
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Can Plaintiff Prove Documented ED Evaluation Never Happened?
Inadvertent checking of items is one of the legal risks of electronic medical records. One common scenario: Someone checks a box stating that the patient’s current medications were reviewed. It turns out the patient was taking a medication that was contraindicated to something that was administered in the ED. This can lead to a "he said/she said" situation.
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Report: Liability Fears of Discharging Low-risk Pulmonary Embolism Patients Unfounded
Various investigators have spent the last several years trying to demonstrate the safety and effectiveness of outpatient care in a community setting.