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In: Infectious Disease, Journal Club, Respirology

Methodology: 4/5 Usefulness: 2/5 Alexander E., et al. JAMA. 2019 Sep 27. doi: 10.1001/jama.2019.15468. Editorial: Lefamulin-A New Antibiotic for Community-Acquired Pneumonia. Question and Methods: LEAP-2 was a phase 3, double-blinded RCT to determine non-inferiority of early clinical response of an oral lefamulin to oral moxifloxacin in Community Acquired Bacterial Pneumonia (CABP). Findings: Early clinical response rates were 90.8%Read More →

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In: Journal Club, Thrombosis

Methodology Score: 4/5 Usefulness Score: 4.5/5 Kearon C, et al. N Engl J Med. 2019 Nov 28;381(22):2125-2134 Question and Methods: the authors sought to demonstrate safety using a d-dimer cut-off of 1000ng/mL for low pre-test probability patients & a cut-off of 500ng/mL for moderate pre-test probability patients. Findings: Of 1325Read More →

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In: Full Article, Journal Club, Trauma

Methodology: 4/5 Usefulness: 2/5 Sims CA, et al. JAMA Surg. 2019 Aug 28. Question and Methods: Single-centre, double-blind, randomized control trial to determine whether low-dose vasopressin decreases the need for blood product transfusion in trauma patients with hemorrhagic shock. Findings: A total of 100 adult trauma patients were enrolled. VasopressinRead More →

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In: Full Article, Journal Club, Neurology, Pediatrics

Methodology: 4/5 Usefulness: 4/5 Lyttle MD, et al. Lancet. 2019 May 25;393(10186):2125-2134. Question and Methods: Eclipse was an open label RCT that evaluated time to seizure cessation in pediatric SE between Keppra and Dilantin Findings: They found that Keppra was not superior (HR 1.2, 95%CI 0.91-1.60, p= 0.20) to DilantinRead More →

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In: Full Article, Journal Club, Neurosurgery, Resuscitation, Trauma

Methodology Score: 3/5 Usefulness Score: 3/5 Cooper DJ, et al. JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075 Question/Methods: This study was done to determine the effectiveness of early prophylactic hypothermia compared with normothermic management of patients after severe traumatic brain injury (TBI). Findings:  No statistically significant difference in favorable neurologic outcomes at 6 months wasRead More →

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In: Full Article, Neurosurgery, Trauma

Methodology: 3.5/5 Usefulness: 3.5/5 The CRASH-3 trial collaborators. The Lancet. 2019 Oct 14. Online First Editorial: CRASH-3: a win for patients with traumatic brain injury Question and Methods: Multi-centre, randomized, placebo-controlled trial looking at whether TXA (1g over 10 minutes followed by infusion over 8 hours) reduces mortality in patientsRead More →

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In: Journal Club, Orthopedics, Orthopedics, Trauma

Methodology: 4/5 Usefulness: 3.5/5 Kortekangas T, et al. BMJ. 2019 Jan 23;364:k5432 Question and Methods: This is a pragmatic, randomized, controlled trial to determine if 3 weeks of immobilization (in cast or orthosis) is non-inferior to usual treatment (6 weeks cast immobilization) for stable Weber B ankle fractures Findings: ImmobilizationRead More →

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In: ENT, Journal Club

Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Akkan S, et al. Ann Emerg Med. 2019 Jul;74(1):72-78 Question and Methods: Prospective RCT comparing compression with saline, compression with tranexamic acid, and nasal packing with merocel for anterior epistaxis. Findings: No difference in 15-minute bleeding cessation for TXA (91.1%) or packing (93.3%), v/s saline (71.1%).  Lower 24hRead More →

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In: cardiac arrest, Cardiology, Journal Club, Resuscitation

Methodology Score: 4.5/5 Usefulness Score: 3.5/5 Lemkes JS, et al. N Engl J Med. 2019 Apr 11;380(15):1397-1407. Editorial: Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients? Question and Methods: Patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm, but without STEMI on ECG following ROSCRead More →

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In: Journal Club, Radiology, Trauma

Methodology: 2/5 Usefulness: 2.5/5 Macri F, Greffier J, Khasanova E, Claret PG, Bastide S, Larbi A, Bobbia X, Pereira FR, de la Coussaye JE, Beregi JP. Ann Emerg Med. 2019 Jun;73(6):665-670.  Question and Methods: This 160-patient pilot study prospectively compared ultra-low dose CT chest and CXR to routine CT chest in minor bluntRead More →