One of the downsides of subscribing to more than 50 journal feeds is the huge number of interesting papers that I flag for later, but never find time to fully appraise. I have been clearing some of these old PDFs out of my computer, but I figured that if the titles caught my eye, you might find them interesting as well. I have not fully appraised these papers. I have scanned them once. Don’t take my summaries as definitive. If something catches your eye, grab the paper and read it for yourself before making any practice changes. (Really, I suggest doing that even when I write a full appraisal.)
Nightingale RS, Etheridge N, Sweeny AL, Smyth G, Dace W, Pellatt RAF, Snelling PJ, Yadav K, Keijzers G. Cellulitis in the Emergency Department: A prospective cohort study with patient-centred follow-up. Emerg Med Australas. 2024 Aug;36(4):579-588. doi: 10.1111/1742-6723.14401. Epub 2024 Mar 13. PMID: 38481041
- I like the idea of a paper looking at the natural history of cellulitis, and it is good to know that most patients have symptoms longer than you would think, but this paper looked at an unusual cohort (almost all IV antibiotics) and wasn’t granular enough to warrant a full write up. I include it here because some people might find the data interesting.
Osman AM, Toson B, Naik GR, Mukherjee S, Delbeck M, Hahn M, Muller T, Weimann G, Eckert DJ. A novel TASK channel antagonist nasal spray reduces sleep apnea severity in physiological responders: a randomized, blinded, trial. Am J Physiol Heart Circ Physiol. 2024 Mar 1;326(3):H715-H723. doi: 10.1152/ajpheart.00541.2023. Epub 2024 Jan 12. PMID: 38214905
- This paper caught my eye, because a pharmacological approach to sleep apnea seemed interesting, but implausible. Implausible turns out to be correct, at least based on this study that only includes 10 patients. They use a lot of spin to make the study seem positive, which is why I originally downloaded it, but a quick skim demonstrates no actual difference, and so this paper was rapidly thrown in the garbage, with just a quick note here in case anyone else found the title interesting.
Ware LB, Files DC, Fowler A, Aboodi MS, Aggarwal NR, Brower RG, Chang SY, Douglas IS, Fields S, Foulkes AS, Ginde AA, Harris ES, Hendey GW, Hite RD, Huang W, Lai P, Liu KD, Thompson BT, Matthay MA; National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Acetaminophen for Prevention and Treatment of Organ Dysfunction in Critically Ill Patients With Sepsis: The ASTER Randomized Clinical Trial. JAMA. 2024 Aug 6;332(5):390-400. doi: 10.1001/jama.2024.8772. PMID: 38762798
- The outcome here was entirely predictable. People have been using acetaminophen to treat feverfor ever, and we know that it has no benefit, even in really sick patients. They weren’t focused on fever here, but it is not surprising that IV acetaminophen has no impact on survival in sepsis.
Miller J, Cook B, Gandolfo C, Mills NL, Mahler S, Levy P, Parikh S, Krupp S, Nour K, Klausner H, Gindi R, Lewandowski A, Hudson M, Perrotta G, Zweig B, Lanfear D, Kim H, Dangoulian S, Tang A, Todter E, Khan A, Keerie C, Bole S, Nasseredine H, Oudeif A, Abou Asala E, Mohammed M, Kazem A, Malette K, Singh-Kucukarslan G, Xu N, Wittenberg S, Morton T, Gunaga S, Affas Z, Tabbaa K, Desai P, Alsaadi A, Mahmood S, Schock A, Konowitz N, Fuchs J, Joyce K, Shamoun L, Babel J, Broome A, Digiacinto G, Shaheen E, Darnell G, Muller G, Heath G, Bills G, Vieder J, Rockoff S, Kim B, Colucci A, Plemmons E, McCord J; RACE-IT Research Group. Rapid Acute Coronary Syndrome Evaluation Over One Hour With High-Sensitivity Cardiac Troponin I: A United States-Based Stepped-Wedge, Randomized Trial. Ann Emerg Med. 2024 Oct;84(4):399-408. doi: 10.1016/j.annemergmed.2024.04.024. Epub 2024 Jun 15. PMID: 38888531
- Not sure I understand this study. They didn’t find a difference in the rate of safe discharge between a 0/1 hour and 0/3 hour high sensitivity troponin protocol, but of course they didn’t. The only value of the 0/1 hour is supposed to be that it is faster, and they actually never mention that outcome in this paper. Considering how most EDs function, I don’t think you are going to get better than a 2 or 3 hour protocol as far as patient turn around goes.
Borgundvaag B, Bellolio F, Miles I, Schwarz ES, Sharif S, Su MK, Baumgartner K, Liss DB, Sheikh H, Vogel J, Austin EB, Upadhye S, Klaiman M, Vellend R, Munkley A, Carpenter CR. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203
- The GRACE guidelines are always worth reading. I just never got around to covering this edition, so I list it in case you missed it.
Peters MJ, Gould DW, Ray S, Thomas K, Chang I, Orzol M, O’Neill L, Agbeko R, Au C, Draper E, Elliot-Major L, Giallongo E, Jones GAL, Lampro L, Lillie J, Pappachan J, Peters S, Ramnarayan P, Sadique Z, Rowan KM, Harrison DA, Mouncey PR; Oxy-PICU Investigators of the Paediatric Critical Care Society Study Group (PCCS-SG). Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. 2024 Jan 27;403(10424):355-364. doi: 10.1016/S0140-6736(23)01968-2. Epub 2023 Dec 1. Erratum in: Lancet. 2024 Jan 27;403(10424):354. doi: 10.1016/S0140-6736(24)00100-4. PMID: 38048787
- This paper was probably big enough to deserve a full write up, but how many of us are spending long periods of time managing pediatric patients on ventilators? If that sounds like you, you definitely should give this paper a read.
Savage TJ, Kronman MP, Sreedhara SK, Lee SB, Oduol T, Huybrechts KF. Treatment Failure and Adverse Events After Amoxicillin-Clavulanate vs Amoxicillin for Pediatric Acute Sinusitis. JAMA. 2023 Sep 19;330(11):1064-1073. doi: 10.1001/jama.2023.15503. Erratum in: JAMA. 2024 Sep 10;332(10):844-845. doi: 10.1001/jama.2024.16020. Erratum in: JAMA. 2024 Sep 10;332(10):845. doi: 10.1001/jama.2024.15865. PMID: 37721610
- Amoxicillin is as effective as amoxicillin-clavulante for the treatment of sinusitis, but obviously amoxicillin-clavulante has more side effects. Seeing as sinusitis doesn’t need antibiotics at all, amoxicillin is also more harmful than appropriate care, but if you for some odd reason feel compelled to prescribe antibiotics, at least use the least harmful option.
Mistry EA, Hart KW, Davis LT, Gao Y, Prestigiacomo CJ, Mittal S, Mehta T, LaFever H, Harker P, Wilson-Perez HE, Beasley KA, Krothapalli N, Lippincott E, Stefek H, Froehler M, Chitale R, Fusco M, Grossman A, Shirani P, Smith M, Jaffa MN, Yeatts SD, Albers GW, Wanderer JP, Tolles J, Lindsell CJ, Lewis RJ, Bernard GR, Khatri P. Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial. JAMA. 2023 Sep 5;330(9):821-831. doi: 10.1001/jama.2023.14330. PMID: 37668620
- I don’t manage patients post thrombectomy, but lowering the blood pressure never ends up helping the brain no matter how many times we try it.
Teja B, Bosch NA, Diep C, Pereira TV, Mauricio P, Sklar MC, Sankar A, Wijeysundera HC, Saskin R, Walkey A, Wijeysundera DN, Wunsch H. Complication Rates of Central Venous Catheters: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2024 May 1;184(5):474-482. doi: 10.1001/jamainternmed.2023.8232. Erratum in: JAMA Intern Med. 2024 Jun 1;184(6):707. doi: 10.1001/jamainternmed.2024.2175. PMID: 38436976
- I feel like this was covered pretty well a few years ago, so I never felt compelled to write this paper up, but if you don’t have a good grasp on the risk of central lines, this is worth a quick read.
Le Gal G, Robert-Ebadi H, Thiruganasambandamoorthy V, Moustafa F, Penaloza A, Catella J, Grenot MC, Visser S, Mazzolai L, Plumacker A, Barco S, Lang E, Tagalakis V, Deroche C, Garnett M, Hulme J, Roy PM, Ghuysen A, Couturaud F, Engelberger R, El Kouri D, Aujesky D, Righini M; ADJUST-DVT Investigators. Age-Adjusted D-Dimer Cutoff Levels to Rule Out Deep Vein Thrombosis. JAMA. 2026 Feb 3;335(5):416-424. doi: 10.1001/jama.2025.21561. PMID: 41490105
- This is a fine study, but I am just assuming everyone is already using age adjusted d-dimers, and so it didn’t make the cut for a full write up.