Research and Reviews in the Fastlane 111

This study from Canada looked at the ED diagnosis of concussion in a convenience sample of 495 kids within 2 weeks of head injury and found that compared to the Zurich criteria, ED physicians underdiagnosed concussion. ED physicians diagnosed concussion in 40.4% of the patients, while the Zurich criteria for concussion were fulfilled by 89.5%. Concussion was more likely to be diagnosed in kids >10 years old, those playing collision sports, those with an injury >1 day prior, or 3+ symptoms. This criteria, in this case defined by SCAT3 (not validated in all head trauma/cumbersome in ED), may represent another area of overdiagnosis as it’s not clear what impact this diagnosis has on patient oriented outcomes. Recommended by: Lauren Westafer Urology, Emergency Medicine Doluoglu OG et al. Can sexual intercourse be an alternative therapy for distal ureteral stones? A prospective, randomized, controlled study. Urology 2015; 86(1):19-24. PMID: 26142575 Forget the tamsulosin. In this small study, sex 3 times/week doubled the rate of stone passage in comparison to tamsulosin or placebo (83.9% vs. 47.6% vs. 34.8%). The study brings up more methodologic issues that we can address (blinding? sham-sex arm? confirmation of sex? prohibiting intercourse/masturbation in other groups) but we’d all like to believe this to be true. Finally, some “busy” work we can send patients home with. PS: only men included in the study. Recommended by: Anand Swaminathan Cr...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Airway Cardiology Emergency Medicine Infectious Disease Intensive Care Pediatrics Resuscitation Toxicology and Toxinology Trauma Urology critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs