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Probiotics don’t improve outcomes in children with acute gastroenteritis

PEMBlog

The trial found that LGG did not significantly improve outcomes compared to placebo. We found that probiotics did not improve patient outcomes when compared to placebo. 2018 Nov 22;379(21):2002-2014. Why is this important for patients and caregivers ? N Engl J Med. doi: 10.1056/NEJMoa1802598. PMID: 30462938; PMCID: PMC6358014.

Outcomes 105
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Use Of Radio-opaque Markers In Penetrating Trauma

The Trauma Pro

OLYMPUS DIGITAL CAMERA The author first reviewed the literature on the use of markers for penetrating injury, which started only recently, in 2002. The reality is that no one will ever be able to design a study that definitively evaluates the very soft outcomes that result from using this technique. So yes, this is dogma.

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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. 2002 Dec;141(6):793-7. Is your patient hyperglycemic, acidotic, with ketonuria? Then we’ve likely got DKA. Triple bag, triple bag, triple bag! The Pediatric Emergency Medicine Collaborative Research Commitee. PMID: 12461495.

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Adjunctive Methylene Blue in Septic Shock?

RebelEM

Without larger studies and a patient centered outcome, the addition of methylene blue within 24 hours of septic shock should still not be part of a general approach but rather an adjunct in specific circumstances (i.e. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145
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Universal Depression Screening Leads to Unnecessary Harm

Sensible Medicine

USPSTF Guidelines Depression screening was first recommended to adults in 2002 with a “B” grade. A 2008 Cochrane review found adult depression screening does not improve outcomes. Screening had no impact on depression, anxiety, or a host of other mental health outcomes.

Outcomes 139
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Trauma Resuscitation Updates

RebelEM

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]

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Issue #4: The Latest in Critical Care, 6/12/23

PulmCCM

” The treatment became widespread after a trial ( NEJM 2002, n=275) showed large neurologic and survival benefits from hypothermia; however, subsequent trials mostly failed to replicate those findings.