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First10EM Journal Club: June 2019

Welcome back to the Journal Club with Justin Morgenstern. This month I have a special bonus segment for you… but first, you have to go through all the usual cacophony of intellectual curiosity that Justin and I seem to indulge in periodically. Below are the papers that made the podcast this month for your reading pleasure.

We were going to discuss the Paeds status epilepsy papers – ConSept and Eclipse…. but then Justin got into a Twitter argument that was too big for our usual 5 minute dissection. So we invited a special guest sceptic and FOAMed super thinker, Dr Damian Roland, onto discuss the nuance of these trials and how EBM works in the modern world….

….. however you will have to wait a few days to hear that discussion. Trust me, it is well worth the wait. So many pearls of wisdom to collect.

OK, onto the papers:

We discuss a Neonatal Sepsis Risk Calculator which can be found at the Kaiser-Permanente website here.

Roy R. Reeves, Mark E Lander, Roy Hart Nocebo effects with antidepressant clinical drug trial placebos General Hospital Psychiatry 29 (2007) A case report of a near-fatal nocebo effect, it may all be a complete misunderstanding but could nocebos undermine the whole basis of EBM as we know it? Probably not…

Berman DA, Porter RS, Graber M. The GI Cocktail is no more effective than plain liquid antacid: a randomized, double-blind clinical trial. The Journal of emergency medicine. 2003; 25(3):239-44. PMID: 14585449B

Young PJ, Bellomo R, Bernard GR, et al. Fever control in critically ill adults. An individual patient data meta-analysis of randomised controlled trials. Intensive care medicine. 2019; 45(4):468-476. PMID: 30741326Bottom line: Treating fever in critically ill patients does not improve survival.

Duggan LV, Marshall SD, Scott J, Brindley PG, Grocott HP. The MacGyver bias and attraction of homemade devices in healthcare. Canadian journal of anaesthesia. 2019; PMID: 30980239

Bottom line: When you see a MacGyvered solution in medicine, remember to consider the underlying system failures that made that improvisation necessary.

Ste-Marie-Lestage C, Adler S, St-Jean G, et al. Complications following chin laceration reparation using tissue adhesive compared to suture in children. Injury. 2019; PMID: 30961924

Wand O, Guber E, Guber A, Epstein Shochet G, Israeli-Shani L, Shitrit D. Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial. Chest. 2018; 154(6):1379-1384. PMID: 30321510

Thiels CA, Habermann EB, Hooten WM, Jeffery MM. Chronic use of tramadol after acute pain episode: cohort study. BMJ (Clinical research ed.). 2019; 365:l1849. PMID: 31088782 [free full text]

Köchling J, Geis B, Wirth S, Hensel KO. Grape or grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine. Am J Clin Nutr 2019;109(2):345-352. PMID: 30753321

Maybe my biggest take away from this paper is that the medical term for a hangover is “veisalgia”. How did I not know that?

Cheesy Joke of the Month

Why shouldn’t you use a broken pencil? Because it’s pointless….

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