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DYSPNEA

Lung ultrasonography is superior to chest radiography in detecting pulmonary edema due to acute decompensated heart failure among adult patients presenting with dyspnea and in the diagnosis of pneumonia in patients admitted to an acute geriatric ward.

CHEST PAIN

One trial of patients hospitalized with mild hemoptysis compared tranexamic acid with saline placebo; within 5 days of hospital admission, hemoptysis resolved in more patients treated with tranexamic acid than in those receiving a saline placebo.

In African-American patients with average cardiovascular risk, HEART score is a better predictive tool for 6-week major adverse cardiac events when compared to TIMI score.

In the PROMISE trial, women had higher rates of normal noninvasive testing compared with men, but those women with abnormalities were less likely to be referred for catheterization or to receive statin therapy.

HEMOPTYSIS

Women are more likely than men to present with 3 or more associated symptoms for myocardial infarction (eg, epigastric symptoms, palpitations, and pain or discomfort in the jaw, neck, arms, or between the shoulder blades). Women with an ST-segment-elevation acute myocardial infarction are more likely than men to present without chest pain.

LOWER EXTREMITY EDEMA

The physical examination is usually inadequate to distinguish lymphedema from venous insufficiency. Only the Kaposi-Stemmer sign (the inability to pinch or pick up a fold of skin at the base of the second toe because of its thickness) is a significant predictor of lymphedema.

Duplex ultrasonography is the diagnostic study of choice to detect chronic venous insufficiency due to venous incompetence.

FEVER & HYPERTHERMIA

In a study of trauma patients, there was a significant association between the presence of early fever and death in the hospital as well as longer median intensive care unit stays.

There is increasing evidence that postoperative atelectasis does not cause fever. However, febrile nonhemolytic transfusion reaction is common.

INVOLUNTARY WEIGHT LOSS

Some patients with cancer-associated weight loss may benefit from nutritional assessment and intervention, since decreased food intake may play a role.

FATIGUE SYNDROME

A critical appraisal of the Cochrane reviews addressing exercise and cognitive behavioral therapy as treatments for chronic fatigue syndrome concludes that these treatments are better characterized as "adjunctive therapies."

ACUTE HEADACHE

A systematic list called the SNNOOP10 has been developed as a screen for secondary causes of headache.

Prochlorperazine appears to be superior to ketamine for the treatment of benign headaches in the emergency department. There may be a role for oral corticosteroids to prevent rebound headache after emergency department discharge.

The oral 5-HT1F receptor agonist, lasmiditan, has been approved for the acute treatment of migraine...

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