Physician Knowledge e-Newsletter - V2 Issue 2, June 2005
Below you will find information related to the Knowledge Based Systems
at MGHS
(Please note you
must be connected to the MGHS Network to gain access to these systems)
Announcing
InfoRetriever 2005 Spring Release
What's new
The InfoRetriever 2005 Spring Release includes over 100 new InfoPOEMs,
11 new Clinical Decision Rules, 163 new Cochrane Reviews, the full 5-Minute
Clinical Consult, and much more.
The InfoRetriever
2005 Spring Release specifically includes:
2,629 InfoPOEMs
2,193 Cochrane Systematic Reviews
The complete 5-Minute Clinical Consult (1,043 summaries and 542 photos)
231 Clinical Rules and Calculators
751 Evidence-Based Practice Guideline Summaries
1,180 Diagnostic Test Calculators
1,282 History and Physical Test Calculators
ICD-9 Look-up tool including the 1,500 most commonly used codes
385 Number Needed to Treat (NNT) values
compiled and organized by system.
You can now get the
newest Natural
Medicines CE course Natural Medicines in the Clinical Management of
Colon Cancer.*
You can also read any of the many prior courses on many other conditions.
All are accredited for physicians, pharmacists, NPs, PAs, CNMs, RDs.
If you are also a subscriber to Pharmacist's Letter or Prescriber's Letter
you will see that when you do any search on those websites, that they
now automatically search Natural Medicines Comprehensive Database at the
same time.
We make updates to Natural Medicines Comprehensive Database every business
day. Here are a few of special interest to you.
• Vitamin E is getting more bad news.
Last year an analysis of previous studies suggested that non-healthy patients
taking 400 IU/day or more have an INCREASED risk of mortality from all
causes. A new large-scale prospective study shows that patients with diabetes
or cardiovascular disease who take 400 IU/day or more have an INCREASED
risk of heart failure...and heart failure-related hospitalizations. Researchers
speculate that high doses of vitamin E might disrupt the normal antioxidant
balance in the body. This could lead to damaging oxidative effects instead
of the desired antioxidant effect. This isn't the final word on vitamin
E. Some proponents suggest that the form of vitamin E might affect results.
They theorize that taking a combination of different vitamin E isomers
might be better. But for now, it makes sense to tell most non-healthy
patients to avoid vitamin E in doses of 400 IU/day or higher.
• Conjugated linoleic acid (CLA) is a
popular weight loss supplement. But new research is showing that it might
not be safe for obese patients. Some evidence suggests that obese people
who take CLA have DECREASED body fat mass and INCREASED lean body mass.
But one isomer of CLA known as "trans-10, cis-12" might also
INCREASE insulin resistance in patients with abdominal obesity. Theoretically,
this could increase the risk of type 2 diabetes and cardiovascular disease.
So far there are no data showing the effect of CLA on long-term outcomes.
Until more is known advise obese patients to think twice about using CLA.
• Jen Fe Patch is a new TOPICAL product
getting a lot of attention for weight loss. It contains forskolin, guarana,
chromium, and a black pepper compound to increase topical absorption.
The catch is that there isn't reliable evidence that this formulation
works for weight loss...or that it is properly absorbed through the skin.
Advise patients not to rely on it.
Get our latest educational program on natural products for colon cancer
and get an update on shark cartilage, lutein, turmeric, and many others.
Click for the latest eCE...Natural Medicines in the Clinical Management
of Colon Cancer.
You can now get the newest Natural Medicines CE course Natural Medicines in the Clinical Management of Fibromyalgia.*
You can also use any of the many prior courses on many other conditions. All are accredited for physicians, pharmacists, NPs, PAs, CNMs, RDs.
If you are also a subscriber to Pharmacist's Letter or Prescriber's Letter you will see that when you do any search on those websites, that they now automatically search Natural Medicines Comprehensive Database at the same time.
We make updates to Natural Medicines Comprehensive Database every business day. Here are a few of special interest to you:
• Lemon eucalyptus oil is a "natural" mosquito repellent that's now recommended by the Centers for Disease Control (CDC). This one really works. It's in brand name products such as Repel Lemon Eucalyptus and Off! Botanicals Insect Repellent. The CDC now considers it a safe and effective alternative to low-dose DEET products. Recommend it for people who don't want to use DEET.
• Bitter orange seems to cause many of the same side effects as ephedra. Over half of the "ephedra-free" products on the market now contain bitter orange. Bitter orange replaced ephedra in many weight loss products when ephedra was banned about a year ago. Bitter orange is a source of the stimulant synephrine...similar to the ephedrine contained in ephedra. Bitter orange has been linked with ischemic stroke, myocardial infarction, arrhythmia, and syncope. Bitter orange will get more FDA scrutiny. For now, advise caution.
• Ephedra proponents got a Utah judge to rule that the FDA did not have enough evidence to say products containing 10 mg or less of ephedra alkaloids are unsafe. The ruling does NOT mean that ephedra will be back on store shelves anytime soon. Companies will wait to see if FDA appeals. Tell people to continue avoiding ephedra.
• Lavigra is a new herbal combo marketed for sexual enhancement...for men AND women. Lavigra contains several herbs that are traditionally promoted as tonics or aphrodisiacs...epimedium, Panax ginseng, yohimbe, lycium, cnidium, fo-ti, and others. A couple of these might help for erectile dysfunction...yohimbe, Panax ginseng...but there's no reliable proof that Lavigra, or its ingredients, improve sex drive or sexual performance. There is also concern that some of the ingredients might not be safe. Epimedium has been linked to hypotension, dizziness, and respiratory arrest. Fo-ti has been linked to diarrhea and cases of hepatitis. Advise patients not to use this product.
Get our latest educational program on natural products for fibromylagia and find out why some patients try turmeric, St. John's wort, malic acid, and others. Click for the latest eCE...Natural Medicines in the Clinical Management of Fibromyalgia.
We're excited to inform you that on July 5th, your institution switched over to the new Ovid Web Gateway interface.
The
new features include:
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Purchase Print Copy (books only)
NEW BOOK EDITIONS LIVE ON OVID
Hospital Medicine 2nd edition
Thoroughly updated for its Second Edition, Hospital Medicine offers practical,
evidence-based guidelines for the care of hospitalized patients. The only
book geared directly and exclusively to inpatient management—and
edited by the national leaders of the hospitalist field—Hospital
Medicine includes indications for admission, guidelines for consultation,
procedures for hospital discharge, diagnostic algorithms, and critical
paths detailing effective, outcomes-oriented treatment plans for a range
of diseases and disorders. New chapters in this edition focus on the hospitalist's
increasing role in providing critical care, managing surgical patients
with medical co-morbidities, ensuring patient safety and preventing adverse
events, and directing hospital systems areas such as informatics, quality
improvement, and practice management.
Merritt's
Neurology 11th edition
The thoroughly updated Eleventh Edition of this classic retains the organization,
practicality, and readability that makes Merritt's Neurology one of the
most popular texts among neurologists, primary care physicians, and residents
reviewing for psychiatry or neurology boards. In 171 short chapters, the
book provides the essentials clinicians need on symptoms/signs, diagnostic
tests, and neurologic disorders of all etiologies.
This edition features new chapters on endovascular surgical neuroradiology
and on psychiatric conditions—schizophrenia, mood disorders, anxiety,
and somatoform disorders. Other new chapters cover disorders of DNA translation,
pachymeningitis, and Hashimoto encephalopathy. Most chapters have been
updated to reflect advances in molecular genetics.
Lippincott
Williams & Wilkins Texts: Primary Care Medicine - 5th edition:
Completely updated for the 5th edition and edited by Allan Goroll and
Albert Mulley, Primary Care Medicine is a comprehensive text that presents
a practical approach to the office evaluation and management of every
problem seen by primary care practitioners. In 239 problem-oriented chapters,
the book provides essential information on medical diagnosis, lab tests,
treatment options, and health maintenance and offers authoritative guidance
on clinical decision-making. Every chapter of this edition ends with practical,
bulleted Recommendations based on the best evidence, expert consensus
guidelines, and clinical judgement. Annotated bibliographies in each chapter
highlight the best available studies and analyses. This edition includes
more Internet references and more evidence-based references that indicate
evidence grades.
The Ovid version of Primary Care Medicine features ongoing updates that
comment on important new studies, particularly those that have received
heavy coverage in the lay press and about which patients are likely to
seek information from their physicians. The Primary Care Medicine updates
feature separate reports for the physician, known as the Physician Advisories
as well as Patient Advisories that serve as an excellent sources for patient
handouts.
Harwood-Nuss' Clinical Practice of Emergency Medicine
- 4th edition:
Harwood-Nuss' Clinical Practice of Emergency Medicine (formerly Clinical
Practice of Emergency Medicine) is organized for easy reference and is
a comprehensive, concise, and clinically focused text that covers all
aspects of emergency medicine. Chapters follow a consistent, structured
format-key points, clinical presentation, differential diagnosis, evaluation,
management, disposition, and common pitfalls. The 4th edition places greater
emphasis on evidence-based medicine and includes tables with statistical
data. A resuscitation section has been added. Medical and surgical emergencies
have been merged together in sections organized by anatomic system. Each
chapter includes specially called out references that will be essential
to prepare for American Board of Emergency Medicine recertification.
NEW Stat!Ref interface includes:
Result Filtering
Extra resources under the "Utilities" tab
Document Printing and Text resizing
New, super fast Table of Contents
Quick Dictionary Definition link from documents
Automatic Related Terms searching
Automatic Additional Utilities Searching
StatRef announces that, at the publishers' request, "Principles of Surgery" will now be listed as "Schwartz' Principles of Surgery" and "Color atlas & synopsis of dermatology" will now be listed as "Fitzpatrick's Color Atlas...."
UpToDate Version 13.2
is now live on our website at www.uptodateonline.com.*
With each new release, the entire program is updated and more than 40%
of our topic reviews are changed based on new information. You can go
to the "What's New" section of our "Table of Contents"
to find a summary of the most important updates.
Read up on the latest news and developments at UpToDate in our 13.2 Newsletter,
accessible on our website at http://www.uptodate.com/img/newsletter.pdf.
The newsletter includes all of our usual features as well as a discussion
of the growing role of UpToDate in healthcare quality initiatives.
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