Physician Knowledge e-Newsletter - V 2(4), December 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)

Try our new resources...

InfoRetriever was featured in the December 2005 issue of Medical Economics "10 great programs for your PDA" as one of the premier search engines for evidence-based medicine.

InfoPOEMS/InfoRetriever

What's new

The InfoRetriever 2005 Winter Release includes over 200 new InfoPOEMs, 256 new H&P and Diagnostic Test Calculators, 200 new Cochrane Systematic Review Abstracts, the full 2006
5-Minute Clinical Consult, and much more. The InfoRetriever 2005 Winter Release specifically includes:

We currently have a beta version of the Auto Update feature for the Palm OS and Pocket PC platforms available on our website. To learn more about the beta, visit the InfoPOEMs website. This feature will be available in Spring 2006.

Installation Instructions

Instructions for downloading the InfoRetriever 2005 Winter Release, as well as detailed installation instructions, can be found on our Getting Started Page. In addition, please note the following information:

If you have previously installed InfoRetriever 2005 Spring Release on your Pocket PC handheld device, you should uninstall InfoRetriever 2005 Spring Release before installing the InfoRetriever 2005 Winter Release.

There is no need for you to re-register InfoRetriever after upgrading to the Winter Release. However, in some cases InfoRetriever on Pocket PC may forget the license code during the upgrade. Pocket PC users may wish to record their license code before performing the upgrade, in order to avoid having to repeat the registration process after the upgrade. To locate your current license code, select File -> Register from within InfoRetriever.

If you signed up for the beta program and installed InfoRetriever with update support, there is no need for you to install this update. You already have the most updated version.

www.InfoPOEMs.com

Natural Medicines Comprehensive Database

You can now get the newest Natural Medicines CE course Natural Medicines in the Clinical Management of Breast Cancer.*

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 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:

• Brain Speed is the latest line of cognitive performance supplements promoted by Natrol. There are three different versions...Brain Speed Attention...Brain Speed Memory...Brain Speed Perform. The ingredients are mostly the same in each formulation...several B vitamins, diethylaminoethanol (DMAE), and Chinese club moss, which is a source of huperzine A. DMAE is a precursor to choline and might increase levels of acetylcholine, which is important for cognitive functioning. But there's no reliable evidence that supplementing it works for improving cognitive performance. Huperzine A is a potent acetylcholinesterase inhibitor and significantly increases acetylcholine levels in the brain. There is some evidence that huperzine A can improve cognitive function in healthy adolescents and patients with dementia. But not much is known about the long-term safety of this ingredient. Explain to patients who try these products to watch for diarrhea, sweating, decreased heart rate, and other cholinergic side effects.

• Pomegranate juice (PomWonderful, etc) is now becoming a popular health drink. There's preliminary evidence that it might help lower blood pressure and cholesterol. There is also growing concern that it might interact with some drugs. Think of it as similar to grapefruit juice. Researchers think pomegranate inhibits the cytochrome P450 3A4 enzyme in the gut. This could lead to INCREASED levels of numerous drugs. So far, the research is preliminary. We still don't know how significant this interaction might be in humans. For now keep an eye out for patients who are consuming pomegranate along with drugs metabolized by CYP3A4...carbamazapine, cyclosporin, felodipine (Plendil), lansoprazole (Prevacid), sibutramine (Meridia), and numerous other drugs.

• Soy is getting more attention for osteoporosis. Prior research shows that soy protein from food MIGHT increases bone mineral density in peri- and post-menopausal women. But until now no findings analyzed the important outcome...fracture risk. Now a new Arch Intern Med study suggests that postmenopausal women in China who consume higher amounts of DIETARY soy tend to have a lowered risk of fracture. But this raises many unanswered questions...how does this apply to Western women? What is the most effective dose? Explain to women that soy is a good substitute for other dietary proteins and can have several benefits...including possibly helping to prevent osteoporosis. Advise women not to rely on soy isoflavone SUPPLEMENTS. There's no reliable evidence that the supplements are as beneficial.

• Olive oil is getting press suggesting that it works like a painkiller. Olive oil contains "oleocanthol"...a molecule that inhibits cyclooxygenase similar to non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Olive oil has long been thought to have anti-inflammatory effects by increasing the anti-inflammatory omega-3 fatty acids. Oleocanthal might be another explanation for the anti-inflammatory effects of olive oil. Explain to patients that it is too soon to use olive oil for inflammation or pain relief. But it's a great healthy alternative to other cooking oils.

Our latest Natural Medicines CE program in the series is now posted online...Natural Medicines in the Clinical Management of Breast Cancer.

Natural Medicine >>
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Revised STAT!Ref Online Title:

In an effort to improve our coding material, the combined single title Ingenix ICD-9-CM Vols. 1&3 and CPT® with RVUs Data File was separated into two distinct titles.

Subscribers who had this combined title now receive the following two titles instead: Ingenix CPT® with RVUs Data File and ICD-9-CM - Volumes 1, 2 and 3. Call your account manager for more information.

Ingenix CPT w/RVU’s Data Files.

Established and copyrighted by the America Medical Association’s Physicians’ Current Procedural Terminology (CPT), CPT’s standardized coding system covers procedures and services provided by physicians, ambulatory surgical centers, and hospital outpatient services, as well as laboratories, imaging centers, physical therapy clinics, urgent care centers and others.

» New Editions:

ICD-9-CM - Volumes 1, 2 & 3 (2006)
This new edition has been updated, expanded and reformatted for ease of use. In addition to the Tabular List for Disease (Vol. 1) and the Tabular List for Procedures (Vol. 3), which was previously offered, this new version of ICD-9-CM also includes:

Alpha index to Diseases (Vol. 2) w/links to the Tabular List of Diseases (Vol. 1)
Alpha index to External Causes (E-Codes) w/links to the Tabular List of Diseases (Vol. 1)
Alpha index to Procedures w/link to the Tabular List of Procedures (Vol. 3)
Table of Drugs and Chemicals w/links to Tabular List of Diseases (Vol. 1)
Official ICD-9-CM Government Appendixes.

Goodman & Gilman's: The Pharmacological Basis of Therapeutics (2006)
Reputed as the "bible of pharmacology," the 11th Edition attempts to standardize the organization of chapters; thus, students should easily find the physiology and basic pharmacology, and the clinician and expert will find details under identifiable headings. Several new chapters have been added.

» Supplemental Updates:

Monthly Updates:
- ACP Medicine
- ACS Surgery: Principles & Practice
- AHFS Drug Information
- USP DI® Drug Information for the Health Care Professional
- USP DI® Advice for the Patient®
- Infectious Diseases: The Clinician's Guide to Diagnosis, Treatment, and Prevention
- The Review of Natural Products

Quarterly Updates:
- Davis's Drug Guide for Nurses
- Mosby's Drug Consult
- AAFP Conditions A-Z (2005) Oct 2005

STAT!Ref

UpToDate -

In order to protect our intellectual property and avoid copyright violations on a massive scale, we will be making some changes to our Table of Contents section starting Monday, December 5th. The Table of Contents will still appear, but some of the topic reviews within the Table of Contents will no longer be live links. This change will not affect the usability of UpToDate, as all of our content is still easily accessible via the main search box.

The following are a few search tips that will help you view topic reviews previously accessible through the Table of Contents. We encourage you to share these tips with your UpToDate users.

Patient Information:
To view our patient information handouts type in the words "patient info" and you will see all of the patient information topics available. To narrow your search, use the "narrow search results" button and type in the disease or condition. All of our patient information is also freely available to patients at www.patients.uptodate.com.

Drug Information:
To view information on a medication, type in the name of the medication, either brand name or generic in the main search box. For each medication you will see a number of drug information topics including adult information, pediatric information, and patient level information. UpToDate also offers international, as well as natural drug information.

UpToDate >>

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