DynaMed Weekly Update

March 17, 2009

Volume 4 Issue 11

DynaMed Systematic Literature Surveillance

For the week ending March 13, 2009

This week, 807 articles were considered for inclusion in DynaMed and 322 met criteria for inclusion.

Based on the criteria of selecting “articles most likely to change clinical practice,” one article of significant interest is included in this weekly update.

Antidepressant Treatment or Psychotherapy May Reduce Symptoms of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic disorder that causes abdominal pain and is often associated with psychological distress. A recent systematic review of 32 randomized trials analyzed the efficacy of various antidepressants and psychotherapies in the treatment of IBS. There was a significant decrease in the relative risk (RR) of persistent IBS symptoms when patients were treated with either tricyclic antidepressants (RR 0.68 [95% CI 0.56 -0.83] in 9 trials) or SSRIs (RR 0.62 [95% CI 0.45 -0.87] in 5 trials) (level 2 [mid-level] evidence). There was a similar benefit in meta-analysis of all psychotherapies (RR 0.67 [95% CI 0.57- 0.79]), though there was significant heterogeneity among trial outcomes. The number needed to treat (NNT) for both antidepressants and psychotherapies was 4 (Gut 2009 Mar;58(3):367). For more information, see the Irritable Bowel Syndrome topic in DynaMed.

DYNAMED EXTRA – Prevalence of Elevated Cholesterol in Children

In June 2008, DynaMed Editors reported on new recommendations for childhood lipid screening (DynaMed Weekly Update Volume 3 Issue 29). A newly published epidemiologic study, using the National Health and Nutrition Examination Survey (NHANES) data set, suggests that only 0.8% of adolescents in the United States meet the AAP criteria to be considered for pharmacological treatment for elevated LDL cholesterol. In a cohort of 9,868 children aged 6-17 years, mean total cholesterol was 163 mg/dL (4.2 mmol/L), with elevated levels (cut point 200 mg/dL or 5.2mmol/L) in about 10.7%. Among 2,724 adolescents aged 12-17 years, mean LDL cholesterol was 90.2 mg/dL (2.3 mmol/L), with elevated levels (cut point 130 mg/dL or 3.4 mmol/L) in 6.6% (Circulation 2009 Mar 3;119(8):1108). For more information, see the Hypercholesterolemia topic in DynaMed.

DynaMed Topic Activity

New summaries added this week:

· Infectious Diseases Society of America guidelines for management of candidiasis

· Neurosarcoidosis

DynaMed Peer Review

We are currently seeking a reviewer for:

· Neurosarcoidosis

For more information, see Editorial Policies for Authors & Reviewers and DynaMed Peer Review.

DynaMed Weekly Update Podcast and RSS Feed Information

Share Update with a Colleague

DynaMed Weekly Update Archives

Subscribe FREE to DynaMed Weekly Update

To receive sign-up instructions, email us at DynaMedWU@ebscohost.com
with Subscribe in the subject line.

DynaMed Weekly Update is a compilation of 1 to 5 articles that are of significant interest to clinicians. Articles are selected from DynaMed's Systematic Literature Surveillance as articles most likely to change clinical practice. Updates are prepared by the DynaMed Editorial Team which includes 28 clinicians from multiple disciplines. Send comments to DynaMedEditor@epnet.com. To learn more about DynaMed, go to www.dynamicmedical.com.

Published by DynaMed
Copyright © 2009 EBSCO Publishing. All rights reserved.
DynaMed® is a registered trademark of and published by DynaMed LLC. Original date of on-line publication December 15, 1995 with continuous daily updating. ISSN: 1554-1177. Subscriptions and queries can be addressed to DynaMed LLC, EBSCO Publishing, 10 Estes St., Ipswich, Massachusetts, USA 01938-0602, telephone (978) 356-6500, facsimile (978) 356-6565, e-mail Editor@DynamicMedical.com. The opinions expressed herein are solely those of the authors and editors and may or may not represent the official position of cooperating or endorsing Medical Societies. Development of DynaMed was supported in part by the National Science Foundation through a Small Business Innovative Research grant. (All other support comes from subscriptions. No advertisements are accepted.)