DynaMed Weekly Update

June 2, 2009

Volume 4 Issue 22

DynaMed Systematic Literature Surveillance

For the week ending May 29, 2009

This week, 611 articles were considered for inclusion in DynaMed and 249 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.

Graduated Compression Stockings May Not Reduce DVT after Stroke

For stroke patients with contraindications to anticoagulants, the American College of Chest Physicians (ACCP) recommends intermittent pneumatic compression devices or elastic stockings for thromboprophylaxis. The Clots in Legs or Stockings after Stroke (CLOTS) trials are a series of randomized trials assessing the efficacy and safety of different external compression strategies. In the recently reported CLOTS trial 1, graduated compression stockings were evaluated in 2,518 stroke patients with impaired mobility. At 30 days there were no significant differences between stocking and control groups in rates of any DVT or pulmonary embolism (17% vs. 18.4%) or symptomatic DVT (4.4% vs. 4.8%) (level 2 [mid-level] evidence). Compliance was low in the stocking group ranging from 79% at 14 days to 73% at 30 days. Compression stockings were associated with higher rates of skin breaks, ulcers, blisters and skin necrosis (5.1% vs. 1.3%, p < 0.05, NNH 26) (Lancet 2009 Jun 6;373(9679):1958). For more information, see the Deep vein thrombosis (DVT) prophylaxis in medical patients topic in DynaMed.

DynaMed Topic Activity

New summaries added to DynaMed this week:

· Breast cancer screening

· Clinical prediction of likelihood of urinary tract infection in adults

· Coronary artery disease possible risk factors

· Diabetes mellitus type 2 screening

· Feeding the premature infant

DynaMed Peer Review

We are currently seeking reviewers for:

· Breast cancer screening

· Feeding the premature infant

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

Medical Calculators Added to DynaMed

DynaMed now includes more than 500 clinical calculators, decision rules and statistics calculators to give clinicians even more decision making tools to use at the point of care.

After logging in, click on Calculators in the upper right corner of the screen to access this new feature.

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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.)