DynaMed Weekly Update

September 8, 2009

Volume 4 Issue 36

DynaMed Systematic Literature Surveillance

For the week ending September 4, 2009

Last week 393 articles were evaluated via DynaMed’s Systematic Literature Surveillance and 171 were added to DynaMed content.

Based on the editors’ criteria of selecting “articles most likely to change clinical practice,” one article of significant interest was selected for the DynaMed Weekly Update.

Addition of Antivirals to Corticosteroids May Have No Benefit for Bell's Palsy

Bell’s palsy is commonly treated with corticosteroids and/or antiviral agents. Two recent systematic reviews call into question the efficacy of antivirals (level 2 [mid-level] evidence).

One review examined randomized trials comparing antivirals and corticosteroids in various combinations. The primary outcome was the rate of unsatisfactory recovery, defined as failure to achieve complete or near normal recovery at ≥ 4 months. There was no significant difference in rates comparing antivirals alone vs. no antivirals in patients not receiving corticosteroids (30.6% vs. 27.7%) in an analysis of 2 trials. There was a trend toward lower rates for antiviral/corticosteroid combination therapy compared to steroids alone (13.4% vs. 17.6%, p = 0.05) in analysis of 8 trials, but this difference was not supported by the results of the higher-quality trials in the analysis (JAMA 2009 Sep 2;302(9):985).

Another review of 5 randomized trials with 738 patients found no significant differences between combination therapy and steroids alone in the rate of facial nerve paralysis at 3, 4, 6, or 9 months (Arch Otolaryngol Head Neck Surg 2009 Jun;135(6):558).

For more information, see the Bell’s palsy topic in DynaMed.

Concerns about Pandemic (H1N1) 2009 and the upcoming flu season have healthcare providers and the public on alert, and the clinical editors from EBSCO Publishing (EBSCO) are responding by making the latest evidence-based flu-related information available for free.

The site (www.ebscohost.com/flu) provides evidence-based clinical information from DynaMed™ and Nursing Reference Center™, EBSCO’s clinical and nursing point-of-care databases, along with patient education information in 17 languages from Patient Education Reference Center™.

The information provided For Clinicians and For Nurses consolidates the best-available evidence from multiple sources along with the latest evidence-based content for healthcare providers to stay current with recommendations for monitoring, diagnosing, and treating patients with flu-like illnesses.

The For Patients section includes current, easy to understand articles written for non-medical professionals. The www.ebscohost.com/flu site adds patient education information in 17 languages. The patient education information allows healthcare providers to have resources to provide to their diverse local communities and allows people to have access to the latest treatment and condition information about Pandemic (H1N1) 2009 and Seasonal Influenza that is easy to understand.

The goal of the site is to be open to all and easy to share among medical colleagues, parents, students, faculty, employees, and co-workers so that preventative measures are well-known and symptoms and treatment options are understood. Medical institutions, organizations, universities, schools and public libraries will be able to easily add links to the EBSCO influenza portal to their own flu resources pages and websites.

The clinical editors responsible for EBSCO’s point-of-care resources continually monitor current information and update the resources in order to ensure that the worldwide medical community has the best available medical evidence. The www.ebscohost.com/flu site pulls together the information collected about the Pandemic (H1N1) 2009 outbreak and other strains of the flu ensuring the best available medical evidence will be easy to find going into the 2009/2010 flu season.

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DynaMed Topic Activity

New summaries added to DynaMed this week:

· Ciguatera fish poisoning

· Stroke in children

DynaMed Peer Review

We are currently seeking reviewers for:

· Endometrial ablation

· Hydrocephalus in children

· Pregnancy in adolescents

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 Archives

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.)