DynaMed™

™
e
er
me ,
h
y
An
ti
s D y na M
s
e
ed
Acc
DynaMed
An y w
™
DynaMed
A product of EBSCO Health
DynaMed™ is a clinical reference tool created by physicians for
physicians and other health care professionals for use at the point-ofcare. With thousands of topics, DynaMed is an indispensable resource
for answering clinical questions during practice.
DynaMed balances the latest content and resources with validity,
relevance and convenience to create the most useful clinical resource
possible. Updated daily, DynaMed applies a 7-step systematic evidencebased process to all of its content, assuring that the science backing the
conclusions is sound.
Why Would I Use DynaMed?
• Improve health outcomes and reduce health care costs by using
the best available evidence for clinical decision-making
How Do I Access DynaMed?
You can access DynaMed from workstations throughout
your institution and from your mobile device. (Contact your
administrator for details about how to take advantage of mobile
access.) Use the information below to log in to DynaMed remotely.
Access URL:
User Name:
• Quickly obtain pertinent information right at the point-of-care
• Keep abreast of the latest medical research with daily updates
through DynaMed’s Systematic Literature Surveillance
• Earn Continuing Medical Education (CME) credits
Password:
Help Contact:
Content information on reverse side...
Content, Features & Functionality at a Glance...
1
2
3
Easy, Powerful Searching
E-Newsletter
6
Mobile
Calculators
Send Comment
Search by keyword or browse alphabetically by
specific topic or by category
Content in this section is updated
frequently to highlight clinically relevant
news and information
Where Care Comes First
Browse:
Recent Updates
ABCDEFGHIJKLMNOPQRSTUVWXYZ
2
3
EBM Focus Newsletter
Sign up for DynaMed’s free newsletter to receive
updates on timely and significant changes from
“articles most likely to change clinical practice.”
Free CME credit is available.
Browse Categories
Search Other Services
• DynaMed shown to be THE MOST CURRENT point-of-care reference (BMJ 2011 Sep 23)
• DynaMed 7-Step Evidence-Based Methodology
• Introducing Practice Changing Updates
• ST-elevation myocardial infarction (STEMI) updated with ESC/ACCF/AHA/WHF 2012 universal
definition of MI (Eur Heart J 2012 Oct)
• Obstructive sleep apnea (OSA) in children updated with AAP recommendations (Pediatrics 2012 Sep)
• Streptococcal pharyngitis updated with IDSA recommendations (Clin Infect Dis 2012 Sep 9)
• DYNAMED WEEKLY UPDATE: Regular Aspirin Use After Diagnosis of Colorectal Cancer
May Reduce Mortality in Patients with Tumor PIK3CA Mutation
Online
PERC
NRC
LEXI-COMP
SMART IMAGEBASE
Easily navigate to other relevant medical
resources directly from DynaMed, including
EBSCO databases (subscription required)
Quickly view a list of the most recently updated
topic summaries
?
4
Spotlight
View details on DynaMed’s 7-step
editorial process for determining
the best available evidence
5
Search
1
Evidence-Based Methodology
Search Other Services
About
Help
F First Hospital
Content Spotlight
4
6
Home Recent Updates
5
EBSCO Support Site
Privacy Policy
Terms of Use
Copyright
© 2012 EBSCO Industries, Inc. All Rights Reserved.
Hover Functionality
Get C
CME for this Topic
Linking Navigation
Navigate directly to a topic section from the
search result list
–
Related Search Results
12
Send feedback directly to the DynaMed
editorial team
13
Search within Text
Search for terms within the body text of
topic summaries
15
Quickly discern the quality of evidence via easyto-interpret Level of Evidence labels
Internal Topic Linking
Easily jump to other related sections of a topic via
embedded links
16
Full Text Links
17
Tools
Access Full Text medical Journals quickly and
easily (subscription required).
Create email alerts, print and email topic
summaries, or generate persistent links
to a topic
•
•
•
•
based on case-control study
retrospective study of 15,326 patients > 65 years old admitted to hospital for AAAvs. placebo for mean 2.5 years
3,379 (22%) had ruptured AAA and 11,947 (78%) had intact AAA
ACE inhibitor use reported in 665 (20%) with ruptured AAA vs. 2,761 (23%) with intact AAA
(odds ratio 0.82, 95% CI 0.74-0.9)
• no statistically significant associations found for beta blockers, calcium channel blockers, alpha blockers,
angiotensin receptor blockers, or thiazide diuretics
• Reference - Lancet 2006 Aug 19;368(9536):659
EBSCOhost Full Text editorial can be found in Lancet
Calculators
Send Comment About
2006 Aug 19;368(9536):622 EBSCOhost Full Text Am Fam Physician 2006 Nov 15;74(10):1780
Search Other Services
E-Newsletter
Send Comment to Editor
Mobile
Search
Abdominal aortic aneurysm (AAA)
10
Result List
1 of 16
Follow-up
A
AA
Search within text
13
• Reference - J Vasc Surg 2002 Jan;35(1):72 in J Watch 2002 Mar 15;22(6):46
Treatment
Prognosis
Collapse All
in 12% vs. 9% (p = 0.36)
◦ mortality
14
surgery for AAA in 20% vs. 26% (p = 0.11)
◦ elective
of study medication in 42.4% vs. 26.8% (p = 0.0002)
◦ cessation
◦ withdrawal due to adverse effects 38% vs. 21% (NNH 6)
◦ propranolol poorly tolerated and might increase mortality (level 2 [mid-level] evidence)
Treatment Overview
+
+
+
+
Where Care Comes First
• comparing propanol vs. placebo
+ History and Physical
+ Diagnosis
+ Medications
+ Surgery and procedures
Expand All
• based on small randomized trial with high dropout rate
• 54 patients with small AAA diagnosed on screening were randomized to propranolol 40 mg vs. placebo
orally twice dailyvs. placebo for mean 2.5 years
• comparing propanol vs. placebo
11
Prevention and Screening
Quality Improvement
in 16.7% vs. 4.2% (relative risk [RR] = 1.6, 95% CI 1.02-2.51)
◦ mortality
◦ dropout rate 60% vs. 25% (RR = 1.74, 95% CI 1.06-2.86)
ACE inhibitors:
Guidelines and Resources
Patient Information
ACE inhibitors reported to be associated with reduced risk of ruptured AAA (level 3 [lacking direct] evidence)
+ ICD-9/ICD-10 Codes
+ References
•
•
•
•
based on case-control study
retrospective study of 15,326 patients > 65 years old admitted to hospital for AAAvs. placebo for mean 2.5 years
15 (78%) had intact AAA
3,379 (22%) had ruptured AAA and 11,947
ACE inhibitor use reported in 665 (20%) with ruptured AAA vs. 2,761 (23%) with intact AAA
(odds ratio 0.82, 95% CI 0.74-0.9)
• no statistically significant associations found for beta blockers, calcium channel blockers, alpha blockers,
angiotensin receptor blockers, or thiazide diuretics
• Reference - Lancet 2006 Aug 19;368(9536):659
EBSCOhost Full Text editorial can be found in Lancet
2006 Aug 19;368(9536):622 EBSCOhost Full Text Am Fam Physician 2006 Nov 15;74(10):1780
Patient Education
Reference Center
Search Other Services
Send Comment to Editor
16
12
Help
F First Hospital
?
Abdominal aortic aneurysm (AAA)
Associated Conditions
Level of Evidence Labeling
Tools
ACE inhibitors reported to be associated with reduced risk of ruptured AAA (level 3 [lacking direct] evidence)
Patient Education
Reference Center
–
14
Guidelines and Resources
Patient Information
+ Related
Re
Summaries
+ Ge
General Information
+ Causes and Risk Factors
+ Complications and
9
in 16.7% vs. 4.2% (relative risk [RR] = 1.6, 95% CI 1.02-2.51)
◦ mortality
◦ dropout rate 60% vs. 25% (RR = 1.74, 95% CI 1.06-2.86)
ACE inhibitors:
+ ICD-9/ICD-10 Codes
+ References
Get C
CME for this Topic
Search within text
• based on small randomized trial with high dropout rate
• 54 patients with small AAA diagnosed on screening were randomized to propranolol 40 mg vs. placebo
orally twice dailyvs. placebo for mean 2.5 years
• comparing propanol vs. placebo
Prognosis
Comments to the Editor
AA
◦ propranolol poorly tolerated and might increase mortality (level 2 [mid-level] evidence)
Prevention and Screening
Quality Improvement
Home Recent Updates
A
Collapse All
in 12% vs. 9% (p = 0.36)
◦ mortality
surgery for AAA in 20% vs. 26% (p = 0.11)
◦ elective
cessation
study medication in 42.4% vs. 26.8% (p = 0.0002)
◦ withdrawalofdue
to adverse effects 38% vs. 21% (NNH 6)
◦
Follow-up
Navigation
Where Care Comes First
• Reference - J Vasc Surg 2002 Jan;35(1):72 in J Watch 2002
8 Mar 15;22(6):46
Treatment
+ Medications
+ Surgery and procedures
+
+
+
+
F First Hospital
?
Expand All
Help
• comparing propanol vs. placebo
7
Treatment Overview
CME
View and select subsections of DynaMed topics
for direct access to specific sections
1 of 16
+ History and Physical
+ Diagnosis
Earn continuing education credits
11
Result List
Associated Conditions
View relevant search results from related EBSCO
databases (subscription required)
10
Search
About
Abdominal aortic aneurysm (AAA)
+ Related
Re
Summaries
+ Ge
General Information
+ Causes and Risk Factors
+ Complications and
»
9
Send Comment
»
8
Calculators
Mobile
Abdominal aortic aneurysm (AAA)
Hover over a topic to see the full table
of contents
»
7
E-Newsletter
»
Home Recent Updates
Tools
17
What will I find in DynaMed?
One-click access
to full-text articles
Ability to
earn CMEs
Alerts when topics
are updated
Practice changing
updates
Clinical
Calculators
Guidelines
Easy access from
EMRs
EBM Focus
e-newsletter
ICD-9 and
ICD-10 codes
© EBSCO Industries, Inc.
Printed in U.S.A. (1013)
EBS-2758