In response to the recent outbreak of Swine Influenza A (H1N1), Thomson Reuters (Healthcare) has updated the MICROMEDEX drug, disease, and patient education documents to reflect the most recent CDC guidelines published on 4/27/09. The MICROMEDEX content used by our hospital customers already includes detailed information on the treatment of influenza. We continue to closely monitor the guidelines provided by the CDC specific to the swine flu outbreak and will update this information accordingly. MICROMEDEX® Healthcare Series Online Below outlines the topics which have been updated specific to swine influenza: Drug Information (DRUGDEX® and DrugPoints™) The following drug monographs have been updated and will be available to customers on Tuesday, April 28:
• Oseltamivir (Tamiflu) – recommended therapy for swine influenza
• Zanamivir (Relenza ) – recommended therapy for swine influenza
• Amantadine (Symmetrel ) – swine influenza is resistant to this treatment; content
has been updated with this recommendation from the CDC
• Rimantadine (Flumadine) – swine influenza is resistant to this treatment; content
has been updated with this recommendation from the CDC
Disease Information (DISEASEDEX™ General Medicine and DISEASEDEX™ Emergency Medicine) The following disease topics have been updated and will be available to customers on Wednesday, April 29:
• Influenza-Acute – for patients with suspected or known disease. New information
was added to the Differential Diagnosis section with information on definitions (confirmed, suspected), testing, and symptoms. Additionally, the Drug Therapy section was updated to provide dosing recommendations for patients who have the disease.
• Influenza-Prevention and Screening – for prevention in patients who do not have the
disease but may be at risk for getting it. New information was added to the Drug Therapy section, detailing who should receive prophylactic antiviral therapy and dosing for prophylaxis.
A new document specific to Swine Influenza will be written by our editorial staff and available on Wednesday, May6. Patient Education (DrugNotes™ and Detailed Drug Info for Consumer™) The following patient education handouts have been updated and will be available to customers by Friday, May 1:
• Oseltamivir (Tamiflu) – recommended therapy for swine influenza
• Zanamivir (Relenza ) – recommended therapy for swine influenza
Consumer Health Solution Customers who subscribe to CHS may have access to either DrugNotes or Detailed Drug Information for the Consumer. The monthly updated data for both products will be available on the FTP download site on Friday,May 1.
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Other MICROMEDEX Delivery Methods For customers on other delivery methods, updated information on swine flu will be available as follows:
• Intranet – updated information will be available in v141 shipping to customers in May
• CD Windows – information will be available in v141 shipping to customers in May
• Corporate Solutions Internet – information will be available in v81, available in June • PDA Mobile Devices – updated drug and disease information available via mobile sync May
• CKO/UltiMedex – updated information will be available in the May monthly updates,
Information available on swine influenza in the MICROMEDEX databases is current as of Monday, April 27, 2009. The CDC is continuing to make revisions to recommendations regarding the management of swine influenza on a daily (and sometimes hourly) basis. We will continue to monitor the information and update the drug and disease information as necessary. Although the online content for drug and disease information is typically updated weekly, we will evaluate off-cycle updates as needed to ensure we push critical information to our customers. CareFocus and Clinical Xpert Navigator Since 2005, North Carolina Public Health (NCPH), a division of the North Carolina Department of Health and Human Services, and the North Carolina Hospital Association (NCHA) have worked together with the Healthcare business of Thomson Reuters on the North Carolina Hospital Emergency Surveillance System (NCHESS), the nation’s first operational statewide, hospital- based, clinical data biosurveillance system to detect public health threats and disease outbreaks in real-time. NCHESS uses Thomson Reuters’ commercially available CareFocus and Clinical Xpert navigator solutions, along with a monitoring web portal, which is built on a unique, event-driven architecture to monitor patient data from health systems across the state. Last week, when evidence emerged that a deadly new flu strain had spread into the US, Thomson Reuters contacts reached out to their counterparts at the NCHA and NCPH to discuss how to create profiles that would alert the State to potential cases of type A influenza occurring anywhere in the state. The following immediate steps are being pursued:
• Thomson Reuters staff, with the assistance of NCHA, will pursue the configuration and
installation of relevant CareFocus profiles at three initial institutions:
Copyright 2009. Thomson Reuters. All Rights Reserved
• The CareFocus profiles will be focused on inpatients with acute respiratory illness
symptoms and those that have positive test results for type A influenza. Where possible, the profiles will also seek to pick up cases where we have evidence that a specimen has been sent to the state lab for analysis.
• Once initial patient results are available, Will Moye, Product Manager, will review these with
NCPH Epidemiologists and let them utilize the reach-back function to determine the validity of the case produced by the CareFocus filters.
• Once we all feel we have good results, PM will determine next steps.
For questions regarding the MICROMEDEX products, please contact Tammy Williams. For questions on CareFocus, please contact Will Moye. Marketing is working on customer-facing messaging this week.
Copyright 2009. Thomson Reuters. All Rights Reserved
Contraindications & Precautions There remains some controversy over exactly what does and does not constitute a contraindication to eachmodality. In addition to any list produced, it is essential that the therapist makes a professional judgementas no listing can cover all variations and clinical circumstances. The lists of contraindications (by modality) below are derived from consensus ra
PROTOCOLO DE ACCION ANTE VICTIMAS DE VIOLACIÓN El presente protocolo define el procedimiento a seguir ante una mujer que ha sufrido una violación y acude a un servicio de salud. El protocolo completo es aplicable en las consultas que se realizan en forma inmediata, ya que la anticoncepción de emergencia y la prevención de VIH-SIDA pierden efectividad transcurridas 72 horas. L