October 24, 2013

DynaMed EBM Journal Volume 8, Issue 43

DynaMed Weekly Updates

Quick Links

Join Mailing List



Physicians: .25 AMA PRA Category ICreditsTM

Family Physicians: .25 Prescribed credits

Nurse Practitioners: .25 Contact hours

Release Date: October 24, 2013

Expiration Date: October 24, 2014

Estimated Completion Time: 15 minutes

There is no fee for this activity.

To Receive Credit

In order to receive your certificate of participation, you should read the information about this activity, including the disclosure statements, review the entire activity, take the post-test, and complete the evaluation form. You may then follow the directions to print your certificate of participation. To begin, click the CME icon at the end of the article.

Program Overview

Learning Objectives

Upon successful completion of this educational program, the reader should be able to:
1. Discuss the significance of this article as it relates to your clinical practice.
2. Be able to apply this knowledge to your patient's diagnosis, treatment and management.

Faculty Information

Alan Ehrlich, MD - Assistant Clinical Professor in Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Senior Deputy Editor, DynaMed, Ipswich, Massachusetts, USA

Michael Fleming, MD, FAAFP - Assistant Clinical Professor of Family Medicine and Comprehensive Care, LSU Health Science Center School of Medicine, Shreveport, Louisiana, USA; Assistant Clinical Professor of Family Medicine, Department of Family and Community Medicine, Tulane University Medical School, New Orleans, Louisiana, USA; Chief Medical Officer, Amedisys, Inc. & Antidote Education Company


Dr. Ehrlich, Dr. Fleming, DynaMed Editorial Team members, and the staff of Antidote Education Company have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.

No commercial support has been received for this activity.

Accreditation Statements

ACCME: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Antidote EducationCompany and EBSCO Publishing. Antidote is accredited by the ACCME to provide continuing medical education for physicians. Antidote Education Company designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AAFP: Enduring Material activity, DynaMed EBM Focus, has been reviewed and is acceptable for up to 13 Prescribed credits by the American Academy of Family Physicians. AAFP certification begins March 7, 2012. Term of approval is for one year from this date with the option of yearly renewal. Each EBM Focus is worth .25 Prescribed credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AANP: This program is approved for 0.25 contact hour of continuing education by the American Academy of Nurse Practitioners.

Program ID: 1210393X


Last week 647 journal articles were evaluated via DynaMed's Systematic Literature Surveillance and summaries of 256 articles were added to DynaMed content.

Based on criteria for selecting "articles most likely to change clinical practice," one article of significant interest was selected by the DynaMed Editorial Team.

Colchicine Hastens Resolution and Reduces Recurrence After First Attack of Acute Pericarditis
Reference: (N Engl J Med 2013 Oct 17;369(16):1522) (level 1 [likely reliable] evidence)

The first attack of acute pericarditis often has a viral cause, while recurrent disease is theorized to be immune-mediated. Colchicine has been shown to speed recovery and reduce the risk of further recurrence in patients with recurrent pericarditis (Ann Intern Med 2011 Oct 4;155(7):409), but its efficacy for the first attack of acute pericarditis has not been previously established. The ICAP trial compared colchicine vs. placebo in 240 patients with a first episode of acute pericarditis.

Patients (mean age 52 years) with their first episode of acute pericarditis were randomized to colchicine 0.5 mg (twice daily if > 70 kg [154.3 lbs] or once daily if ≤ 70 kg) vs. placebo for 3 months. All patients also had conventional treatment with aspirin or ibuprofen for 3-4 weeks, or prednisone for patients with contraindications for NSAIDs. The primary outcome was incessant or recurrent pericarditis during follow-up. Incessant disease was defined as persistent symptoms or no symptom-free period > 6 weeks. Recurrent disease was defined as a second episode of pericarditis following a symptom-free period > 6 weeks.

Mean follow-up was 22 months. The incidence of incessant or recurrent pericarditis was 16.7% with colchicine vs. 37.5% with placebo (p <0.001, NNT 5), and remission rates at 1 week were 85% with colchicine vs. 58.3% with placebo (p < 0.001, NNT 4). Colchicine was also associated with reduced persistence of symptoms at 72 hours (19.2% vs. 40%, p = 0.001, NNT 5), and reduced risk of pericarditis-related hospitalization during follow-up (5% vs. 14.2%, p < 0.001, NNT 4). There were no significant differences in rates of adverse events, and no serious adverse events occurred in either group.

For more information, see the Acute pericarditis and Colchicine topics in DynaMed.

Earn CME Credit for reading this e-Newsletter.
For more information on this educational activity, see the CME sidebar.

DynaMed Events

American Academy of Pediatrics (AAP), October 24 - 29, 2013
Deputy Editor Mike Woods, MD, MS, FAAP, will be attending the AAP conference, held at the Orange County Convention Center in Orlando, Florida. Representatives will be available to discuss peer review, mobile access, and free trial information.

Visit the AAP website to learn more about the event and for registration information.

American College of Rheumatology (ACR), October 25 - 30, 2013
Representatives will be attending the ACR conference, held at the San Diego Convention Center in San Diego, California. Stop by booth 1807 to discuss peer review, mobile access, and free trial information.

Visit the ACR website to learn more about the event and for registration information.

Kidney Week, November 5 - 10, 2013
Representatives will be attending Kidney Week, held at the Georgia World Congress Center in Atlanta, Georgia. Visit booth 1231 to discuss peer review, mobile access, and free trial information.

Visit the Kidney Week website to learn more about the event and for registration information.

If you would like to meet with a DynaMed representative at an event, please contact us at DynaMedCommunity@ebscohost.com.

Call for Peer Reviews

We are currently seeking reviewers for:

Myocardial bridging

Congenital long QT syndrome

DynaMed Careers

Looking for a change? The DynaMed editorial team is expanding and looking for talented and driven individuals. Visit the links below to learn about these exciting opportunities.

Medical Writer
Medical Editor
Associate Editor