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Physicians: .25 AMA PRA Category I CreditsTM
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 above.
Upon successful completion of this educational program, the reader should be able to:
Alan Ehrlich, MD
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.
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 Education Company 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.
Last week 493 journal articles were evaluated via DynaMed's Systematic Literature Surveillance and summaries of 200 articles were added to DynaMed content.
Bedside Ultrasound May Be an Alternative to Computed Tomography for Evaluation of Suspected Nephrolithiasis in the Emergency Department
Suspected nephrolithiasis is commonly encountered in the emergency department, with almost 1 million emergency department visits annually in the United States (J Urol 2014 Jan;191(1):90). Imaging is typically required to confirm the diagnosis. Noncontrast computed tomography (CT) is recommended to confirm a diagnosis of nephrolithiasis in adults by both the American Urological Association (AUA 2012 May PDF) and the European Association of Urology (EAU 2014 Mar PDF). Ultrasound has also been evaluated in this setting, and has several potential advantages over CT, including lack of radiation exposure and lower cost. A small diagnostic cohort study previously found that ultrasound had moderate sensitivity and high specificity for detecting nephrolithiasis in children (J Urol 2009 Oct;182(4 Suppl):1829). A new randomized trial in adults assessed initial diagnostic evaluation with ultrasound performed by an emergency physician, ultrasound performed by a radiologist, or abdominal CT in 2,759 patients presenting to the emergency department with suspected nephrolithiasis.
The findings from this new trial suggest bedside ultrasound and abdominal CT have similar rates of return emergency department visits and hospitalization after emergency department discharge. However, the large proportion of patients who were randomized to initial bedside ultrasound who subsequently received CT is a potential limitation, since some of the evaluation performance attributed to bedside ultrasound may have resulted from the combination of ultrasound and CT. Nonetheless, this new study demonstrates that bedside ultrasound may be a reasonable alternative to CT for assessing suspected nephrolithiasis in the emergency department, potentially reducing radiation exposure and costs associated with CT.
Updated ACP Guideline for Nonsurgical Management of Urinary Incontinence in Women
The American College of Physicians (ACP) guidelines for nonsurgical management of urinary incontinence in women have recently been updated (Ann Intern Med 2014 Sep 16;161(6):429 PDF). The guidelines have been incorporated into the Urinary incontinence in women and Behavioral interventions for urinary incontinence topics. For more information, see these topics in DynaMed.
EBSCO Health Launches Pediatric Clinical Information Mobile App
PEMSoft Now Available For iPhone, iPad, and Android Devices
A mobile app designed specifically for pediatricians, emergency department physicians, physicians-in-training and other medical providers caring for children with acute illnesses and injury, is now available from EBSCO Health, the leading provider of clinical decision support solutions for the healthcare industry.
Call for Peer Reviews
We are currently seeking subspecialty reviewers for our Patient Education Resource Center (PERC). PERC provides fact sheets and discharge instructions for patients leaving the hospital or emergency room. These hand-outs fulfill the meaningful use requirements for the Medicare & Medicare Services Incentive Programs.
DynaMed Contribution Opportunities
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.