New Guidelines for Screening Mammography

Breast cancer is one of the most common causes of death for women in their 40s in the United States. Individualized risk assessment plays an important role when making decisions about screening mammography, especially for women 49 years of age or younger. The purpose of this guideline is to present the available evidence for screening mammography in women 40 to 49 years of age and to increase clinicians' understanding of the benefits and risks of screening mammography.

Screening Mammography for Women 40 to 49 Years of Age: A Clinical Practice Guideline from the American College of Physicians. Annals of Internal Medicine vol. 146 no. 7 511-515.

Extended-Release Niacin Outperforms Ezetimibe in Lowering Cardiovascular Risk

In patients with high cardiovascular risk, extended-release niacin is associated with better outcomes than ezetimibe, according to a New England Journal of Medicine study released online.

Researchers randomized over 350 patients on long-term statins to added therapy with either niacin or ezetimibe. The primary endpoint was the difference in change of carotid artery intima-media thickness from baseline to 14 months between groups. After 208 patients had completed the trial, it was stopped when results significantly favored niacin.

Two accompanying editorials bemoan the trial's early end, arguing that all patients studied up to the point of stoppage should have been analyzed, not just those who completed 14 months' therapy. Nonetheless, both support the use of niacin over ezetimibe in high-risk patients, and both point to trials, now under way, that may provide more definitive results. In Journal Watch Cardiology, Dr. Harlan Krumholz says that these results "will not be available for many years. In the meantime, ezetimibe should be a drug of last resort, if it is used at all."

More In the Literature

More Medical Apps for the iPhone

In last week's New York Times, technology writer David Pogue discussed some of his favorite applications for the iPhone / iPod Touch including applications for patients and doctors. His list included some known favorites like ePocrates, but also had some new suggestions that hint at what the future might hold, such as AirStrip OB, which allows an OB to monitor a fetal heartbeat from across the hospital and OsiriX, a medical image viewer.

Do you have favorites not on this list? Let us know by commenting or emailing us at mclref[at]mc.duke.edu.

Button Chair Exhibit Here!

This interactive exhibit is designed to increase awareness of breast cancer.

On display Nov. 9th - 30th
Entrance Level

Reception: Nov. 19th, 5 - 7 pm
First Stack Level

Free and open to the public!

Spotlight on Diabetes

November is American Diabetes Month, a time to highlight a serious disease that leads to potentially life-threatening complications such as heart disease, stroke, and kidney disease.

PubMed Redesigned!!

New changes are in effect at PubMed, the National Library of Medicine's search interface for MEDLINE. Most of the features you are familiar with are still available, they just may be in a new place.

One notable change is that the tabs for Details, History, and Limits are no longer on your results page.

• To see how your search terms were mapped, look for the Details box on the righthand side of your results list. You may need to scroll down a bit as it is below other features such as "Also Try," "Titles With Your Search Terms," and "Find Related Data." Details is also accessible on the Advanced Search screen.
• To combine search sets (formerly accomplished on the History tab), click on Advanced Search. If you do not see your full list of searches, click on "More History" to see your activity.
• To limit your search results to a specific age group, language, publication type, etc., click on Advanced Search. Options from the Limits tab are now included on the Advanced Search screen.

Other changes include:

• Filters, such as the default filters for Review Articles, Systematic Reviews and dukemlib (articles available in print or electronically through the Duke Medical Library) are now located on the righthand side of the results screen. Customized MyNCBI filters are also located here when you are signed into your MyNCBI account.
  
• Suggested terms appear as you are typing terms into the search box. Note: these are not MeSH terms and thus should be used with caution. To find MeSH terms for your topic, change the database selection option from PubMed to MeSH on the drop-down menu on the results screen or click on the MeSH database link on the bottom of the Advanced Search page.
  
• The Single Citation Matcher is now linked from the main PubMed home screen. Additionally, the library's links to the Single Citation Matcher remain functional.

For help using the redesigned PubMed, please IM, email, or call us at 660-1100 and ask to speak to a librarian, or read more about the changes to PubMed online.

H1N1 Flu (Swine Flu) Resources

Difference Between Cold & Swine Flu Symptoms (chart) - Baptist Health

Duke International Travel Policy

Duke - Fight the Flu

Duke Responding to Influenza Cases on Campus

Enviro-Health Links - Swine Flu - NLM

H1N1 Flu (Swine Flu) - MedlinePlus

H1N1 Flu: Information and Guidance for Professionals - NC Division of Public Health

H1N1 Flu RSS Feed - CDC

H1N1 Flu (Swine Flu) - CDC

H1N1 Novel Influenza Information (multi-language) - ECHO Minnesota

H1N1 Update (Press Releases) - NC DHHS

Influenza - DynaMed

Influenza (Flu) - NC DHHS

iPhone H1N1 Drug App - WebMD

Pandemic (H1N1) 2009 - World Health Organization

Tracking Swine Flu Cases Worldwide (Last update May, 2009) - New York Times

Twitter Feed - CDC

US, Other Nations Stop Counting Pandemic Flu Cases - New York Times

Revised 10/16/09

New H1N1 Resource for your iPhone

Get the latest information on the H1N1 Influenza A Vaccine with WebMD's free drug app for your iPhone or iPod Touch.

Features:

• Look up adult/pediatric dosing information
• Learn about the adverse affects, cautions, and drug interactions
• See information for pregnant and lactating women

This app has drug information for over 6,000 generics and brands as well as OTC medications and supplements.

Go to http://www.medscape.com/public/iphone to download the Medscape app.