Clinical Reference Updates – January 2012 Summary for Medscape App for Android™

• 487 diseases & conditions updated
• 114 drug monographs updated
• 4 new drug monographs added

Featured Content of the Month – Heart Failure

This month we bring you an expanded collection of over 30 Heart Failure topics that have been updated with the most recent developments from medical literature and guideline recommendations from the American Heart Association, the New York Heart Association, and the European Society of Cardiology.

Comprehensive coverage on Heart Failure, including:

Heart Failure – includes the latest guidelines from the ACCF/AHA, NYHA, and ESC, as well as a greatly expanded multimedia library of clinical images and videos

Echocardiography – discusses the technical aspects of 2-D and Doppler echocardiography and provides an overview of equipment and patient preparation

Transvenous Cardiac Pacing - provides details on obtaining venous access, a technique for placement of the pacing lead, and complications that may occur

Permanent Pacemaker Insertion – offers information on devices and equipment, details on the implantation technique, and a discussion of technical considerations

New Drug Monographs

azilsartan/chlorthalidone (Edarbyclor)
New drug combination of an angiotensin II receptor blocker and thiazide-like diuretic indicated for treatment of hypertension.

glucarpidase (Voraxaze)
New carboxypeptidase enzyme indicated for toxic plasma methotrexate concentrations in patients with delayed methotrexate clearance due to impaired renal function.

Drug Monograph Updates

brentuximab (Adcetris)
A new black box warning was added that describes cases of progressive multifocal leukoencephalopathy, a rare but serious brain infection that can result in death.

C1 inhibitor human (Berinert)
Expanded indication includes treatment of acute attacks for laryngeal hereditary angioedema.

pneumococcal vaccine 13-valent (Prevnar 13)
New indication for prevention of pneumonia caused by Streptococcus pneumoniae in adults aged 50 years or older.

raltegravir (Isentress)
New pediatric indication for HIV-1 infection in children aged 2 years or older.

Fentanyl transmucosal (Subsys)
New sublingual spray indicated for breakthrough cancer pain.

Practice Changing Updates

Our app is continually being updated with new FDA drug approvals, the latest clinical updates from medical literature and current guidelines to help you stay informed and make the best decisions in the treatment of your patients. Here are this month’s featured updates:

Bacterial Pneumonia – Prevnar 13, a pneumococcal 13-valent conjugate vaccine, has been approved by the U.S. Food and Drug Administration for people aged 50 years and older to prevent pneumonia and invasive disease caused by the bacterium, Streptococcus pneumoniae.

Human Papillomavirus – The CDC now recommends the quadrivalent HPV vaccine (Gardasil) for routine use in boys aged 11 or 12 years. Current recommendations advise vaccination for males aged 13-21 years who have not been vaccinated previously or who have not completed the 3-dose series.

I really think the hybrid design of the TFP is ideal for many situations, especially for those people that truly want to carry a single device. As much as I like tablets I find that I still need a keyboard for any significant data entry chores, whether it be with a spreadsheet, word processor, etc.

I would really like to see tablet PC manufacturers like Lenovo and Samsung do something similar, i.e. a keyboard dock that increases battery life and folds into a laptop style portfolio with the tablet docked. My dream machine would be a Samsung Series 7 Slate with a laptop dock similar to the TFP. It doesn’t appear that Samsung is interested in such a docking solution, but I’m hopeful that a third party will take the hint and do it anyway.

According to Tablets Planet the “Latitude ST tablet features a Intel Atom processor, Windows 7, Microsoft Bitlocker, Kensington lock, USB port, SD card slot, HDMI port, and a LCD that features finger multi-touch and a stylus for input, and there are also front and rear-facing cameras for video conferencing (front) and taking photos (rear).”

In addition the Latitude ST claims an 8 hour battery life. This is in line with the battery life claims of the Samsung Series 7 tablet.

Now if I could just get Samsung or Dell to develop a docking solution similar to the Asus Transformer we’d have something.

In this case it’s ASHP’s Interactive Handbook on Injectable Drugs: IV Decision Support by Lawrence A. Trissel. Every pharmacist working in a hospital pharmacy knows about this reference. And if they don’t then they have a big problem because it’s only one of the most definitive reference sources for IV compatibility. Over the course of my career it’s simply been know as “the Trissel’s”. (kind of like “the Talyst”…just sayin’ – private joke people)

There’s a link in the ASHP web store leading to a “getting started video”, but I couldn’t get the video to run. Little bit of a fail. Perhaps ASHP’s never heard of YouTube. Who knows.

I have no idea why HP killed the webOS, but I’m sure we’ll find out more in the weeks to come. The operating system itself was awesome. I personally think it had the best user experience of all the current tablet platforms. I was looking forward to it’s maturation as a mobile computing ecosystem. With that said I think HP failed to offer the smartphone variety necessary to make the HP TouchPad meaningful.

I considered buying a TouchPad, but ultimately decided against it. Like many others I have a host of tablets to chose from these days. Why did I baulk at the TouchPad? Basically it boils down to cost, lack of smartphone choice and the feeling that the TouchPad still had some growing pains to go through. These are the same reasons that lead me to hold off on purchasing many of the early Android tablets.

Good-bye TouchPad. Your death was premature to say the least. Shame on you HP for destroying such a beautiful tablet operating system.

The most common uses for the device to date have been:

1. Games – hands down the activity that I use the tablet for most. Favorite games include Drag Racing, Pinball Ride and Peggle
2. Reading – Pulse, Google Reader, etc.
3. Interacting with social media – Google+, Twitter, Facebook
4. Email, both work and personal
5. Surfing the net – I don’t do this nearly as much as I thought I would. Most of my surfing is the result of following a link in Twitter or Google+

One of the things I’ve been playing with is launchers. Throw in the fact that I’ve been recently considering converting to a Windows 7 smartphone and you can imagine my intrigue when I came across Launcher 7 for Android.

Description from the Android Market:

A Windows Phone 7 style launcher for Android.

Unlike other current WP7 launchers (Windows Phone Android, Metro UI), this one allows you to properly modify your start screen. Just long press on a tile and drag tile where you want!

I installed Launcher 7 and have been using it for about a week. I like it a lot. It does seem a little weird to be running a Windows 7 launcher on a Nook Color rooted to run Android.

Overall I like the Windows 7 Phone experience. One thing that’s missing is widgets. Having widgets for Android is a real game changer for me. I use widgets for a lot of things; weather, Evernote, news, calendar, agenda, alarm  clock, etc. I’m not sure I want to live without them.

Final verdict? I think I like having widgets enough to continue using Android for now. My new launcher of choice? Go Launcher EX. 

To me, easily the most appealing iPad competitor. But I think the Pre is the most appealing iPhone competitor, and it hasn’t fared well. HP has matched the iPad’s pricing: $499/599 for 16/32 GB Wi-Fi models.

I think the problem facing HP is summed up in the sub-head on this promotional page:

The ultimate in entertainment with Beats Audio and Adobe Flash.

That’s not a compelling answer to “Why should I buy this instead of an iPad?” I mean, who has even heard of “Beats Audio”?

Update: Lots of feedback arguing that Dr. Dre’s Beats brand has good consumer recognition. I remain skeptical that this is a flagship selling point for a tablet, though, no matter how popular their headphones are.

And Glenn Fleishman had a good quip:

Whenever a hardware maker has to put the name of another company
in its ads as a selling point, it may already have lost.

via daringfireball.net

I don’t typically agree with anything this guy says, but I can’t ignore this post. Unfortunately he’s spot on. The HP ecosystem is incredibly well designed and for all intents and purposes is probably the best tablet/smartphone UI on the market.

While Dr. Dre’s Beats brand does in fact have a solid consumer following it won’t be enough to make the device compelling. And as I mention here, HP needs to expand their line of smartphones to compel consumers to make the transition; or at least design a device that people can’t ignore, i.e. like Apple and the iPhone.

Recently I’ve been thinking, out loud, about getting an Android tablet. I’ve also been bemoaning the fact that I’ve never rooted an Android device. I’ve thought about rooting my Droid, but haven’t done it. I’ve also toyed with the idea of purchasing a Barnes & Noble Nook Color just so I could root it.

Well, my awesome wife and kids heard my rumblings and bought me a Nook Color for Father’s Day for the sole purpose of rooting it. That’s pretty darn cool.

Here’s the poem my kids wrote me that was attached to the box. They made me read it before I could open the gift and asked me if I caught the hint. I did.

Dad,

Today is a day made just for you,
To honor and celebrate all that you do.
We love you with all of our hearts,
Even when you let loose a fart.
We hope that made you smile,
Because it took us quite a while.

You’ve given us strong roots to help us grow,
And now a gift we will bestow,
Upon this day, we love you so.

Now take this gift and root it well,
We hope you think it’s very swell.

We wish you luck on this task.
If you need help just ask,
Because you have two brilliant daughters,
Who will always look up to their one great father.

Now this is getting much to long,
So take this gift and be gone.

Love,
Mikaela and Josslyn

Rooting the Nook Color turned out to be much more difficult than I thought it would be. I had version 1.2 of the Nook software which is apparently designed to make rooting the device harder. Mission accomplished.

Fortunately there are a lot of really smart people in the world and they like tinkering with things a whole lot more than I do.

The first time I rooted the device I used this YouTube Video to get the job done. The kid in the video walked me through the rooting process step by step. It worked perfectly, but I was only able to layer Android Gingerbread on top of the Nook Color software. It was kind of cool, but I had a lot of trouble accessing the Android Market so I decided to jump in with both feet and burn the sucker to the ground and start over. Sounded great in theory, but it gave me some headaches and a little heartburn. I ended up turning my Nook Color into a doorstop for a few hours, but was finally able to get a complete Android Gingerbread v. 2.3.4 installed on my Nook Color, or should I say my new Android Tablet; dubbed FrankenNook by my brother, Robert.

Why did I chose Gingerbread over the other versions? Good question. I did quite a bit of research before starting the process at Gingerbread appeared to be one of the simpler installations as well as one of the most stable.

Thanks to the ladies and gentlemen at xdadevelopers for all their hard work and for putting the information up on the internet for all to enjoy. And thanks to my lovely wife and incredible girls for the gift.

Oh, the rooted Nook Color makes a great 7-inch Android Tablet. My wife asked me if I still wanted an “Android tablet” off the shelf, i.e. a Galaxy tablet or Xoom. The honest answer is no, not at this time. At the moment I’m enjoying the device immensely. When I get tired of it I’ll just re-flash it with Honeycomb. Just sayin’.

There are a couple of take home messages from this article. First, the increased use of mobile technology is finally forcing healthcare systems to make changes to their approach to technology. It’s something that’s been needed for a long time. Second, the article clearly demonstrates that our healthcare system remains physician centric. It isn’t until physicians cry foul that changes are made. I first asked for “mobile support” in a hospital setting nearly a decade ago, and continued to ask for it until I left the industry about six months ago. Unfortunately I’m a lowly pharmacist. Even at the last facility I worked in, which considered themselves quite technologically advanced, it wasn’t until physicians began demanding iPad support that we got it.

The more things change, the more they stay the same. Just sayin’.