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.

Fortunately for me there’s no shortage of tablets on the market: Windows OS, Android OS, iOS. Crud, based on reports from CES 2012 I’ll have a much bigger selection within another 6 months or so.

The iPad is out. Been there, done that. It didn’t meet my needs.

I’ve thought many times about going with an Android device. After all, I’ve used an Android smartphone for the better part of 3 years and love the operating system. The Samsung line of Android tablets is awesome, and the Asus Transformer Prime is nothing short of spectacular. If I were to purchase an Android tablet I’m certain that it would be the Prime, but alas, as a productivity device the Android tablets suffer from the same shortcomings as that fruity device.

Which brings us to the Windows tablets. I’ve been eying Windows tablets for a while, but I’ve been a bit underwhelmed. In addition I’m a fan of convertible tablets and those have virtually disappeared as everyone seems to be going to a slate model these days.

After looking over my options I think the Samsung Series 7 Slate is my best bet. It’s a fully functional Windows computer with no compromise. In addition it has decent battery life, good specs and works well with both touch and a pen – yes, I still prefer a pen for note taking. A friend and colleague recently purchased a Series 7 Slate and he’s been raving about it. I spent a little time playing with it today and I must say that I found it to be quite impressive.

So there you go. If I were to purchase a new tablet today it would be the Samsung Series 7 Slate. Then again, I did drool a little when I read about the Lenovo IdeaPad Yoga.

And now for the bummer, it’s only available in Japan. Doh! Why can’t the U.S. have all these cool toys too?

The first video below shows the gesture control while the second is just a basic overview of the hardware and software.

You can find more information here.

Lexicomp’s I.V. Compatibility module is now available for your Lexicomp On-Hand subscription for Android™! By following the update instructions below, you can add this module to your existing Lexicomp On-Hand subscription. There is no additional charge for this enhancement.

The I.V. Compatibility module allows you to review compatibility and stability information for hundreds of parenteral medications and fluids. This module is based on information from the King® Guide to Parenteral Admixtures®. Thousands of clinicians are already using Lexicomp’s I.V. Compatibility module every day – now you can access this vital information on your Android smartphone or tablet as well.

To update your subscription to include I.V. Compatibility, follow these instructions:
Ensure you have a strong Wi-Fi or cellular connection.
On your Android device, tap the Market icon and search for Lexicomp.
Select Lexicomp and tap Update. When the warning appears, tap Accept & Download.
When the application is installed, tap the Lexicomp icon to access your software.

Lenovo T410S Laptop or Lenovo x201t Tablet PC – I go back and forth between these two machines. The T410S has a bigger screen, faster processor and more memory, but it’s not a tablet PC. The x201t is smaller, easier to use and I can take notes directly on the screen. The smaller size is especially important when I have a long flight; the T410S doesn’t fit well in the cattle-car seats on planes.

Motorola DROID – I love this phone and haven’t seen anything new to convince me to change, although I think I’ll have a Motorola DROID BIONIC shortly.

Kindle DX – Still nothing better than an e-ink screen for reading. Period. When I see a journal article worth reading I simple dump it in a “To Read” folder on my computer. Every so often I move those on to my Kindle DX and read them when I have down time. The DX’s large screen works well for PDFs.

Android Tablet (my rooted NOOK Color) – Games, email and social media in a small package with long battery life.

Verizon MiFi, a.k.a. “Mobile Hotspot” – Simply can’t live without connectivity

I recently purchased an HP TouchPad. It’s turned out to be a really nice tablet. I’ve enjoyed using it over the past few weeks.

On a recent trip to Cincinnati, OH I decided to leave my Kindle DX and Android tablet at home, and take the TouchPad instead. I used it for email, web surfing, social media and games; just like its Android counterpart. I tried using it for reading in place of the Kindle DX. It worked, but found that I like the e-ink screen better.

I’ve heard people say they use their tablets, specifically their iPads, for document creation, editing, etc. I managed to use the TouchPad to compose a blog post for another website while en route to Cincinnati, but I wouldn’t recommend doing it on a regular bases. Sure, I was able to create the post, but there were several things I missed. I’m not a natural writer and many of my blog posts go through several edits before getting pushed to the web. In my opinion a keyboard and mouse work better than a touchscreen for editing a document. Overall it worked, but certainly not as good as a laptop.

So, what’s the final verdict? The TouchPad could easily take the place of my Android tablet and my Kindle DX, but I still prefer the Kindle for reading. And you can forget about using something like the TouchPad in place of a laptop, it’s not even close.

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. 

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’.

Anyway, I was reading through the MedicalSmarphones.com website and came across the video below demonstrating Epocrates Essentials for Android. It’s pretty cool. I’d love to see it on a Samsung Galaxy Tab or Motorola XOOM. As far as that goes I’d love to see Lexicomp software on a Samsung Galaxy Tab or Motorola XOOM as well.

Medscape Mobile is also available for the iPhone, iPad and BlackBerry, just in case you don’t have an Android device.