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Medical Resources

Lewis P. Gundry Health Sciences Library

900 S Caton Ave, Baltimore MD 21229
Phone: 667-234-3134
Email: stagneslibrary@ascension.org

1st Floor (main building)

Library Open Hours: 7:30AM - 4:00PM (Monday - Friday)

After Hours Access limited (door unlocks at 6:30AM weekdays) 

Librarian: Lucinda Bennett

Medical Databases & Platforms

Access Medicine

Cochrane Database of Systematic Reviews

PubMed

PICO Search

Mobile Apps

http://www.imedicalapps.com/

"iMedicalApps is the leading online publication for medical professionals, patients, and analysts interested in mobile medical technology and health care apps. Our physician editors lead a team of physicians, allied health professionals, medical trainees, and mHealth analysts in providing reviews, research, and commentary of mobile medical technology. Our publication is heavily based on our own experiences in the hospital and clinic setting."

 

http://www.medscape.com/public/iphone?src=emed-call

8,500+ prescription and OTC drugs, herbals, and supplements
6,200+ Reference articles for decision-making support
Clinical tools: drug interaction checker, calculators, and pill identifier
And more!

 

sanfordguide.com/coronavirus

"In the interest of providing the medical community with concise information about the rapidly changing SARS-CoV-2/COVID-19 situation, Sanford Guide has made its resources related to the pandemic available without a digital subscription."
Access is available on the Web, on IPhone or IPad, and Android devices.

 

Access App

"Learn when you want, where you want, and how you want. Access is your personal medical resource library that makes studying easier and more efficient. Currently available in its preview phase, as early adopters, you have the opportunity to shape the future of optimized and personal medical education. Access personalizes and tailors your medical education experience, giving you the healthcare content you need, on the go, even when you’re offline."

Be sure to create an account on Access Medicine first (on a desktop) and then use those credentials to log into the app.

Inclusive Language & Mental Health Environments

Healthcare is an ever-changing and dynamic environment. It is important that providers in all fields learn the language and skills to compassionately care for patients of vast backgrounds and mental health status. The following PDFs are crafted by the American Hospital Association to help healthcare workers practice such language. Take a look and feel free to print, share and spread the word in your department.

Compassionate SUD Language

Culturally Aware Language

Mental Health Conditions

People First Language

PTSD Supportive Language

Suicide Destigmatizing Language

Medal - The Medical Algorithms Company

Check out the Medical Algorithms Project, now called Medal The Medical Algorithms Company

It has been around for over a decade, and has 1,000s of medical care algorithms for over 45 different specialties in medicine and nursing.  

It was developed by Dr. Sriram Iyengar, Ph.D., of the School of Health information Systems, University of Texas, Houston, and the Institute for Algorithmic Medicine.  For individuals, it is still freely accessible at the URL below. 

You will need to register to gain access; it has iOS and Android apps available. This is an evidence-based clinical decision support tool, with over 22,000 plus calculators and risk scores.  

Here is the URL below:

https://www.medicalalgorithms.com/ 

Open Access Journals & Other Resources

 

Citation Matcher

Catalog: Search for Print Resources 

ABOG Recertification

Reading List for January 2024 is now available!

Access the electronic readings lists below. Note, there will be no August reading list. The Library will no longer be providing print copies of the articles, but we will announce the full reading lists here with live links to each citation. 

 

 

 

  • August 2024 Reading List - Coming Later this year

 

The ACOG Practice Advisory linked below has been added to the 2023 MOC from ABOG in the Emerging Topics section:

Maternal Respiratory Syncytial Virus Vaccination

Articles of Interest - From our Subscriptions

Heartfelt Healing: Charting New Trajectories in Postsurgical Pain

Vanneman, M. , Kiwakyou, L. , Harrison, T. & Mariano, E. (2024). Heartfelt Healing: Charting New Trajectories in Postsurgical Pain. Anesthesia & Analgesia, 138 (6), 1187-1191. doi: 10.1213/ANE.0000000000006871.

Excerpt 

"Despite substantial advances in the perioperative care of cardiac surgical patients that have led to enhanced recovery and improved quality of life, there continues to be a subset of patients who develop chronic postsurgical pain (CPSP). The incidence of CPSP after cardiac surgery has been reported to be as high as 37% at 6 months and up to 17% at 2 years. As with any perioperative complication, identifying which patients may be at greatest risk for CPSP is an essential element in developing a plan to reduce or even eliminate this risk. Knowing which patients are highest risk before surgery is one of the ultimate goals of precision perioperative medicine. While this goal is still yet unrealized, the predictive instruments available to clinicians for this purpose continue to evolve.
Postoperative pain trajectory analyses are tools that facilitate the categorization of patients who are recovering well with mild or resolving pain scores and those with persistently high pain scores who are not meeting expected pain resolution “milestones.” Categorizing patients by pain trajectories has been previously validated in multiple studies examining patients in noncardiac surgery, and a persistently high acute pain trajectory has been associated with CPSP and persistent postoperative opioid use. Less is currently known about pain trajectories after cardiac surgery and their associations with long-term outcomes."

The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Schnurr, P. P. , Hamblen, J. L. , Wolf, J. , Coller, R. , Collie, C. , Fuller, M. A. , Holtzheimer, P. E. , Kelly, U. , Lang, A. J. , McGraw, K. , Morganstein, J. C. , Norman, S. B. , Papke, K. , Petrakis, I. , Riggs, D. , Sall, J. A. , Shiner, B. , Wiechers, I. & Kelber, M. S. (2024). Annals of Internal Medicine, 177 (3), 363-374. doi: 10.7326/M23-2757.

Abstract

Description:

The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. This article summarizes the 2023 clinical practice guideline (CPG) and its development process, focusing on assessments and treatments for which evidence was sufficient to support a recommendation for or against.

Methods:

Subject experts from both departments developed 12 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. Recommendations were made after consensus was reached; they were based on quality and strength of evidence and informed by other factors, including feasibility and patient perspectives. Once the draft was peer reviewed by an external group of experts and their inputs were incorporated, the final document was completed.

Recommendations:

The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions. Six recommendations on PTSD treatment were rated as strong. The CPG recommends use of specific manualized psychotherapies over pharmacotherapy; prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when that therapy has been validated for use with video teleconferencing or when other options are unavailable. The CPG also recommends against use of benzodiazepines, cannabis, or cannabis-derived products. Providers are encouraged to use this guideline to support evidence-based, patient-centered care and shared decision making to optimize individuals' health outcomes and quality of life.
This article summarizes updates from the 2023 U.S. Department of Veterans Affairs and Department of Defense guideline for the management of posttraumatic stress disorder (PTSD) and acute stress disorder. It summarizes changes from the 2017 guideline and describes 34 recommendations in 5 topic areas—assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of PTSD with co-occurring conditions—while highlighting 6 recommendations rated as strong.

Curing pediatric cancer : A global view. Examples from acute lymphoblastic leukemia

Duffy, C. , Hunger, S. P. , Bhakta, N. , Denburg, A. E. , Antillon, F. & Barr, R. D. (2024). Curing pediatric cancer. Cancer, 130 (13), 2247-2252. doi: 10.1002/cncr.35290.

Excerpt:

"Curing children and adolescents with acute lymphoblastic leukemia (ALL) is a 60‐year story of steady, incremental success. Today, for those living in high‐income countries (HICs), more than 90% of children survive at least 5 years and, despite this originally being a universally fatal diagnosis, encouragingly, a definition of cure has also been proposed: remaining in remission at 5 years after completion of treatment, not including cranial radiation.
However, the picture is often very different and highly variable for patients in low‐ and middle‐income countries (LMICs). Several single‐center and countrywide studies in upper middle‐income countries have demonstrated event‐free survival comparable to but slightly lower than in Western Europe (71%–78% in the same era), such as 66% at 15 years in Brazil. However, in low‐income countries, prospects for curing children with ALL are at most 10%, which corresponds to an estimated 9‐ to 10‐fold difference in overall 5‐year survival rates compared to HICs. This difference in global survival rates is termed the “pediatric cancer survival gap.” Although this discrepancy is multifactorial, it highlights an underlying “discovery–delivery gap,” where inequity exists because of failure to translate science for global impact."

 
Levin, M. , Kia, A. , Timsina, P. , Cheng, F. , Nguyen, K. , Kohli-Seth, R. , Lin, H. , Ouyang, Y. , Freeman, R. & Reich, D. (2024). Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial*. Critical Care Medicine, 52 (7), 1007-1020. doi: 10.1097/CCM.0000000000006243.
 

Abstract

OBJECTIVES:

Machine learning algorithms can outperform older methods in predicting clinical deterioration, but rigorous prospective data on their real-world efficacy are limited. We hypothesized that real-time machine learning generated alerts sent directly to front-line providers would reduce escalations.

DESIGN:

Single-center prospective pragmatic nonrandomized clustered clinical trial.

SETTING:

Academic tertiary care medical center.

PATIENTS:

Adult patients admitted to four medical-surgical units. Assignment to intervention or control arms was determined by initial unit admission.

INTERVENTIONS:

Real-time alerts stratified according to predicted likelihood of deterioration sent either to the primary team or directly to the rapid response team (RRT). Clinical care and interventions were at the providers’ discretion. For the control units, alerts were generated but not sent, and standard RRT activation criteria were used.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was the rate of escalation per 1000 patient bed days. Secondary outcomes included the frequency of orders for fluids, medications, and diagnostic tests, and combined in-hospital and 30-day mortality. Propensity score modeling with stabilized inverse probability of treatment weight (IPTW) was used to account for differences between groups. Data from 2740 patients enrolled between July 2019 and March 2020 were analyzed (1488 intervention, 1252 control). Average age was 66.3 years and 1428 participants (52%) were female. The rate of escalation was 12.3 vs. 11.3 per 1000 patient bed days (difference, 1.0; 95% CI, –2.8 to 4.7) and IPTW adjusted incidence rate ratio 1.43 (95% CI, 1.16–1.78; p < 0.001). Patients in the intervention group were more likely to receive cardiovascular medication orders (16.1% vs. 11.3%; 4.7%; 95% CI, 2.1–7.4%) and IPTW adjusted relative risk (RR) (1.74; 95% CI, 1.39–2.18; p < 0.001). Combined in-hospital and 30-day-mortality was lower in the intervention group (7% vs. 9.3%; –2.4%; 95% CI, –4.5% to –0.2%) and IPTW adjusted RR (0.76; 95% CI, 0.58–0.99; p = 0.045).

CONCLUSIONS:

Real-time machine learning alerts do not reduce the rate of escalation but may reduce mortality.
 

Tannis, A. , Miele, K. , Carlson, J. , O'Callaghan, K. , Woodworth, K. , Anderson, B. , Praag, A. , Pulliam, K. , Coppola, N. , Willabus, T. , Mbotha, D. , Abetew, D. , Currenti, S. , Longcore, N. , Akosa, A. , Meaney-Delman, D. , Tong, V. , Gilboa, S. & Olsen, E. (2024). Syphilis Treatment Among People Who Are Pregnant in Six U.S. States, 2018–2021. Obstetrics & Gynecology, 143 (6), 718-729. doi: 10.1097/AOG.0000000000005586.
 

Abstract:

OBJECTIVE:
To describe syphilis treatment status and prenatal care among people with syphilis during pregnancy to identify missed opportunities for preventing congenital syphilis.
METHODS:
Six jurisdictions that participated in SET-NET (Surveillance for Emerging Threats to Pregnant People and Infants Network) conducted enhanced surveillance among people with syphilis during pregnancy based on case investigations, medical records, and linkage of laboratory data with vital records. Unadjusted risk ratios (RRs) were used to compare demographic and clinical characteristics by syphilis stage (primary, secondary, or early latent vs late latent or unknown) and treatment status during pregnancy (adequate per the Centers for Disease Control and Prevention’s “Sexually Transmitted Infections Treatment Guidelines, 2021” vs inadequate or not treated) and by prenatal care (timely: at least 30 days before pregnancy outcome; nontimely: less than 30 days before pregnancy outcome; and no prenatal care).
RESULTS:
As of September 15, 2023, of 1,476 people with syphilis during pregnancy, 855 (57.9%) were adequately treated and 621 (42.1%) were inadequately treated or not treated. Eighty-two percent of the cohort received timely prenatal care. Although those with nontimely or no prenatal care were more likely to receive inadequate or no treatment (RR 2.50, 95% CI, 2.17–2.88 and RR 2.73, 95% CI, 2.47–3.02, respectively), 32.1% of those with timely prenatal care were inadequately or not treated. Those with reported substance use or a history of homelessness were nearly twice as likely to receive inadequate or no treatment (RR 2.04, 95% CI, 1.82–2.28 and RR 1.83, 95% CI, 1.58–2.13, respectively).
CONCLUSION:
In this surveillance cohort, people without timely prenatal care had the highest risk for syphilis treatment inadequacy; however, almost a third of people who received timely prenatal care were not adequately treated. These findings underscore gaps in syphilis screening and treatment for pregnant people, especially those experiencing substance use and homelessness, and the need for systems-based interventions, such as treatment outside of traditional prenatal care settings.

 

American Academy of Pediatrics Resources

As of November 2021, all publications via the AAP have been on a single platform All journals subscribed to by the Library will be housed on the following pages, which will be made available on the Library site:

Briggs

These helpful guides on how to access Briggs Drugs in Pregnancy have been shared by a fellow Ascension Librarian in Wisconsin.

How to get to Briggs Drugs in Pregnancy & Lactation through Lexicomp

Briggs Drugs in Pregnancy & Lactation – via LexiComp [Direct Link]

MKSAP

Medical Knowledge Self-Assessment Program 19: Parts A & B now available for check-out!

Print copies of the latest Parts A & B are available for check-out in the Library Office - not in the stacks! MKSAP 18 IS in the stacks.

The borrowing time for each volume is 2 weeks. There is only a single copy of each volume so please be mindful of your due dates.

If you have a personal subscription to the online content of MKSAP, using the print resource as a supplement is an excellent way to diversify your study game.

Blogs & Podcasts

  • Elsevier Clinical Insights
  • Not Otherwise Specified 
    • "In “Not Otherwise Specified,” Dr. Lisa Rosenbaum, cardiologist and national correspondent for the New England Journal of Medicine, defies our sound-bite culture to go deep with some of medicine’s most innovative thinkers. Her guests’ stories and ideas about health care’s toughest challenges and greatest promise may change the way you think about medicine, health, and society."

Guideline Resources

Academy Websites & Publisher's Open Access  


Official Government Guidelines

The US government's National Guideline Clearinghouse is a repository of US clinical practice guidelines as well as some international guidelines with the goal of improving patient safety standards and healthcare measures.  Click on the NGC links below to take you to the URLs, to the link for the Agency for Healthcare Research and Quality, and to the link to the US government site for the Preventive Taskforce guidelines.

Governments & Free Agency Websites

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