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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

 

Top Medical Journals

Citation Matcher

Titles From Our Print Collection

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. 

 

 

  • May 2023 Reading List - Coming Later this year

 

  • 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

Teaching Airway Management Using Virtual Reality: A Scoping Review

Duffy, C. , Bass, G. , Yi, W. , Rouhi, A. , Kaplan, L. & O’Sullivan, E. (2024). Teaching Airway Management Using Virtual Reality: A Scoping Review. Anesthesia & Analgesia, 138 (4), 782-793. doi: 10.1213/ANE.0000000000006611.

Abstract

Airway management, a defined procedural and cognitive skillset embracing routine tracheal intubation and emergency airway rescue, is most often acquired through an apprenticeship model of opportunistic learning during anesthesia or acute care residency training. This training engages a host of modalities to teach and embed skill sets but is generally time- and location-constrained. Virtual reality (VR)-based simulation training offers the potential for reproducible and asynchronous skill acquisition and maintenance, an advantage that may be important with restricted trainee work hours and low frequency but high-risk events. In the absence of a formal curriculum from training bodies—or expert guidance from medical professional societies—local initiatives have filled the VR training void in an unstructured fashion. We undertook a scoping review to explore current VR-based airway management training programs to assess their approach, outcomes, and technologies to discover programming gaps. English-language publications addressing any aspect of VR simulation training for airway management were identified across PubMed, Embase, and Scopus. Relevant articles were used to craft a scoping review conforming to the Scale for quality Assessment of Narrative Review Articles (SANRA) best-practice guidance. Fifteen studies described VR simulation programs to teach airway management skills, including flexible fibreoptic bronchoscopic intubation (n = 10), direct laryngoscopy (n = 2), and emergency cricothyroidotomy (n = 1). All studies were single institution initiatives and all reported different protocols and end points using bespoke applications of commercial technology or homegrown technologic solutions. VR-based simulation for airway management currently occurs outside of a formal curriculum structure, only for specific skill sets, and without a training pathway for educators. Medical educators with simulation training and medical professional societies with content expertise have the opportunity to develop consensus guidelines that inform training curricula as well as specialty technology use.

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.

The association between food access and frailty among older adults with gastrointestinal malignancies—The CARE Registry

Fowler, M. E. , Harmon, C. , Sharafeldin, N. , Baker, E. , Oates, G. , Nassel, A. , Clausing, D. , Giri, S. & Williams, G. R. (2024). The association between food access and frailty among older adults with gastrointestinal malignancies—The CARE Registry. Cancer, 130 (7), 1083-1091. doi: 10.1002/cncr.35144.

INTRODUCTION

"Older adults are the fastest growing subset of the US population. 1 The risk of cancer increases with advancing age, and most cancers are diagnosed among older adults. 2 By 2040, nearly 70% of all new cancer diagnoses will be in older adults, and the number of adults aged 85 years and older who develop cancer is expected to more than double in the United States. 3 Gastrointestinal (GI) cancers are particularly more common among older adults (percentage of incident cases: aged 65 years and older, 58.5%; younger than 65 years, 41.4%; median age at diagnosis, 67 years). 4
Clinical management and treatment of older adults with GI cancers are complicated by aging‐related syndromes, such as frailty. 5 , 6 Frailty is a syndrome characterized by decreased physiologic reserve and ability to resist stress, ultimately leading to decline across multiple organ systems, decreased physical activity, and poor nutritional status. 7 , 8 Frailty is more prevalent in patients with cancer than in the general population because of accelerated aging associated with cancer diagnosis and treatment. 9 Frailty can also increase the risk for treatment toxicity, reduced health‐related quality of life, institutionalization, and mortality. 9 , 10 , 11 , 12 Therefore, whereas the relative effect of frailty in older adults with cancer is similar to that without cancer, the cumulative effect becomes greater in those with cancer.
Upstream factors, such as genetics and environment, can influence the development of frailty. 8 According to the Healthy People 2030 framework, social determinants of health (SDOH) are a key set of environmental factors defined as the environmental conditions where people are born, live, learn, work, play, worship, and age that affect a wide range of risks and outcomes, including health, functional, and quality‐of‐life outcomes. SDOH can be subdivided into five domains with various area‐level and person‐level measures across each domain: (1) economic stability, (2) education access and quality, (3) health care access and quality, (4) neighborhood and built environment, and (5) social and community context. 13 Food access is an important SDOH marked by limited access to supermarkets, supercenters, grocery stores, or other healthy, affordable food because of either income or distance and can be due to issues in SDOH domains of economic stability and/or neighborhood and built environment. 13 , 14 Prior studies demonstrated differences in survival for breast, colorectal, and GI cancer populations among those with poorer food access, but these cohorts were generally younger than 65 years, even though older adults have a high rate of low food access and the greatest risk for cancer incidence and mortality. 4 , 15 , 16 , 17
Geriatric assessment (GA) is a recommended part of routine clinical care for older adults with cancer and is used in part to identify aging‐related impairments like frailty. 5 , 18 , 19 GA typically involves evaluation and management of deficits like frailty and has demonstrated the ability to predict treatment toxicity, mortality, and other adverse outcomes. 5 SDOH evaluation in the clinic setting is still relatively novel. 20 Therefore, our objective was to evaluate the association between food access and GA‐identified frailty among older adults with GI cancers."
 
Tonna, J. (2024). More Evidence That We Should be Using Resuscitative Extracorporeal Membrane Oxygen Among the “Not Quite Dead Yet?”: The Importance of Signs of Life Before Extracorporeal Cardiopulmonary Resuscitation Cannulation*. Critical Care Medicine, 52 (4), 659-663. doi: 10.1097/CCM.0000000000006146.
 

Excerpt

"Extracorporeal membrane oxygen (ECMO) is well established as a resuscitative adjunct or treatment modality in severe respiratory failure ( 1), refractory cardiogenic shock ( 2 , 3), and during sudden cardiac arrest ( 4 , 5)—where it can be applied during active chest compressions and is known as extracorporeal cardiopulmonary resuscitation (ECPR). Acknowledging some controversy over optimal use, we can observe that survival on ECMO is better among patients who are alive and have a pulse at the time of cannulation than among patients who are not and do not. Further, among patients who receive ECMO, be it for respiratory failure, cardiogenic shock, or cardiac arrest, observational data suggest earlier initiation ( 6–8) and initiation among lower severity of illness ( 9) is generally associated with better outcomes. What is relatively unknown is exactly how early.
It is against this brief summary of adult ECMO that we discuss the significance of signs of life (SOL) among patients who have cardiac arrest. SOL are physical manifestations of cerebral activity, and include gasping, movement, and pupillary reflexes. It has been previously shown that +SOL during cardiac arrest resuscitation are associated with improved outcomes, although data are sparse ( 10 , 11). Furthermore, research into the prognostic value of these SOL has been limited given the rarity of the outcome of interest (survival), and the fact that a given prognostic factor (e.g., SOL) has limited utility in situations where we cannot control the outcome. In the situation of out-of-hospital cardiac arrest (OHCA), by 20 minutes of refractory arrest, only 5% of patients survive ( 12); prognostic factors are not needed when the outcome is nonmodifiable death."
Barbera, J. , Cichon, B. , Ankam, N. & Schwartz, B. (2024). Equitable Care for Patients With Disabilities. Obstetrics & Gynecology, 143 (4), 475-483. doi: 10.1097/AOG.0000000000005493.
 

Abstract:

"All patients deserve high-quality health care. Patients with disabilities have historically experienced discrimination in health care and subsequently detrimental health outcomes. Health care professionals often lack confidence and preparedness in treating patients with disabilities effectively. Barriers such as communication difficulties, biased assumptions, and inadequate equipment hinder comprehensive care. These barriers to care lead to health inequalities and a diminished overall quality of life for individuals with disabilities. Existing clinical guidelines for care of this underserved population are lacking. This article establishes a comprehensive educational framework and accessible reference tools for gynecologic health care professionals to enhance their ability to offer inclusive and effective care to patients with disabilities. Insights in this article stem from expert consensus among clinicians experienced in this field and ongoing dialog with community-based disability care partners. We present actionable steps to cultivate an open, adaptable, and patient-centric method to actively engage patients and to provide suitable accommodations when needed."

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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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