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Lewis P. Gundry Health Sciences Library

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Medical Databases & Platforms

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Cochrane Database of Systematic Reviews

PubMed

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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

 

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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. 

 

 

 

 

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

Quality of Recovery After Unplanned and Planned Cesarean Deliveries: A Prospective Observational Study Using the Obstetric Quality of Recovery-10 Tool

Morales, J. , Gomez, A. , Carvalho, J. , Ye, X. , Downey, K. & Siddiqui, N. (2024). Quality of Recovery After Unplanned and Planned Cesarean Deliveries: A Prospective Observational Study Using the Obstetric Quality of Recovery-10 Tool. Anesthesia & Analgesia, 139 (4), 754-760. doi: 10.1213/ANE.0000000000006876.

Abstract

BACKGROUND:

There is a paucity of literature examining the differences between patient-reported outcome measures after planned and unplanned cesarean delivery using a validated quality of recovery tool. The Obstetric Quality of Recovery-10 (ObsQoR-10) scoring tool has been validated to quantify functional recovery after cesarean delivery. We aimed to use the ObsQoR-10 to compare the postoperative recovery characteristics of patients undergoing planned and unplanned cesarean deliveries.

METHODS:

We conducted a prospective single-center observational study. Patients undergoing planned and unplanned cesarean deliveries under neuraxial anesthesia were asked to complete the ObsQoR-10 questionnaire 24 hours, 48 hours, and 1 week postpartum. We collected information on total in-hospital postoperative opioid consumption and patients´ perception of readiness for discharge at 24 and 48 hours postpartum. Additionally, patient characteristics were collected to assess their correlation with our findings.

RESULTS:

We included 112 patients (56 in each group). No statistical differences in ObsQoR-10 scores at 24 hours, 48 hours, and 1 week postpartum were observed between the planned and unplanned cesarean deliveries. Additionally, there was no difference between the groups in patients’ perception of readiness for hospital discharge at 24 and 48 hours and opioid consumption in the first 2 days after surgery. Most patients in both groups did not think they would be ready for discharge at 24 hours postpartum. Analysis of the individual components of ObsQoR-10 at 24 hours showed a difference in the responses assessing the severity of shivering (higher in unplanned cesarean deliveries) and the ability to look after personal hygiene (lower in unplanned cesarean deliveries).

CONCLUSIONS:

As assessed by the ObsQoR-10, no significant difference in the quality of recovery was observed between patients undergoing planned and unplanned cesarean delivery.

Fatal and Nonfatal Firearm Injury Rates by Race and Ethnicity in the United States, 2019 to 2020

Kaufman, E. J. , Song, J. , Xiong, R. , Seamon, M. J. & Delgado, K. M. (2024). Annals of Internal Medicine, 177 (9), 1157-1169. doi: 10.7326/M23-2251.

Abstract

Background:

Racial disparities in firearm injury death in the United States are well established. Less is known about the magnitude of nonfatal and total firearm injury.

Objective:

To combine health care data with death certificate data to estimate total firearm injuries in various racial and ethnic groups.

Design:

Retrospective, cross-sectional study.

Setting:

Fatal injury data were collected from the Centers for Disease Control and Prevention. Data on nonfatal injuries were collected from the Nationwide Emergency Department Sample (NEDS), a 20% stratified sample of U.S. emergency department visits, weighted to provide national estimates for the United States, 2019 to 2020.

Participants:

All firearm injuries and deaths in the United States.

Intervention:

Race and ethnicity were classified into 5 mutually exclusive categories: Asian or Pacific Islander, Black, Hispanic, Native American, and White. International Classification of Diseases, 10th Revision codes were used to classify firearm injury intent.

Measurements:

Incidence of fatal and nonfatal injury in the U.S. population and case-fatality ratios (CFRs).

Results:

There were 252 376 total firearm injuries, including 84 908 deaths from firearm injures. Of all firearm injuries, 37.8% were unintentional, 37.3% were assault related, 21.0% were self-harm, and 1.3% were law enforcement associated. Self-harm had the highest CFRs (90.9% overall). Unintentional injuries accounted for just 1021 (1.2%) deaths but 94 433 (56.4%) of nonfatal injuries. Rates of self-harm were highest among White persons (11.0 per 100 000 population in 2020) followed by Native Americans (8.6 per 100 000). Rates of assault were highest among Black persons (70.1 per 100 000), as were unintentional injuries (56.1 per 100 000).

Limitation:

Findings are limited by the accuracy of discharge coding in NEDS, particularly regarding injury intent and patient race and ethnicity.

Conclusion:

From 2019 to 2020, the total burden of firearm injuries amounts to an average of 1 injury every 4 minutes and 1 death every 12 minutes in the United States. Racial disparities in firearm injury death are mirrored in nonfatal injury.

Primary Funding Source:

None.
Racial disparities in firearm injury death in the United States are well established, but less is known about the magnitude of nonfatal and total firearm injury. This study leverages several national data sources to estimate fatal and nonfatal firearm injuries and their underlying causes across racial and ethnic groups in the United States.

Evolving patterns and clinical outcome of genetic studies performed at diagnosis in acute myeloid leukemia patients : Real life data from the PETHEMA Registry

 Labrador, J. , Martínez‐Cuadrón, D. , Boluda, B. , Serrano, J. , Gil, C. , Pérez‐Simón, J. A. , Bernal, T. , Bergua, J. M. , Martínez‐López, J. , Rodríguez‐Medina, C. , Vidriales, M. B. , García‐Boyero, R. , Algarra, L. , Polo, M. , Sayas, M. J. , Tormo, M. , Alonso‐Domínguez, J. M. , Herrera, P. , Lavilla, E. , Ramos, F. , Amigo, M. L. , Vives‐Polo, S. , Rodríguez‐Macías, G. , Mena‐Durán, A. , Pérez‐Encinas, M. M. , Arce‐Fernández, O. , Cuello, R. , Sánchez‐García, J. , Gómez‐Casares, M. T. , Chillón, M. C. , Calasanz, M. J. , Ayala, R. , Rodriguez‐Veiga, R. , Barragán, E. & Montesinos, P. (2024). Evolving patterns and clinical outcome of genetic studies performed at diagnosis in acute myeloid leukemia patients. Cancer, 130 (20), 3436-3451. doi: 10.1002/cncr.35431.

Introduction

  • Over the past 2 decades, extensive efforts have been made to identify genetic and molecular markers that can predict the outcome of acute myeloid leukemia (AML) patients and guide their treatment. These efforts have led to the discovery of several prognostic markers and actionable mutations, for which screening is currently recommended at diagnosis in routine clinical practice. ,  For instance, mutations in the FMS‐like tyrosine kinase 3 (FLT3) gene, which occur in approximately 30% of AML patients, have been associated with poor prognosis and could be used to guide post‐remission therapy based on its allele ratio and the patient's NPM1 mutational status. ,  ,  Nevertheless, with the development of tyrosine kinase inhibitors (TKIs), such as midostaurin or gilteritinib, patients with FLT3‐ITD AML are now considered to be in the intermediate group, regardless of their allelic ratio or the presence of NPM1 mutation. ,  ,  In a similar vein, genetic mutations affecting nucleophosmin 1 ( NPM1 ) gene have been found between 21% and 27% of AML patients and linked to a favorable prognosis. ,  ,  Consequently, such mutations have been implemented as prognostic markers in various treatment algorithms adjusted to the risk levels. Based on a recent meta‐analysis assessing additional cytogenetic abnormalities in this population, NPM1 ‐mutated AML patients with adverse cytogenetic abnormalities have been reclassified as adverse risk. , 
    Despite the increasing availability and use of genetic and molecular panel screening at diagnosis, these prognostic markers or actionable mutations may not always be available in routine practice, and therefore a proportion of patients will not be screened. Moreover, the landscape of genetic and molecular markers has evolved rapidly over the past few years, with the emergence of novel targeted therapies, ,  such as mutations in isocitrate dehydrogenase 1 and 2 (IDH1/2) or spliceosome mutations. Certainly, the diagnostic needs for AML patients have gain in complexity across past decades, and it is possible that real life practices do not match with current expert recommendations, ,  ,  ,  ,  especially in some populations. As far as we know, there are no studies assessing the evolution and patterns of genetic and biological studies performed at diagnosis in AML patients. Such studies could be helpful to identify potential gaps in our present diagnostic practices.
    The REALMOL study (NCT05541224) describes main genetic and molecular studies performed at diagnosis in adult AML patients included in the PETHEMA AML registry (NCT02607059) through last 20 years.
 
Harlan, E. , Ghous, M. , Moscovice, I. & Valley, T. (2024). Characteristics of Patients Hospitalized in Rural and Urban ICUs From 2010 to 2019. Critical Care Medicine, 52 (10), 1577-1586. doi: 10.1097/CCM.0000000000006369.
 

Abstract

OBJECTIVES:

Rural hospitals are threatened by workforce shortages and financial strain. To optimize regional critical care delivery, it is essential to understand what types of patients receive intensive care in rural and urban hospitals.

DESIGN:

A retrospective cohort study.

SETTING AND PATIENTS:

All fee-for-service Medicare beneficiaries in the United States who were 65 years old or older hospitalized in an ICU between 2010 and 2019 were included. Rural and urban hospitals were classified according to the 2013 National Center For Health Statistics Urban-Rural Classification Scheme for Counties. Patient comorbidities, primary diagnoses, organ dysfunction, and procedures were measured using the International Classification of Diseases , 9th and 10th revisions diagnosis and procedure codes. Standardized differences were used to compare rural and urban patient admission characteristics.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

There were 12,224,097 ICU admissions between 2010 and 2019, and 1,488,347 admissions (12.2%) were to rural hospitals. The most common diagnoses in rural hospitals were cardiac (30.3%), infectious (24.6%), and respiratory (10.9%). Patients in rural ICUs had similar organ dysfunction compared with urban hospitals (mean organ failures in rural ICUs 0.5, sd 0.8; mean organ failures in urban ICUs 0.6, sd 0.9, absolute standardized mean difference 0.096). Organ dysfunction among rural ICU admissions increased over time (0.4 mean organ failures in 2010 to 0.7 in 2019, p < 0.001).

CONCLUSIONS:

Rural hospitals care for an increasingly complex critically ill patient population with similar organ dysfunction as urban hospitals. There is a pressing need to develop policies at federal and regional healthcare system levels to support the continued provision of high-quality ICU care within rural hospitals.

 

 
 
Larish, Alyssa MD; Long, Margaret E. MD. Diagnosis and Management of Cervical Squamous Intraepithelial Lesions in Pregnancy and Postpartum. Obstetrics & Gynecology 144(3):p 328-338, September 2024. | DOI: 10.1097/AOG.0000000000005566 
 

Abstract:

"Perinatal care provides important health care opportunities for many individuals at risk for cervical cancer. Pregnancy does not alter cervical cancer screening regimens. ASCCP risk-based management has a colposcopy threshold of a 4% immediate risk of cervical intraepithelial neoplasia (CIN) 3 or cancer, but the actual risk can be considerably higher based on current and past screening results. Improving cervical cancer outcomes with diagnosis during pregnancy rather than postpartum and facilitating further evaluation and treatment postpartum for lesser lesions are the perinatal management goals. Although colposcopy indications are unchanged in pregnancy, some individuals with lower risk of CIN 2–3 and reliable access to postpartum evaluation may defer colposcopy until after delivery. Cervical intraepithelial neoplasia diagnosed in pregnancy tends to be stable, with frequent regression postpartum, though this is not universal. Colposcopic inspection during pregnancy can be challenging. Although biopsies in pregnancy are subjectively associated with increased bleeding, they do not increase complications. Endocervical curettage and expedited treatment are unacceptable. Treatment of CIN 2–3 in pregnancy is not recommended. Excisional biopsies in pregnancy are reserved for suspicion of malignancy that cannot be confirmed by colposcopic biopsy and when excisional biopsy results would alter oncologic or pregnancy care. Surveillance of high-grade lesions in pregnancy uses human papillomavirus-based testing, cytology, and colposcopy, with biopsy of worsening lesions every 12–24 weeks from diagnosis until postpartum evaluation. Mode of delivery does not definitively affect persistence of CIN postpartum. Postpartum care may involve a full colposcopic evaluation or expedited excisional procedure if indicated."

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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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