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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. 

 

 

 

 

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

A Prospective Observational Cohort Study of Language Preference and Preoperative Cognitive Screening in Older Adults: Do Language Disparities Exist in Cognitive Screening and Does the Association Between Test Results and Postoperative Delirium Differ Based on Language Preference?

Canales, C. , Ramirez, C. , Yang, S. , Feinberg, S. , Grogan, T. , Whittington, R. , Sarkisian, C. & Cannesson, M. (2024). A Prospective Observational Cohort Study of Language Preference and Preoperative Cognitive Screening in Older Adults: Do Language Disparities Exist in Cognitive Screening and Does the Association Between Test Results and Postoperative Delirium Differ Based on Language Preference?. Anesthesia & Analgesia, 139 (5), 903-911. doi: 10.1213/ANE.0000000000006780.

Abstract

BACKGROUND:

A greater percentage of surgical procedures are being performed each year on patients 65 years of age or older. Concurrently, a growing proportion of patients in English-speaking countries such as the United States, United Kingdom, Australia, and Canada have a language other than English (LOE) preference. We aimed to measure whether patients with LOE underwent cognitive screening at the same rates as their English-speaking counterparts when routine screening was instituted. We also aimed to measure the association between preoperative Mini-Cog and postoperative delirium (POD) in both English-speaking and LOE patients.

METHODS:

We conducted a single-center, observational cohort study in patients 65 years old or older, scheduled for surgery and evaluated in the preoperative clinic. Cognitive screening of older adults was recommended as an institutional program for all patients 65 and older presenting to the preoperative clinic. We measured program adherence for cognitive screening. We also assessed the association of preoperative impairment on Mini-Cog and POD in both English-speaking and LOE patients, and whether the association differed for the 2 groups. A Mini-Cog score ≤2 was considered impaired. Postoperatively, patients were assessed for POD using the Confusion Assessment Method (CAM) and by systematic chart review.

RESULTS:

Over a 3-year period (February 2019–January 2022), 2446 patients 65 years old or older were assessed in the preoperative clinic prior. Of those 1956 patients underwent cognitive screening. Eighty-nine percent of English-speaking patients underwent preoperative cognitive screening, compared to 58% of LOE patients. The odds of having a Mini-Cog assessment were 5.6 times higher (95% confidence interval [CI], 4.6–7.0) P < .001 for English-speaking patients compared to LOE patients. In English-speaking patients with a positive Mini-Cog screen, the odds of having postop delirium were 3.5 times higher (95% CI, 2.6–4.8) P < .001 when compared to negative Mini-Cog. In LOE patients, the odds of having postop delirium were 3.9 times higher (95% CI, 2.1–7.3) P < .001 for those with a positive Mini-Cog compared to a negative Mini-Cog. The difference between these 2 odds ratios was not significant ( P = .753).

CONCLUSIONS:

We observed a disparity in the rates LOE patients were cognitively screened before surgery, despite the Mini-Cog being associated with POD in both English-speaking and LOE patients. Efforts should be made to identify barriers to cognitive screening in limited English-proficient older adults.

Association Between Hospital Type and Resilience During COVID-19 Caseload Stress : A Retrospective Cohort Study

Neupane, M. , Warner, S. , Mancera, A. , Sun, J. , Yek, C. , Sarzynski, S. H. , Amirahmadi, R. , Richert, M. , Chishti, E. , Walker, M. , Swihart, B. J. , Mitchell, S. H. , Hick, J. , Rochwerg, B. , Fan, E. , Demirkale, C. Y. & Kadri, S. S. (9000). Association Between Hospital Type and Resilience During COVID-19 Caseload Stress. Annals of Internal Medicine - Latest, Publish Ahead of Print , doi: 10.7326/M24-0869.

 

Abstract

Background:

Imbalances between hospital caseload and care resources that strained U.S. hospitals during the pandemic have persisted after the pandemic amid ongoing staff shortages. Understanding which hospital types were more resilient to pandemic overcrowding-related excess deaths may prioritize patient safety during future crises.

Objective:

To determine whether hospital type classified by capabilities and resources (that is, extracorporeal membrane oxygenation [ECMO] capability, multiplicity of intensive care unit [ICU] types, and large or small hospital) influenced COVID-19 volume-outcome relationships during Delta wave surges.

Design:

Retrospective cohort study.

Setting:

620 U.S. hospitals in the PINC AI Healthcare Database.

Participants:

Adult inpatients with COVID-19 admitted July to November 2021.

Measurements:

Hospital-months were ranked by previously validated surge index (severity-weighted COVID-19 inpatient caseload relative to hospital bed capacity) percentiles. Hierarchical models were used to evaluate the effect of log-transformed surge index on the marginally adjusted probability of in-hospital mortality or discharge to hospice. Effect modification was assessed for by 4 mutually exclusive hospital types.

Results:

Among 620 hospitals recording 223 380 inpatients with COVID-19 during the Delta wave, there were 208 ECMO-capable, 216 multi-ICU, 36 large (≥200 beds) single-ICU, and 160 small (<200 beds) single-ICU hospitals. Overall, 50 752 (23%) patients required admission to the ICU, and 34 274 (15.3%) died. The marginally adjusted probability for mortality was 5.51% (95% CI, 4.53% to 6.50%) per unit increase in the log surge index (strain attributable mortality = 7375 [CI, 5936 to 8813] or 1 in 5 COVID-19 deaths). The test for interaction showed no difference ( P = 0.32) in log surge index-mortality relationship across 4 hospital types. Results were consistent after excluding transferred patients, restricting to patients with acute respiratory failure and mechanical ventilation, and using alternative strain metrics.

Limitation:

Residual confounding.

Conclusion:

Comparably detrimental relationships between COVID-19 caseload and survival were seen across all hospital types, including highly advanced centers, and well beyond the pandemic's learning curve. These lessons from the pandemic heighten the need to minimize caseload surges and their effects across all hospital types during public health and staffing crises.

Common strategy to diagnose endometrial cancer may not be reliable for Black women

 Nierengarten, M. B. (2024). Common strategy to diagnose endometrial cancer may not be reliable for Black women. Cancer, 130 (22), 3783. doi: 10.1002/cncr.35594.

Excerpt

  • A common diagnostic approach to identifying endometrial cancer based on endometrial thickness (ET) may not be reliable in Black women according to a retrospective study published in JAMA Oncology .
    The study found that up to 11% of the time, according to the level of ET considered, pelvic transvaginal ultrasonography (TVUS) failed to diagnose endometrial cancer in a cohort of Black women.
    Guidelines currently suggest that women with postmenopausal bleeding, a common sign of endometrial cancer, undergo TVUS to assess ET. An ET of 4 mm or greater is a common threshold used to indicate the need for triage for further workup with a tissue biopsy.
 
Scott, B. , Singh, J. , Hravnak, M. , Everhart, S. , Armaignac, D. , Davis, T. , Goede, M. , Haranath, S. , Kordik, C. , Laudanski, K. , Pappas, P. , Patel, S. , Rincon, T. , Scruth, E. , Subramanian, S. , Villanueva, I. , Williams, L. , Wilson, R. & Pamplin, J. (2024). Best Practices in Telecritical Care: Expert Consensus Recommendations From the Telecritical Care Collaborative Network. Critical Care Medicine, 52 (11), 1750-1767. doi: 10.1097/CCM.0000000000006418.
 

Abstract

OBJECTIVES:

Telecritical care (TCC) refers to the delivery of critical care using telehealth technologies. Despite increasing utilization, significant practice variation exists and literature regarding efficacy remains sparse. The Telecritical Care Collaborative Network sought to provide expert, consensus-based best practice recommendations for the design and delivery of TCC.

DESIGN:

We used a modified Delphi methodology. Following literature review, an oversight panel identified core domains and developed declarative statements for review by an expert voting panel. During three voting rounds, voters agreed or disagreed with statements and provided open-ended feedback, which the oversight panel used to revise statements. Statements met criteria for consensus when accepted by greater than or equal to 85% of voters.

SETTING/SUBJECTS:

The oversight panel included 18 multidisciplinary members of the TCC Collaborative Network, and the voting panel included 32 invited experts in TCC, emphasizing diversity of discipline, care delivery models, and geography.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We identified ten core domains: definitions/terminology; care delivery models; staffing and coverage models; technological considerations; ergonomics and workplace safety; licensing, credentialing, and certification; trust and relationship building; quality, safety, and efficiency, research agenda; and advocacy, leading to 79 practice statements. Of 79 original statements, 67 were accepted in round 1. After revision, nine were accepted in round 2 and two in round 3 (two statements were merged). In total, 78 practice statements achieved expert consensus.

CONCLUSIONS:

These expert consensus recommendations cover a broad range of topics relevant to delivery of TCC. Experts agreed that TCC is most effective when delivered by care teams with specific expertise and by programs with explicit protocols focusing on effective communication, technical reliability, and real-time availability. Interventions should be tailored to local conditions. Although further research is needed to guide future best practice statements, these results provide valuable and actionable recommendations for the delivery of high-quality TCC.

 

 
 
Liu, E. , Ferrara, A. , Sridhar, S. , Greenberg, M. & Hedderson, M. (2024). Association Between Neighborhood Deprivation in Early Pregnancy and Gestational Diabetes Mellitus. Obstetrics & Gynecology, 144 (5), 670-676. doi: 10.1097/AOG.0000000000005521.
 

Abstract:

OBJECTIVE:

To evaluate whether having a pregnancy in a deprived neighborhood was associated with an increased risk of gestational diabetes mellitus (GDM) compared with having a pregnancy in the least-deprived neighborhoods.

METHODS:

This was a retrospective observational cohort study of pregnant individuals within Kaiser Permanente Northern California from 2011 to 2018 with residential history from prepregnancy through 24 weeks of gestation and clinical data from prepregnancy through delivery. The primary outcome was a diagnosis of GDM. Neighborhood deprivation was characterized with an index aggregating multiple indicators of Census tract–level sociodemographic information. Mediation analysis using inverse odds ratio weighting estimated the mediation effects of prepregnancy body mass index (BMI), gestational weight gain, smoking tobacco, and illegal drug use before GDM diagnosis.

RESULTS:

Overall, 214,375 pregnant individuals were included, and 11.3% had a diagnosis of GDM. Gestational diabetes prevalence increased with neighborhood deprivation from 10.0% in the lowest Neighborhood Deprivation Index quintile to 12.7% in the highest quintile. Compared with pregnant individuals in the least deprived neighborhoods (quintile 1), pregnant individuals in quintiles 2–5 had elevated risk of GDM (relative risk [95% CI]) when adjusted for maternal age, parity, insurance type, and residential history (quintile 2, 1.17 [1.10–1.23]; quintile 3, 1.38 [1.30–1.46]; quintile 4, 1.54 [1.45–1.63]; quintile 5, 1.71 [1.62–1.82]). There was a dose-response relationship between relative risk of GDM and increasing quintile of neighborhood deprivation ( P for trend <.001). Prepregnancy BMI mediated 45.8% (95% CI, 40.9–50.7%) of the association. Other potential mediators were found to mediate a small if not negligible proportion of this association (2.4–3.6%).

CONCLUSION:

Neighborhood deprivation was associated with GDM, and a considerable proportion of this relationship was mediated by prepregnancy BMI.

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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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