Archive for the ‘Clinical Corner’ Category
Trip Database is an evidence based search filter for research articles, evidence based synopses, DynaMed (an evidence based clinical information tool), and non-evidence based image, video, and news resources. It provides an efficient first stop for searching for evidence based information.
Trip has enabled full text linking to the University of Colorado Anschutz Medical Campus’ journal subscriptions and to PubMed Central’s (PMC) free full text collection.
To set up full text linking, first sign up for an account (your account will facilitate full text linkage, saving searches, and convenient return to prior search topics via the timeline.)
Once you have signed in, alter your profile (via the ‘Setting’ button) by selecting the “University of Colorado Anschutz Medical Campus Health Sciences Library option from the Your Institution menu.
Trip now offers the following resources with its one-stop searching interface:
- DynaMed integration: Click on the DynaMed tab and you’ll see the results. Access to the actual content is only available for those with subscription access – the Health Sciences Library provides a subscription. To utilize this resource through Trip when off-campus, go to the Clinical Tools list, click on Dynamed, and log in as prompted (use your employee or student ID. Hospital staff should put an H in front of their 5 digit ID number). Users may need to repeat this process if your login times out while browsing Trip results.
- Case Reports: Working with BioMedCentral’s Cases Database we’re really pleased to see this interesting collection added to the site.
- Developing World Filter: Working with a slightly modified filter from a Norwegian Cochrane site we have created a specific and sensitive filter to quickly and easily find evidence suitable for low and middle income countries. This is a great tool for evidence based decision making for Global Health projects.
To see these changes, click here.
If you’d like to work with a Health Sciences Librarian to use Trip more efficiently, feel free to set up a consultation. We’re happy to meet in your office to provide the training and consultation you need to efficiently tackle any project!
[Lynne M. Fox, Education Librarian]
With a location like Colorado, we encounter a fair number of cases involving altitude sickness. HAPE or High Altitude Pulmonary Edema is one of the more severe types. How do you find the right articles when looking at the journal literature? The closest Medical Subject Heading for this condition is Altitude Sickness. The search “Altitude Sickness”[MeSH] retrieves at least 2740 citations in PubMed. Synonym keywords you might include for better coverage for your search: Altitude Sickness (2805), Altitude Sicknesses (1), Mountain Sickness (1184), Mountain Sicknesses (1) and you might have other phrases or wording that you might decide to use as well. If you want to focus on particular type of altitude sickness you might need to use keywords and phrases like: HAPE (329) or “high altitude pulmonary edema” (500) or “high altitude pulmonary oedema” (114). This table gives you an idea of how including different synonym phrases can affect the quality of your search retrieval.
|Just the MeSH term||“Altitude Sickness”[MeSH]||2740|
|MeSH with MeSH as keyword phrase and entry term synonyms||“Altitude Sickness”[MeSH] OR “Altitude Sickness” OR “Altitude Sicknesses” OR “Mountain Sickness” OR “Mountain Sicknesses”||3044|
|MeSH with MeSH as keyword phrase and entry term synonyms and other identified synonyms (there could still be more)||“Altitude Sickness”[MeSH] OR “Altitude Sickness” OR “Altitude Sicknesses” OR “Mountain Sickness” OR “Mountain Sicknesses” OR HAPE OR “high altitude pulmonary edema” OR “high altitude pulmonary oedema”||3274|
|Just keyword phrases for HAPE||HAPE OR “high altitude pulmonary edema” OR “high altitude pulmonary oedema”||665|
You can use PubMed’s Clinical Queries to limit any of the above searches to articles about Therapy, Etiology, Prognosis, Clinical Prediction Guides or Diagnosis with a Broad/Sensitive or Narrow/Specific focus. I’ll use the last example with just the keyword phrases for HAPE - Therapy B 163 | N 26, Etiology B 223 | N 15, Prognosis B 72 | N 5, Clinical Prediction Guides B 137 | N 5 or Diagnosis B 172 |N 4.
If you are looking for resources that may help explain this condition to a patient, MedlinePlus has several topics that may help.
Please feel free to comment on the post or contact me if you have clinical pearls, questions or great resource suggestions that we should consider for this column in HSLNews.
John.Jones@ucdenver.edu OR 303-724-2117
Here’s a quick post to introduce a new column/category of the Health Sciences Library News blog. As we have opportunities to interact with and learn from our clinical faculty and staff, we’ll turn that information around and put it out there to our broader clinical audience. Researchers and educators might find it of interest as well. In general, anything that builds synergy and collaboration is probably a good thing.
We already have one posting in Clinical Corner about our new subscription to JAMAevidence, which can help you around all evidence-based medicine searching, article critiques and teaching. Any time you want to see the postings in the Clinical Corner, all you need to do is choose the Clinical Corner category from the Categories drop down menu and there you’ll have it.
Anyway, don’t hesitate to comment on the post or contact me if you have clinical pearls, questions or great resource suggestions that we should consider for this new part of the HSLNews.
John.Jones@ucdenver.edu OR 303-724-2117
PubMed’s Clinical Queries can save you time when trying to incorporate evidence based medicine or evidence based practice into the fast-paced and time sensitive clinical environment or other patient settings. Clinical Queries gives you a fast and easy way to throw in a few search terms and limit to one of five categories – Therapy, Etiology (Harm/Causation), Prognosis, Diagnosis, & Clinical Prediction Guide – and begin to see some of the best types of articles related to the category and your search terms. Clinical Queries also allows you to limit the scope of your search to Broad/Sensitive – where the search includes more citations even if they may be more peripheral or less relevant – or Narrow/Specific – where the search may miss some citations but is trying to identify the most relevant core citations. When you search Clinical Queries to find citations concerning the prevention of deep vein thrombosis (dvt) with the use of compression stockings during traveling, you’ll get results similar to this (Table results searched as of 3/25/2013).
(Harm / Causation)
|Diagnosis||Clinical Prediction Guide|
|deep vein thrombosis||12166||3333||28459||2227||26308||3268||22434||1110||9529||253|
|deep vein thrombosis AND
|deep vein thrombosis AND
compression stockings AND
You can see that as you add applicable search terms with the Boolean operator ‘AND’ you can quickly reduce the number of appropriate citations that you’ll need to wade through to find good relevant evidence to support or deny the use of compression stockings to prevent (prognosis) DVT when traveling.
If this is new to you, schedule a consultation with one of our librarians for more info about using Clinical Queries as well as other searching tips and tricks we can help you with.
[John Jones, Librarian]
At Internal Medicine Report involving a case of potential infection and heroin addiction, one of the infection vectors brought up was – did the person reuse needles? For a lot of practitioners that probably seems like a pretty obvious question but one of the Hospitalists brought up a couple of other transmission vectors for practitioners to consider when looking for potential infection sources when dealing with needle administered drug addictions. Here’s 3 things to think about when working with potential infection and a needle drug addiction:
- Does the person reuse needles?
- Does the person lick the needle before injection?
- Has the person put the needle plunger in their ear?
The hospitalist conveyed that a wide held belief among injection drug users is that licking the needle will make the tip sharper and therefore ease the insertion. You can easily see that if this is their practice, injection drug users are opening themselves up to any number of contaminates from the mouth and saliva.
Did they stick the plunger where? Apparently as needle plungers become less effective, addicts may use ear wax to create a tighter seal to prolong the use of the needle which introduces another transmission vector for infections or pathogens.
If you know of other journal articles, pearls or questions like this or have anything else to add, please comment below or send me the information to update this posting – John.Jones@ucdenver.edu.
Here’s some articles that may be of interest:
- Del Giudice P, Vandenbos F, Boissy C, Cua E, Marion B, Bernard E, Dellamonica P, Counillon E. Cutaneous complications of direct intra-arterial injections in drug addicts. Acta Derm Venereol. 2005;85(5):451-2. PubMed PMID: 16159743. For more articles like this one use Related Articles.
- Del Giudice P. Cutaneous complications of intravenous drug abuse. Br J Dermatol. 2004 Jan;150(1):1-10. Review. PubMed PMID: 14746612. For more articles like this one use Related Articles.
- Ebright JR, Pieper B. Skin and soft tissue infections in injection drug users. Infect Dis Clin North Am. 2002 Sep;16(3):697-712. Review. PubMed PMID: 12371123. For more articles like this one use Related Articles.
- Deutscher M, Perlman DC. Why some injection drug users lick their needles: a preliminary survey. Int J Drug Policy. 2008 Aug;19(4):342-5. doi:10.1016/j.drugpo.2007.06.006. Epub 2007 Jul 26. PubMed PMID: 18638706. For more articles like this one use Related Articles.
- Oh S, Havlen PR, Hussain N. A case of polymicrobial endocarditis caused by anaerobic organisms in an injection drug user. J Gen Intern Med. 2005 Oct;20(10):C1-2. PubMed PMID: 16191149; PubMed Central PMCID: PMC1490230. For more articles like this one use Related Articles.
- Swisher LA, Roberts JR, Glynn MJ. Needle licker’s osteomyelitis. Am J Emerg Med. 1994 May;12(3):343-6. Review. PubMed PMID: 8179747. For more articles like this one use Related Articles.
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Do you teach about Evidence Based Practice? Run a Journal Club? Or, just want to learn more about EBP and critical appraisal? Then, JAMAevidence is the resource for you!
The Health Sciences Library is pleased to provide JAMAevidence (go to J in All Databases), an online resource for learning and teaching about evidence based health care. Available both on and off campus, JAMAevidence includes the full content of the JAMA Users’ Guides to the Medical Literature, The Rational Clinical Examination, Care at the Close of Life, and Core Topics in Evidence-Based Medicine. In addition, calculators, podcasts, education guides, and a host of other tools for teaching, learning, and practicing evidence based clinical care are available. Try it today!