Friday, May 11, 2012
Medical references 2012
Medical References
Last modified by John Faughnan on 2012 May 11 09:44
References to answer QM related questions. The cost of medical references seems to be rising.
Pharmacology
- ePocrates for iOS: free for clinicians. Topical but limited therapeutic information, almost no pharmacology.
- MPR: Concise prescription and OTC drug information. Ad supported. I'm fond of this one for quick lookups. (iOS app as well). The form of the search URL works well with Chrome (http://www.empr.com/search/%s/type-Drug)
Online Reference: General IM
- Diseases & Conditions - eMedicine (MedScape) Reference
- THE MERCK MANUALS: sometimes dated, not highest quality - but free
- Up To Date: industry leader for online references. Currently we don't have a license
Infectious Disease
- Sanford antimicrobial therapy (self-published, I think it's only available as a booklet or an App). I have the iOS version ($30)
Oncology
UMN references (requires UMN login)
- STAT!Ref: AHFS DRUG INFORMATION® (2012). A great reference, but, even by the standards of online textbooks, the STAT!Ref UI is unusually bad
- MICROMEDEX® 2.0: rivals AHFS
- First Consult/MD Consult: Includes Saunders, Elsevier, Mosby.
- MD Consult: Johns Hopkins: The Harriet Lane Handbook
- MD Consult: Kumar: Robbins and Cotran Pathologic Basis of Disease, Professional Edition
- MD Consult: McPherson: Henry's Clinical Diagnosis and Management by Laboratory Methods
- MD Consult: Goldman: Goldman's Cecil Medicine
- MD Consult: Bope and Kellerman: Conn's Current Therapy 2012
- MD Consult: Habif: Clinical Dermatology
- Rheumatology Primer: It's a set of chapter PDFs. The UI is awful, but they can be saved locally.
- E-Books in the Health Sciences: Includes Cecil's, Harrisons. Some are older (Washington Manual 2007) reflecting turmoil in this industry
- AccessMedicine: similar to above, but Goodman and Gilman, Current Medical Dx and Treatment (2012)
- Google Scholar with integrated full text link (umn)
- PubMed with integrated full text link (umn)
- OVID MEDLINE; Full text, through UMN
Monday, March 15, 2004
Orton-Gillingham approach to learning to read
Sensational Strategies for Teaching Beginning Readers
Despite its roots in teaching rather well off children this approach is gaining favor in special education circles and among clinical neuropsychologists.
The costs of professional tutoring in Orton-Gillingham (used in leading centers across the country) range from $30.00 to $55.00 for a 50 minute hour. Normally, children are seen multiple times each week. As you can see, the cost of 'Sensational Strategies for Teaching Beginning Readers' is quite small in comparison.
Despite its roots in teaching rather well off children this approach is gaining favor in special education circles and among clinical neuropsychologists.
Saturday, August 30, 2003
Orthopedics: add to my low back pain notes
Orthopedics
For acute severe low back pain (torn muscle, etc):
1. Tru-Fit "one size back/shoulder polar-preene wrap": It's a neoprene belt with a mesh poush. You put a gel pack in the pouch. Roughly $16 with a gel pack.
2. Gott Blue Block "ice" for cooler. Flat, about 6"x3"x1". Contains antifreeze, so is colder than ice. Risk of cold injury if poor circulation. I liked the hard brick pressure. An Ace reusable cold compress is safer and softer.
3. Canes. Lightweight cane is a fantastic aid to early ambulation.
4. Motrin, optional additional vicodin for day 1-2.
5. encourage ambulation.
For acute severe low back pain (torn muscle, etc):
1. Tru-Fit "one size back/shoulder polar-preene wrap": It's a neoprene belt with a mesh poush. You put a gel pack in the pouch. Roughly $16 with a gel pack.
2. Gott Blue Block "ice" for cooler. Flat, about 6"x3"x1". Contains antifreeze, so is colder than ice. Risk of cold injury if poor circulation. I liked the hard brick pressure. An Ace reusable cold compress is safer and softer.
3. Canes. Lightweight cane is a fantastic aid to early ambulation.
4. Motrin, optional additional vicodin for day 1-2.
5. encourage ambulation.
Friday, July 25, 2003
Management of Carpal Tunnel Syndrome - July 15, 2003 - American Family Physician
Summary
- hypalgesia and weak thumb abduction predict abnormal nerve conduction
studies. - splint the wrist in a neutral position and ultrasound therapy.
- local corticosteroid injections can help
- nonsteroidal anti-inflammatory drugs, pyridoxine, and diuretics don't
work - treat conservatively (splint) in pregnant women, resolves after delivery
- Nonspecific flexor tenosynovitis is the most common cause
History
- flick sign: "flick" wrist as if shaking down a thermometer for relief
Nerve Conduction Studies
NCS findings have only a loose association with symptoms. In one popn study
(below) having symptoms tripled the probability of a positive study, but the
half of studies in symptomatic patients are negative. Would be very good to know
what happened over time to the asymptomatic group with a positive NCS.
- 15%: pain, numbness, or tingling median nerve distn.
- half had neuropathy by NCS
- clinical certainty did not predict NCS findings
- a subgroup of pts. with no symptoms hand NCS done:
- 18% had median nerve neuropathy by NCS
Treatment
- this paper includes an instrument for predicting the outcome of
conservative treatment. If probability of success is low, consider early
surgery?
- risk factors for failure: > 10 months, constant parathesias, trigger
digits, age > 50, phalen +ve<30 sec
- risk factors for failure: > 10 months, constant parathesias, trigger
- outcomes
- Only 1/6 pts have long term relief with conservative mgt (80% initial
response, but only 1/5 of those do not recur by 1 year) - 2/3 patients very satisfied 6/18/30 mo post surgery
- Only 1/6 pts have long term relief with conservative mgt (80% initial
- injection: 10 of lidocaine (Xylocaine) without epinephrine and 40 mg of
methylprednisolone acetate (Depo-Medrol)