Rational Clinical Examination Series from JAMA

The Society of General Internal Medicine has compiled the Rational Clinical Exam Series from JAMA, focusing on signs and symptoms to answer questions such as:

Does this patient have dementia?

Holsinger T, Deveau J, Boustani M, Williams JW.
JAMA 2007;297:2391-404. PMID: 17551132

PubMed: Abstract - Related articles

Fulltext options: JAMA: html - pdf

Does this dyspneic patient in the emergency department have congestive heart failure?

Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT.
JAMA 2005;294:1944-56. PMID: 16234501

PubMed: Abstract - Related articles

Fulltext options: JAMA: html - pdf

Does this patient with headache have a migraine or need neuroimaging?

Detsky ME, McDonald DR, Baerlocher MO, Tomlinson GA, McCrory DC, Booth CM.
JAMA 2006;296:1274-83. PMID: 16968852

PubMed: Abstract - Related articles

Fulltext options: JAMA: html - pdf

JNC-7: Guidelines for the Treatment of High Blood Pressure

The National Heart Lung and Blood Institute(NHLBI) publishes clinical guidelines for the treatment of hypertension. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure, otherwise known as JNC-7, was published in 2003 and is currently in revision for JNC-8 due out in March 2010 for comment and in final form in summer of 2010.

A JNC-7 Express Guide has been written for primary care.

A JNC-7 Pocket Reference Card contains all the main points in a concise 2 pages.

JNC-7 PDA Application

Printable Patient Diaries

There is an abundance of patient symptom diaries and trackers available on the internet. Many are sponsored by drug companies in hopes that you will prescribe their medication for the symptoms. Others are from associations or foundations devoted to advocacy for a specific disease.

Cigna Insurance has a huge collection of symptom trackers, self-assessments and checklists for patients with topics such as:

• Asthma diary template(What is a PDF document?)
• Blood pressure: Home log(What is a PDF document?)
• Diabetes: Home blood sugar diary(What is a PDF document?)
• Chronic pain diary(What is a PDF document?)
• Heart failure: Sodium record(What is a PDF document?)
• ADHD: Treatment plan record(What is a PDF document?)
• Symptom diary(What is a PDF document?)

The medical librarian blogger at InfoRxCases has assembled a useful list of printable symptom diaries for patients to fill out.

Some topics include:

Health Link BC: Sleep diary
International Foundation for Functional Gastrointestinal Disorders: Bowel disorder symptom diary (pdf)
About.com: Tracking fibromyalgia or chronic fatigue syndrome symptoms
American Urogynecologic Society Foundation: Bladder diary
National Headache Foundation: Headache diary
WebMD: Food diary and food allergy triggers
American Cancer Society's Great American health challenge: Food diary

Symptom Diary from Ovarian Cancer Alliance

DynaMed is going away

Unfortunately, due to budget constraints and low user numbers, the Library will not be renewing DynaMed for 2010. Many of you found this to be a useful tool that you could use from anywhere, but at $9350.00 per year, it was not sustainable. Please feel free to call the Library if you need clinical information--the hospital has onsite access to UptoDate, a similar point of care tool, and I am always glad to send copies of topics as needed, or other resources.

Resources for Helping Patients with Obesity

Yale's Rudd Center for Food Policy and Obesity offers several resources for communicating with patients about obesity without harming.

Toolkit for Preventing Weight Bias: Helping without Harming in Clinical Practice
AMA's Primer for Physicians on Assessment and Management of Adult Obesity

Handouts:

• Promoting a Positive Office Environment for Obese Patients
• Checklist for Assessing the Office Environment
• Motivational Interviewing Strategies
• Motivational Interview Example Scripts
• Assessing Weight Bias with Validated Measures
• Pediatricians: How to Talk to Parents

Featured Library Book: Difficult Conversations in Medicine

Difficult Conversations in Medicine, edited by Elisabeth Macdonald, is a collection of essays about effective communication between health care professionals, patients, and families. Topics range from legal and ethical issues, to planning for such conversations, apologies, strong emotions and cross-cultural issues. Dr. Macdonald is a Consultant Clinical Oncologist from London, and writes in the context of the NHS and , and mostly from the point of view of physicians but will also be useful to other healthcare professionals. Finally, there is an appendix of transcriptions of illustrative conversations in order to see how others have approached them. A review of this book is available in the Journal of the Royal Society of Medicine. You can find this book on the shelves at the library at W 62 D569 2004.

Related:
Cecil Textbook of Medicine
A Practical Guide to Palliative Care
Medical Management of Vulnerable and Underserved Patients

Searching for Articles with PubMed

The gold standard database of medical journal abstracts is PubMed/Medline, a service of the US National Library of Medicine, which indexes 5300+ biomedical journals.

Frequently Asked Questions:

Is there a fee for using PubMed?

You can get to PubMed from any computer at any location free of charge, because it is a public database.

Is there a username and password?
Just go to http://pubmed.gov/. That's it, no username or password required.

Are there actual full text articles in PubMed?
Yes, there are some free full text articles available. Some are provided by the journal publishers, and others are from PubMed Central(PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature. Here is a list of the PMC Journals.

How do I find the free full text articles?

After entering your topic, a link on the right hand side of the screen will alert you to the number of free full text articles. Screen shots of PubMed.

Why can't I get to the article I want?

If there is a link to full text, but you get the dreaded "you are attempting to access restricted content" message, or a screen asking for a username and password or the link is no longer valid, and you still want the article, you will need to provide a credit card number for "pay per view" to the publisher.

Can I search just nursing journal articles?

Go to Advanced Search, and scroll down to Limit by Topics, Languages and Journal Groups, and under subsets choose "Nursing Journals."

PubMed doesn't look the same. What happened?

PubMed was redesigned with a new interface in November 2009.

Where do I find more information?

PubMed Redesign from NLM Technical Bulletin

PubMed Ten Tips from UNC-Chapel Hill

PubMed Tutorial from NLM

Related Posts

PubMed Redesign: Where has it gone?