Merck Medicus: Free Access to Merck Manual and More

The Merck Manual Professional Edition is a manual of diagnosis and treatment. Merck provides the content of these Merck Manuals on the web for free (visit www.merckmanuals.com). Registration is not required, and use is unlimited. The web publications are continuously updated to ensure that the information is as up-to-date as possible.

In 1899, the American drug manufacturer Merck & Co. first published a small book titled Merck's Manual of the Materia Medica. It was meant as an aid to physicians and pharmacists, reminding doctors that “Memory is treacherous.” Compact in size, easy to use, and comprehensive, The Merck Manual (as it was later known) became a favorite of those involved in medical care and others in need of a medical reference. Even Albert Schweitzer carried a copy to Africa in 1913, and Admiral Byrd carried a copy to the South Pole in 1929.

Merck offers Merck Medicus, to qualified health professionals in the United States with registration. Additional resources include Harrison's, access to PDA applications, and full text journals.

NOTE: By providing your information and clicking on the Register button, you agree that Merck, the companies with whom Merck collaborates to jointly offer products and services, and the companies working on their behalf may contact you via email regarding product information, site enhancements, special offers, educational opportunities, additional resources, programs and information about Merck.

For purposes of this consent, you can manage your contact preferences, including a request not to be contacted by e-mail, by clicking Edit My Info from the MerckMedicus home page upon sign in.

Clinical Cases Online

Clinical Cases and Images is a useful resource that brings together various pearls of medical wisdom and aims to bridge the gap between clinical theory and practice.

Learn by reading case studies, such as this one about an 84 year old woman admitted for COPD exacerbation: http://clinicalcases.blogspot.com/2004/02/copd-vs-chf-exacerbation.html

And these cases are in test format:
Anemia with hemoglobin 4.2 mg/dL. What is the cause?

Shortness of breath and diffuse ground glass pattern on CT of the chest. What is the cause?

Abdominal pain in a 93-year-old male. What is the cause?

Elderly female with CHF complains of abdominal pain, nausea and vomiting, dizziness, and confusion for 5 days. What is the cause?

Most of the contributors to the web site are physicians at Cleveland Clinic or Case Western Reserve University (St. Vincent/St. Luke) Internal Medicine Residency Program (the blog web site is maintained by Dr. Dimov alone).

Related Posts on Pearls:

Current Psychiatry Online Pearls
PURL's from Journal of Family Practice
Tips on Prescribing for Walmart
Neurology E-Pearls of the Week
CT is Us: Radiology Pearls

Finding Free Articles in PubMed

PubMed does have some free full text articles, and the following screens show the places to look to see if an article is free:

In PubMed results, in the default Summary display format, the "Free article" link under a citation indicates that free full text of the article is available (Figure 1).

The "Free article" link opens the citation in Abstract display where users can choose icon links to the full text (Figure 2).


Additional access to other free full text articles (if available) also appears on the search results screen (Figure 3). The "Free Full Text" filter in the upper right narrows the search results to only citations with free full text. Also, free full text articles in PubMed Central are indicated.
TIP: Sometimes articles are no longer on the publisher's website but will still be in PubMed Central.


Information from NLM's FAQ.

Medical Images from Hardin MD on your mobile device

Hardin MD Gallery Collections are going mobile. Hardin MD Mobile makes it easier to see the medical images in their entirety on a mobile screen. The first collection to mobile:

Free public-domain galleries

Images include many skin manifestations, such as scabies, measles, thrush, and psoriasis.

Patient Education Search Engine

Check out this custom search engine for Patient Education Handouts by David Rothman. This (recently re-created) Custom Search Engine searches authoritative and trusted consumer health information and patient education resources recommended by the U.S. National Library of Medicine and/or by CAPHIS (the Consumer and Patient Health Information Section of the Medical Library Association).

Consumer Health and Patient Education Information Search Engine

Systematic Reviews: Knowing Where the Evidence Came From

Systematic Reviews are a key part of any research you do on a topic, because as the name implies, the evidence is reviewed systematically, with a formal plan, and the reader gets to know what the plan is, and how it was executed. Hopefully you will be getting more than someone's opinion about the medical literature, but instead an evaluation using specific criteria of quality. The biggest challenge with Systematic Reviews is that since they are so thorough, they can take a long time to be published, so the topic you are interested in might not have any, or be out of date.

A Narrative Review article is much more common. An author gives a summary or overview of the evidence, but doesn't have to tell you how they searched for the evidence, how many articles they looked at, or what their criteria was in deciding which articles to include.

TABLE 1. Contrasting systematic review and the methods of other types of reviews¹

Systematic review (minimum criteria) Other types of reviews A protocol (ie, working plan for the systematic review) is developed, along with a clearly formulated question. A protocol is not used, and the question may not be clear and concise. The literature is searched broadly by using many different methods (eg, searching multiple relevant databases, contacting experts, or scanning reference lists). The search strategy, including databases and years searched and search terms employed, is transparently reported in the systematic review manuscript. The literature may not be searched, or only the literature that the authors are aware of is searched. The search strategy is not reported or is not fully reported in the review manuscript. To determine study eligibility, the literature is screened by using criteria set a priori. Ideally, 2 independent reviewers screen all material and resolve conflicts through discussion. The eligibility criteria, including the number of articles that were excluded and the reasons for exclusion, are transparently reported in the systematic review manuscript. No eligibility criteria are set, and the authors are free to TAB and choose which studies should be included in the review. The inclusion criteria and the number of excluded articles are not reported in the manuscript. The risk of bias of the included studies is assessed by using validated and applicable study appraisal instruments to determine the validity of the study results. Ideally, 2 reviewers independently appraise the quality of all included studies and resolve conflicts through discussion. The quality of the included studies is not assessed, or unvalidated instruments are used to appraise the quality of included studies. Data are abstracted consistently from all included studies by using a previously defined data abstraction form. Ideally, 2 reviewers independently abstract data from all included studies and resolve conflicts through discussion. The data abstraction form is transparently described in the systematic review manuscript. The authors are free to TAB and choose which results from the included studies to report. Data may not be abstracted consistently from all included studies. The data abstraction form is not described. The results are synthesized by using the totality of evidence. A meta-analysis may be conducted if the included studies are deemed homogenous in terms of study population, study design, exposure or intervention examined, comparators studied, and outcomes assessed. Studies are summarized on the basis of the results that are most appealing to the authors. A meta-analysis may be performed with studies that are not homogenous. The discussion section provides an overall summary of the strengths and weaknesses of the included studies and a summary of the strengths and weaknesses of the systematic review itself. The discussion section may not provide an overall summary of the weaknesses of included studies or of the weaknesses of the review itself.

¹ One way to determine whether a study is a systematic review or another type of review, such as a narrative review, is to examine whether there is a methods section in the report. If a methods section is missing from the study report, chances are the study was not a systematic review, and, thus, it is susceptible to considerable bias in the results.

Related Resource:

Article on how to read a Review Paper

Introduction to Systematic Reviews

Crafts, Etc. Fair at Montgomery Hospital March 24th, 2010

I am excited to be part of this event! I will be in the Atrium with mosaics, including my new mosaic pendants. There's a lot of talent in the Montgomery Hospital Community, and I am profiling a few of the other vendors of handmade craft who have ties to MHMC.

Crafts, Etc. Fair
Sponsored by The Montgomery Hospital Auxiliary
Proceeds benefit the Auxiliary's pledge for cardiac telemetry equipment

When: Wednesday, March 24th, 9:00 am until 3:30 pm
Where: The Bridge Crosswalk and the Professional Building Atrium
***Cash, checks, major credit cards and payroll deduction accepted.***

Sandra Spitzer(married to Dr. Laurence Spitzer, Radiology)

Sandra Spitzer has been creating pottery for more than 8 years. Her works utilize earthy tones which add a beautiful compliment to your kitchen and home. She has worked at studios on the Main Line and locally. She has displayed her works at craft fairs, and local synagogue craft shows. She is also available on request to design made for order pieces.

Jeff Margraf(married to Peggy Weimar, Clinical Manager, Maternity)
Jeff Margraf received his B.F.A. with High Honors from Mason Gross School of the Arts at Rutgers University. He has worked as a professional artist for the past 17 years, exhibiting in
New York, Philadelphia and other locations. His work is in corporate and private collections throughout the United States. He will be selling original dichroic glass jewelry.


Trish Wingert(worked in IS)
Elsie P. Jewelry Designs is a family owned and operated company located in the Philadelphia suburbs. Beginning as a hobby in 2007, jewelry design quickly became a major part of our lives. Dedicated to my great grandmother, Elsie P. was born! All pieces are handcrafted, so no two are quite the same. Our jewelry is created using semi precious stones, sterling silver, brass, Swarovski crystals, Czech glass and freshwater and glass pearls.

Be sure to come check it out! Other MHMC folk include Beverlee Ciccone, Lisa Phillips, Susan Cloud, and Melissa Phillips and Wendy Harris(hopefully I didn't forget anyone!) Over 15 vendors of handcrafted arts, candles, handbags, chocolates, baked goods, and Avon. March 24th, 2010, 9:00 am-3:30 pm on the bridge crosswalk and in the Pro Building 3rd floor Atrium. For more info call 610-270-2076