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PubMed1978

A health sciences libraries consortium in a rural setting.

The coming of the East Tennessee State University College of Medicine and its effect on the health sciences institutions and practitioners in upper east Tennessee (southern Appalachia) required increased and improved information resources and arrangements for delivery and for use. The Tri-Cities Health Sciences Libraries Consortium was organized to facilitate collection development and to improve services and staff qualifications. The progress of the consortium during the initial two and one-half years of its existence is delineated. Data reflecting the dramatic growth in collection development and staff are given.

Financing, Government↗
PubMed1978

Area health education center libraries and medical school libraries: establishing an interface.

Establishing an interface between area health education center (AHEC) libraries and medical school libraries requires careful planning, including: the overall plan, needs assessment, resource evaluation, a developmental plan, monitoring and evaluation, institutional agreements, and publicity. This paper reports on the development of AHEC libraries in North Dakota.

Health Education↗
PubMed1989

Developing a preservation policy and procedure statement for a health sciences library.

The preconditions for creating a preservation policy document in a health sciences library are an existing preservation policy for the institution of which it is a part and administrative support for preservation. The assumption underlying preservation activity, from the formulation of general guidelines to the detail of operating procedure, is that collection development and preservation are complementary functions. Documentation of operational procedures in some detail should be a part of the statement. Since preservation activity cuts across functional library structures, all management staff should be involved in the planning process and be made aware of their responsibilities. The creation of a preservation policy statement will highlight unaddressed issues, procedural inadequacies, and differences in staff perceptions of priorities, but a written statement provides a framework for setting priorities and making decisions.

Corrosion↗
PubMed1994

On the design of the Health Sciences Library/Information Services building at the University of Maryland at Baltimore.

The architect provides his perspective on issues in designing a new library building, including: civic and urbanistic purposes of the building; the process of analysis and synthesis; and the place and meaning of 'library' today. Special attention is given to adjacencies, reader services, space devoted to the study of change, administration, and presentation and itinerary. A verbal floor-by-floor tour of the building is provided.

Architecture↗
PubMed1982

Appraisal and evaluation of the workshop instruction program for untrained health sciences library managers in Region VIII: 1976-1978.

A study was conducted to determine whether the basic skills workshop offered by the Midcontinental Regional Medical Library Program from 1976 through 1978 should be revised. Results indicated that a majority of workshop participants were library managers in hospitals with under 200 beds. Workshop attendance was most helpful in libraries where new services were initiated after the workshop, although existing services (particularly interlibrary loan) were noticeably improved. Cataloging was considered to be the most useful workshop topic by former participants. Increased emphasis on administrative functions and on the provision of reference services was recommended.

Libraries, Hospital↗
PubMed1996

The commerce of ideas: Internets and Intranets.

Academic physicians pride themselves on their intelligent use of medical technology, their innovativeness, and their ability to market their excellence to the public. Although this pride is extraordinarily justified in the areas of clinical medicine, biomedical research, and health sciences education, academic physicians have less reason to be proud of their accomplishments in the area of information management. In years past, a lack of attention to coherent information management had few consequences so long as there were foci of excellence in clinical disciplines, libraries, core research laboratories, and selected training programs. But the widespread adoption of network-based communications has changed both the priorities of faculty and the information infrastructure necessary to maintain a competitive advantage. In the arena of health care information technology, many medical centers have chosen indiscriminate consumption over focused leadership. This essay speculates on how technologies based on the World Wide Web (WWW) may affect academic medicine through both the greater penetration of the Internet and a wider use of internal "intranets." The Internet is transforming the landscape of biomedical publishing, biomedical education, and the hospital library. The intranet is becoming a vital means of providing documents to support the administration of academic medicine and, in many circumstances, the delivery of patient-specific information. Although there is great potential for transformation, many academic medical centers have not yet fully demonstrated either the wisdom to advance a great information-technology vision or the will necessary to turn a vision into a coherent plan of action.

Academic Medical Centers↗
PubMed1975

Teaching of formal courses by medical librarians.

Medical education should include formal course work on the use of the medical library. The formal teaching effort of medical librarians at the University of Tennessee Center for the Health Sciences is described. Three courses on the use of the library are offered to graduate students in basic medical sciences, dentistry, and pharmacy and to undergraduate students in medical records administration. A review of the literature covering teaching by medical librarians and the results of a questionnaire survey also are reported. A 95 percent response to a questionnaire sent to 105 health-science-related school libraries was received. Of the 100 libraries responding, only 18 offered formal course work. An additional 19 reported plans for offering formal courses on the use of the library.

Curriculum↗
PubMed2001

Molecular cloning of a novel isoform of diphosphoinositol polyphosphate phosphohydrolase: a potential target of lithium therapy.

The mechanisms underlying the therapeutic effects of lithium are largely unknown but may involve progressive adaptive alterations at the level of gene expression. Using differential display PCR, we identify a novel cDNA fragment, the expression of which was increased in the rat frontal cortex after 5 weeks of lithium administration. A full-length cDNA (2954-nt) was cloned by arrayed cDNA library screening, and sequencing of the clone revealed an open reading frame of 537-bp encoding a 179-residue protein. Amino acid sequence comparisons revealed that our clone is a member of the Nudix hydrolase family, with the highest percentage of homology (95%) being with a subtype of human diphosphoinositol polyphosphate phosphohydrolase, hDIPP2. Northern blot analysis revealed that chronic lithium treatment significantly increased rDIPP2 mRNA levels in frontal cortex, but not in hippocampus, midbrain, and cerebellum. The effect of lithium on rDIPP2 mRNA expression was not shared by two other anticonvulsant mood stabilizers, carbamazepine and valproate. Time-course studies showed that 1-week of lithium had no effect on rDIPP2 mRNA abundance in the frontal cortex. Our results suggest that DIPP2 may represent a biologically relevant target of lithium therapy, further supporting the notion that abnormalities in inositol phosphate metabolism may be significant in the pathophysiology and pharmacotherapy of bipolar disorder.

Acid Anhydride Hydrolases↗
PubMed1986

Isolation and characterization of cDNA clones for cytochromes P-450 immunochemically related to rat hepatic P-450 form PB-1.

Rat hepatic cytochrome P-450 PB-1 is a prominent constitutive P-450 form whose levels increase approximately 2-3 fold upon phenobarbital administration. Antibodies raised against this protein recognized two major proteins in immunoblots of rat liver microsomal proteins and precipitated comparable amounts of two electrophoretically separable hepatic mRNA translation products. The levels of the two mRNAs encoding these polypeptides were increased substantially upon phenobarbital administration. The anti-PB-1 antibodies were used to screen a cDNA library, and two distinct cDNA clones, pTF-1 and pTF-2, were isolated. These clones contain inserts of 1227 and 410 base pairs, respectively, and show 80% nucleic acid sequence homology in their region of overlap. The DNA sequences of these clones show 54% sequence homology to the corresponding portions of the mRNA encoding P-450 PB-4, a major phenobarbital-inducible form of rat liver P-450, and can be optimally aligned with the PB-4 sequence without introducing insertions or deletions. The level of hepatic mRNA which hybridizes to clone pTF-2 increases approximately 2-4-fold after phenobarbital treatment, whereas mRNA which hybridizes to pTF-1 does not change in concentration after this treatment. mRNA, which hybridizes to pTF-1, is, however, 4-fold more abundant in livers of female rats than in livers of male rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

Magnesium sulphate versus diazepam for eclampsia.

BACKGROUND: A number of different anticonvulsants are used to control eclamptic fits and to prevent future seizures. OBJECTIVES: The objective of this review was to assess the effects of magnesium sulphate compared with diazepam when used for the care of women with eclampsia. Magnesium sulphate is compared with phenytoin and with lytic cocktail (in preparation) in other Cochrane reviews. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth trials register and the Cochrane Controlled Trials Register, 1999 Issue 3. SELECTION CRITERIA: Randomised trials comparing magnesium sulphate (intravenous or intramuscular administration) with diazepam for women with a clinical diagnosis of eclampsia. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data extraction was done by the two reviewers. MAIN RESULTS: Five trials involving 1236 women were included. Most of these trials were of good quality. Magnesium sulphate was associated with a substantial reduction in the recurrence of convulsions, when compared to diazepam (relative risk 0.45, 95% confidence interval 0.35 to 0.58). Maternal mortality was also reduced, although this difference was borderline for statistical significance (relative risk 0.60, 95% CI 0.36-1.00). There are no differences in any other measures of outcome, except for fewer Apgar scores <7 at five minutes (relative risk 0.72, 95% CI 0.55-0.94) and in length of stay in SCBU >7 days (relative risk 0. 66, 95% CI 0.46-0.95) associated with magnesium sulphate. REVIEWER'S CONCLUSIONS: Magnesium sulphate appears to be substantially more effective than diazepam for treatment of eclampsia.

Anticonvulsants↗
PubMed2006

Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis.

BACKGROUND: The newer 5-ASA preparations were intended to avoid the adverse effects of SASP while maintaining its therapeutic benefits. The efficacy and safety of 5-ASA preparations have been evaluated in numerous clinical trials that have often lacked sufficient statistical power to arrive at definitive conclusions. Previously, it was found that newer 5-ASA drugs in doses of at least 2 g/day, were more effective than placebo but no more effective than SASP in inducing remission in ulcerative colitis. This updated review includes more recent studies and evaluates the effectiveness, dose-responsiveness, and safety of 5-ASA preparations in terms of more precise outcome measures. OBJECTIVES: To assess the efficacy, dose-responsiveness and safety of the newer release formulations of 5-aminosalicylic acid (5-ASA) compared to placebo or sulfasalazine (SASP) for the induction of remission in active ulcerative colitis. SEARCH STRATEGY: A computer-assisted literature search for relevant studies (1981-2005) was performed using MEDLINE, BIOS, the Cochrane Controlled Trials Register, the Cochrane IBD/FBD group specialized trials register and the Science Citation Index, followed by a manual search of reference lists from previously retrieved articles, review articles, symposia proceedings, and abstracts from major gastrointestinal conferences. SELECTION CRITERIA: Studies were accepted for analysis if they were randomized, double-blinded, and controlled clinical trials of parallel design, with treatment durations of a minimum of four weeks. DATA COLLECTION AND ANALYSIS: Based on an intention to treat principle, the outcomes of interest in the treatment of active disease were the failure to induce global/clinical remission, global/clinical improvement, endoscopic remission, or endoscopic improvement. MAIN RESULTS: 5-ASA was superior to placebo with regard to all measured outcome variables. For the failure to induce global/clinical improvement or remission, the pooled Peto odds ratio was 0.40 (95% CI, 0.30 to 0.53). A dose-response trend for 5-ASA was also observed. When 5-ASA was compared to SASP, the pooled Peto odds ratio was 0.83 (95% CI 0.60 to 1.13) for the failure to induce global/clinical improvement or remission, and 0.66 (95% CI 0.42 to 1.04) for the failure to induce endoscopic improvement. SASP was not as well tolerated as 5-ASA. AUTHORS' CONCLUSIONS: The newer 5-ASA preparations were superior to placebo and tended towards therapeutic benefit over SASP. However, considering their relative costs, a clinical advantage to using the newer 5-ASA preparations in place of SASP appears unlikely. This review updates the existing review of oral 5-aminosalicylic acid for induction of remission in ulcerative colitis which was published in the Cochrane Library (Issue 1, 2006).

Administration, Oral↗
PubMed2006

Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis.

BACKGROUND: The newer 5-ASA preparations were intended to avoid the adverse effects of SASP while maintaining its therapeutic benefits. The efficacy and safety of 5-ASA preparations have been evaluated in numerous clinical trials that have often lacked sufficient statistical power to arrive at definitive conclusions. Previously, it was found that newer 5-ASA drugs were more effective than placebo but no more effective than SASP in inducing remission in ulcerative colitis. This updated review includes more recent studies and evaluates the effectiveness, dose-responsiveness, and safety of 5-ASA preparations in terms of more precise outcome measures. OBJECTIVES: To assess the efficacy, dose-responsiveness and safety of the newer release formulations of 5-aminosalicylic acid (5-ASA) compared to placebo or sulfasalazine (SASP) in the maintenance of remission in ulcerative colitis. SEARCH STRATEGY: A computer-assisted literature search for relevant studies (1981-2005) was performed using MEDLINE, BIOS, the Cochrane Controlled Trials Register, the Cochrane IBD/FBD Group Specialized Trials Register, and the Science Citation Index, followed by a manual search of reference lists from previously retrieved articles, review articles, symposia proceedings, and abstracts from major gastrointestinal conferences. SELECTION CRITERIA: Studies were accepted for analysis if they were prospective, randomized, double-blinded, and placebo- or SASP-controlled clinical trials of parallel design with treatment duration of at least six months. DATA COLLECTION AND ANALYSIS: Based on an intention to treat principle, the primary outcome was the failure to maintain clinical or endoscopic remission. Secondary outcomes were the number of patients experiencing adverse events, the number of patients withdrawn due to adverse events, and exclusions or withdrawals after entry into the study (not due to relapse). All data were analyzed using the Peto odds ratio and corresponding 95% confidence intervals (CI). MAIN RESULTS: The Peto odds ratio for the failure to maintain clinical or endoscopic remission (withdrawals and relapses) for 5-ASA versus placebo was 0.47 (95% CI, 0.36 to 0.62) with an NNT of 6. These values were also calculated for the trials in which SASP and 5-ASA were compared, revealing an odds ratio of 1.29 (95% CI, 1.05 to 1.57), with a negative NNT value (-19), suggesting a higher degree of therapeutic effectiveness for SASP.SASP and 5-ASA had similar adverse event profiles, with odds ratios of 1.16(0.62 to 2.16), and 1.31(0.86 to 1.99), respectively. The NNH values were determined to be 171 and 78 respectively. AUTHORS' CONCLUSIONS: The newer 5-ASA preparations were superior to placebo in maintenance therapy. However, the newer preparations had a statistically significant therapeutic inferiority relative to SASP. This review updates the existing review of oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis which was published in the Cochrane Library (Issue 1, 2006).

Administration, Oral↗
PubMed1976

Biomedical periodicals in Nigerian Medical Libraries: the medical librarian's dilemma.

The Nigerian medical librarian has an uphill task in his effort to satisfy the journal needs of users of his library. His problems stem from difficulties in the selection and acquisition of journals, delay in postal services, budgetary and other administrative controls, and the changing nature of medical education and health-care services in Nigeria. The librarian's attempts to solve these problems include increased subscriptions to journals and use of interlibrary loans, but the absence of union lists of holdings of other libraries, the heavy cost of photocopying services, and poor postal facilities present another dimension to his problems. Eventually his best solution seems to lie in the establishment of a national center for "least used" journals to serve as a source stock for the country's medical libraries.

Book Selection↗
PubMed1970

An investigation of the educational needs of health sciences library manpower. I. Definition of the manpower problem and research design.

In order to plan adequately for education in health science librarianship and to be able to project future demands and needs we need to know a great deal more about existing manpower in health science libraries. This paper, the first in a series of reports on an investigation to gather this data, discusses the research methodology and the development of an inventory of the institution-program population upon which the survey is based. An analysis in terms of geographic location, type (educational, research, etc.), administrative control, and primary cognate area of these institutions is presented, and their distribution through the various Regional Medical Library areas is noted. Preliminary estimates are made, based on a questionnaire to the libraries, on the size of the library population, their relationship to reporting programs or institutions, exclusive of the hospital population which is being covered in an independent survey. A questionnaire to library personnel is underway which will establish, along with the other questionnaires, a basis for exploring the relationships which exist between institutions or programs, libraries and manpower.

Libraries, Medical↗
PubMed2003

Magnesium sulphate versus diazepam for eclampsia.

BACKGROUND: Eclampsia, the occurrence of a convulsion in association with pre-eclampsia, remains a rare but serious complication of pregnancy. A number of different anticonvulsants are used to control eclamptic fits and to prevent further fits. OBJECTIVES: The objective of this review was to assess the effects of magnesium sulphate compared with diazepam when used for the care of women with eclampsia. Magnesium sulphate is compared with phenytoin and with lytic cocktail in other Cochrane reviews. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth trials register (28 November 2002) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2002). SELECTION CRITERIA: Randomised trials comparing magnesium sulphate (intravenous or intramuscular administration) with diazepam for women with a clinical diagnosis of eclampsia. DATA COLLECTION AND ANALYSIS: Both reviewers assessed and extracted data. MAIN RESULTS: Seven trials involving 1441 women are included. Most of the data are from trials of good quality. Magnesium sulphate is associated with a reduction in maternal death when compared to diazepam (six trials 1336 women; relative risk (RR) 0.59, 95% confidence interval (CI) 0.37 to 0.94). There is also a substantial reduction in the risk recurrence of further fits (seven trials 1441 women; RR 0.44, 95% CI 0.34 to 0.57). There were few differences in any other measures of outcome, except for fewer Apgar scores less than seven at five minutes (two trials 597 babies; RR 0.72, 95% CI 0.55 to 0.94) and fewer babies with a length of stay in special care baby unit more than seven days (three trials 631 babies; RR 0.66, 95% CI 0.46 to 0.95) associated with magnesium sulphate. REVIEWER'S CONCLUSIONS: Magnesium sulphate appears to be substantially more effective than diazepam for treatment of eclampsia.

Anticonvulsants↗