Some gynecological cancers linked genetically to salivary gland malignancy

July 9, 2009

New studies reveal a genetic rearrangement involving the oncogene mammalian mastermind like 2 (MAML2) in some cancers of the cervix and breast, relating them genetically to mucoepidermoid carcinoma of the salivary glands and distinguishing them from squamous cell carcinomas of these tissues.

Therefore, they would demand careful pathological analysis and different therapeutic strategies.

A 2006 study associated this fusion gene of MAML2 with favorable prognosis in salivary cancer.

Recent Searches in Cancer/Hemic
What have other doctors been finding on SearchMedica?

Search term: thyroid cancer

Is surgery always the best option for early thyroid cancer? Authors from Memorial-Sloan Kettering Cancer Center inquire whether the approach should be more strategic.

RESULT: Can Risk-Adapted Treatment Recommendations Replace the “One Size Fits All” Approach for Early-Stage Thyroid Cancer Patients?
Oncology

Search term: palliative and supportive care

A “generation” of studies in palliative care are ethically or methodologically flawed, contend the authors of a systematic review. These all need to be reexamined, they say.

RESULT: Improving the Methodological and Ethical Validity of Best Supportive Care Studies in Oncology: Lessons From a Systematic Review
Journal of Clinical Oncology

NOTEWORTHY SEARCH of the week
Lessons to improve your success on SearchMedica, drawn from a genuine search

The query behind the frustrating search result from the Meeting Abstracts article category was leuprolide breast cancer NOT prostate.

“It sent me to the ASCO home page, not the abstract,” wrote the unhappy searcher.

RESULT: Leuprorelin acetate every-3-months depot versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant treatment in premenopausal patients with node-positive breast cancer: the TABLE study
ASCO Annual Meeting Abstracts

TIP: When you reach a Web site outside SearchMedica, but don’t find the result you’re looking for, there’s a problem on the other Web site.

Unfortunately, ASCO misfiled this abstract on its Web site. The bad news is that there’s nothing we can do about it.

The good news is that the entire article was also published in the Journal of Clinical Oncology. The article appears in the Research/Reviews category using the same query, leuprolide breast NOT prostate.

Leave a Comment » | Breast, Cancer, Cervical, Uncategorized | Tagged: , , , , , , | Permalink
Posted by smnewsletters

Confirmed: Contrast media can be deadly for kidney patients

July 8, 2009

Contrast-enhanced coronary angiography causes adverse events including death in patients with kidney disease. As many as one in ten patients experience a bad effect of some kind.

This new information comes from a randomized multicenter trial that compared people who underwent angiography using one of two iodinated contrast agents, iopamidol or iodixinol, with others who did not have angiography.

Adding fuel to a long-standing controversy about contrast-induced nephropathy, the report appears in the Clinical Journal of the American Society of Nephrology.

Practical Articles/News

Find background and commentary on the new study of contrast-induced nephropathy in this article category.

Evidence-based Articles

Are there established ways to prevent contrast-induced nephropathy?

Recent Searches in All of Medicine
What have other doctors been finding on SearchMedica?

Search term: raltegravir

Someone looking for treatments for resistant HIV pointed out numerous useful results including the following:

RESULT: Raltegravir With Optimized Background Therapy for Resistant HIV-1 Infection
New England Journal of Medicine

There’s also, in the Practice Guidelines article category, this recent guideline on new antivirals against HIV:

RESULT: New antiretroviral drugs: maraviroc, raltegravir, and etravirine.
National Guideline Clearinghouse

(See also the third result, international guidelines on new antiretrovirals for HIV. You can reach full text by clicking through to the PubMed.gov site via the link at the bottom of the abstract.)

Search term: diffuse scleroderma

An important contributor to disability in scleroderma is fatigue, according to this study that a colleague recommends for your consideration.

RESULT: Fatigue: an overlooked determinant of physical function in scleroderma
Rheumatology

Search term: intravenous vitamins and fatigue

Someone else pointed out two studies of an alternative-medicine approach to chronic fatigue.

RESULT: Reduction of Fibromyalgia Symptoms Through Intravenous Nutrient Therapy
Alternative Therapies

RESULT: Intravenous nutrient therapy: The “Myers cocktail”
Alternative Medicine Review (PubMed)

(Again, full text is available by clicking on the PubMed.gov link at the bottom of the abstract, and then on the link to the journal’s Web site at the right side of the following screen.)

NOTEWORTHY SEARCH of the week
Lessons to improve your success on SearchMedica, drawn from a genuine search

Want to find a graph, rather than words?

Alas, someone’s search on the query graph of FSH and LH levels during the menstrual cycle was destined for failure.

RESULT: Follicular Phase Dynamics With Combined Aromatase Inhibitor and Follicle Stimulating Hormone Treatment
Journal of Clinical Endocrinology & Metabolism

At first glance, we thought it would be a challenge to find such a graph. But thanks to a little strategizing, we retrieved it on the first attempt.

TIP: SearchMedica is not designed to search for images, because it looks for the frequency of words in text. Finding specific images would require searching for captions. And captions, after all, don’t include much text.

However, it’s still possible to find graphs by thinking about what kind of article would include them.

Here’s what we did:

1. Eliminate all “generic” words and list the most important terms first. The key is to think of relevant words most likely to appear often in an article that would contain the information you want.

In the original query, “graph” wouldn’t help the search at all, because our target article is unlikely to have numerous occurrences of that word in its text. “Of,” “the,” and “during” are just potentially confounding clutter.

We chose the query FSH LH “menstrual cycle”.

2. Un-click the option “Prioritize results by publication date.” Normal menstrual cycles haven’t changed over the course of recent history, so almost any old article will do the trick. We want to make relevance to the search term—not publication date—the most important search criterion in this case. Un-clicking “publication date” accomplishes that.

3. Given a choice, select the PDF version of the full text if you’re looking for images. Publishers often don’t include images in the HTML versions of their articles. When they do, the graphs are often reached via separate links. (This is another reason they’re difficult to find in SearchMedica searches. The captions may not even appear in the main HTML text).

Here’s what we found:

RESULT: Menopause Transition: Annual Changes in Serum Hormonal Patterns Over the Menstrual Cycle in Women During a Nine-Year Period Prior to Menopause
Journal of Clinical Endocrinology & Metabolism

The graph of normal FSH and LH levels over the menstrual cycle appears in the top two panels of Figure 3 on page 2768 of this article. Be certain to choose “Full Text (PDF)” in the upper right column of the screen on which the abstract appears.

The filled symbols in the chart represent a normal ovarian cycle.

Leave a Comment » | Alternative Medicine, Cardiovascular, Diabetes-Endocrine, Uncategorized | Tagged: , , , , , , | Permalink
Posted by smnewsletters

How often does a negotiator avert gunfire, in real life?

July 7, 2009

It was a tense and potentially violent few days in the Mental/Nervous System tab on SearchMedica. The statistics reveal that there were many searches related to violent crisis in the past week. But they can’t tell us why.

A top search term one day was “crisis intervention.”

It points up a new study testing a hypothesis raised every evening on TV—that professional negotiators actually reduce the risk that someone will get hurt when a mentally ill person threatens the public peace.

Do police officers trained in crisis intervention actually restrain the actions of SWAT teams (and the resulting risk of injuries)?

More than 400 police crisis intervention teams have been formed since the effort was pioneered in Memphis 20 years ago, but very few studies have examined their effectiveness.

(Numerous related articles in the same issue of the journal appear in the list of search results because the journal has prominently linked the study about SWAT teams to those articles on its own Web site.)

Practical Articles/News

Look in this article category to learn about the issues for mental health professionals acting in hostage crises.

RESULT: The Role of Mental Health Consultants on Hostage Negotiation Teams
Psychiatric Times

Recent Searches in Mental/Nervous System
What have other doctors been finding on SearchMedica?

“Crisis intervention” was the a top search one day last week, but others were looking at different kinds of crisis.

Search term: PTSD children

Would kids exposed to the 9/11 attacks in New York develop PTSD? Researchers looked at their mothers.

RESULT: School based intervention improves PTSD symptoms in children affected by political violence
Evidence-Based Mental Health

Search term: psychopathy

A new study shows that people who kill their fathers (in Finland) tend to lack remorse, empathy, and a sense of responsibility, but generally are less psychopathic than other murderers.

RESULT: Differences between homicide and filicide offenders; results of a nationwide register-based case-control study
BMC Psychiatry

Search term: Wortzel

Someone wrote in to point out a review by Hal S. Wortzel, MD, of a textbook for psychiatrists who must deal with violence.

RESULT: Textbook of Violence Assessment and Management
Psychiatric Times

There were also a few moments of calm.

Search term: yoga

A small controlled study from Iran found yoga effective against anxiety and depression in women.

RESULT: Effects of yoga on depression and anxiety of women
Complementary Therapies in Clinical Practice (PubMed)

Switching over to the All of Medicine tab, you’ll find a small study from Texas suggesting that yoga can reduce anxiety in adolescents.

RESULT: Ashtanga yoga for children and adolescents for weight management and psychological well being: an uncontrolled open pilot study.
Complementary Therapies in Clinical Practice (PubMed)

NOTEWORTHY SEARCH of the week
Lessons to improve your success on SearchMedica, drawn from a genuine search

Someone who searched on the term Brodie, pet-facilitated therapy, 1997 saw the discouraging reply “There were no documents found for your search. Please try again.”

TIP: If your search fails, please change something and try again!

We omitted “1997″ from the search term and found the article—which was published in 1999.

RESULT: An exploration of the potential benefits of pet-facilitated therapy
Journal of Clinical Nursing (PubMed)

The Brodie article points out that (at least in 1999) few hospitals were encouraging visits from pets, even though their positive effects on healing are well documented.

The general query pets therapy drew our attention to a recent review that mentions this strategy among many other ways to improve the likelihood that medical institutions actually encourage healing.

RESULT: Creating a healing environment: Rationale and research overview
Cleveland Clinic Journal of Medicine

Leave a Comment » | Medical ethics, Psychiatry, Uncategorized | Tagged: , , , , , , , | Permalink
Posted by smnewsletters

Automated MRI method makes Alzheimer’s visible before it’s obvious

July 1, 2009

The large number recent searches on the term Alzheimer MRI are evidence of tremendous curiosity about a new noninvasive diagnostic method, reported recently in Brain.

(The full text of the report currently heads the list of results.)

Software tools divide MRI scans of the brain into anatomically meaningful sections and quantify tissue atrophy, allowing early noninvasive diagnosis of both mild cognitive impairment (MCI) and Alzheimer’s disease. The report is from the Alzheimer’s Disease Neuroimaging Initiative, headquartered at Massachusetts General Hospital.

Three anatomical measures—entorhinal cortex thickness, hippocampal volume, and supramarginal thickness—correlate significantly and consistently with neuropsychological and CSF measures of Alzheimer’s disease.

RESULT: Automated MRI measures identify individuals with mild cognitive impairment and Alzheimer’s disease
Brain

Scroll down the same search results page for another study suggesting that MRI measures of brain atrophy may be particularly useful for predicting Alzheimer’s in highly educated patients (among whom high cognitive reserve can complicate the diagnosis).

RESULT: Early diagnosis of Alzheimer’s disease using cortical thickness: impact of cognitive reserve
Brain

How accurate are CSF findings as diagnostic predictors of Alzheimer’s disease and MCI? A new report in Lancet recounts a prospective study from Europe that examines the question.

(If you’re not a subscriber, you’ll have to pay to access full text of this article.)

RESULT: Prevalence and prognostic value of CSF markers of Alzheimer’s disease pathology in patients with subjective cognitive impairment
Lancet

Practice Guidelines

The British National Institute for Clinical Excellence has just posted new guidance on treatment of Alzheimer’s disease online.

(Someone forgot to remove the word “Confidential” from the top of this freely available document.)

Research/Reviews

Have you seen the new report that donepezil delays progression to Alzheimer’s in patients with MCI and depression?

RESULT: Donepezil delays progression to AD in MCI subjects with depressive symptoms
Neurology

IN THE JOURNALS
What have other doctors been finding on SearchMedica?

Search term: pancytopenia

A new study shows PML a rare but possible sequela of rituximab treatment.

RESULT: Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project
Blood

Search term: H1N1

The CDC reports that health care personnel generally did not follow recommendations on how to avoid getting swine flu this spring. Why not?

RESULT: Novel Influenza A (H1N1) Virus Infections Among Health-Care Personnel—United States, April-May 2009
MMWR

The full history of the swine flu pandemic (thus far) has now been published by the H1N1 Virus Investigation Team. (Full text is online here for free.)

RESULT: Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans
New England Journal of Medicine

Search term: quality improvement hypertension

“Small, focused, and inexpensive” interventions in a Tennessee program achieved measurable improvements against hypertension.

RESULT: Quality Improvement Initiatives Improve Hypertension Care Among Veterans
Circulation: Cardiovascular Quality and Outcomes

NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search

“I am asking for Cushing’s ulcer not Cushing’s syndrome,” said the feedback message. The search term, not surprisingly, was Cushing’s ulcer.

RESULT: Effect of Calcipotriol Plus Hydrocortisone Ointment on the Adrenal Hormone Balance and Calcium Metabolism in Patients With Psoriasis Vulgaris on the Face and Skin Folds
ClinicalTrials.gov

TIP: First, why did this result show up at all?

There’s a clue in the blurb beneath the article title, where the search terms appear in bold:

… fragility of skin veins ichthyosis acne rosacea
ulcers and wounds … Clinical signs or symptoms
of Cushing´s disease or Addison’s disease …

This result appeared first because it was the item posted online most recently that was relevant to the search term.

There are several possible strategies for narrowing the results to the ones relevant to this search term:

1. Put the search term inside quotation marks: “Cushing’s ulcer”

2. Use the word NOT to eliminate unwanted terms: Cushing’s ulcer NOT syndrome NOT disease.

3. De-select “Prioritize results by publication date” just beneath the search box. This will limit the search criterion to relevance only: Cushing’s ulcer [with “prioritize by date” un-clicked].

(But bear in mind that choosing this option will probably offer many results that are quite old. In this search, the top result is from 1982.)

Remember that it’s always possible to target your search further using the article categories just above the results list, such as Patient Education and Research/Reviews.

Leave a Comment » | Uncategorized | Permalink
Posted by smnewsletters

Teen depression diagnosis, treatment declined in wake of FDA warning

June 30, 2009

As predicted, diagnosis and treatment of depression have declined after FDA warnings about suicide risk associated with antidepressant treatment of children, teens, and young adults.

“Diagnosing decreases persist,” says the abstract. “Substitute care did not compensate.”

We still need to figure out what to do for teens with serious depression.

RESULT: Persisting Decline in Depression Treatment After FDA Warnings
Archives of General Psychiatry

Among adolescents with a history of a depressive disorder whose parents are similarly affected, cognitive behavior therapy (CBT) prevents symptoms of depression—unless the parent is currently depressed.

This result comes from a large multicenter randomized trial reported in JAMA.

RESULT: Prevention of Depression in At-Risk Adolescents
JAMA

Also in this search on the term depression adolescents is a new study showing that fluoxetine is no better than placebo for treating comorbid depression and substance abuse in this group.

RESULT: The short-term safety and efficacy of fluoxetine in depressed adolescents with alcohol and cannabis use disorders: a pilot randomized placebo-controlled trial
Child and Adolescent Psychiatry and Mental Health

Clinical Trials

Both the NIMH and the New York State Psychiatric Institute are recruiting for clinical trials of family-based strategies for adolescent depression.

IN THE JOURNALS
What have other doctors been finding on SearchMedica?

Search term: bipolar disorder

The era of genetic testing to predict response to psychiatric medications is a step closer.

RESULT: A Genomewide Association Study of Response to Lithium for Prevention of Recurrence in Bipolar Disorder
American Journal of Psychiatry

Search term: stimulants sudden death adolescents

A case control study of state vital statistics raises the possibility that stimulants may, on rare occasions, be deadly for children and teenagers.

RESULT: Sudden Death and Use of Stimulant Medication in Youths
American Journal of Psychiatry

Search term: donepezil MCI

Aricept appears to delay onset of Alzheimer’s disease in people who have both mild cognitive impairment (MCI) and depression.

(Scroll down for another recent study of MCI patients that had equivocal results.)

RESULT: Donepezil delays progression to AD in MCI subjects with depressive symptoms
Neurology

NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search

Someone who searched on COUPLES THERAPY REVIEW 2009 must have been disappointed by the results. Can we do better?

RESULT: Gender Identity Disorder
MedlinePlus

TIP: First, there’s no journal called “Couples Therapy Review”, as far as we can tell. So this isn’t a journal search.

Adding “2009″ is unnecessary because SearchMedica results are ranked according to publication date. So articles from 2009 should rise near the top of the list in any case.

You can target a search for reviews by looking in the article category Research/Reviews.

We tried this category using the search term couples therapy. Looking at 2009 results, the search offers a few book reviews and this one study.

RESULT: Facilitated disclosure versus clinical accommodation of infidelity secrets: an early pivot point in couple therapy
Journal of Marital and Family Therapy (PubMed)

The study is published in a Wiley journal. After clicking on “View MedLine abstract on PubMed.gov,” look for the Wiley Interscience link at the top right of the abstract, through which you can access full text for a fee.

(Note that the query “couples therapy” does deliver an article that uses the term “couple therapy.”)

Leave a Comment » | Adolescent, Depression, Family Medicine, Pediatrics, Psychiatry, Uncategorized | Tagged: , , | Permalink
Posted by smnewsletters

New ways to avoid “going green” after chemotherapy

June 25, 2009

A power user of SearchMedica looks regularly for new results from the query nausea and vomiting. Last week, that vigilance paid off.

(We added “chemotherapy” to the search term to bring the reports relevant to cancer to the top of the list.)

RESULT: Efficacy and safety of casopitant mesylate, a neurokinin 1 (NK1)-receptor antagonist, in prevention of chemotherapy-induced nausea and vomiting in patients receiving cisplatin-based highly emetogenic chemotherapy: a randomised, double-blind, placebo-controlled trial
Lancet Oncology

RESULT: Palonosetron plus dexamethasone effectively prevents acute and delayed chemotherapy-induced nausea and vomiting following highly or moderately emetogenic chemotherapy in pre-treated patients who have failed to respond to a previous antiemetic treatment: comparison between elderly and non-elderly patient response.
Critical Reviews in Oncology/Hematology

SearchMedica is working to develop new features such as saved searches and alerts.

Meanwhile, you can easily follow a tip from this colleague: Bookmark your favorite SearchMedica search pages, and check those bookmarks regularly.

Don’t forget to look at the article categories for other relevant results.

Practical Articles/News

Can’t access full text of the new article from Lancet because you don’t have a subscription? Look for summaries of the study in this category, using the simple search term casopitant.

RESULT: Novel drug boosts standard anti-emetic treatment
MedPage Today

Meeting Abstracts

A new study shows that, even using the best available preventive methods, nausea and vomiting remain distressingly prevalent after moderately or highly emetic chemotherapy. About 6% experience acute vomiting and at least 40% experience nausea.

RESULT: Incidence of chemotherapy-induced nausea and vomiting in 2008
2009 ASCO Annual Meeting Abstracts

IN THE JOURNALS
What have other oncologists been finding on SearchMedica?

Search term: rcc

RESULT: From bench to bedside: current and future applications of molecular profiling in renal cell carcinoma
Molecular Cancer

Search term: pancreas

RESULT: A prospective observational clinical study involving an alternative cancer treatment, psorinum therapy, in treating stomach, gallbladder, pancreas, and liver cancers
2009 ASCO Annual Meeting Abstracts

Search term: cancer patients resilience

RESULT: Analysis of resilience scores in a cohort of solid tumors ambulatory cancer patients in chemotherapy treatment.
2009 ASCO Annual Meeting Abstracts

NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search

Whoever searched on mri last week in the Cancer/Hemic tab may have missed something important.

TIP: If you’re searching on an imaging modality, it’s worth looking in the Radiology tab as well as the Cancer/Hemic tab.

The two specialty collections contain almost completely different sets of resources.

Leave a Comment » | Cancer, Uncategorized | Tagged: , , , , , , | Permalink
Posted by smnewsletters

Genetic factors, obesity correlated with major cause of kidney failure

June 24, 2009

A top search term last week was IgA glomerulonephritis. The results yielded the latest from medical researchers working to understand this increasingly important cause of kidney failure.

The first results list you’ll see with the search term IgA glomerulonephritis contains a mix of patient information, guidelines, and clinical trials. We focused the search for clinically relevant news by looking in the article category Research/Reviews.

Research/Reviews

A study from Japan shows glomerular changes that contribute to proteinuria in obese but not in non-obese patients.

RESULT: Impact of Obesity on IgA Nephropathy: Comparative Ultrastructural Study Between Obese and Non-Obese Patients
Nephron: Clinical Practice

Another research team has found genetic patterns that predict progression.

RESULT: A candidate gene approach to genetic prognostic factors of IgA nephropathy
Nephrology, Dialysis, Transplantation

Farther down the same page are separate studies showing that:

* the complement activation factor C4d may be a useful prognostic factor
* some patients have high levels of platelet-derived growth factor that may serve as a clue to new treatments

Want information that’s more useful to you right now? Scroll halfway down the screen for a comprehensive review, published last July.

RESULT: IgA nephropathy: Challenges and opportunities
Cleveland Clinic Journal of Medicine

Evidence-based Articles

A new meta-analysis in this category fails to find any positive effect on IgA nephropathy from taking polyunsaturated fatty acids (PUFAs). But a study published last January showed that PUFAs and renin/angotensin blockers reduce proteinuria more than either treatment alone.

There was no significant change in renal function, however.

IN THE JOURNALS
What have other doctors been finding on Searchmedica?

Search term: Kawasaki disease

RESULT: Recognition of a Kawasaki Disease Shock Syndrome
Pediatrics

Search term: total hip replacement

RESULT: The Squeaking Hip: A Phenomenon of Ceramic-on-Ceramic Total Hip Arthroplasty
Journal of Bone and Joint Surgery

NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search

Someone told us that neither of these results from the search on ascus was useful. But it’s not always obvious why not.

RESULT #10: Control de efectos secundarios
Cancer Net (ASCO)

We’re glad someone let us know that a foreign language result has slipped in. We can remove the Spanish-language articles on this website from our searches, and we will do so.

RESULT #16: HPV detection and prevention
OBG Management

But we can only try to guess what was unacceptable about this result, because we weren’t told.

TIP: If you don’t like a result, please use the comment box in the “Was this helpful?” link to tell us why.

Maybe this person doesn’t want to see newsy articles written by medical journalists rather than doctors or researchers. Avoid those by choosing the article category “Research/Reviews.”

If you like to see that kind of content, it’s collected under “Practical Articles/News,” along with practice-oriented (rather than research) articles written by clinicians.

Leave a Comment » | Diabetes-Endocrine, Family Medicine, Internal Medicine, Uncategorized | Tagged: , , , , , , | Permalink
Posted by smnewsletters

To live longer, be happy and clever

June 23, 2009

Two large studies, found last week with the simple search term personality assessment, confirm that personality has long-term effects on overall mortality, irrespective of standard medical risk factors.

The first, a follow-up study of more than 7000 Minnesotans who lived near the Mayo Clinic in the mid-1960s, correlated earlier death with negative emotions expressed at age 20-39.

RESULT: Pessimistic, Anxious, and Depressive Personality Traits Predict All-Cause Mortality: The Mayo Clinic Cohort Study of Personality and Aging
Psychosomatic Medicine

Researchers from Scotland have found neuroticism an independent mortality risk factor among 4200 men observed over 15 years.

Low cognitive ability was also a risk factor, but it was associated with mortality indirectly because of its effects on income and general health.

RESULT: Emotionally Stable, Intelligent Men Live Longer: The Vietnam Experience Study Cohort
Psychosomatic Medicine

Evidence-based Articles

Unfortunately, the recent evidence also suggests that neuroticism affects the success of treatment for mood disorders.

IN THE JOURNALS
What have other clinicians been finding on SearchMedica?

Search term: sleep dependent memory humans

RESULT: Does Sleep Really Influence Face Recognition Memory?
PLoS One

Search term: agoraphobia

RESULT: Psychiatric Treatment Received by Primary Care Patients With Panic Disorder With and Without Agoraphobia
Psychiatric Services

NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search

“Exactly what I was looking for!” someone wrote us.

The search term was American Academy of Child and Adolescent Psychiatry: PTSD review article.

RESULT #6: Practice Parameters for the Assessment and Treatment of Children and Adolescents With Posttraumatic Stress Disorder
American Academy of Child and Adolescent Psychiatry

TIP: A pretty good result. But here’s an example in which removing publication date from the ranking algorithm would actually improve the search, because the result is fairly old (2005) and this person knew precisely what he or she was seeking.

With “Prioritize results by publication date” un-clicked, this practice parameter appears as Result #1.

(You’d also find it at the top in the article category Practice Guidelines.)

Leave a Comment » | Advanced Search, Anxiety, Depression, Mood Disorder, Psychiatry | Tagged: , , , , , , , , , , | Permalink
Posted by smnewsletters

New forecast for those born too soon

June 17, 2009

What are the survival odds for very preterm infants (22-26 weeks’ gestation) given the best intensive perinatal care? About 70%, according to a collaborative study from Sweden.

RESULT: One-year Survival of Extremely Preterm Infants After Active Perinatal Care in Sweden
JAMA

The authors believe their results can be generalized to countries with universal access to health care and active perinatal programs.

More than half of the babies had lung or retinal complications. About one in 10 had neurological problems.

Scroll down slightly to find a related study from the US that is troubling to both pediatricians and parents.

A “significant proportion” of very low birth weight infants develop cerebral palsy many months after they have left the hospital apparently in the clear, according to a recent study from the US.

Diagnosis of cerebral palsy at 30 months of age was associated with postnatal steroid use (one of the survival factors in the Swedish study) and with periventricular leukomalacia or severe intraventricular hemorrhage.

RESULT: Stability of Neuromotor Outcomes at 18 and 30 Months of Age After Extremely Low Birth Weight Status
Pediatrics

Farther down in the same search results we found another relevant study from the US.

Researchers warn that there is no “safe window” during which a premature infant will not risk neurodevelopmental impairment as a result of postnatal steroid treatment.

RESULT: Impact of Postnatal Corticosteroid Use on Neurodevelopment at 18 to 22 Months’ Adjusted Age
Pediatrics

However, a study from the Netherlands suggests that most preterm infants who develop cerebral palsy due to periventricular hemorrhage do better by school age than has been expected.

RESULT: Functional Outcome at School Age of Preterm Infants With Periventricular Hemorrhagic Infarction
Pediatrics

Clinical Trials

Watch for results of a trial of low-dose hydrocortisone for very low birth weight preemies at risk for bronchopulmonary dysplasia, just completed in Texas.

IN THE JOURNALS
Find what’s new and learn more about it

Long-awaited results from the BARI-2D trial of diabetes and coronary artery disease (CAD) have been published.

RESULT: A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease
New England Journal of Medicine

Note the second result in this search. Another recent study argues against screening for CAD in patients with type 2 diabetes.

RESULT: Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes
JAMA

TIP: Does your list of results grow smaller with every search?

SearchMedica has a “drill-down” feature that narrows searches with every successive click.

If you want to broaden your searches or try again with a different query, click on the SearchMedica logo and start again from the home page.

Leave a Comment » | Cardiovascular, Diabetes-Endocrine, Nervous System, Pediatrics, Women | Tagged: , , , , , , , , | Permalink
Posted by smnewsletters

Are seeds of psychosis sown in utero?

June 16, 2009

Someone’s search term schizophrenia gestation alerts us to several new studies about the influence of prenatal factors, especially infection, on the risk of psychosis during childhood or adulthood.

RESULT: Targeting Cognition in Schizophrenia Research: From Etiology to Treatment
American Journal of Psychiatry

The second half of this editorial in the American Journal of Psychiatry points out a new study that examines prenatal exposure to infection (specifically, influenza and Toxoplasma) as a cause of cognitive dysfunction in schizophrenia—one of the first to do so.

TIP: If you see a citation to another study that hasn’t turned up in your original search, and there’s no automatic link to it in the citation list, you can probably still find it on SearchMedica. Try a separate search using several terms in the citation title as your query.

We found the study mentioned in the editorial using the term maternal infection schizophrenia executive function.

RESULT: Prenatal Exposure to Maternal Infection and Executive Dysfunction in Adult Schizophrenia
American Journal of Psychiatry

Another result, a registry study from Finland, posits an interaction between prenatal infection, heredity and schizophrenia.

RESULT: Evidence for an Interaction Between Familial Liability and Prenatal Exposure to Infection in the Causation of Schizophrenia
American Journal of Psychiatry

Scroll a little farther down for a British study that finds a link between impaired prenatal growth and symptoms of psychosis at age 12.

RESULT: Association of measures of fetal and childhood growth with non-clinical psychotic symptoms in 12-year-olds: the ALSPAC cohort
British Journal of Psychiatry

IN THE JOURNALS
What have other clinicians been finding on SearchMedica?

Search term: Tourette

The first prevalence study in the US finds Tourette syndrome in about three of every 1,000 children—usually mild but often comorbid with ADHD or OCD.

RESULT: Prevalence of Diagnosed Tourette Syndrome in Persons Aged 6-17 Years: United States, 2007
MMWR

Search term: traumatic neurosis

A new review alerts doctors to the increased risk of cardiovascular disease in people who have PTSD, especially firefighters, police officers and, of course, soldiers.

RESULT: Is posttraumatic stress disorder related to development of heart disease? An update
Cleveland Clinic Journal of Medicine

TIP: Does your list of results grow smaller with every search?

SearchMedica has a “drill-down” feature that narrows searches with every successive click.

If you want to broaden your searches or try again with a different query, click on the SearchMedica logo and start again from the home page.

Leave a Comment » | Adolescent, Pediatrics, Psychiatry, Schizophrenia, Women | Tagged: , , , , | Permalink
Posted by smnewsletters

« Previous Entries