A dense but fascinating report describes a computer-modeling study that analyzed the influence of social learning versus the influence of media coverage of celebrity suicides in creating clusters of suicides. The increase in focus on non-politician celebrities, the spread of reality television, and the globalization of media may be leading to an increase in clusters of copycat suicides, the authors conclude. New media guidelines are in order, they add.

RESULT: The Cultural Dynamics of Copycat Suicide
PLoS One | Sep 30, 2009

Childhood adversity, medical illnesses, impulsivity, aggression, and certain personality disorders are among the factors that increase the risk of completing a suicide attempt, according to this news report of a psychiatric conference in Canada. Among physicians, who are well known to be at high risk of suicide, the most important contributing factors appear to be perfectionism, narcissism, and rugged individualism.

RESULT: More Clues Uncovered in Suicide’s Many Mysteries
Psychiatric News | Oct 2, 2009

Impulsive aggression appears to be the trait that runs in families prone to suicide, according to a new genetic study. But what is the role of environment? And are these two traits that merely coincide or does the former contribute to the latter? This editorial includes, among its citations, a link to full text of the report in question.

RESULT: In Search of Endophenotypes for Suicidal Behavior
American Journal of Psychiatry | Oct 1, 2009

Search: concerns raised about high suicide

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SEARCH TIP: Retrieving a slow-loading document (or one that never loads)

The first result above seemed to take forever to load.

We got around this by clicking the “Cached” adjacent to the publication date, which delivered a version of the text stored previously in SearchMedica’s database. The “cached” option isn’t always available, but this strategy should work for most journal articles.

An article that doesn’t load when you click on the title indicates a problem with the source website. Unfortunately, there’s nothing SearchMedica can do about this.

However, if your list of results loads slowly after you click the Search button (or if you see an error message), that signals a problem on SearchMedica itself.

You can alert us to such a problem by scrolling to the bottom of the screen and clicking “Contact Us.” We’d be very grateful to know about it.

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RECENT SEARCHES ON SEARCHMEDICA

Search: bulimia

RESULT: Increased Mortality in Bulimia Nervosa and Other Eating Disorders
American Journal of Psychiatry | Oct 15, 2009

It has already been established that people with anorexia nervosa have higher mortality rates than the general public. A new study using a large national database establishes a higher mortality risk associated with eating disorder not otherwise specified, and an increased risk of suicide for all eating disorders.

Search: high IQ

RESULT: Executive function impairments in high IQ adults with ADHD
Journal of Attention Disorders (PubMed)| Sep 1, 2009

High-IQ adults with ADHD are significantly likely to show impairments in executive function, according to a special set of measures developed at Yale University School of Medicine. (You can purchase full text of this article for $25 by clicking on “View MedLine abstract on PubMed.gov at the bottom of the screen, and then on the publisher’s link in the right column of the subsequent screen.)

Search: social anxiety Cleveland Clinic

RESULT: Muzina (Recognizing and Treating Social Anxiety Disorder)
Cleveland Clinic Journal of Medicine | June 28, 2001

Unfortunately, the screening questionnaire has been excluded from this 2001 review about diagnosis and treatment of social anxiety disorder. But descriptions of physical symptoms and common fears, a table about differential diagnosis, and medication dosing regimens are present, in addition to the full text. (Find more recent information on the topic by deleting “Cleveland Clinic” from the search term.)

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SEARCH TIP: Multiple versions of the same result

This successful search tactic retrieved a classic article using the topic and the author’s institution as search terms.

The article appears twice, first as the PDF of the full text (identified by the author’s surname) and a few lines farther down as the abstract, which is in HTML.

We human beings know the content is basically the same, but the search engine sees the document name, the format, and the length as different. So both results appear.

Earlier we found a third result that showed just the electronic frame, a bar at the top reading “Cleveland Clinic.” We’ve deleted that one from the results list. If you find such a quirky result, please take a moment to clue us in using the link “Was this helpful?”.

A new guideline from the American College of Physicians takes no stand one way or the other on the use of hormonal testing or hormone-based treatments for erectile dysfunction (ED). For initial treatment, it says, most affected men should try one of the available phosphodiesterase-5 (PDE-5) inhibitors, based on their own preference, ease of use, cost, and side effects. (Full text is available for free.)

RESULT: Hormonal Testing and Pharmacological Treatment of Erectile Dysfunction
Annals of Internal Medicine | Oct 19, 2009

The journal has also published the systematic review behind the guidelines. It finds no differences in effectiveness or adverse effects among the various PDE-5 inhibitors.

RESULT: Oral Phosphodiesterase-5 Inhibitors and Hormonal Treatments for Erectile Dysfunction: A Systematic Review and Meta-analysis
Annals of Internal Medicine | Oct 19, 2009

Search: erectile dysfunction

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: physician leadership

RESULT: How Perceived Physician Leadership Behavior Affects Physician Satisfaction
Mayo Clinic Proceedings | Nov 19, 2008

Physicians’ satisfaction with their physician colleagues in leadership positions is shaped by five key factors, according to this study from the Mayo Clinic. Ironically, the factors that led to the greatest satisfaction were the ones least often displayed.

Search: MRSA infection

RESULT: MRSA infections in patients treated with tumour necrosis factor inhibitors
Annals of the Rheumatic Diseases | Nov 1, 2009

Patients may already be carriers of methicillin-resistant Staphylococcus aureus (MRSA) when they start taking tumor necrosis factor (TNF) inhibitors for arthritis, warn the authors of this 430-patient retrospective study from Maryland. Among the 15 patients in whom MRSA developed, most infections were severe and required hospitalization. Seven of those patients had recurrences of MRSA after TNF inhibitor treatment was restarted.

Search: comparison of ilioinguinal nerve block versus regional nerve block in inguinal hernia

RESULT: A Multi-Site Randomized Controlled Trial Comparing Regional and General Anesthesia for Effects on Neurodevelopmental Outcome and Apnea in Infants
ClinicalTrials.gov | Jun 23, 2009

Children’s Hospital Boston is coordinating a multicenter study to test the neurodevelopmental effects of regional versus general anesthesia on infants undergoing inguinal hernia repair. A major goal of the study is to establish  whether general anesthesia is dangerous for infants, and if so, how.

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SEARCH TIP: The virtue of editing

Whoever typed the search above also tried replacing “comparison” with “benefit” in the search term. Both searches delivered two results describing a trial that was recently suspended because of neurological side effects from ilioinguinal nerve block:

RESULT: Local Anaesthetic Following Hernia Repair
ClinicalTrials.gov | Jan 2, 2009

Following its orders to take the first words in the search term (“comparison of”) most seriously, SearchMedica also finds the dated article below, which praises ilioinguinal nerve block as easier and quicker than spinal anesthesia.

RESULT: Comparison of ilioinguinal-iliohypogastric nerve block versus spinal anesthesia for inguinal herniorrhaphy
Southern Medical Journal (PubMed)| Jan 1, 2006

A better choice would be “ilioinguinal versus regional nerve block inguinal hernia” in which this misleading result (from today’s perspective) does not appear on the first page of results.

Treatment of first-episode psychosis must also address comorbid addiction, say the authors of this study, who found that people who have stopped misusing drugs or alcohol fare no worse than non-abusers after a first episode of psychosis. Persistent substance abusers, predictably, have far worse outcomes.

RESULT: Impact of persistent substance misuse on 1-year outcome in first-episode psychosis
The British Journal of Psychiatry | Sep 1, 2009

Not only do neurological soft signs such as poor motor coordination and sensory perception correlate with reductions in brain volume among adolescents with first-episode psychosis; they correspond with specific structural brain deficits.

RESULT: Brain morphology and neurological soft signs in adolescents with first-episode psychosis
The British Journal of Psychiatry | Sep 1, 2009

Search: first episode psychosis

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SEARCH TIP: What’s wrong with the Back button?

In many cases, clicking the Back button at the top left of the screen after reading an abstract no longer returns you to your previous results page on SearchMedica.

You need to double-click the Back button to see your results list again.Sometimes that won’t work either, unfortunately.

This is a bug that arose with the new release of SearchMedica’s saved searches function. Please bear with us; we’re working on it.

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: transference

RESULT: A Different Perspective in Listening: Understanding Transference Interpretation and the Nature of Therapeutic Action in Dynamic Psychotherapy
American Journal of Psychiatry | Oct 1, 2009

The effect of therapy is more profound when clinicians try to understand the patient’s vantage point and its inherent legitimacy rather than actively trying to “correct” a perception, writes the author of this letter responding to a case report about transference anger. (There’s a link to full text of the original report at the end of the letter.)

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SEARCH TIP: Another good use for quotation marks

In addition to defining a phrase, quotation marks can limit a search to exactly the word you have typed. That would prove useful in this case.

This search includes many other results in which the term “regression” is highlighted in the blurb beneath the result, indicating that SearchMedica interprets it as a synonym for “transference.” In many of these results, “regression” is used in a physiological or statistical context, rather than as a term in psychology.

We know that “regression” is not exactly a synonym for “transference.” We’ll have this fixed.

In the meantime, when you encounter a situation like this, putting the word inside quotation marks will exclude the irrelevant results.

(In the case of words like “regression” that have more than one context, however, this would not work.)

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Search: traumatic grief

RESULT: Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11
PLoS Medicine | Aug 4, 2009

Persistent grief disorder is a clinically significant and distinct form of psychological distress associated with significant disability that should be included as a disorder in DSM-V, contend the 19 authors of this article. They used a structured interview (Inventory of Complicated Grief) to assess 317 bereaved individuals identified by an outreach program in Connecticut. Their report offers a diagnostic paradigm for the proposed disorder.

Search: enmeshment between mother and daughter

RESULT: Disturbed families, or families disturbed?
The British Journal of Psychiatry | March 1, 2004

Maternal control and disorganized mealtimes were strong contributors to development of eating disorders, in the study described in this 2004 editorial (the most recent result that appears with this very specific search term).

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SEARCH TIP: In a search term, less is sometimes more

In general, specific search terms produce more targeted results. But it’s possible to go too far with this strategy.

The person who tried the search above found only four results, then came back again with the simple query “enmeshment.” Removing mother and daughter offered a much richer set of options. For instance:

RESULT: Overparenting and the Narcissistic Pursuit of Attachment
Psychiatric Annals | April 2009

After receiving information about recurrence risk based on the Dx oncotype, oncologists are likely to change their minds about the kind of adjuvant treatment they plan for women with newly diagnosed, estrogen receptor–positive breast cancer.

RESULT: Effect of oncotype Dx (ODx) recurrence score (RS) information on physician prescribing plans for women with breast cancer (BC) in whom adjuvant therapy (ARx) is being considered
ASCO 2009 Breast Cancer Symposium Abstracts | Oct 5, 2009

When a woman has more than one malignant breast lesion at the same time, are they manifestations of the same oncogenic event or are they different? The first genetic profiling study to address the question finds that most synchronous breast tumors are independent phenomena and should be treated as such.

RESULT: Gene expression profiles of synchronous breast cancers
ASCO 2009 Breast Cancer Symposium Abstracts | Oct 5, 2009

Search: DX breast cancer

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: patient navigator

RESULT: Patient Navigators: A Different Viewpoint
Journal of Oncology Practice | Sep 1, 2009

A New Mexico cancer specialist responds sharply to two clinicians from Georgia who have suggested assigning dedicated “patient navigators” to explain the situation to new cancer patients and help them interact with the health care bureaucracy. Doctors should tell patients to bring a family member or friend along, says Barbara McAneny, MD, and it’s the physician’s job to make sure they understand the clinical information. As to navigating the system, she adds, forthcoming reforms should make it less complicated to gain and maintain access to cancer care.

There’s a link at the bottom of this rebuttal to the article that prompted it. What do you think? Share your opinion with others who read this newsletter by writing us at searchmedica@cmpmedica.com.

Search: sexuality cancer

RESULT: Understanding the Needs of Young Adult Cancer Survivors: A Clinical Perspective
Oncology – Nurse Edition | Oct 8, 2009

Among the challenges that face the roughly 1 million young cancer survivors (aged 15-39) in the U.S. today, issues of sexuality, infertility, and sudden-onset menopause can cause invisible scars and hinder maturation. This article offers insights with quotes from survivors and resources that can help.

Search: comedo dcis

RESULT: Evaluation of the confidence in pathologic diagnosis by core needle biopsy for conducting preoperative, personalized treatment for breast cancer
ASCO 2009 Breast Cancer Symposium Abstracts | Oct 5, 2009

In planning preoperative systemic therapy for breast cancer, core needle biopsy can reliably assess histologic grade as well as progesterone, estrogen, and HER2 receptor status. But it was not reliable in assessing invasiveness of the tumor, according to this study from Japan.

Also note this interesting related result found with the search term neuroendocrine breast carcinoma:

RESULT: Accuracy of diagnostic modalities used for the diagnosis of breast carcinoma
ASCO 2009 Breast Cancer Symposium Abstracts | Oct 5, 2009

This study from Pakistan finds core needle biopsy more accurate than fine needle aspiration cytology in diagnosing breast cancers detected by mammography.

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SEARCH TIP: Why don’t these abstracts from an ASCO conference appear in the Meeting Abstracts category?

SearchMedica results are delivered as quickly as possible to the main results list. But it takes the technology some time to sort them into the article categories.

Thus, very recent results may not always appear in the article categories.

Confirming the observations of individual pediatric hematologists, a study of records from tertiary care pediatrics hospitals shows a 70% increase in the number of children in whom venous thromboembolism (VTE) was diagnosed over 7 years. How much of this is because of greater vigilance and better detection? Whatever the situation, the article makes an urgent appeal for VTE guidelines that apply to children, not adults.

RESULT: Dramatic Increase in Venous Thromboembolism in Children’s Hospitals in the United States From 2001 to 2007
Pediatrics | Oct 1, 2009

A child presents with headache and vomiting. Is it cerebral VTE? Diagnosis and treatment are challenging. This series report from a pediatric neurology center in the U.K. discusses presenting features and the results of thrombolytic treatment.

RESULT: Cerebral venous sinus thrombosis: a case series including thrombolysis
Archives of Disease in Childhood | Oct 1, 2009

Search: thrombosis child

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: sepsis associated delirium

RESULT: Gaps in patient care practices to prevent hospital-acquired delirium
Canadian Family Physician | Oct 1, 2009

Doctors in the Canadian province of Alberta took a close look at what could be done to prevent dementia from developing in older people who are hospitalized—a common and often deadly problem attributable to both hospital and patient factors. The study found numerous gaps in practice that could reduce hospital-associated dementia, potentially saving both cost and lives.

Search: RA

RESULT: RA therapies in 2009: The latest on drug effectiveness
Journal of Musculoskeletal Medicine | Oct 1, 2009

Recent trials have led to a consensus that rheumatoid arthritis (RA) should be treated early and aggressively. But how? Use of drug combinations is increasing, and there are many new medications. This article reviews the efficacy and safety of new therapies for RA.

RESULT: Rheumatoid arthritis in elderly patients
Geriatrics | Sep 15, 2009

Diagnosing and treating RA in older patients is even more of a challenge; advanced age and comorbidities change the results of diagnostic tests for RA and complicate treatment. This article is a detailed overview of considerations in differential diagnosis and drug therapy, taking special note of the effects of newer medications in this patient group.

Search: trial study pediatrics influenza antivirals

RESULT: Pandemic influenza planning: Addressing the needs of children
American Journal of Public Health | Oct 1, 2009

This search was intended to find either a clinical trial involving children with influenza or a report about such a trial. It was a valiant effort that fell flat, bringing up an essay intended for public health specialists. What went wrong?

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SEARCH TIP: Power searching on SearchMedica

1. Put your topic (influenza, antivirals) first in the search term, not last. Add modifiers or qualifiers (pediatric, trial, study) after the words describing your main topic.

2. To limit your search to a specialty, choose the most appropriate tab from the list above the search box (e.g., Pediatrics).

3. To target a particular type of article, use the article categories (Research/Reviews, Clinical Trials) rather than adding article-type descriptors (trial, study) to the query.

Here’s what you find with the query influenza antivirals children, using the Pediatrics tab and the article category Research/Reviews:

RESULT: Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomized controlled trials
British Medical Journal | Aug 11, 2009

Looking for a clinical trial in which to enroll a child who has influenza? Try influenza antivirals children in the Clinical Trials category.

RESULT: Oseltamivir Treatment for Children Less Than 24 Months of Age With Influenza
ClinicalTrials.gov | Sep 10, 2009

(In both cases, we added the modifier “children” to eliminate studies that focus on adults, because the major journals and other websites in the Pediatrics category do include information about adults as well as children.)

Marijuana causes anxiety, panic attacks, and psychotic symptoms, but most often in first-time users, according to the Australian authors of a meta-analysis. Its effects on cognitive function are real but perhaps not permanent, they find, adding that pot may cause less severe impairment than alcohol or other drugs of abuse.

RESULT: Health Risks of Marijuana
MedPage Today | Oct 15, 2009

The news report provides a detailed summary of the results and comments from sources not involved in the study. If you’d rather read the study itself, and you have access to full text from Lancet, you can find it in the Research/Reviews category on SearchMedica.

RESULT: Adverse health effects of non-medical cannabis use
Lancet | October 16, 2009

Search: marijuana

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SEARCH TIP: New feature: Saved searches

Now you can save any of the results that you find on SearchMedica for later reference. It’s simple.

Click on the word “Save” in the last line below the title of any search result. You’ll be asked to assign a tag, or topic name, to your result.

You can save other results using the same tag, or create new tags for unrelated articles. All of your saved tags appear in the left column under “My links by tag.” You can also see links that colleagues have tagged, which appear just beneath your list of tags.

The saved results feature is available only to registered members of SearchMedica. (Searching on SearchMedica remains available without registration.)

The link for registration appears in the black bar at the top of the screen.

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: depression measurement

RESULT: Implementing Standardized Assessments in Clinical Care: Now’s the Time
Psychiatric Services | Oct 1, 2009

Standardized scales for depression may not capture all of a patient’s symptoms and may include some measures that are irrelevant. These may be unfamiliar, time-consuming, and confusing for clinicians. Nonetheless, it’s time to begin using standardized outcome assessment in psychiatry, contends the Group for the Advancement of Psychiatry in an article focusing largely on depression. It suggests some scales that may be relatively user-friendly. (Scroll down to find this result.)

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SEARCH TIP: Word order, again

To highlight an interesting result, we changed the word order of the query. What this person actually typed was “measurement based care depression.”

Remember, the electronic algorithm thinks you have put the most important word first. When creating a search term, figure out your main topic (depression) and place modifying terms (measurement based care) after it.

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Search: computer game addiction

RESULT: Predictive Values of Psychiatric Symptoms for Internet Addiction in Adolescents
Archives of Pediatrics & Adolescent Medicine | Oct 1, 2009

At least for kids in Taiwan, where this study took place, those who developed Internet addiction (measured by a scale created by one of the authors) had shown depression, ADHD, social phobia or hostility two years earlier. There were gender differences in the psychiatric precursors to Internet addiction that should be taken into account in interventions, say the authors. 

Search: EMDR 2009

RESULT: Post Traumatic Stress Disorder and Neural Mechanisms Involved in Its Treatment
ClinicalTrials.gov | Jun 10, 2009

Subjects in this French trial of PTSD treatment will undergo either Eye-Movement Desensitization and Reprocessing treatment or cognitive behavior therapy.

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SEARCH TIP: Adding a date to a query

Someone has tried to limit SearchMedica’s results to the current year by adding it to the query. Why doesn’t this work? Results from 2008 and even from the 1990s appear if you scroll beyond page 1 of results.

You can find out by clicking the word “Cached” beneath any of these older results. You’ll see that many publication websites link older articles to newer articles, and these words often appear within the text (which is what SearchMedica searches for your queries).

The default setting on SearchMedica is to give high priority to publication date in ranking results. Occasionally an older article will trump a newer one because it’s more relevant to your search term. But by and large, the most recent articles will appear at the top of the list.

There is substantial evidence that magnesium sulfate, either intravenous or inhaled, can benefit children with severe asthma, but it is not mentioned in most guidelines. This review weighing in on the much-discussed question of magnesium in asthma is available in full text. It adds to a chorus of appeals for further careful study of the use of magnesium in asthma treatment, particularly among children.

RESULT: Magnesium for treatment of asthma in children
Canadian Family Physician | Sep 1, 2009

Among other useful resources, this review includes a questionnaire for caregivers to help a physician assess the degree of asthma control in a preschool child.

RESULT: A Guide to Monitoring and Achieving Asthma Control in Children Younger Than 5 Years
ConsultantLive | Sep 3, 2009

Search: severe asthma

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SEARCH TIP: Going back to the beginning

Some multi-page articles will appear in search results beginning somewhere other than page 1.

When you find you’re not at the beginning of an article, scroll down until you see a list of numbers at the bottom of the text and click on the number 1.

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: perinatal asphyxia

RESULT: Moderate Hypothermia to Treat Perinatal Asphyxial Encephalopathy
New England Journal of Medicine | Oct 1, 2009

Moderate hypothermia for 72 hours did not reduce the risk of death or severe disability after perinatal asphyxia. But neurological outcomes were improved among survivors, without any major adverse effects.

Search: emotional disorder in childhood

RESULT: Anxiety Disorders in Children and Adolescents: Early Identification and Evidence-based Treatment
Psychiatric Times | Oct 8, 2009

This review focuses on assessment and evidence-based treatment for childhood anxiety disorders including separation anxiety, panic disorder, selective mutism, and social phobia.

Search: hyperhomocysteinemia pediatrics

RESULT: Celiac Disease
eMedicine Pediatrics | Jan 1, 2009

This article about the workup of celiac disease has no information about the search term, although the word does appear in a related link in the right-hand column.

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SEARCH TIP: The Pediatrics tab

The search term tells SearchMedica to look for exactly those words in an article. Here, it found the words “hyperhomocysteinemia” and “pediatrics” in sidebars, but they never appeared in the main article.

An easier way to find the right content is to use the term hyperhomocysteinemia in the Pediatrics tab, found among the specialties in the blue bar above the search box.

Looking for articles on that topic from the journal Pediatrics? Type the word “Pediatrics” into the search box, and then cut and paste the URL for that journal (pediatrics.aappublications.org) from the result. Typing d: and the journal URL, followed by your search term (d:pediatrics.aappublications.org hyperhomocysteinemia), provides a list of the articles on hyperhomocysteinemia in Pediatrics.

A functional neuroimaging study involving combat veterans and their identical twins not exposed to combat has unearthed a metabolic marker for risk of posttraumatic stress disorder (PTSD) after trauma.

RESULT: Resting Metabolic Activity in the Cingulate Cortex and Vulnerability to Posttraumatic Stress Disorder
Archives of General Psychiatry | Oct 1, 2009

Being injured in a fall and sustaining a head injury were the most common reports from soldiers who have had a traumatic brain injury complicated by PTSD, according to this study from Yale University.

RESULT: Separating deployment-related traumatic brain injury and posttraumatic stress disorder in veterans: preliminary findings from the Veterans Affairs traumatic brain injury screening program
American Journal of Physical Medicine and Rehabilitation (PubMed) | Aug 1, 2009

Search: veteran combat trauma

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SEARCH TIP: Reminder: Finding full text from a PubMed abstract

1. Scroll to the bottom of the abstract.
2. Click on the link “View MedLine abstract on PubMed.gov”
3. In PubMed’s version of the abstract, look to the upper right of the screen for a link to the publisher’s website.
4. Follow directions on the publisher’s website for accessing or purchasing a copy of the full text.

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Search: veteran combat trauma (in Practical Articles/News category)

RESULT: From War to Home: Psychiatric Emergencies of Returning Veterans
Psychiatric Times | Oct 2, 2009

From the perspective of PTSD, deployment in Iraq and Afghanistan is different from previous wars, according to this review for clinicians who treat returning soldiers.

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: post-concussion syndrome

RESULT: Impaired eye movements in post-concussion syndrome indicate suboptimal brain function beyond the influence of depression, malingering or intellectual ability
Brain | Oct 1, 2009

Post-concussion syndrome is not a purely psychological entity. It has biological roots that can be identified by tracking eye movements.

Search: conversion disorder trauma

RESULT: Medically unexplained visual symptoms in children and adolescents: an indicator of abuse or adversity?
Eye | Aug 12, 2009

Child abuse can lead to sudden vision changes that are medically inexplicable, according to this report of a case series published in an ophthalmology journal.

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SEARCH TIP: Venturing outside the tab

The Mental/Nervous tab focuses on journals in psychiatry and neurology and includes the major cross-specialty journals such as JAMA and the New England Journal of Medicine.

Many reports relevant to psychiatry and neurology are published in journals for other specialties.

It’s always a good idea to check the All of Medicine tab as well.

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Search: BPRS

RESULT: A Reverse-Translational Study of Dysfunctional Exploration in Psychiatric Disorders
Archives of General Psychiatry | Oct 1, 2009

People who have bipolar disorder move and behave differently in an unfamiliar environment from those who have schizophrenia. This behavior among humans is different in some ways from an animal model of mania and casts some question on earlier research.

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SEARCH TIP: Using SearchMedica to find rating scales

It’s reasonable to assume that whoever typed this query was looking for the Brief Psychiatric Rating Scale itself and not for articles about studies that have used it.

Here’s how to find the rating scales themselves on SearchMedica:
1. Un-click “Prioritize results by publication date” just beneath the search box, which makes relevance (not publication date) the only factor for ranking your results.
2. Type the name of the scale into the search box.
3. Choose the option “Practical Articles/News” among the article categories listed above the first result.
4. If a link to the scale itself does not appear among the top results, click the Psychiatric Times link at the top of the left column.

What happens to people who develop feelings of faintness while driving? Should they be told to  stop driving, and for how long? A study from the Mayo Clinic defines who has this problem and how often it recurs within a year after the first episode. This editorial describes the study, and weighs in on its implications for recommendations about driving. (There is a prominent link to the study itself near the top of the page.)

RESULT: Syncope While Driving: How Safe Is Safe?
Circulation | Sep 15, 2009

Search: blackout

Another recent study used a driving simulator to assess the risks of driving under the influence of sleep apnea. Presumably patients can control one of the two risk factors in the study: alcohol use. (The first result here is a patient summary of the study. Click the second result for the study itself.)

RESULT: Effects of Alcohol and Sleep Restriction on Simulated Driving Performance in Untreated Patients With Obstructive Sleep Apnea
Annals of Internal Medicine | Oct 6, 2009

Search: driving apnea

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SEARCH TIP: Duplicate results

It may appear from the result titles that SearchMedica has offered you the same result twice. But often (as in the case above) when you click you will find that the two results are actually different articles with the same title.

Sometimes the website has made a subtle change in the article content, and the older version is still present in the SearchMedica database, so you see results for both. This often occurs on clinicaltrials.gov, the US government’s database for clinical trials. It’s not possible for us to find all of these and delete them manually.

We hate seeing duplicate results and try to find automatic ways to eliminate them (along with other kinds of clutter) whenever possible. We’re working on it; please bear with us.

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: stopping ppi

RESULT: Results of an intervention in an academic Internal Medicine Clinic to continue, step-down, or discontinue proton pump inhibitor therapy related to a Tennessee Medicaid formulary change
Journal of Managed Care Pharmacy (PubMed) | May 1, 2009

What happens when you stop PPI treatment? Is it better to step down to an H2 blocker? This article tells what happened in response to a formulary change that forced the question.

Search: ppi C difficile

RESULT: Examination of Potential Mechanisms to Explain the Association between Proton Pump Inhibitors and Clostridium difficile Infection
Antimicrobial Agents and Chemotherapy | Oct 1, 2009

A related search finds new evidence that PPIs do not encourage the growth of C difficile, which previous reports have suggested.

Search: confidentiality law

RESULT: Confidentiality, consent, and caring for the adolescent patient
Current Opinion in Pediatrics (PubMed) | Aug 1, 2009

Adolescent patients are likely to say more about health issues if they know a doctor will keep the information private, but physicians rarely discuss confidentiality with adolescent patients. In this review, authors from Ohio State University Medical Center provide an overview of state and federal laws relevant to the question.

Search: joint instability hypermobility joint instability joint laxity joint Bursitis

RESULT: The Approach to the Painful Joint
eMedicine Rheumatology | Jan 1, 2009

Someone threw everything that came to mind at SearchMedica, hoping to find the best result. This review of joint pain is relevant, but was it necessary to do all that typing to find it?

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SEARCH TIP: Long search terms

Notice that this query generated only 4 results.

SearchMedica’s mandate is to look for articles that contain all or most of the words in your search term. Therefore, the longer the search term, the fewer results it is likely to generate.

There’s no advantage to adding the same word more than once. (This query repeats the word “joint” 4 times, and the word “instability” twice.)

Also, it’s not usually necessary to think of synonyms for your concept (instability, laxity, hypermobility). SearchMedica’s lexicon will automatically include synonyms.

Put some thought into what topic is most important to you, and make that the first word in the query.

The search term “bursitis joint instability“  offers 455 results.

Remember that you can target your search using the article categories above the first result.

Are depot injections of antipsychotic medications a means of coercion in public mental health? This search unearthed a debate on the topic.

The letter that prompted this reply argued that people who have schizophrenia or drug addiction are prone to denial and poor insight, making them prime candidates for coercion. But is this coercion worthwhile if the treatment itself is effective?

Search: compliance with depot injections

RESULT: The Role of Coercion in Public Mental Health Practice: Reply
Psychiatric Services | Sep 1, 2009

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SEARCH TIP: Following a trail

The result above is a reply to a letter that was critical of a previously published study. There’s no hyperlink to the original letter in the reply.

Here’s how to follow the conversation in reverse:

1. Disable “Prioritize results by publication date” to make relevance the sole criterion for your next search.

2. Cut and paste or type the title of the letter (The Role of Coercion in Public Mental Health Practice) into the search box.

The letter that prompted the reply is the second result. There’s a hyperlink to the original article at the bottom of this letter.

Search: The Role of Coercion in Public Mental Health Practice

RESULT: The Role of Coercion in Public Mental Health Practice
Psychiatric Services | Sep 1, 2009

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Disabling publication-date ranking (as mentioned above) delivers full text of very relevant but older article about compliance with depot injection among patients living in the community.

Search: compliance with depot injections
(publication date ranking disabled)

RESULT: Compliance With Depot Antipsychotic Medication by Patients Attending Outpatient Clinics
Psychiatric Services | Sep 1, 1998

OTHER RECENT SEARCHES

Search: juvenile delinquent

RESULT: Offense related characteristics and psychosexual development of juvenile sex offenders
Child and Adolescent Psychiatry and Mental Health | Aug 4, 2009

A team from the Netherlands studied 174 adolescent sex offenders to find factors that predict recidivism for both sexual and non-sexual violent offenses among juveniles.

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SEARCH TIP: When no article title appears

We regret that the journal in the example above, like a few others, does not format its electronic files to allow the article title to appear in search results.

The good news is that, when you click through to find out what’s there, you can see full text.

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Search: group CBT

RESULT: A nonrandomized effectiveness comparison of broad-spectrum group CBT to individual CBT for depressed outpatients in a community mental health setting
Behavior Therapy (PubMed) | Sep 1, 2009

A preliminary study from Australia suggests that group cognitive behavior therapy may be as effective as individual therapy for depression if symptoms are not severe.

Search:  OCD uptodate

RESULT: Obsessive-compulsive disorder: Symptoms
Mayoclinic.com | Jun 23, 2009

Someone who came to SearchMedica for a review on obsessive-compulsive disorder from the website UpToDate found a page about OCD from the Mayo Clinic website instead. Why?

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SEARCH TIP: UpToDate

Patient-directed information from the UpToDate website is available on SearchMedica. The overview of obsessive-compulsive disorder is present.

But it’s not easy to find.

Because UpToDate doesn’t supply publication dates for its content, you need to disable “Prioritize results by publication date” just below the search box.

Even so, with only one article on the topic in question, UpToDate will rank far below Mayo Clinic in relevance.

You can always specify content from a particular website, as we did in this case, by typing d: and then the URL of that website (excluding “http://www”) into the searchbox. You can also add a topic query.

In this case, we typed d:uptodate.com obsessive compulsive. (There was no result for “OCD” because the overview does not use that abbreviation.)

(The physician-directed content on UpToDate is a subscription product and is not searchable.)