Medicine

New edition of the DSM available through PsychiatryOnline

The fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) is now available through the PsychiatryOnline database. The DSM-5?« is the product of more than ten years of effort by hundreds of international experts in all aspects of mental health.

The DSM has been the most comprehensive resource used by health professionals, social workers, and forensic and legal specialists to diagnose and classify mental disorders. In the United States the DSM serves as a universal authority for the diagnosis of psychiatric illnesses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has significant practical importance.

The DSM-5?« was published on May 18, 2013, superseding the DSM-IV?«, which was published in 1994. The development of the new edition began with a conference in 1999, and proceeded with the formation of a Task Force in 2007, which developed and field-tested a variety of new classifications. In most respects DSM-5?« is not greatly changed from DSM-IV?«. Notable innovations include dropping Asperger syndrome as a distinct classification; loss of subtype classifications for variant forms of schizophrenia; dropping the “bereavement exclusion” for depressive disorders; a revised treatment of gender identity issues; and a new gambling disorder.

?áAlso featured in PsychiatryOnlineÔÇÖs DSM Library are:

• Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR?«)
• DSM-IV-TR?« Handbook of Differential Diagnosis
• Cases from DSM-IV-TR?« Casebook and Its Treatment Companion

PsychiatryOnline is a web-based psychiatry portal that includes books, journals, textbooks, practice guidelines, self-assessment, clinical and research news and medication patient handouts. LSUHSC-NO faculty, staff, and students can access PsychiatryOnline on campus, or off campus with use of a valid LSUHSC library barcode and PIN. Visit our PsychiatryOnline electronic resource page for more info. You can also connect to PsychiatryOnline by visiting the LibraryÔÇÖs website, and then selecting the ÔÇ£Online ResourcesÔÇØ category.

This Month in History: The Hardened Artery Blues

ÔÇ£We first make our habits, and then our habits make us.ÔÇØÔÇöJohn Dryden

Integral to a discussion of health is a discussion of habit. This excerpt from Dryden points out the consequences of habit-forming. Health-wise, each personÔÇÖs habits contribute to that personÔÇÖs overall health including but not limited to how they eat, drink, smoke, and exercise. While this is now a well-known fact of life, bad habits persist.

The 1960s were no stranger to poor health and heart disease. A Times-Picayune article highlights the LSU Medical SchoolÔÇÖs pathology unit of the 1960s and their research into atherosclerosis, a hardening of the arteries due to plaque formation. Dr. Jack C. Geer and Dr. Henry C. McGill, Jr. sought to study the effects of exercise and diet habits, saturated fat intake, geographic and economic environment, genetic predisposition, and stress levels on arterial health. Scientists began to understand that a low-fat diet is not enough to ensure a strong heart, but is only one aspect of leading a healthy lifestyle.

Along with Dr. Jack P. Strong, Dr. Geer and Dr. McGill were known as “The Three Amigos.” Dr. Strong would become Chair of Pathology from 1966 to 2009 and receive numerous awards and honors. Dr. Geer graduated from LSU Medical School in 1956 and took on the role of Professor from 1956-1966, eventually serving as Chair and Professor of Pathology at the University of Alabama at Birmingham. Dr. McGill served as Head and Professor of Pathology at LSU Medical School from 1960 to 1966 and became one of the founding faculty members at the University of Texas Health Sciences Center at San Antonio.

Research for this post lead me to a video interview of Dr. McGill on his lengthy career in pathology. He describes his ideal pathology department as comprehensive: with anatomy, laboratory, and surgery. Dr. McGill endearingly and vehemently promotes preventive care as opposed to treatment plans applied after the damage has been done.?á Unfortunately, he says, ÔÇ£There is no moneyÔÇØ in that game in a familiar trend of “No Pills, No Profit.”?á He mourns the fact that by middle age, it is often too late to prevent the type of lifelong damage done to your arteries as they form the fibrous plaque that leads to heart disease. Watching the video is worth the pearls of wisdom that he offers. One such instance is a life philosophy: “Everybody needs to get fired once in their life.” In describing his classroom experience, he tells that, “The style was to quiz a student until he admitted to absolute ignorance and that was the lesson for the day.”

According to the 2011 edition of The Merck Manual of Diagnosis and Therapy, atherosclerosis ÔÇ£is the leading cause of morbidity and mortality in the US and in most developed countries.ÔÇØ A big thanks to the work of LSU Medical School’s “The Three Amigos” for doing their part along the line of pathology research to help combat our bad habits.

Glimpse of the Past is an ongoing project to promote the Louisiana Digital Library effort. This Month in History will present for your reading pleasure a closer look into a newspaper clipping of note from our Digital Collections and articles relating to the LSU Medical School.

CDC Celebrates Mothers

The Centers for Disease Control and Prevention released a feature this week in anticipation of Mother’s Day and National Women’s Health Week.?á This feature, Ways to Help Make Mother’s Day Healthy, offers advice on how Moms can keep themselves healthy for their families.

They also created a feature, Celebrate Moms who Protect Children’s Health, so Mom’s who don’t smoke deserve extra love!

This Month in History: The Truth and Community Water Fluoridation

We learned from childhood that if you give a mouse a cookie heÔÇÖs going to want a glass of milk. It is lesser known, however, whether an increase in milk consumption in the general rodent population is directly caused by rampant cookie consumption among mice. Correlation does not necessarily indicate causation.?á A similar logical fallacy comes from one member of the Church of the Flying Spaghetti Monster who claims that there exists ÔÇ£a statistically significant inverse relationship between pirates and global temperature;ÔÇØ therefore, according to him, more piracy will decrease global temperature and the number of natural disasters. These examples, though silly, illustrate the importance of scientific research in drawing causation in an uncontrolled environment and in distinguishing between folklore, coincidence, and the truth.

One such truth-seeking project involves public health and is the source of long-standing controversyÔÇöthe issue: community water fluoridation (CWF). Beginning in 1954 in New Orleans, a committee of health professionals convened to address CWF. The committee consisted of several area doctors including LSU Medical CenterÔÇÖs Dr. Russell Holman, who served as Professor and Head of the Pathology Department from 1946 until his death in 1960. An article from the New Orleans Item in 1955 describes the committee as divided and unsure with the exception of Dr. Holman, who planted his support firmly on the side of fluoridation. A final decision was made in 1957 to veto CWF due to a need for further study.

Articles within the past few years on nola.com address CWF in New Orleans following Hurricane Katrina as being a lack of supply. Now it appears that fluoride has been returned to our water. A 2010 Sewage and Water Board of New Orleans report defines fluoridation as a way ÔÇ£to prevent tooth decay.ÔÇØ Later in the same report, fluoride is defined as a ÔÇ£contaminantÔÇØ: its presence on average .8ppm on the East Bank and .81ppm on the West Bank. Likely sources are listed as ÔÇ£erosion of natural deposits; water additive which promotes strong teeth; discharge from fertilizer and aluminum factories.ÔÇØ

Though the addition of fluoride to the nation’s drinking water has become common practice, the matter of its efficacy is still unresolved. In weighing the risks and benefits of CWF, the exact nature of correlation between improvements and harm to the publicÔÇÖs dental health remains unclear. Proponents of community health attempt to account for socioeconomic factors, access to dental care, pyorrhea and periodontal concerns in children and adults, as well as fluorosis, a cosmetic issue caused by over-fluoridation.

The CDC has called water fluoridation ÔÇ£one of the 10 great public health achievements of the 20th century,ÔÇØ and in 2010, the center’s statistics show the percentage of the U.S. population receiving fluoridated water at 66.2%. Perhaps we ought to take a cue from the Church of the Flying Spaghetti Monster: take to sea, forget dental care, and go marauding!

Glimpse of the Past is an ongoing project to promote the Louisiana Digital Library effort. This Month in History will present for your reading pleasure a closer look into a newspaper clipping of note from our Digital Collections and articles relating to the LSU Medical School.?á

The 6th National Prescription Drug Take Back Day

Got Drugs? ThatÔÇÖs the question the National Prescription Drug Take Back Initiative is asking. The program promotes an opportunity to properly dispose of expired and unneeded prescription drugs. In recent years, over 2 million pounds of prescription drugs were taken out of circulation and disposed of properly. ?áAccording to the Environmental Protection Agency, there has been no evidence of human health effects from prescription drug remnants on the environment thus far, however precautionary measures are still in affect to prevent cases from developing. So while you embark on this year’s spring cleaning, keep prescription drugs in mind.

Save the Date:

Saturday, April 27, 2013
10:00 am – 2:00 pm

For more info, visit:

http://www.deadiversion.usdoj.gov/drug_disposal/takeback/

To find a drop off location near you, visit:

https://www.deadiversion.usdoj.gov/NTBI/NTBI-PUB.pub;jsessionid=F97E8C13E24A4F4158917E505D922D9A?_flowExecutionKey=_c3781D16F-8320-60D6-9549-1E08043E201E_k2BCC5296-9265-E6B3-A22D-C9656693160A

Match Day 2013

Congrats to all the Medical Students who matched on Friday. Glad to hear that over 100 of you will be sticking around.
Check out a few local news stories: from Fox8 and NOLA.com and the Advocate.

LSUHSC Hosts Asthma Study for Adults

LSUHSC is hosting a free study for adults with well-controlled asthma as part of the American Lung AssociationÔÇÖs Long-acting Beta Agonist Step-Down Study (LASST). People 18 years of age and older who have controlled asthma are encouraged to call 504-568-3450 for more information.

With the high cost of medicine, patients have been known to lower their own dosages as their health improves in order to save money. LASST seeks to study various treatment plans as a way to safely decrease dosages of asthma medication over time. Below is the description of LASST as presented on the American Lung Association website:

ÔÇ£Current asthma guidelines recommend stepping down therapy once asthma is controlled for at least three months. For patients treated with inhaled corticosteroids (ICS) alone, a dose reduction of 25ÔÇô50 percent to a minimal dose that controls disease is established. However, the optimal approach to reducing treatment in patients with asthma that is well controlled on fixed dose combination ICS/LABA (long-acting beta agonists) is not clear. The study will compare three approaches of care to patients with asthma well controlled for three months on combination ICS/LABA therapy: reduction of ICS dose and maintenance of LABA, initial discontinuation of LABA with continuation of ICS and continuation of stable dose ICS/LABA. The data will allow the determination of?áthe optimal treatment strategy?ádefined as that which results in the lowest rate of treatment failure over 48 weeks of follow up. Additional exploratory analyses will include assessing risk factors for step-down failure and assessing the optimal duration of time that asthma control should be maintained before therapy is reduced.ÔÇØ

CDC 2013 Adult Vaccine Recommendations

The Centers for Disease Control have released?á2013 Vaccine Recommendations for adults. Changes include new recommendations for Pneumococcal Vaccine and Tdap/ Td Vaccines.?á There is also a simple quiz to help patients figure out what vaccines may be necessary. For more complete information, see the complete report, Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedule for Adults Aged 19 Years and Older ÔÇö United States, 2013.

This Month in History: A Nation of Neurotics

In America, methods of care for our mentally ill have become intertwined with the politics of universal healthcare, hospital administration, and prevention of violent crime, all of which suffer under an increasingly budget-cut government. This issue is not a new one, however. The Newspaper Clippings Digital Collection of the Isch?® Library shows an emerging pattern: a pattern of need. Hospitals and treatment centers need enough beds for psychiatric patients; hospitals need staff to treat those patients; police officers, clergy, and even the general public need training to assess and assist the mentally ill.

Linkages of mental illness and criminal tendencies also surface. In recent news, LSU psychiatrist Dr. Jose Calderon-Abbo joined the vice presidentÔÇÖs task force on gun violence; he has also partnered up with Tulane public health criminology expert Dr. Peter Scarf to present a paper of similar topic to the House Subcommittee on Crime, terrorism, and Homeland Security at a hearing on The Youth Promise act.

Not only do mental illness and crime sometimes occur simultaneously, but those charged with apprehending the mentally ill are often the same people who apprehend criminals.?á One of our newspaper clippings from 1961, entitled ÔÇ£How Police Can Help Mentally Ill,ÔÇØ addresses the need for officers of the law to be properly trained on how to interact with, assess urgency of treatment for, and detain suspects who appear to be suffering from illness, loss of competency, or loss of sanity.

The clergy are often called upon to assist the mentally ill; one article, ÔÇ£Help of Clergy Asked by Many: Role of Churchmen for Mentally Ill Cited,ÔÇØ explains how the clergy ought to be well versed in tactics to understand and aid their congregations. Examples of tactics used to interact with those in need in the include: a manual from 1954 ÔÇ£How to Recognize and Handle Abnormal PeopleÔÇØ by Robert A. Matthews and Loyd W. Rowland, former director of the Louisiana Association for mental health and former Head of the department of psychiatry and neurology, ?áin addition to a 1960 New Orleans officer training film, ÔÇ£Booked for Safekeeping,ÔÇØ produced by George C. Stoney.

In 1961, the name of the game was “expedite”: complex legislature required the approval of a hospital director, an order of commitment signed by the coroner, a psychiatrist, and a responsible party, and approval from a civil judge. Convoluted commitment laws and lack of funding for psychiatric facilities and staff were concerns at this time, but these concerns continue today as the Greater New Orleans area loses beds at Charity Hospital and MandevilleÔÇÖs Southeast Louisiana Hospital.

In the words of Dr. Robert A. Matthews, former head of the department of neuropsychiatry at LSUHSC from 1950-1957, ÔÇ£While we are passing the hat around for money to fight polio, heart disease, cancer, tuberculosis and other maladies, we ought also to be financing some exploration in to the cause and cure of emotional storms and mental defectiveness. We are fast becoming a nation of neurotic people.ÔÇØ

Glimpse of the Past is an ongoing project to promote the Louisiana Digital Library effort. This Month in History will present for your reading pleasure a closer look into a newspaper clipping of note from our Digital Collections and articles relating to the LSU Medical School.

The Poetry of Dr. George William Cooper

Dr. Cooper, a one-time anatomy Professor at the LSU Medical School, was also well-renowned for his poetry.?á Recognized for his ÔÇ£consistently good work in poetryÔÇØ by a forum of the National Writers Club in 1951 and awarded the position of Louisiana Poet Laureate from 1973-1976, Dr. Cooper is a?ácommon subject of our Newspaper Clippings Digital Collection. Though the Isch?® Library does not own any of his poetry collections, they are available through InterLibrary Loan.

Excerpted below?á is a poem from one of?áhis collections dedicated to a previous ÔÇ£Glimpse of the PastÔÇØ honoree, Dr. Frank N. Low. I would like to?áshare this poem with our new and returning students, who will surely feel the ÔÇ£grindÔÇØ immediately upon returning to classes:

DynaMed instead of UpToDate

The LSUHSC Libraries support Dynamed, a point of care database that provides the best available evidence to support clinical decision-making.?á DynaMed is?áa comparable product to UpToDate and much more affordable.

While the?áLSUHSC New Orleans Libraries were never involved in the UpToDate subscription and had no access, we are hearing that it is no longer available from various hospital websites. We suggest you try DynaMed as the alternative.

2,000-year-old Medicine Discovered in a Shipwreck

Would you trust a medicine that’s been under water for a couple of millennia??áAn early edition article (and a link straight to the PDF) in Proceedings of the National Academy of Sciences analyzes tablets found in a sealed container that was part of the material recovered from the a wreck in the Mediterranean sea off the coast of Tuscany in Italy. The abstract for the article states, “The composition and the form of the Pozzino tablets seem to indicate that they were used for ophthalmic purposes.”

The article is certainly generating a lot of press, from Wired to the Smithsonian to the BBC?áto the Washington Post.

Link to the pdf of the article is available to LSUHSC faculty, staff & students. It can be accessed off-campus with a valid LSUHSC library barcode & PIN. You can find more information at our remote access webpage.

Popular health topics of 2012

Last week, MedlinePlus, the National Library of Medicine and National Institute of Health’s consumer health database, published the top 10 most?ávisited health topic searches?áof 2012:

• High Blood Pressure
• Exercise and Physical Fitness
• Diabetes
• Diabetic Diet
• COPD (Chronic Obstructive Pulmonary Disease)
• Skin Conditions
• Autoimmune Diseases
• Herpes Simplex
• Herniated Disk
• Heart Diseases

Looking at these searches, it would seem that the public are?ásearching for information on?áthe most common health?áthreats in the?áUnited States.?á?áAccording to the Mayo Clinic, the top seven threats to women’s health are?áheart disease, cancer, stroke, chronic lower respiratory diseases, Alzheimer’s disease, accidents, and type 2 diabetes. The top seven threats to men’s health are similar:?áheart disease, cancer, accidents, chronic lower respiratory diseases, stroke, type 2 diabetes, and suicide.

Of course the most visited sites could also mean that people who were diagnosed with high blood pressure and diabetes started exercising?ábut they had trouble breathing, had heart palpitations,?ágot sunburned, and hurt their backs!

This Month in History: The Remedies of Mr. William D. Postell

Do you ever drink water from the opposite side of the glass to cure hiccups or apply duct tape to a wart or spray Windex on a zit? These are just a few examples of therapeutic home remedies, but where do they originate? A collector of ÔÇ£weird-lookingÔÇØ medicinal gadgets and medical historian, Mr. William Dosite Postell, is the star of our highlighted article this month.

Former Librarian of the LSU Medical School, Mr. Postell was a Will of all trades: as he believed, ÔÇ£There is a little bit of the clinician, the research worker, the medical historian, the medical philosopher, the bibliophile, as well as the custodian and the library technician, in each successful librarian.ÔÇØ Though his career at LSUMS was principally one of librarianship, Postell was able to branch out from that role, becoming a scholar of wacky medical wares like cholera baths and mad dag stones.

One outdated cure is the ÔÇ£vapor bath,ÔÇØ invention of a Louisianan, Dr. Louis H. Lefebrve. Depicted in the drawing here, Postell found an early bath in the possession of the Prudhomme family of Natchitoches, Louisiana on one of his excursions to area antebellum plantations. The bath utilized sulphuric acid to assuage the effects of cholera. The story of the madstones or ÔÇ£bezoarsÔÇØ comes from the frontier. These stony hairball-like concretions were taken from the stomachs of deer, cows, or goats and placed on a bleeding wound to draw out poisons like those from the rabies virus or snake venom. In modern medicinal practice, the bezoar is considered a serious health risk in gastrointestinal tracts of humans and has lost its curative mythos (unless, of course, you live in the Wizarding World of Harry Potter, where the bezoar cure is alive and well).

Postell was quite the adventurous and successful librarian no stranger to going above and beyond his position in pursuit of knowledge. Having served as President of the Medical Library Association (MLA) in 1952 and 1959, he was awarded the prestigious Marcia C. Noyes award for his outstanding contributions to medical librarianship. In a memorable article of the Bulletin of the MLA, Postell wrote, ÔÇ£The best publicity a library can secure is by way of service given. The circulation and reference desk is the best place at which good will can best be cultivated. It is here that the public is met and served. It is the here that new patrons obtain their first impression of the library. If they are met graciously and served competently, they will return.ÔÇØ

Stop by the Isch?® Library sometime and let us graciously and competently show you the wonderful resources at your fingertips! If you are interested in reading PostellÔÇÖs work, the LibraryÔÇÖs holdings include: Applied Medical Bibliography for Students, The Development of Medical Literature, and The Health of Slaves on Southern Plantations.

Glimpse of the Past is an ongoing project to promote the Louisiana Digital Library effort. This Month in History will present for your reading pleasure a closer look into a newspaper clipping of note from our Digital Collections and articles relating to the LSU Medical School.

BLS for Healthcare Providers

Any free time during the holidays? Well you might want to take advantage the Basic Life Support for Healthcare Providers course. You will learn CPR techniques to assist people of all ages and how to use an AED. Cost is $50 and itÔÇÖll only take approximately 4hours.

For more info, check out the flyer:?á