Faculty Bibliography

The clinical practice guideline was explicitly developed to include only treatments less invasive than knee replacement (ie, arthroplasty). Patients with symptomatic osteoarthritis of the knee are to be encouraged to participate in self-management educational programs and to engage in self-care, as well as to lose weight and engage in exercise and quadriceps strengthening. The guideline recommends taping for short-term relief of pain as well as analgesics and intra-articular corticosteroids, but not glucosamine and/or chondroitin. Patients need not undergo needle lavage or arthroscopy with debridement or lavage. Patients may consider partial meniscectomy or loose body removal or realignment osteotomy, as conditions warrant. Use of a free-floating interpositional device should not be considered for symptomatic unicompartmental osteoarthritis of the knee. Lateral heel wedges should not be prescribed for patients with symptomatic medial compartmental osteoarthritis of the knee. The work group was unable either to recommend or not recommend the use of braces with either valgus- or varus-directing forces for patients with medial unicompartmental osteoarthritis; the use of acupuncture or of hyaluronic acid; or osteotomy of the tibial tubercle for isolated symptomatic patellofemoral osteoarthritis

In September 2008, the Board of Directors of the American Academy of Orthopaedic Surgeons approved a clinical practice guideline on the treatment of carpal tunnel syndrome. This guideline was subsequently endorsed by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. The guideline makes nine specific recommendations: A course of nonsurgical treatment is an option in patients diagnosed with carpal tunnel syndrome. Early surgery is an option with clinical evidence of median nerve denervation or when the patient so elects. Another nonsurgical treatment or surgery is suggested when the current treatment fails to resolve symptoms within 2 to 7 weeks. Sufficient evidence is not available to provide specific treatment recommendations for carpal tunnel syndrome associated with such conditions as diabetes mellitus and coexistent cervical radiculopathy. Local steroid injection or splinting is suggested before considering surgery. Oral steroids or ultrasound are options. Carpal tunnel release is recommended as treatment. Heat therapy is not among the options to be used. Surgical treatment of carpal tunnel syndrome by complete division of the flexor retinaculum is recommended. Routine use of skin nerve preservation and epineurotomy is not suggested when carpal tunnel release is performed. Prescribing preoperative antibiotics for carpal tunnel surgery is an option. It is suggested that the wrist not be immobilized postoperatively after routine carpal tunnel surgery. It is suggested that instruments such as the Boston Carpal Tunnel Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire be used to assess patient responses to carpal tunnel syndrome treatment for research

PURPOSE: To examine reference questions asked through traditional means at an academic health sciences library and place this data within the context of larger trends in reference services. METHODOLOGY: Detailed data on the types of reference questions asked were collected during two one-month periods in 2003 and 2004. General statistics documenting broad categories of questions were compiled over a fifteen-year period. RESULTS: Administrative data show a steady increase in questions from 1990 to 1997/98 (23,848 to 48,037, followed by a decline through 2004/05 to 10,031. The distribution of reference questions asked over the years has changed-including a reduction in mediated searches 2,157 in 1990/91 to 18 in 2004/05, an increase in instruction 1,284 in 1993/94 to 1,897 in 2004/05 and an increase in digital reference interactions 0 in 1999/2000 to 581 in 2004/05. The most commonly asked questions at the current reference desk are about journal holdings 19%, book holdings 12%, and directional issues 12%. CONCLUSIONS: This study provides a unique snapshot of reference services in the contemporary library, where both online and offline services are commonplace. Changes in questions have impacted the way the library provides services, but traditional reference remains the core of information services in this health sciences library

Providing library patrons with seamless linking from database citations to full-text electronic journals (e-journals) is a goal of librarians, database vendors, and patrons. A number of products have been developed with this goal in mind. One important resource that provides such links to full-text publications from PubMed is LinkOut, freely available from the National Library of Medicine. Libraries face three practical issues when trying to implement PubMed's LinkOut: managing e-journals in general, determining which vendors, aggregators, and/or e-journals can work with LinkOut, and guiding patrons to access all of the full text that the library offers. This paper discusses each of these challenges from one library's perspective