• Top e-Journals and e-Books in 2012
• Tibetan Medical Manuscripts
• RACE Exhibit – Jacksonville, Florida

Newsbytes

• New! Neofax/Pediatrics Databases in Micromedex
• Patient Education Resource Center

NLM Updates

What’s Your Reference Question?

• I Want To Do a Systematic  Review

Book Notes

• Mayo Clinic Family Health Book
• Navigating Life With a Brain Tumor

Staff News

• Professional Associations — Current memberships
• Presentations
• Professional Travel and Meeting Attendance
• Publications

In 2012, the New England Journal of Medicine and Circulation continued to hold the top two spots respectively, but a couple of titles dropped off the list to be replaced by Neurology and AJR. These were the top 10 eJournals in 2012:

Here’s a graphical display of the data between the two years:

In 2011 the top 10 eBooks were:

In 2012, the order changed; Hematology: Basic Principles & Practice made the list, and Sleisenger and Fordtran’s Gastrointestinal and Liver Disease dropped from the list.

Here is a graphical display of the eBook data between the two years:

Thanks to Kelly Arp, eResources librarian, for supplying the data.

Ann Farrell
Reference Librarian

Tibetan Medicine

Tibetan medicine is an ancient holistic healing system, emphasizing balance in mind and body, that was developed over 1300 years ago and based on several medical traditions including Ayurveda, Western (Greek), Persian, Chinese, and the Buddhist and indigenous Bonpo religions of Tibet. In historical times, Tibetan medicine was taught only in Buddhist monasteries and practiced by Lama Physicians (Emchi). It has gained popularity throughout the world with increased interest in holistic and complementary medicine, and as Tibetan Culture spread since the 1970s.

Traditional Tibetan Library

Medical and Buddhist texts were stored in libraries similar to this one existing today.  The collection pictured represents a very small number of the numerous texts of Tibet. Many other texts were destroyed during China’s communist invasion of Tibet in the 1950s. China’s Cultural Revolution in the 1960s resulted in further destruction of recorded knowledge, places of learning and worship, and killing of people and their cultures.

Library at the main monastery in Gyantse,Tibet, southwest of Lhasa. Storage of a small collection of texts, individually wrapped in protective fabric and stored in colorful boxes with fabric index tags. June 2012.

Xylography or Wood Block Printing

Most Tibetan texts were produced using the process of xylography, the art of making engravings on wood, especially for printing. It is the oldest known relief printmaking technique, first practiced in China. Woodcut, or xylography, is a technique in which an image is carved into the surface of a block of wood, with the printing parts remaining level with the surface, while the non-printing parts are removed. The areas to show ‘white’ are cut away with a knife or chisel, leaving the characters or image to show in ‘black’ at the original surface level. The block is cut along the grain of the wood (unlike wood engraving where the block is cut in the end grain). The surface is covered with ink by rolling over it with an ink-covered roller (brayer), leaving ink upon the flat surface but not in the non-printing areas. This is the rubbing technique, the most common method for Far Eastern printing on paper at all times. Two other techniques are stamping, used mostly in fabric design, and printing in a press, used in Asia only in relatively recent times. Multiple colors were printed by keying the paper to a frame around the woodblocks (where a different block is used for each color).

Xylographs of Tibetan medical and Buddhist texts are typically elongated shapes, imitating the form of ancient Indian Palm Leaf manuscript. The pothi style of book, loose leaves in cloth covers with wooden boards, is most representative of Tibetan books, independent of time period.

A printer rolling or applying pressure to paper which takes up the ink on the raised part of the xylograph. Main monastery. Gynatse, Tibet, June 2012.

Notable Tibetan Medical Texts

The most notable Tibetan medical texts are the “Four Tantras” (rygud bzhi) and a history of Tibetan Medicine by Desi Sangye Gyatso (gso rig sman gyi khog ‘bugs), 1653-1705. The earliest surviving medical texts pre-date these more theoretical and systematic medical works, and were produced in the 8th-9th century CE or even earlier. Many Tibetan manuscripts, 24 of which are medical (currently in 2 libraries in France and Britain), were retrieved from Mogoa cave library in 1900 at Dunhuang, now in Gansu Province, People’s Republic of China. Dunhuang was formerly an important town along the Silk Road as the primary land passage and point of cultural exchange from the Chinese area toward the Western Regions, especially before the ‘maritime Silk Routes’ were established in the Southern Song (1127-1279). Trade developed, and culture was enriched with religious communities, including Confucianism, Daoism, Buddhism, Zorastrianism and Manichaeism, which provided production and dissemination of new knowledge.

In addition to medical texts, an invaluable set of Tibetan medical paintings survived, with two copies currently in Lhasa, Tibet and one copy in the History Museum of Buryatia in Ulan-Ude, Republic of Buryatia in the south-central region of Siberia. A set consists of 76 plates, each with 90-274 images. The full set consists of about 10,000 drawings for The Atlas of Tibetan Medicine, generally dated by scholars to the 12th century CE. The sets illustrate material for “Four Tantras” and its encyclopedic commentary, ‘Lapis Lazuli’ (vaidurya sngon po –‘Vaidurya onbo’). Created by medical doctors and professional artists from 1687-1703, these medical paintings are still used for study of theory and practice of Tibetan medicine.

Efforts to Conserve and Digitize Tibetan Medical and Historical Texts and Illustrations

The International Trust for Traditional Medicine (ITTM), a public charitable Trust founded in 1995 and dedicated to the study and research of Indo-Tibetan and allied medical systems, oversaw the Tibetan Medical Digital Research Archive Project. Work began in March 1999 and focused on the study, translation and preservation of classical Tibetan medical texts, preparing electronic versions of key Tibetan medical works covering the 9th to 19th century AD. The ITTM also published a periodical on Indo-Tibetan and allied medicine cultures, Ayurvijnana, twice a year until 2002, and maintained trial plots of land for cultivation of traditional medicinal herbs. In August 2008 the ITTM in Kalimpong, India was closed, due to major political issues.

The International Dunhuang Project

The Silk Road Online is an international collaboration to make information and images of all manuscripts, paintings, textiles and artifacts from Dunhuang and archaeological sites of the Eastern Silk Road freely available on the Internet and to encourage their use. IDP partners with other institutions which provide data for and act as hosts to the multilingual website and database. These institutions include the:

• British Library for English versions – London,
• National Library of China for Chinese versions – Beijing, and
• Institute for Oriental Manuscripts for Russian versions – St. Petersburg.

The IDP 4D database, implemented in 1994, was initially designed on the basis of manuscript catalogs, using existing print and digital standards, but with added fields and functionality. The structure has been suitable for including details of artifacts other than manuscripts, such as paintings, 3D objects, textiles and historical photographs, as well as archaeological sites. The IDP database was intended as much more than a manuscript catalog. It was designed with three levels of use — and users — in mind:

1. Curators and conservators in the holding institutions as a tool for managing the collections
2. Scholars and others wishing to consult or learn more about the collections
3. A broader range of users wishing to learn about the context of the finds.

The database continues to evolve and can be explored at IDP’s website.

REFERENCES

Badmaev, V.  (2012). Principles of Tibetan medicine.  Adaptrin.com.   Retrieved  from http://www.adaptrin.com/principles-of-tibetan-medicine.html

Bolsokhoyeva, N. (2008).  Tibetan medical illustrations from the History Museum of Buryatia, Uland Ude.  Asian Medicine, 3(2):347-367. doi: 10.1163/157342008X307938 

Dharmananda S. (1999 Sep.).  Resource guide for Tibetan medicine.  Institute for Traditional Medicine (ITM).  Retrieved from   http://www.itmonline.org/arts/tibetmed.htm

Esaak, S.  (2012). Xylography.  In About.com; Art History.  Retrieved from http://arthistory.about.com/od/glossary/g/x_xylography.htm   

Helman-Wazny, A.   (2007 Spring).  A chronology of Tibetan bookbinding.  Recent IDP Conservation Initiatives, IDP News.  29.  Retrieved from http://idp.bl.uk/downloads/newsletters/IDPNews29.pdf

International Trust for Traditional Medicine (ITTM).  (2008 July 9).  Retrieved from http://www.ittm.org

Whitfield, S.  (2012 July).  The International Dunhuang Project:  The Silk Road Online. IDP International Dunhuang Project.  Retrieved from http://idp.bl.uk/idp.a4d

Woodcut.  (2012 Sep.)  In Wikipedia, the free encyclopedia.  Retrieved from http://en.wikipedia.org/wiki/Woodcut

Yan, Z. (2007 June 1).  rTsa in the Tibetan manuscripts from Dunhuang.  Asian Medicine 3(2):296-307. doi: 10.1163/157342008X307893.

Nancy Moltaji
Reference Librarian

Although the official count is not in yet, many Mayo employees have visited this powerful and thought-provoking exhibit. Employees were encouraged to take advantage of the special discussions led by trained facilitators after they explored the exhibit. While the RACE exhibit was located about 17 miles away at the Museum of Science and History (MOSH), there were many activities and events located right on the Mayo campus. One of the highlights was a complementary exhibit called “FACERACE with Mayo”.  The exhibit featured 18 Mayo Clinic employees who agreed to submit DNA samples to have the global origins of their DNA mapped. Each participant’s name and photo, handwritten description of themselves, their racial categorization in the U.S. Census and the global origins DNA results were included in the exhibit.

There were also three Grand Rounds lectures at Mayo Clinic held to promote the RACE exhibit and stimulate conversation about the issues raised by the exhibit. The three Grand Rounds lectures were presented by: Dr. Mary O’Connor, the chair of the Department of Orthopedic Surgery at Mayo Clinic in Jacksonville, Florida; Dr. Marcia Alesan Dawkins, an author, speaker and educator at the Annenberg School for Communication and Journalism at the University of Southern California; and Dr. Thomas C. Spelsberg, a consultant in the Department of Biochemistry and Molecular Biology at Mayo Clinic in Rochester, Minnesota.

The Humanities in Medicine section also orchestrated a number of events, including three concerts and a portrait exhibit called “About Face: Turning to New Ideas of Identity”.

Finally, but certainly not least, Dr. Henry Louis Gates, Jr. gave a very interesting lecture based on the “Finding Your Roots” series he hosts on PBS. He spoke about his passion to find out more about his ancestors and tracing his genealogy and how it inspired him to help others to do the same.

The RACE exhibit ran from January 26 until April 28, 2013 at the Museum of Science and History (http://www.themosh.org/Home.html) in Jacksonville, Florida.

Tara Brigham, Librarian
Winn Dixie Foundation Medical Library

NeoFax/Pediatrics is now available for optimal drug and parenteral nutrition care of infants and children. The “NeoFax” portion of Micromedex reduces medication errors in infants with tools that help prescribe, calculate, formulate and administer drugs and nutrition solutions. The “Pediatrics” portion provides similar prescribing and calculating services in the care of children.  Access these resources at the last tab menu of Micromedex via intranet or VPN.  Please contact the library with questions or refer to the NeoFax/Pediatrics User Guide.

Susan Mayer
Patient Education Specialist

My NCBI saved searches now allow modifying of search terms.

PubMed for Librarians: Free Online Classes Open for Registration

Join the National Library of Medicine Training Center (NTC) for the free online class “PubMed for Librarians.” Classes in April, June, and September 2013 are now open for registration.

PubMed History and Search Bar Updates

Several enhancements to the History and Search bars have been added to PubMed.

Non-English Abstracts in PubMed

Publishers will soon have the opportunity to submit non-English abstracts to PubMed.

Author Keywords in PubMed

PubMed now displays author keywords when supplied by publishers.

NISO Publishes Recommended Practice PIE-J: Presentation & Identification of E-Journals

On March 27, 2013, NISO announced the publication of a new Recommended Practice: PIE-J: Presentation & Identification of E-Journals (NISO RP-16-2013). This Recommended Practice was developed to provide guidance on the presentation of e-journals.

NLM @ MLA – 2013

The Annual Meeting of the Medical Library Association (MLA) will be held May 3-8, 2013 at the Hynes Convention Center in Boston, MA. Attendees are invited to visit the NLM exhibit booth #226 (May 4-7) to meet NLM staff and see NLM Web products and services.

My Bibliography: Public Access Compliance Video

“I want a systematic review.“

The refrain is increasingly common, but it’s not always clear what someone means by a systematic review. Before our reference librarians will start on a “systematic review” literature search, they will work with you to make sure that what you really need–and want–is a systematic review.

So, what is a systematic review?

In basic terms, a systematic review is a protocol-driven, comprehensive literature review, usually designed to answer a specific clinical question.

What’s different about a systematic review than a regular literature review?

• Systematic reviews generally answer very focused, PICO-based questions.
• Systematic reviews have a protocol in place prior to the literature review beginning, including:
  • The clinical question
  • Specific inclusion and exclusion criteria
  • Methods for assessing bias
  • Methods for combining the data (e.g., via a meta-analysis)
• A systematic review literature search is pre-specified and designed to find all relevant materials; a literature review does not follow a pre-specified protocol, nor does it need to be truly “comprehensive”.
• A systematic literature search attempts to reduce bias by searching in all languages; searching across multiple databases, including subject-based and regional databases; and searching “grey literature” sources like clinical trial repositories, the web, and unpublished trials.
• Systematic review protocols generally dictate that two or more individuals independently review each retrieved article separately to determine whether it meets inclusion criteria. Conflicts are solved by a third party.  A literature review, on the other hand, could be done by a single person.
• Systematic reviews commonly produce large amounts of search results, sometimes even in the tens of thousands, because they are designed for high sensitivity. A typical literature review would aim primarily for specificity–that is, all of the results would be focused on the topic.
• Systematic reviews publish, as part of their methods sections, the details of the search strategy. Systematic review literature searches are ultimately replicable; the search strategies (including database names and platforms, dates of the search, all search terms, and any limits used) are published so that others who want to redo the searches can find the same information.
• Regular literature review searches do not need to be replicable or even reported, though on occasion, you may see a published search strategy or a list of keywords the author used to search as part of a regular review’s methodology. Just because a literature review does not publish a list of search terms (which is not particularly helpful without the logic behind it) or a full strategy does not make it a bad or “loosey-goosey” search–it just means the authors did not need to make the search replicable for a systematic review.
• Systematic reviews are often the basis for a meta-analysis, where the data from the materials fitting the pre-specified criteria are pooled and statistically analyzed. Traditional literature reviews do not apply additional statistical methods to the materials found.
• Systematic reviews take exponentially more time to do, from the search strategy creation itself, to going through each retrieved citation in duplicate or triplicate, to analyzing the data from the included articles.

Before you begin a systematic review, ask yourself:

• Do I have a clearly defined clinical question with established inclusion and exclusion criteria?
• Do I have a team of at least three people assembled?
• Do I have time to go through as many search results as we might find?
• Do I have resources to get foreign-language articles appropriately translated?
• Do I have the statistical resources to analyze and pool data?

If you answered “No” to any of the first four questions, a traditional literature review will be more appropriate to do. If you answered “No” to the last question, a meta-analysis will not be an appropriate methodology for your review.

Systematic Review Standards: Include a Librarian on Your Team

The Institute of Medicine recently issued standards for systematic review teams, including a set of standards specifically for conducting searches. The first standard (3.1.1) for searching states that systematic review teams should work with a librarian to plan the search strategy. The third searching standard (3.1.3) also states that a second librarian should peer review the strategy.

This peer review step is a relatively new concept for systematic review searches, but is one that many of the Mayo Clinic librarians have been using amongst themselves when working on systematic review searches. A peer reviewer might be able to easily spot a mistake in the Boolean logic or a typo that the original searcher might have missed.

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, which has been adopted by many major medical journals, including BMJ, JAMA, and many others, includes two reporting items relevant to the search:

• Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched
• Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

Librarians can help you understand which information sources are appropriate to search, conduct the search, and write the methods section pertaining to the search.

Because the heart of any systematic review is the literature search, librarians should be offered authorship or at minimum, and with permission of the librarian, acknowledged for their efforts in the manuscript. A systematic review literature search is a major intellectual undertaking, and can take several weeks to produce, depending on the topic.

The Mayo Clinic Libraries and Systematic Reviews

The reference librarians at the Mayo Clinic libraries have experience with systematic review searches, and would be happy to help any Mayo Clinic staff member or student contemplating a systematic review.

Want some examples? Here are 10 of the most recent systematic reviews with Mayo Clinic librarian authors:

1. Deo SV, Shah IK, Dunlay SM, Erwin PJ, Dillon JM, Park SJ. Myocardial Revascularisation in Renal Dysfunction: A Systematic Review and Meta-Analysis. Heart Lung Circ. 2013 Mar 30. doi:pii: S1443-9506(13)00098-X. 10.1016/j.hlc.2013.03.005. [Epub ahead of print] PubMed PMID: 23548338.
2. Deo SV, Dunlay SM, Shah IK, Altarabsheh SE, Erwin PJ, Boilson BA, Park SJ, Joyce LD. Dual Anti-platelet Therapy After Coronary Artery Bypass Grafting: Is There Any Benefit? A Systematic Review and Meta-Analysis. J Card Surg. 2013 Mar;28(2):109-16. doi: 10.1111/jocs.12074. PubMed PMID: 23488578.
3. Tleyjeh IM, Abdulhak AA, Riaz M, Garbati MA, Al-Tannir M, Alasmari FA, Alghamdi M, Khan AR, Erwin PJ, Sutton AJ, Baddour LM. The Association between Histamine 2 Receptor Antagonist Use and Clostridium difficile Infection: A Systematic Review and Meta-analysis. PLoS One. 2013;8(3):e56498. doi: 10.1371/journal.pone.0056498. Epub 2013 Mar 4. PubMed PMID: 23469173; PubMed Central PMCID: PMC3587620.
4. Rubin MN, Wellik KE, Channer DD, Demaerschalk BM. A systematic review of telestroke. Postgrad Med. 2013 Jan;125(1):45-50. doi:  10.3810/pgm.2013.01.2623. Review. PubMed PMID: 23391670.
5. Deo SV, Shah IK, Dunlay SM, Erwin PJ, Locker C, Altarabsheh SE, Boilson BA, Park SJ, Joyce LD. Bilateral internal thoracic artery harvest and deep sternal wound infection in diabetic patients. Ann Thorac Surg. 2013 Mar;95(3):862-9. doi: 10.1016/j.athoracsur.2012.11.068. Epub 2013 Jan 24. PubMed PMID: 23352296.
6. Rank MA, Hagan JB, Park MA, Podjasek JC, Samant SA, Volcheck GW, Erwin PJ, West CP. The risk of asthma exacerbation after stopping low-dose inhaled corticosteroids: a systematic review and meta-analysis of randomized  controlled trials. J Allergy Clin Immunol. 2013 Mar;131(3):724-9. doi: 10.1016/j.jaci.2012.11.038. Epub 2013 Jan 12. PubMed PMID: 23321206.
7. Prutsky GJ, Domecq JP, Elraiyah T, Wang Z, Grohskopf LA, Prokop LJ, Montori VM, Murad MH. Influenza vaccines licensed in the United States in healthy children: a systematic review and network meta-analysis (Protocol). Syst Rev. 2012 Dec 29;1(1):65. doi: 10.1186/2046-4053-1-65. PubMed PMID: 23272706; PubMed Central PMCID: PMC3537683.
8. Singh B, Murad MH, Prokop LJ, Erwin PJ, Wang Z, Mommer SK, Mascarenhas SS, Parsaik AK. Meta-analysis of Glasgow coma scale and simplified motor score in predicting traumatic brain injury outcomes. Brain Inj. 2013;27(3):293-300. doi: 10.3109/02699052.2012.743182. Epub 2012 Dec 19. PubMed PMID:  23252405.
9. Tleyjeh IM, Bin Abdulhak AA, Riaz M, Alasmari FA, Garbati MA, AlGhamdi M,  Khan AR, Al Tannir M, Erwin PJ, Ibrahim T, Allehibi A, Baddour LM, Sutton AJ. Association between proton pump inhibitor therapy and clostridium difficile infection: a contemporary systematic review and meta-analysis. PLoS One. 2012;7(12):e50836. doi: 10.1371/journal.pone.0050836. Epub 2012 Dec 7.  PubMed PMID: 23236397; PubMed Central PMCID: PMC3517572.
10. Rubin MN, Wellik KE, Channer DD, Demaerschalk BM. Systematic review of teleneurology: methodology. Front Neurol. 2012;3:156. doi: 10.3389/fneur.2012.00156. Epub 2012 Nov 8. PubMed PMID: 23162527;  PubMed Central PMCID: PMC3497715.

For more, see a complete list in Mayo Authors (Mayo Clinic only).

More Resources:

• Finding What Works in Health Care: Standards for Systematic Reviews
• PRISMA Statement
• Systematic Review Tutorials from the Yale Medical Library
• Resources to Support Systematic Reviews (Washington University – Becker Library)
• Systematic Reviews: The Process (Duke University – Medical Library)

Melissa L. Rethlefsen, MLS, AHIP
Learning Resource Center

Mayo Clinic Family Health Book

Part I on Injuries and Symptoms reviews valuable information on how to react in various emergency situations, complete with illustrations, but also encourages readers to take a certified first-aid course to learn lifesaving skills, such as cardiopulmonary resuscitation (CPR), Heimlich maneuver, and how to respond to a heart attack, stroke or cardiac arrest.

First Aid and Emergency Care offers a wide-range of information, including how to treat minor burns at home, eye injuries, recognizing and treating shock, basic first aid supply list, poisoning, bites and stings, how to handle foreign bodies in the eyes, nose, ears, windpipe and lungs, and when a fever becomes an emergency.

Also provided is a chart on troublesome bacteria and how you can stop them. The chart lists the bacterium, how it’s spread, signs and symptoms, and how to prevent its spread. Additionally a section lists common plants that can be poisonous if swallowed, as well as signs and symptoms of poisoning. Examples of poisonous plants include the pits of apricots and cherries, the entire philodendron plant, poinsettia’s leaves, stem and sap, rhubarb leaves, and the sprouts, roots and vines of potatoes.

In addition to treating illness and understanding medical disorders, Mayo Clinic Family Health Book focuses on wellness for people of all ages. It describes common types of exercise, beginning with creating a walking program. A brisk walk provides a simple and cost-free method for improving your physical fitness, can be a valuable part of a weight-loss program, and help prevent some age-related diseases. Walking increases bone density and may lower the risk of osteoporosis, improve balance and coordination, and lessen the pain of arthritis.

Walking shoe features describe everything from the gel pad that cushions and reduces impact when the foot strikes the ground to the roll bar that stabilizes the foot if it tends to roll inward when striking the ground.

Different stretches and flexibility exercises illustrate how to limber up which can reduce the risk of injury and even make us feel younger. Core exercises show how to strengthen abdominal and back muscles. Strength exercises build muscle strength and endurance, which can improve balance and coordination, plus improve your posture. In general, people, who aren’t active, lose about 10 percent of their lean muscle mass each decade after age 30, but strength training can slow, prevent, or even reverse this process.

Nutrition and healthy eating teaches how to size up a serving, understand nutrient claims on food labels, reviews vitamin and mineral supplements, and types of diet pyramids including Mediterranean, Asian, Latin American, and Vegetarian.

Learn how to participate in your health care by undergoing preventive screenings. For example, recommended age-specific tests for women include blood cholesterol test baseline by age 20, then every 5 years. Also advised is blood pressure measurement every two years, eye exam at least once for ages 20 to 39; every 3 to 5 years for ages 40 to 50; and every 1 to 3 years for women older than 50.

The visual guide illustrates join disorders, such as a meniscus tear which is a common knee injury. Rotator cuff injuries involve inflammation of the tendons or one or more tears in the tendons. Illustrations provide a look at a normal knee joint, a knee damaged by osteoarthritis and an inset showing a knee repaired by total knee replacement.

The section on Staying Healthy When Traveling covers pre-travel planning, immunizations, common ailments of travelers, and precautions including insects, accident prevention and safety, food and water. For example, all water and other drinks should be boiled or bottled and ice cubes should be avoided. Food that is steaming hot has been cooked to a high enough temperature to kill any bacteria. Peel fruits to make them safer to eat.

Mayo Clinic Family Health Book offers a valuable resource to help families understand and play a crucial role in determining their future health and wellness by preventing disease and developing healthy lifestyle habits. It provides the tools needed to maintain good health, as well as offering information on how the body functions and potential threats to health in order to better equip families to live well.

Debbie Fuehrer, L.P.C.C.
Coordinator/Counselor-Mind Body Medicine

This thoughtful, compassionate book joins the reader on the journey from diagnosis to planning for the future. It covers basics of the brain, understanding brain tumors, treatment options, including radiation therapy and side effects, as well as lifestyle and symptom management, and care for the caregiver.

This physician-prepared guide provides medically authoritative and valuable advice that can be used numerous times as different issues arise: new questions, unfamiliar terminology, treatment options, or searching for inspiration from people who have faced the same issues.

It reviews the first step needed when facing a medical concern. Take a deep breath and remember you’re not alone.  Physicians and health care professionals are dedicated to providing expert assistance. Seek out information from your medical team, second opinions from other neuro-oncologists, reputable Internet sites, and local support groups that may supply additional information about new clinical trials and medications. Assemble your team of brain tumor specialists and keep a journal to record symptoms, treatments, and discussions with physicians and your healthcare providers. This diary will also assist you in recording questions between appointments.

Navigating Life with a Brain Tumor offers clear, easily understandable information for the layperson.  The chapter on basics of the brain describes how the brain is organized, why the location of the brain tumor matters, how tumors differ and their basic types, risk factors, common symptoms, and current technologies.

It also reminds the reader to be careful not to draw conclusions based on one specific symptom. The brain is a very complicated organ and development of a brain tumor may be accompanied by a variety of symptoms, depending on type and location.

In a precise, understandable way, brain tumors are described and classified, explaining the types that originate in the brain, whether benign or malignant, and those tumors that spread from elsewhere. Tumors are an abnormal collection of cells that multiply and may cause damage to surrounding tissue and involved organs. Brain cancer accounts for only 1.4 percent of all cancer cases, but is also one of the most difficult types to fight. Tumors are classified as either primary or secondary. Primary originates within the brain, while secondary or metastatic tumors originate elsewhere in the body, and then spread throughout the bloodstream to the brain.

Through technological advances in neuroimaging, medical experts are able to obtain more accurate information about tumor classification which provides clues regarding tumor type. This information will help to shape future treatment options and plans.

The chapter on lifestyle management reviews the importance of maintaining a healthy diet and exercise routine, reducing stress and increasing relaxation, discussion of complementary alternative therapies, cosmetic issues and balancing emotional, spiritual, and mental health.

Suggestions include rediscovering creative outlets or directing energy into new endeavors. Research shows that when the left side is the brain is compromised by dementia, strokes, or tumors, the right side can become more creative. Artistic approaches may offer an opportunity to bring up difficult topics and to participate more fully in recovery.

This comprehensive guide covers managing personal affairs, financial information, durable power of attorney, different types of trusts, and information about health care directives, as well as a guide to drugs prescribed for brain tumors and a helpful glossary for medical terms. Perhaps more importantly, it reminds readers to indulge in life’s pleasures, love and accept love in return, and find laughter and joy amid the difficulties.

Debbie Fuehrer, L.P.C.C.
Coordinator/Counselor-Mind Body Medicine

Tara Brigham.  Mayo Clinic Libraries: Resources for Operating Room Allied Health Staff. March, 2013, Mayo Clinic, Florida.

Nancy Moltaji, Dawn Littleton, Brian Lind.  Tibet: From Tourist to Witness. Rochester International Association, February 2013, Rochester, MN.

Dawn Littleton attended the Association of American Indian Physicians 21st Annual Native American Cross Cultural Medicine Workshop in Santa Fe, New Mexico, April 25-28, 2013.

Melissa Rethlefsen attended the New England Journal of Medicine Library Advisory Board Meeting in Clearwater, Florida, April 21-22, 2013.

Rank MA, Hagan JB, Park MA, Podjasek JC, Samant SA, Volcheck GW, Erwin PJ, West CP. The risk of asthma exacerbation after stopping low-dose inhaled corticosteroids: A systematic review and meta-analysis of randomized controlled trials. Journal of Allergy and Clinical Immunology. 2013 Jan 12;

Deo SV, Shah IK, Dunlay SM, Erwin PJ, Locker C, Altarabsheh SE, Boilson BA, Park SJ, Joyce LD. Bilateral internal thoracic artery harvest and deep sternal wound infection in diabetic patients. Annals of Thoracic Surgery. 2013 Jan 24;

Tleyjeh IM, Abdulhak AA, Riaz M, Garbati MA, Al-Tannir M, Alasmari FA, Alghamdi M, Khan AR, Erwin PJ, Sutton AJ, Baddour LM.  The association between histamine 2 receptor antagonist use and clostridium difficile infection: A systematic review and meta-analysis. PLoS One. 2013;8(3):e56498

Deo SV, Dunlay SM, Shah IK, Altarabsheh SE, Erwin PJ, Boilson BA, Park SJ, Joyce LD. Dual anti-platelet therapy after coronary artery bypass grafting: Is there any benefit? A systematic review and meta-analysis. Journal of Cardiac Surgery. 2013 Mar; 28(2):109-16.

Singh B, Murad MH, Prokop LJ, Erwin PJ, Wang Z, Mommer SK, Mascarenhas SS, Parsaik AK. Meta-analysis of Glasgow Coma Scale and Simplified Motor Score in predicting traumatic brain injury outcomes. Brain Injuries. 2013; 27(3):293-300.

Deo SV, Shah IK, Dunlay SM, Erwin PJ, Dillon JM, Park SJ.  Myocardial revascularisation in renal dysfunction: A systematic review and meta-analysis. Heart Lung Circ. 2013 Mar 30.

Gerberi D, Gajic-Zoric V.  Venables Health Sciences Library: Striving to meet the needs of Mayo Clinic’s health sciences students. BOSNIACA: Journal of the National and University Library of Bosnia and Herzegovina.  17(17):57-9, 2012.

Kanwar A, Malik S, Prokop LJ, Sim LA, Feldstein D, Wang Z, Murad MH. The association between anxiety Disorders and suicidal behaviors: A systematic review and meta-analysis. Depress Anxiety. 2013 Feb 13. doi: 10.1002/da.22074. [Epub ahead of print] PMID: 23408488 [PubMed - as supplied by publisher]

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