Searching Strategies Kim Solez, M.D.

Searching - A Wonderful World Out There!

General Search Tools Currently searching 3,151,743,117 web pages Google - Searching 3,307,998,701 web pages

Searching Web Pages of the Past - “Wayback Machine” Search 11 billion pages of the Wayback Machine The Internet Archive is building a digital library of Internet sites and other cultural artifacts in digital form. Like a paper library, provides free access to researchers, historians, scholars, and the general public.

Searching The “Invisible Web” Database pages and pages with a ? In the URL are excluded from standard searches. Search engine databases are created by robot programs called spiders, computer robot programs that crawl the web seeking search engine content. These spiders crawl or navigate the Web by following the links in the web pages that are already in the database of their parent search engine. If there is no link to a page, a spider cannot "see" it. They lack the ability to type or think of any string of characters. They not only lack fingers for typing, but also lack a brain capable of judgment.

Searching The “Invisible Web” One can seach the Invisible Web using the following tools:

Slide 7 Searching Collaboratively

Using the Help of Medical Librarian Not just a last resort. Can be helpful from beginning. And not only in only in searches! An important part of health care team. A part of planning for new library facilities/online resource provision.

Pubmed - Searching the Medical LIterature PubMed, a service of the National Library of Medicine, includes over 14 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Pubmed - Searching the Medical LIterature - MeSH MeSH is NLM's controlled vocabulary used for indexing articles in PubMed. MeSH terminology provides a consistent way to retrieve information that may use different terminology for the same concepts.

Pubmed - Searching the Medical LIterature - MeSH MeSH descriptors are arranged in both an alphabetic and a hierarchical structure. At the most general level of the hierarchical structure are very broad headings such as "Anatomy" or "Mental Disorders." At more narrow levels are found more specific headings such as "Ankle" and "Conduct Disorder." There are 21,973 descriptors in MeSH.

Pubmed - MeSH Examples from Nephrology Therapeutics [E02] Renal Replacement Therapy [E02.870] Renal Replacement Therapy [E02.870] Renal Dialysis [E ] + Hemofiltration [E ] + Kidney Transplantation [E ]

Pubmed - MeSH Examples from Nephrology Surgical Procedures, Operative [E04] Transplantation [E04.936] Transplantation [E04.936] Organ Transplantation [E ] Organ Transplantation [E ] Bone Transplantation [E ] Heart Transplantation [E ] + Kidney Transplantation [E ] Liver Transplantation [E ] Lung Transplantation [E ] + Pancreas Transplantation

Pubmed - MeSH Examples from Nephrology Therapeutics [E02] Renal Replacement Therapy [E02.870] Renal Replacement Therapy [E02.870] Renal Dialysis [E ] Hemodiafiltration [E ] Hemodialysis, Home [E ] Peritoneal Dialysis [E ] + Hemofiltration [E ] + Kidney Transplantation [E ]

Pubmed - MeSH Examples Therapeutics [E02] Sorption Detoxification [E02.912] Sorption Detoxification [E02.912] Enterosorption [E ] Hemofiltration [E ] + Hemoperfusion [E ] Plasmapheresis [E ] Renal Dialysis [E ] Hemodiafiltration [E ] Hemodialysis, Home [E ] Peritoneal Dialysis [E ] +

Clinical Practice Guidelines KDOQI European Best Practices

Subject Examples: Target Hemoglobin with EPO Treatment of Anemia of Chronic Kidney Disease Joseph W. Eschbach, MD The target hemoglobin/hematocrit (Guideline 4) of 11 to 12 g/dL/33% to 36% has been reaffirmed by new data showing that patient survival is better when these values are >11 g/dL or >32% to 33%, respectively. Perhaps the most significant new recommendation is that anemia should be quantified using hemoglobin rather than hematocrit measurements. The rationale for this change is detailed in Guideline 1. Hematocrit, as measured by an autoanalyzer, is a product of the mean corpuscular volume (MCV) and the total erythrocyte count. Storage of an anticoagulated blood sample at room temperature for more than 8 hours (or for >24 hours when refrigerated), results in erythrocyte swelling and, therefore, in an erroneously high hematocrit. In contrast, the hemoglobin level remains constant under the same conditions.

Subject Examples: Target Hemoglobin with EPO cont. Additional studies that have been reported also confirm the value of maintaining hemoglobin values >11 and hematocrit >33%. Hospitalization rates were lower when the hematocrit was 33% to 36% compared with lower values5 and various physiological parameters: physicalperformance,6 cognitive function,7 and brain oxygen supply8 were better at a normal hemoglobin level than at lower levels. In striving to maintain the Hgb/Hct within this target range, the Hgb/Hct will likely, at times, rise above this range. The reasons why some patients will temporarily exceed an Hbg/Hct of 12g/dL/36% is that the response to Epoetin varies among patients, the interplay between IV iron supplementation and Epoetin dosing may be unpredictable, and it is mathematically impossible for the bell-shaped distribution for all patients to be limited to between 11 and 12 g/dL of hemoglobin or 33% and 36% hematocrit.