Search

In this paper, we describe the Clinical Health Information Retrieval Project (CHIRP), a trial program which provided online access to MEDLINE for third year students on medicine and pediatrics clerkships at The University of North Carolina School of Medicine. We present the project evaluation plan, report data from student questionnaires and interviews with the chief residents, clerkship directors, and clerkship coordinators, identify problems encountered, and address considerations for extension of the project.

In order for reference librarians to overcome feelings of inadequacy which they experience in aiding physically disabled patrons, they must educate themselves about the special needs of these patrons. This article will address the concerns, common mistakes, and difficulties involved in personal interactions with disabled individuals, particularly as they relate to the reference setting. In addition, specific steps will be described to minimize the difficult aspects of these interactions; these will be presented in terms of attitudinal and service activities. An attempt also will be made to describe aspects of these reference interactions which are unique to various health care settings.

Fifty-one sera from patients with systemic lupus erythematosus (SLE) were studied in order to evaluate the prevalence of anticardiolipin (ACA) and anti-mitochondrial antibodies (AMA) type M5, and also to explore their relationship with the main serological and clinical features of the disease. A group of 25 (49.0%) patients was found to be ACA positive (IgG or IgG and IgM); in this group we found a significantly higher prevalence of false positive VDRL (p less than 0.01), lupus-like anticoagulant (p less than 0.05), and AMA type M5 (p less than 0.01), but not of anti-ds or ss-DNA antibodies. Three sera positive for ACA, AMA-M5 and anti ss-DNA were absorbed with cardiolipin liposomes. Anti-DNA and AMA-M5 showed only a minimal decrease. Central nervous system involvement and especially seizure syndrome was demonstrated with a higher prevalence in ACA-positive groups (p less than 0.05). Despite the results of absorption experiments, the close relationship between AMA-M5 and ACA, false positive VDRL or lupus-like anticoagulant (LLAC) might justify a speculation on the antiphospholipid nature of this antimitochondrial activity.

Computed tomography scanning in two young patients with recurrent, pulsating, migraine-like headache showed parieto-occipital calcifications. One patient presented with an atypical form of the Sturge-Weber syndrome, and the other with celiac disease and folic acid deficiency. The clinical features were analyzed and compared with those in other cases reported in the recent literature which have shown bioccipital calcifications but no cutaneous angiomas, sometimes associated with visual and/or intelligence deficit and epilepsy. Finally, the possible connection between cerebral calcifications and headache is discussed.