Retrieving Rare Cases: A Protocol for Searching Complex Medical Cases.

This study sought to provide a protocol for searching complex medical cases of grand rounds. A clinical informationist was embedded in gastroenterology grand rounds to use comprehensive search strategies and summarize patients' information through concept mapping. Our proposed protocol classifies into three categories: (1) The general search strategy, (2) The protocol for searching for evidence about rare diseases, and (3) Identifying other resources more than routine medical databases. This approach represents a novel method beyond previous studies which were focused on usual ward rounds to facilitate evidence-based decision-making by providing and simplifying a comprehensive summary view of complex medical cases.

Comparison the effects and side effects of Covid-19 vaccination in patients with inflammatory bowel disease (IBD): a systematic scoping review.

Covid-19 is a pandemic disease that is more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. We focused on the research studies on the effect and side effects of Covid-19 vaccination in patients with IBD. Articles were excluded if they were not relevant, or were performed on other patients excerpt patients with IBD. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: (1) the effect of vaccination, and (2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 and its resulting mortality with a high success rate. They should be also mentioned in booster doses.

Clinical informationist participation in grand round sessions of gastroenterology department: An action research study.

BACKGROUND: Nowadays, providing access to the required information by clinical informationist (CI) is vital for clinical teams to make the best decision. This study was carried out to identifying how CIs should participate in grand round (GR). MATERIALS AND METHODS: The current study is an action research study. It was conducted in the GR sessions of the Gastroenterology department of Al-Zahra Hospital affiliated with Isfahan University of Medical Sciences in 2017. Participants included attending physicians, fellowship students of the Gastroenterology departments, a CI, and two supervising medical librarians. Data were collected through observation and discussion. Qualitative content analysis and concept mapping were used for data analysis. RESULTS: The findings indicated that existing problems were related to the CI, medical team, and infrastructural ones. The participation of the CI in medical team was arranged based on the following steps: planning, action, evaluation, and suggestions. It started from an initial diagnosis of patients and ended in GR meetings. During evaluation step, suggestions were made to remove the existing problems and in the fifth step, results were summarized and a framework for the participation of the CI in GR sessions was suggested. CONCLUSIONS: Medical team members were satisfied with the participation of the CI, but it is necessary to remove the existing structural and personal barriers (related to the CI and medical team members), in order to improve the efficiency of this participation.

Schizophrenia and Macroprolactinoma: Is There a Deep Link?

Prolactinomas are the most common type of functional pituitary tumors. Dopamine agonists is the most important drugs used in prolactinoma,have antagonistic effect with antipsychotic drugs used in schizophrenia. Conversely, dopamine antagonist drugs increase prolactin in patients with simultaneous schizophrenia. In the present case, we report a 29-year-old single male with schizophrenia who treated for 8 years with risperidone and presented with macroprolactinoma. Iatrogenic hyperprolactinemia is a well-known side effect of dopamine antagonist drugs for treatment in a patient with schizophrenia. On the other hand, it appears these drugs have the other side effects, such as drug- induced prolactinoma or boost growth.

Pre-requisites, barriers and advantages of clinical informationist participation in grand round: a qualitative study.

BACKGROUND: Clinical specialists require access to the most recent and up to date professional information. However, barriers such as insufficient time and lack of necessary information retrieval skills necessitate the presence of clinical informationist (CI) in medical teams. OBJECTIVES: This study sought to determine the pre-requisite for CI participation in the grand round. METHODS: This was a qualitative study carried out using content analysis approach. Study involved all fellowship students and attending physicians in the department of gastroenterology at Al-Zahra hospital in Isfahan (Iran), who were selected using purposive sampling. Gathered reports were analysed using qualitative content analysis and concept mapping approaches. DISCUSSION: To improve the process of CI collaboration with clinical specialists during the educational rounds, it is necessary for CI to have certain pre-requisite skills. CONCLUSIONS: By identifying the pre-requisites for CI participation in the grand round and explaining advantages of this participation for clinical specialists, this study proposes a suitable process for implantation of CI participation in grand rounds.