New Exhibit: Pick Your Poison

Cocaine Toothache DropsThe Claude Moore Health Sciences Library is now hosting a new travelling exhibit from the National Library of Medicine. Pick Your Poison: Intoxicating Pleasures and Medical Prescriptions examines shifting attitudes in the United States towards five mind-altering drugs: tobacco, alcohol, opium, cocaine, and marijuana.
 
In addition to six exhibit banners, the library is proud to present two display cases full of related artifacts from our historical collections. Featured items include anti-smoking paraphernalia, a request from UVA Hospital to operate a still during the Prohibition era, and notes documenting drug education at the UVA School of Medicine during the 19th century.
 
Pick Your Poison: Intoxicating Pleasures and Medical Prescriptions will be on display in the front lobby of the Claude Moore Health Sciences Library from July 27, 2015 to September 4, 2015.
 
The exhibit banners were produced by the National Library of Medicine and the artifact displays were prepared by Emily Bowden and Janet Pearson of the Health Sciences Library. To learn more, visit the accompanying online exhibit or contact Alvin V. & Nancy Baird Curator for Historical Collections, Joan Echtenkamp Klein at jre@virginia.edu.

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Updated Current Diagnosis & Treatment E-Books

For more than 70 years, professors, students, and clinicians have trusted the LANGE Current Diagnosis & Treatment books for high-quality, current, concise medical information in a convenient, portable format. Whether for coursework, clerkships, USMLE preparation, specialty board review, or patient care, there are a variety of LANGE books for many medical specialties. The following e-books were recently updated with important new information:

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Yellow Fever in the United States

This post is the third in an ongoing series about the history of the U.S. Army Yellow Fever Commission and the historical context of its work. The posts are and will become pages of a revamped online exhibit about the Commission. Some of the posts will contain content that has been previously published by the Claude Moore Health Sciences Library, while others will contain new content. The post preceding this one in the series is titled, Symptoms and Epidemiology of Yellow Fever.

“The Exodus from Newport News Caused by the Yellow Fever Outbreak,” Harper’s Weekly, August 12, 1899.

“The Exodus from Newport News Caused by the Yellow Fever Outbreak,” Harper’s Weekly, August 12, 1899.

Before the U.S. Army Commission published its findings in 1901, yellow fever was a serious threat in the United States. While other diseases in the country were more prevalent and more deadly, no other could generate as much terror. It spread unpredictably and could kill 20% of a city’s population over the course of two to three months. The virus also unraveled the social fabric of the communities it struck—creating refugee populations, undermining trusted institutions, and dissolving familial bonds.

In 1693, the first irrefutable outbreak of yellow fever in North America likely occurred in Boston, although there has been some evidence of earlier outbreaks. [1] For the next 200 years, the disease regularly visited Boston and other coastal cities in North America. Outbreaks generally followed a common and frightening progression. During the summer, a ship from a region where the disease was endemic, most often the Caribbean, arrived with infected passengers. Soon after, isolated cases of yellow fever occurred in the city. A week or two later, the disease rapidly spread through the whole population. Finally, without explanation, the outbreak quickly subsided as winter approached and temperatures dropped.

In the 19th century, U.S. newspapers reported on and often sensationalized yellow fever outbreaks. This is an engraving from the article: “The Great Yellow Fever Scourge-Incidents of its Horrors in the Most Fatal Districts of the Southern States,” Frank Leslie’s Illustrated Newspaper, September 28, 1878.

In the 19th century, U.S. newspapers reported on and often sensationalized yellow fever outbreaks. This is an engraving from the article: “The Great Yellow Fever Scourge-Incidents of its Horrors in the Most Fatal Districts of the Southern States,” Frank Leslie’s Illustrated Newspaper, September 28, 1878.

An especially deadly series of outbreaks in North American cities during the 1790s terrified the inhabitants of the newly-formed United States. During the U.S. War of Independence, disruption of commerce between the United States and the rest of the world discouraged the spread of yellow fever from endemic regions to the nation’s seaports. After the war, the formation of the federal government led to an expansion in international trade and encouraged the migration of large non-immune populations to the prospering coastal cities. These factors together contributed greatly to the spread of yellow fever. Outbreaks occurred in nearly all the major coastal cities of the nation, with particularly deadly ones in Philadelphia and New York. In Philadelphia, the temporary capital of the nation, three outbreaks of yellow fever during this period shut down the new federal government, paralyzed commerce, and caused the death of almost 10% of the city’s population.[2]

The outbreaks in Philadelphia and other northeastern ports during the 1790s spurred a modest public health movement in the northern United States. Although the cause of yellow fever and how it was transmitted were a mystery to physicians, local and state governments implemented strict quarantine systems and some sanitation reforms hoping that they could prevent future outbreaks. [3] Researchers do not fully understand how effective these measures were in preventing the spread of yellow fever, but there is a strong correlation between public health reforms in the northern cities and the absence of major outbreaks in those communities after 1822. Yellow fever continued to plague southern ports throughout the rest of the 19th century. The worst epidemic occurred in 1878, when an outbreak in New Orleans spread into the lower Mississippi Valley infecting at least 120,000 and killing between 13,000 and 20,000 Americans. [4] Similar to the outbreaks of the 1790s, the 1878 epidemic spurred a new public health campaign in the Southern United States and created a new urgency within the U.S. medical community to determine the cause of yellow fever. [5]

Selected scenes of Memphis, Tennessee under quarantine during a yellow fever outbreak. Frank Leslie’s Illustrated Newspaper, September 20, 1879.

Selected scenes of Memphis, Tennessee under quarantine during a yellow fever outbreak. Frank Leslie’s Illustrated Newspaper, September 20, 1879.

Sources:

[1] There has been some dispute about the first outbreak of yellow fever in the United States. In the 17th century, many diseases, including yellow fever, were poorly understood and difficult to diagnose. Public health pioneer J.H. Griscom, on page 2 of his work, A History Chronological and Circumstantial of the Visitations of Yellow Fever at New York (1858), suggests that an earlier outbreak may have occurred in New York in 1668. Griscom may be correct, but the evidence is not irrefutable. The earliest confirmed outbreak, according to historian John Duffy, occurred in Boston in 1693 when a British fleet from Barbados docked in the harbor. See Duffy, John. Epidemics In Colonial America. Baton Rouge: Louisiana State University Press, 1971. pg. 141. 

[2] Carey, Mathew. A Short Account of the Malignant Fever: Lately Prevalent In Philadelphia… To Which Are Added, Accounts of the Plague In London and Marseilles.. 4th ed., improved. Philadelphia: Printed by the author, 1794. and Jones, Absalom, Richard Allen, and Matthew Clarkson. A Narrative of the Proceedings of the Black People, During the Late Awful Calamity In Philadelphia, In the Year 1793: and a Refutation of Some Censures, Thrown Upon Them In Some Late Publications. Philadelphia: Printed for the authors, by William W. Woodward, at Franklin’s Head, no. 41, Chesnut-Street, 1794.  

[3] Duffy, John. The Sanitarians : a History of American Public Health. Urbana: University of Illinois Press, 1990. pp. 38-50.

[4] Carrigan, Jo Ann. The Saffron Scourge: a History of Yellow Fever In Louisiana, 1796-1905. 1961. Thesis–Louisiana State University of Agricultural and Mechanical College, 1961. pg. 184. Other more recent works about the 1878 epidemic include: Bloom, Khaled J. The Mississippi Valley’s Great Yellow Fever Epidemic of 1878. Baton Rouge: Louisana State University Press, 1993. and Crosby, Molly Caldwell. The American Plague : the Untold Story of Yellow Fever, the Epidemic That Shaped Our History. New York: Berkley Books, 2006. 

[5] Ellis, John H. Yellow Fever & Public Health In the New South. Lexington, Ky.: University Press of Kentucky, 1992. pp. 166-168.

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The Symptoms and Epidemiology of Yellow Fever

This post is the second in an ongoing series about the history of the U.S. Army Yellow Fever Commission and the historical context of its work. The posts are and will become pages of a revamped online exhibit about the Commission. Some of the posts will contain content that has been previously published by the Claude Moore Health Sciences Library, while others will contain new content. The post preceding this one in the series is titled, Introduction to the History of the U.S. Army Yellow Fever Commission.

A Girl Suffering from Yellow Fever, watercolour by an unknown artist, 1800s. Wellcome Library, London. images@wellcome.ac.uk http://wellcomeimages.org

A Girl Suffering from Yellow Fever, watercolour by an unknown artist, 1800s. Wellcome Library, London. images@wellcome.ac.uk
http://wellcomeimages.org

In 1900, when the U.S. Army Yellow Fever Commission completed its landmark work, the scientific community was just beginning to understand the yellow fever virus. Today we know a great deal more about this deadly disease.

Yellow fever belongs to a group of illnesses called viral hemorrhagic fevers (VHFs).  VHFs, which also include dengue fever and ebola, are viruses that affect multiples organ systems in the human body and cause severe bleeding. According to the World Health Organization:

“Once contracted, the [yellow fever] virus incubates in the body for 3 to 6 days, followed by infection that can occur in one or two phases. The first, “acute”, phase usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve and their symptoms disappear after three to four days.

However, 15% of patients enter a second, more toxic phase within 24 hours of the initial remission. High fever returns and several body symptoms are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and feces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.” [1]

Yellow fever, as the U.S. Army Yellow Fever Commission verified, is primarily transmitted to humans by mosquitoes. A mosquito either inherits the virus from its mother or contracts it when it bites another animal infected with the disease. After an incubation period, the mosquito may then transfer the virus to healthy subjects it bites. Those who survive infection of yellow fever acquire a lifelong immunity to it.

Three epidemiological cycles, urban, intermediate, and sylvanic, characterize the spread of yellow fever. Major outbreaks of the disease are associated with urban cycles. In these kinds of outbreaks female members of the mosquito species Aedes aegypti, which are well-adapted to built environments, spread the virus in dense populations. [2] Without human intervention, urban outbreaks end when cold weather kills the mosquitoes or when most of the host population acquires immunity to the virus.

The Aedes Aegypti Mosquito, coloured drawing by Amedeo John Engel Terzi. Courtesy of the Wellcome Library, London, Wellcome Images: images@wellcome.ac.uk

The Aedes Aegypti Mosquito, coloured drawing by Amedeo John Engel Terzi.
Courtesy of the Wellcome Library, London, Wellcome Images: images@wellcome.ac.uk

The evolutionary origins of yellow fever are unknown, but the most popular theory is that the disease originated in West Africa and spread to the Americas and Europe in the 17th century. The proponents of this theory believe that ships participating in the trans-Atlantic slave trade carried infected mosquitoes and passengers from Africa to Europe and its colonies. [3] The disease soon became endemic in areas of the Western Hemisphere where there was a tropical climate and a steady flow of non-immune immigrants.

Sources:

[1] “Yellow Fever.” The World Health Organization. The World Health Organization, 2014. Web. 30 June 2015.

[2] “Yellow Fever.” The Centers for Disease Control and Prevention. The Centers for Disease Control and Prevention, 2011. Web. 30 June 2015.

[3] Henry Rose Carter was one of the leading proponents of the African-origins theory and extensively examined the idea in his work, Yellow Fever: An Historical and Epidemiological Study of Its Place of Origin. Baltimore: The Williams & Wilkins Company, 1931. More recent molecular studies of the yellow fever virus support the African-origins theory and the idea that it spread via the trans-Atlantic slave trade. See: Bryant JE, Holmes EC, Barrett ADT. “Out of Africa: A molecular perspective on the introduction of yellow fever virus into the Americas.” PLoS Pathog 3(5): e75, 2007.  For an interesting examination of the possible connection between the epidemiology of yellow fever and the history of sugar production see: Goodyear, James D. “The sugar connection: a new perspective on the history of yellow fever.” Bulletin of the History of Medicine 52(1): 5-21, spring 1978.

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Health & Medical Mobile Software

Certain Library resources, such as our databases, provide applications for use on mobile devices. This page provides information about apps available to UVa faculty, staff, and students. As these apps are included in our subscriptions, they are free to our users.

AccessMedicine

For Apple and Android Devices
  • This app contains only a subset of the titles available via the web version of the resource. Titles include Quick Medical Diagnosis & TreatmentFitzpatrick’s Color Atlas of Clinical DermatologyDiagnosaurus (differential diagnosis tool) and Pocket Guide to Diagnostic Tests. These resources are designed for use in a point-of-care setting.
  • Prior to using this app, you must create a My Access account while on-Grounds, or while using a proxy connection. Learn more about the app and My Access accounts.
  • You must log onto your My Access account while on-Grounds, or while using a proxy connection, at least once every 90 days to verify your affiliation with UVa.

Browzine

For Apple Devices and Android Tablets
  • Use this app to browse e-journals by subject or title, and read the complete current issue as well as older issues.
  • After installing the app, select “University of Virginia” from the list of institutions, and log in via NetBadge.
  • Create a personal bookshelf of up to 64 titles, enabling you to quickly review new issues of the publications you follow.

The Cochrane Library

For iPads
  • Get monthly selections from Cochrane Systematic Reviews selected by their Editor in Chief.
  • New content can be downloaded automatically.
  • Once downloaded, content can be viewed without a Wi-Fi connection; take Cochrane on your travels!

Micromedex Drug Interactions and Free Drug Reference

For Apple, Android, and Windows Devices
  • When you first access these apps, and periodically thereafter, you will need an access code. Find this code by selecting “Download Center” from the Micromedex website:

  • Scroll down the page to find the codes for each app and then enter the codes in the app when prompted.
  • Use this guide for additional help when using mobileMicromedex.

Micromedex NeoFax and Pediatric Essentials

For Apple (NeoFax & Pediatric Essentials) and Android (Pediatric Essentials) Devices

  • When you first access these apps, and periodically thereafter, you will need an access code. Find these codes by selecting “NeoFax/Pediatrics” from the Micromedex website:

  • Then select “Mobile“:

  • Scroll down the page to find the codes for each app and enter the codes in the apps when promoted.

PubMed for Handhelds

For Apple and Android Devices.
  • Take the power of PubMed with you with an app that makes mobile searching easier!
  • Search via one of several methods, including natural language queries and PICO questions and then quickly view abstracts the TBL (the bottom line) summaries.
  • Save search results to your archive, or email them to yourself and others.

STAT!Ref

For Apple, Android, and Blackberry Devices
  • Search across the Library’s STAT!Ref titles, including Davis’s Drug Guide for NursesMerck Manual of Diagnosis and Therapy, and the Red Book Atlas of Pediatric Infectious Diseases
  • You must verify your access every 90 days. You will receive an email warning when this is necessary.

UpToDate

For Apple, Android, and Windows Devices
  • Prior to using this App, you must create a personal account while on an on-Grounds network. See “How do I configure my mobile device for remote access to UpToDate?” for step-by-step instructions.
  • You must log onto your UpToDate account while on Grounds, or while using a proxy connection, at least once a month to verify your affiliation with UVa. UpToDate will send you an email reminder before access expires.
  • You can have only two mobile devices registered to your account, and must remove a device from your account before you can install the app on a new device.

Additional Sources

Additional free and pay-per-view resources can be found at the various app stores:

While the Library focuses on apps available via our purchased resources, many additional healthcare apps exist. Sites such as iMedicalApps can help you find user-generated reviews of medical apps.

Do you need help optimizing your mobile device? Request a consultation and receive a one-on-one training session. Make your mobile device work for you!

 

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Featured E-book: Fostering Clinical Success

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Massachusetts General Hospital (MGH), long esteemed for its rigorous science and technical excellence, takes time each day for something seemingly unscientific: telling stories. Why? Research has shown that in today’s high-tech, rapid-change environment, one of the simplest tools — storytelling — can significantly improve outcomes. MGH’s systematic use of clinical narratives has improved patient care and increased patient, family, and staff satisfaction while reducing costs. Used in conjunction with best-practice technical expertise, clinical narratives have become a key component of the hospital’s evidence-based practice (EBP) implementation. In Fostering Clinical Success, MGH nurse leaders share their model for creating, embedding, and fostering a narrative culture. Create a safer environment for your patients and improve the practice environment for your staff through storytelling and other evidence-based techniques presented by three nurse leaders at a premier U.S. hospital.

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Here’s Where Most of Our Old Print Journals Are Located

Ivy Stacks is a high-density shelving facility located on Ivy Road.  Several years ago, we made the decision to send most of our older print journals to Ivy Stacks in order to free up space for other purposes.  Here’s a short video of the facility produced by the University of Virginia Magazine.

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Introduction to the History of the U.S. Army Yellow Fever Commission

This post will be the first in an ongoing series that will tell the history of the U.S. Army Yellow Fever Commission and the historical context of its work. The posts are and will become pages of a revamped online exhibit about the Commission. Some of the posts will contain content that has been previously published by the Claude Moore Health Sciences Library, while others will contain new content. 

Walter Reed sailing to Cuba, circa 1900. Philip S. Hench Walter Reed Yellow Fever Collection 1806-1995, Box-folder 87:39, Historical Collections, Claude Moore Health Sciences Library, University of Virginia.

Walter Reed sailing to Cuba, circa 1900. Philip S. Hench Walter Reed Yellow Fever Collection 1806-1995, Box-folder 87:39, Historical Collections, Claude Moore Health Sciences Library, University of Virginia.

Here I have been sitting reading that most wonderful book — La Roche on Yellow Fever — written in 1853. Forty-seven years later it has been permitted to me & my assistants to lift the impenetrable veil that has surrounded the causation of this most dreadful pest of humanity and to put it on a rational & scientific basis.” —Walter Reed in a letter he wrote to his wife at midnight, December 31, 1900 [1]

In Cuba, at the dawn of the twentieth century, the U.S. Army Yellow Fever Commission had demonstrated irrefutably that the mosquito was the vector of transmission for yellow fever. Cuban scientist Carlos J. Finlay had first proposed such a connection in 1881, but had not been able to prove his theory conclusively to the world scientific community.

The members of the Commission, Walter Reed, James Carroll, Aristides Agramonte, and particularly Johns Hopkins scientist Jessie Lazear, had sought Finlay’s assistance to clarify and ultimately test the mosquito theory. Indeed in the very early stages of the investigation, Lazear lost his life to a case of yellow fever, very likely experimental in origin.

Deeply dismayed at the loss of their friend and colleague, but intrigued by the very real possibility of a solution within reach, the Commission designed an experimental protocol which would withstand strict scientific scrutiny. They obtained permission from the military leadership to establish an experimental facility — which they named Camp Lazear — on the outskirts of Havana and implemented a bold study using human subjects. Despite the risk, the experiment required human subjects because yellow fever was not known to have an affect on any other species. In 1900, human experimentation was not a new idea, but unlike most other studies of that period, the subjects at Camp Lazear would be volunteers. They would have full knowledge of the experiment and its potential consequences.

As Walter Reed wrote to his wife, the experiments proved dramatically successful. Mosquito eradication programs were soon implemented throughout the Americas and yellow fever was largely conquered in the Western Hemisphere.

Sources:

[1] Letter from Walter Reed to Emilie Lawrence Reed,  December 31, 1900. Philip S. Hench Walter Reed Yellow Fever Collection 1806-1995, Box-folder 22:62. Historical Collections, Claude Moore Health Sciences Library, University of Virginia.

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Minor Changes to CMHSL Webpage

The following changes were made recently to the vertical orange ribbon on the CMHSL webpage.  If you have questions about the changes, please contact David Moody, IT Department Manager, at dam8u@virginia.edu.

1. The list title is now Top Resources rather than Databases.

2. A link to AccessMedicine has been added.

3. The link to Virgo has been moved up to the Top Resources section.

4. The header , Journals & Books, has replaced by dashes.

5. The link to ILLiad Interlibrary Loan has been removed from  A link to ILL is still available in the Library at a Glance box under Services.

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