Medical webwatch.

Immunotherapy in Allergic Asthma, www.audiodigest.org/cgi-bin/start/acaai/immunotherapy/main.html is a continuing medical education course from the American College of Allergy, Asthma & Immunology. In the format of slide and audio presentations it covers "Immunotherapy a Historical Perspective," "Immunotherapy as a Treatment for Asthma--an Evaluation of Studies, Preventative Aspects, Safety and Economic Issues," and finally, a discussion of "Future Directions." The program is targeted at "Practicing allergists/immunologists, fellows in accredited allergy-immunology training programs, primary care physicians who care for asthma patients, allied health professionals in the field of asthma care, and health care administrators." The course was originally presented in the year 2000, and the slide presentations (averaging 30+ slides each) have various authors.

Evidence-Based Medicine (EBM), www.hsl.unc.edu/services/tutorials/ebm/index.htm. This short introduction to evidence-based medicine was developed by Connie Schardt of the Duke University Medical Center, and Jill Mayer from the University of North Carolina. The units of the course are "What is Evidence Based Medicine?," "The Well Built Question," "Literature Search," "Evaluating the Evidence," and "Testing Your Knowledge." This tutorial is not designed to teach you how to search--although it does provide links to outsourced tutorials on searching Medline in Ovid and Medline in PubMed--but introduces the EBM process by considering a fictitious case history. It will guide you through constructing a well-built question, conducting a Medline inquiry based on this question, along with screen shots of the search. It then considers the validity of the results returned from studies with reference to the rigor of their protocols. The results are then applied back to case notes in the example. Using this approach, the relevance of EBM is clearly demonstrated.

"Puzzled by an unusual clinical presentation and wish you could quickly turn to a colleague? Find information on how to manage over 50 commonly encountered ocular diseases? Find information on signs and symptoms, underlying pathophysiology, recommendations on treatment, and clinical pearls?" Then turn to the Handbook of Ocular Disease Management, www.revoptom.com/HANDBOOK/default.htm. Conditions are listed under eight anatomical categories and are dealt with under "Signs and Symptoms," "Pathophysiology," "Management," and "Clinical Pearls."

Multiple Sclerosis National Clinical Guidelines, developed by the National Collaborating Centre for Chronic Conditions at Royal College of Physicians, UK, www.rcplondon.ac.uk/pubs/books/MS/index.asp. "The guideline sets out specific advice to clinical staff on a wide range of issues from the initial diagnosis of MS to the management of complications. These include the management of muscle spasticity, bladder problems, reduced walking ability and difficulties in swallowing." The guideline is in eight sections that can be downloaded as separate PDF files.

The Auscultation Assistant, www.med.ucla.edu/wilkes/inex.htm, was created by a fourth year medical student at University of California, Los Angeles as a unique way of utilizing the multimedia capabilities of the Internet to enhance the teaching of physical diagnosis to second year medical students. The top menu covers "Physiology," "Systolic," "Diastolic," "Gallop," "Rub," and "Lungs." Each of these categories has subsidiary side menus for a range of common cardiac conditions with explanatory text. But the attraction of this site is that for each of the pathologies selected, the sound of the auscultation is played through your speakers. A nice way to absorb both the pathophysiology and heart sounds at one sitting.

Osteoporosis and Bone Physiology, http://courses.washington.edu/bonephys/ophome.html, is a tutorial maintained by Susan Ott, MD, Associate Professor, Department of Medicine, University of Washington. This interactive site uses animated cartoons to augment the tutorials. The animations help to keep the tutorial fresh and interesting and assist the reader in assimilating quite detailed explanations of physiology, prevention, treatment, diagnosis, bone density measurement, etc. There are tutorials specifically designated for fellows, trainees and medical students, with their own "start here" icon. Osteomalacia and secondary osteoporosis are also covered. The main menu to the left of the home page opens the chapters, with subsidiary menus presenting content. Pages are progressed via the arrow at the bottom of each page. References are available for each chapter, and the site is cross-referenced throughout. All the images used on the site can be browsed via a "Gallery" link. Frequently asked questions sent to Dr. Ott from practitioners are also on the menu. Because this is a large site, the "Index" and "What's New" links on the home page are very welcome.

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