Ask a Librarian! addresses questions that clinicians commonly ask medical librarians, with the goals of providing information about the various resources offered by medical libraries and of promoting collaboration between PAs and medical librarians. Do you have a question for a medical librarian? Send your question to ask.a.librarian.jaapa@gmail.com.

Question: I recently saw a patient with a rare genetic disorder. Can you suggest reliable sites or resources that will help me broaden my understanding of such conditions?

Answer: Locating authoritative, current information on rare genetic disorders can sometimes be challenging, so take advantage of these free, highly respected resources.

Genetics Home Reference is a great first stop for both you and your patients. You can search the database from several different angles – genetic condition, specific genes or chromosomes. There's also a glossary and a full-text handbook to help you interpret genetic concepts. All sections are interlinked, making it easy to navigate.

Gene Tests is primarily for health care providers and includes a variety of information related to genetic issues. A section called Gene Reviews provides peer-reviewed entries on specific genetic conditions, including research being conducted, lists of support organizations, and in-depth medical discussions with references. Gene Tests also contains voluntary listings of laboratories and clinics worldwide that perform various types of genetic testing.

Finally, OMIM (Online Mendelian Inheritance in Man) has a comprehensive catalog of human genes and inherited genetic disorders. The search interface is similar to PubMed's, and results will link you to literature, sequence records, maps, and related databases. Because of its technical nature, OMIM is designed for the health care professional.

Question: I work in maxillofacial surgery and am looking for reliable related online resources, including information about “delusional halitosis.”

Answer: There are three professional organization Web sites that offer a variety of resources for clinicians working in the maxillofacial surgery specialty. The largest share of resources is available in the “members only” sections, but there are a variety of tools and information available for nonmembers as well. These Web sites include the American Academy of Oral and Maxillofacial Pathology; the American Board of Oral and Maxillofacial Surgery; and the American Association of Oral and Maxillofacial Surgeons.

Additionally, several journals focused on maxillofacial surgery are indexed by Medline, including the British Journal of Oral and Maxillofacial Surgery, the International Journal of Oral and Maxillofacial Surgery, the International Journal of Oral and Maxillofacial Implants, and the Journal of Oral and Maxillofacial Surgery.

Finally, clinicians working in the oral and maxillofacial surgery field may encounter patients with delusional halitosis, also known clinically as pseudo-halitosis and halitophobia. Several indexed articles describe this condition. These include: Characteristics of 2000 patients who visited a halitosis clinic from 2009 in the Journal of Clinical Periodontology; a 2006 German article called Halitophobia-An under-recognized clinical picture; Successful treatment by paroxetine of delusional disorder, somatic type, accompanied by severe secondary depression, a 2010 piece from the Journal of Clinical Neuropharmacology examining an interesting case involving this malady and its successful treatment with paroxetine; and Delusional halitosis. Review of the literature and analysis of 32 cases, a 1990 review from the British Dental Journal.
Jim Anderson is a physician assistant in the Department of Neurological Surgery at Harborview Medical Center in Seattle. He is a former chair of the AAPA's Committee on Diversity and a member of the JAAPA editorial board. Susan Klawansky is a medical librarian at Seattle Children's Hospital.