tbuckley/cabot-search huggingface dataset:
Local Fasciocutaneous Sliding Flaps for Soft-Tissue Defects of the Dorsum of the Hand
Authors: Joseph F. Sobanko, John Fischer, Jeremy R. Etzkorn, Christopher J. Miller
Journal: JAMA Dermatology (2014)

Appropriate coverage of defects that expose tendon, joints, and/or neurovascular structures is necessary to preserve optimal hand function. Local, random-pattern flaps and skin grafts may be inadequate because of the hand's finite skin reservoir or the presence of a poorly vascularized and mobile wound bed. Described herein is a novel method of dorsal hand reconstruction.A fasciocutaneous sliding flap and the underlying vascular anatomy of the dorsal hand are described. The flap takes advantage of the distinct fascial layers of the hand by raising the skin and fascia with bilevel undermining.The proposed single-stage, bilevel undermined fasciocutaneous sliding flap based on the perforating vessels running through fascial septae recruits pliable, easily mobilized skin, preserves neurosensory innervation, and facilitates early hand mobilization with reduced postoperative care. This flap, and its proposed variations, are ideal for use when paratenon is exposed and immobilizing the hand would be necessary for graft survival or when tension at the wound precludes reconstruction with primary closure or a traditional flap.
ITAM signaling in dendritic cells controls T helper cell priming by regulating MHC class II recycling
Authors: Daniel B. Graham, Holly M. Akilesh, Grzegorz B. Gmyrek, Laura Piccio, Susan Gilfillan, Julia Sim, Roger Belizaire, Javier A. Carrero, Yinan Wang, Gregory S. Blaufuss, Gabriel Sandoval, Keiko Fujikawa, Anne H. Cross, John H. Russell, Marina Cella, Wojciech Swat
Journal: Blood (2010)
Using 'Windows of Opportunities' in Brief Interviews to Understand Patients' Concerns
Authors: William T. Branch
Journal: JAMA (1993)

WE OBSERVED five seasoned clinicians in practice to find out how they interact with patients. We analyzed videotapes made of their interactions with randomly selected, regular office patients. We found five instances during four of the 20 videotaped interviews during which patients discussed their concerns about personal, emotional, and/or family issues in sequences lasting from 1 to 7 minutes. These interactions stood out from the rest of the interviews, so that we termed them windows of opportunity.  We believe that we have observed an approach taken by some highly experienced practitioners for the purpose of efficiently exploring their patients' psychological and social issues during brief interviews. By describing our observations, we hope to encourage other clinicians to employ this approach.  Method  We did not plan to compare one physician with another, but rather, to discern the ways by which experienced clinicians related to their patients. We employed the iterative process
Human Milk Contaminated With Salmonella kottbus
Authors: Robert W. Ryder
Journal: JAMA (1977)

Human milk contaminated with<i>Salmonella kottbus</i>caused an outbreak of illness in seven of 22 infants in a neonatal intensive care unit. A case-control investigation failed to identify any risk factor except consumption of milk from a single donor, whose milk was subsequently found to be contaminated with<i>S kottbus</i>. Collection of human milk from properly instructed donors screened for microbiological pathogens, refrigeration of this milk at 1 to 5 °C after collection, and controlled distribution by a milk bank should minimize the few hazards associated with its consumption. (<i>JAMA</i>238:1533-1534, 1977)
Composite-Tissue Transplantation — A New Frontier
Authors: James H. Herndon
Journal: New England Journal of Medicine (2000)

Limb transplantation has long been of interest to surgeons. The legend of the pysician twins Saint Cosmos and Saint Damian, who transplanted a whole leg in a.d. 348, has come down to us from antiquity. The first successful transplantation of an allograft of a forearm and hand from a cadaver was performed in Lyons, France, in 1998.1 The second successful forearm-and-hand transplantation took place in 1999 in Louisville, Kentucky. In this issue of the Journal, Jones et al. report on the status of the transplant recipient after one year of follow-up.2 The technical demands of this procedure are now well . . .
The dizzy patient
Authors: B. J. Renton
Journal: BMJ (2010)

A 62 year old man was referred by his general practitioner with a one month history of intermittent dizziness and unsteadiness. He described the dizziness as “light headedness,” occasionally with the sensation of the room spinning. His dizziness had some postural element and the episodes were self limiting, usually lasting a few seconds only. He also admitted to feeling unsteady on his feet, with a tendency to veer to the left. 

The patient had no history of headache; nausea or vomiting; tinnitus; hearing loss; syncope; limb weakness; altered sensation; speech or visual disturbance. His medical history included chronic obstructive pulmonary disease, dyspepsia, and depression. He used to smoke (10 a day for 30 years) and denied drinking alcohol to excess. 

On examination, the patient’s blood pressure was 133/76 (with no postural drop elicited) and his pulse was 60 beats/min regular. Oxygen saturations were 96% in room air. Cardiovascular, respiratory, and gastrointestinal examinations were within normal limits. Examination of the limbs revealed symmetrical brisk reflexes without weakness. Tests showed coordination to be intact, but the patient had mild gait ataxia manifest on “heel to toe” walking. Sensation, including proprioception, was intact, with no rombergism. Cranial nerve examination was normal and fundoscopy was unremarkable. Baseline blood tests were normal, except for an isolated polycythaemia: haemoglobin 184 g/l (normal range 133-167); haematocrit 0.53 (0.39-0.50); normal white cell and platelet count. Electrocardiogram was normal. 

The patient was discharged and an outpatient computed tomography brain scan was arranged. His general practitioner was advised to repeat the full blood count and refer the patient to a haematologist if his haematocrit remained elevated. The scheduled computed tomography was subsequently substituted with magnetic resonance imaging by the radiologist because it provides better images of the posterior fossa.⇓ ⇓



Fig 1 Gadolinium enhanced T1 weighted axial image





Fig …
Identifying Mobility Dysfunctions in Elderly Patients
Authors: Mary E. Tinetti
Journal: JAMA (1988)

The need to assess functions such as mobility in elderly patients is increasingly recognized. Lacking other methods, clinicians may rely on the standard neuromuscular examination to evaluate mobility. Therefore, we checked the sensitivity of the neuromuscular examination for identifying mobility problems by comparing relevant neuromuscular findings with performance during four routine mobility maneuvers: (1) getting up from a chair, (2) sitting down, (3) turning while walking, and (4) raising the feet while walking. The subjects investigated were 336 elderly persons living in the community. Many subjects who performed poorly during mobility maneuvers did not have the corresponding neuromuscular abnormalities. For example, although hip and knee flexion are needed to sit down safely, abnormal hip flexion was found in only 15% and abnormal knee flexion in only 30% of the subjects who had difficulty sitting down. The relationship between neuromuscular findings and functional mobility was not predictable enough to rely on neuromuscular findings for identifying mobility problems. Therefore, a simple assessment that reproduces routine daily mobility maneuvers should be developed for use in the clinical care of elderly patients.
SOME CHEMICAL INFLUENCES ON HAIR (GROWTH AND PIGMENTATION.*
Authors: ARTHUR ROOK
Journal: British Journal of Dermatology (1965)

Journal Article SOME CHEMICAL INFLUENCES ON HAIR (GROWTH AND PIGMENTATION. Get access ARTHUR ROOK, M.D., F.R.C.P. ARTHUR ROOK, M.D., F.R.C.P. Consultant Dermatologist, Addenbrooke's Hospital, Cambridge Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 77, Issue 3, 1 March 1965, Pages 115–129, https://doi.org/10.1111/j.1365-2133.1965.tb14614.x Published: 01 March 1965
APPROPRIATE THERAPIES IN DEVICE RECIPIENTS WITH IMPROVED LEFT VENTRICULAR FUNCTION
Authors: Sankar N. Varanasi, M. Zubair Jafar, Erin Gillen, Kelly Crump, Haaris Muneer, Hafshah Ubaid, Sonum Samra, Sami Siddiqui, Venkateshwar Gottipaty
Journal: Journal of the American College of Cardiology (2014)
HOW DOES THE NUMBER OF NORMALS AFFECT THE RELIABILITY OF A NORMAL REFERENCE DATABASE?
Authors: S Khanna, G Porenta, M DeGroof, J Czernin, A Kim, R Brunken, M Di Carli, M Phelps, R Hawkins, H Schelbert, J Maddahi
Journal: Clinical Nuclear Medicine (1992)

Khanna, S.; Porenta, G.; DeGrmf, M; Czernin, J.; Kim, A.; Brunken, R.; Carli, M. Di; Phelps, M.; Hawkins, R.; Schelbert, H.; Maddahi, J. Author Information
A TEST OF THE SUNSCREENTNG EFFECTS OF TRIPROLIDINE
Authors: W. GORDON
Journal: British Journal of Dermatology (1964)

Journal Article A TEST OF THE SUNSCREENTNG EFFECTS OF TRIPROLIDINE Get access W. GORDON, M.B., Ch, B., M.R.C.P. Edin W. GORDON, M.B., Ch, B., M.R.C.P. Edin Member of the Photobiological Research Group, Council of Scientific and Industrial Research, Department of Dermatology and Medicine, Groote Schuur Hospital, Cape Town and University of cape Town. republic of South Africa Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 76, Issue 6, 1 June 1964, Pages 265–267, https://doi.org/10.1111/j.1365-2133.1964.tb14527.x Published: 01 June 1964
LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS) OF THE PALMS AND SOLES*
Authors: MARY S. SMITH
Journal: British Journal of Dermatology (1942)

Journal Article LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS) OF THE PALMS AND SOLES Get access MARY S. SMITH MARY S. SMITH Assistant Physician, Skin‐Department, Victoria Infirmary, Glasgow Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 54, Issue 10, 1 October 1942, Pages 255–264, https://doi.org/10.1111/j.1365-2133.1942.tb10560.x Published: 01 October 1942
Necropsy rates in the United Birmingham Hospitals.
Authors: H A Waldron, L Vickerstaff
Journal: BMJ (1975)

The necropsy rate in the United Birmingham Hospital has fallen from 74-4% in 1958 to 46-0% in 1972. In the Birmingham region as a whole the rate is 27-3%, approximately equal to the national rate. Most clinicians in the group who replied to a standard questionary considered that the necropsy still has an important part to play in their own practice and in undergraduate training, and they viewed the declining rate as a matter for concern. Some measure of disagreement was found between the ante-mortem and post-mortem diagnoses of patients in the two largest hospitals in the group. This suggests that the necropsy has a role to play in medical audit and that attempts to reverse the declining trend should be encouraged.
Diabetes groups call for better regulation of insulin pumps
Authors: S. Mayor
Journal: BMJ (2015)

Regulatory agencies should adopt a more rigorous, standardised approach to assessing the safety of insulin pumps and require manufacturers to provide safety data during development and throughout clinical use, suggest leading diabetes organisations in new recommendations to reduce adverse events and deaths among patients undergoing insulin pump therapy.

A working group of the European Association for the Study of Diabetes and the American Diabetes Association warns in a statement in Diabetologia that insulin pump users are “exposed to significant and potentially fatal hazards.”1 Potential problems include pump failure, blockage of the insulin infusion set, and problems …
Cost and mortality associated with hospitalizations in patients with immune thrombocytopenic purpura
Authors: Mark D. Danese, Karla Lindquist, Michelle Gleeson, Robert Deuson, Joseph Mikhael
Journal: American Journal of Hematology (2009)

Immune thrombocytopenic purpura (ITP) is associated with low platelet counts and, consequently, a high risk of adverse events leading to hospitalization. However, there are few data on the clinical and economic burden of hospitalizations for ITP. The Nationwide Inpatient Sample (NIS) database of discharges, a stratified 20% sample of all United States (US) community hospitals across all payers, was used to evaluate discharges in ITP patients. We developed nationally representative numbers of discharges in ITP patients from 2003 to 2006 based on diagnosis codes. Using appropriate weights for each NIS discharge, we created national estimates of average cost, length of stay, and in-hospital mortality for specific groups of ITP-related hospitalizations. Approximately 129,000 discharges occurred between 2003 and 2006 in ITP patients. The average cost associated with all discharges in 2008 dollars was 16,476, with a 6.4-day length of stay and in-hospital mortality of 3.8%. In contrast, the average cost of all hospitalizations in the US population during the same period was 10,039, the average length of stay was 4.8 days, and in-hospital mortality was 2.5%. Mortality risk was higher for ITP patients than for the standard US population adjusted for age and gender, with a relative mortality ratio of 1.5 (95% CI: 1.4-1.6). On the basis of a nationally representative sample of US discharge records from 2003 to 2006, hospitalization with ITP represents an economically and clinically important event. ITP was associated with higher costs, longer stays, and more in-hospital deaths on average than all other hospitalized patients combined.
An Evaluation of Cellular Lineages in the Pathogenesis of Experimental Hepatocellular Carcinoma
Authors: Stewart Sell, Hyam L. Leffert
Journal: Hepatology (1982)

Analysis of liver from rats exposed to chemical hepatocarcinogens has led to a model that postulates sequential premalignant changes, culminating in hepatoma formation from neoplastic nodules. Several experimental protocols devised during the last quarter century have focused upon this lineage model. But proof that neoplastic nodules are the definitive premalignant lesions has not been achieved. Recent work, using α-fetoprotein as a marker for liver cell alterations induced by different carcinogen-feeding regimens, suggests that chemically induced hepatomas may also arise from nonnodular cell populations. Therefore, the extensive biochemical and biological studies of presumed “premalignant” cells may have utilized the wrong cells. Unequivocal identification of the cell population at risk for malignancy is needed to delineate mechanisms by which chemicals cause hepatocellular carcinoma.
Rule out twin pregnancy in first-trimester bleeding
Authors: W. A. Check
Journal: JAMA (1979)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
197 FACTORS RELATED TO HOSPITALIZATION BUT NOT THE SEVERITY OF THE LIVER DISEASE INCREASE THE RISK OF NOSOCOMIAL INFECTION IN CIRRHOTIC PATIENTS
Authors: V. Di Gregorio, V. Giannelli, C. Lucidi, M. Giusto, B. Imperatrice, G. Iacovone, B. Lattanzi, O. Riggio, M. Merli
Journal: Journal of Hepatology (2013)
SOME OF THE USES OF STRYCHNIA IN OBSTETRIC PRACTICE.Read in the Section on Obstetrics and Diseases of Women, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: JOHN MILTON DUFF
Journal: JAMA (1894)

In February, 1893, I read a paper before the Pittsburg S. S. Medical Society on, "Strychnia in Obstetric Practice," a synopsis of which appeared in the<i>Therapeutic Gazette</i>of May 15, 1893. Incidentally, in a paper "On the Care of Pregnant Women," read by me at the last meeting of the American Association of Obstetricians and Gynecologists, published in the annual transactions of that Association for 1893, I referred to some of the indications for the administration of strychnia in obstetric practice. R. Bell, in the<i>British Medical Journal</i>, page 715, 1890, refers to strychnia as an aid in parturition, as does Dr. J. C. Edgar in the<i>New York Journal</i>of May 12, 1894. Almost simultaneously with my own paper of May 15, 1893, there appeared in the<i>Medical and Surgical Reporter</i>of May 13,1893, an article on "Strychnia vs. Ergot in Obstetric Practice," by G. V. Hall, M.D.,
Effectiveness of Safety Measures Recommended for Prevention of Workplace Homicide
Authors: Dana Loomis
Journal: JAMA (2002)

ContextHomicide is the second leading cause of death on the job for US workers. Government agencies recommend that employers prevent violence against workers by adopting interventions originally designed to prevent robbery, but the effectiveness of these interventions is unknown.ObjectiveTo investigate the effectiveness of existing administrative and environmental interventions recommended for preventing workplace homicide.Design, Setting, and ParticipantsPopulation-based case-control study of North Carolina workplaces where a worker had been killed between January 1, 1994, and March 31, 1998, identified through a statewide medical examiner system (cases; n = 105) and an industry-matched random sample of workplaces at risk during the same period, selected from business telephone listings (controls; n = 210).Main Outcome MeasureRisk of death of a worker due to homicide.ResultsAmong environmental interventions, strong and consistent reductions in the risk of a worker being killed on the job were associated with bright exterior lighting (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.3-1.0). Among administrative interventions, the largest beneficial effect was for staffing practices that prevented workers from being alone at night (OR, 0.4; 95% CI, 0.2-0.9). Keeping doors closed during working hours was also associated consistently with substantially reduced risk (OR, 0.4; 95% CI, 0.1-1.1) but was not statistically significant. Combinations of 5 or more administrative measures were associated with significantly lower levels of risk (OR, 0.1; 95% CI, 0.0-0.5).ConclusionsWe found evidence suggesting that eliminating solo work at night could reduce the risk of homicide for workers. Keeping doors closed and using bright exterior lighting or combinations of administrative interventions also appear to be beneficial, but there was no evidence of effectiveness for a number of other recommended measures.
Prediction of Hypothyroidism after Partial Thyroidectomy for Thyrotoxicosis
Authors: W. Michie, C. A. S. Pegg, P. D. Bewsher
Journal: BMJ (1972)

Hypothyroidism is one of the major complications after thyroidectomy for thyrotoxicosis, but the factors responsible are not well defined. In an attempt to define these factors 278 patients operated on in 1965-9 were studied in detail. The overall incidence of hypothyroidism was 49%. The high incidence of hypothyroidism during 1965-6 led to a policy of leaving larger remnants in the later years of the study, and it became apparent that the most important aetiological factor in postoperative hypothyroidism was small remnant size. There seemed to be an association between the incidence of hypothyroidism and the presence of antithyroglobulin antibodies, but this association was not statistically significant. The data suggested that blood group O might be more common and blood group A less common in hypothyroid patients. The incidence of hypothyroidism seemed to be uninfluenced by the age or sex of the patient, the size of the gland, or the amount and duration of preoperative antithyroid drug therapy. Though a reasonable prediction of the incidence of hypothyroidism can be made for a group of patients on the basis of remnant size, the fate of the individual can be predicted only within very wide limits. An indication of the future status of the individual patient at one year and subsequently does, however, seem possible from serum protein-bound iodine estimations at one and four months after operation. Hypothyroidism developing later than one year after operation has not been observed in this series. The ability to assess thyroid status early after surgery is of some merit in the long-term supervision of the postoperative thyrotoxic patient, and in this respect surgical treatment seems to have some advantage over radioiodine therapy.
Rapid diagnostic tests to improve treatment of malaria and other febrile illnesses: patient randomised effectiveness trial in primary care clinics in Afghanistan
Authors: T. Leslie, A. Mikhail, I. Mayan, B. Cundill, M. Anwar, S. H. Bakhtash, N. Mohammed, H. Rahman, R. Zekria, C. J. M. Whitty, M. Rowland
Journal: BMJ (2014)

To assess the impact of rapid diagnostic tests on the diagnostic accuracy and treatment of malaria and non-severe fever in an Asian setting.Patient randomised trial in primary level clinics.Two areas of Afghanistan where Plasmodium vivax and Plasmodium falciparum are endemic; one area with moderate transmission (eastern region) and one with low transmission (northern region).5794 patients of all ages with suspected malaria enrolled by 80 clinicians in 22 clinics.Malaria rapid diagnostic tests were compared with clinical diagnosis where no parasite diagnostic test was available, longer established field microscopy, and recently introduced microscopy.Proportion of patients appropriately treated with an antimalarial, defined as patients with P vivax who received chloroquine, patients with P falciparum who received artemisinin based combination therapy, and patients with no malaria parasites who did not receive an antimalarial. Secondary outcomes included diagnostic test accuracy and the proportion of patients negative for malaria who received antibiotics and antimalarials.In the low transmission area, comparing rapid diagnostic tests with clinical diagnosis, 65% (212/325) versus 12% (40/321) of febrile patients were appropriately treated for malaria (adjusted odds ratio 92.7, 95% confidence interval 12.4 to 694.1, P<0.001). The proportion of patients who were negative for malaria and received an antibiotic was 57% (185/325) in the rapid diagnostic test arm compared with 14% (46/321) in the clinical diagnosis arm (16.9, 3.8 to 75.4, P<0.001). In the comparison of rapid diagnostic test with microscopy in the moderate transmission area, 83.6% (1696/2028) versus 76.3% (1512/1983) of patients were appropriately treated for malaria (1.70, 1.30 to 2.23, P<0.001). A higher proportion of P falciparum cases received appropriate treatment with artemisinin based combination therapy when malaria was diagnosed by rapid diagnostic test (82%, 58/71 v 32%, 24/76; 9.2, 3.88 to 21.66, P<0.001).In South and central Asian regions of low to moderate malaria transmission where clinics lack capacity for diagnosis with rapid diagnostic tests or microscopy, the introduction of the tests should be considered to improve clinical care, reduce the overuse of antimalarials, and improve disease surveillance.