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Biomedical subjects

E A Jackson

Publications and source records attributed to E A Jackson.

At least 19 recordsLinked to original sources
PubMed2001

The V-Y plasty in the treatment of fingertip amputations.

Fingertip amputations are injuries commonly seen by family physicians. The classification of fingertip injuries corresponds with the normal anatomy of the tip of the digit. There are three zones of injury; the V-Y plasty technique is used to repair zone II injuries. The plane of the injury can be described as dorsal, transverse or volar. The dorsal and transverse planes lend themselves to the use of the V-Y plasty technique. In carefully selected injuries, the family physician can use this technique to repair the injured digit. The use of a single V-Y plasty has replaced the original technique that repaired the digit and restored the contour of the fingertip. Good cosmetic and functional results can be obtained. Complications may include flap sloughing, infection and sensory changes.

Amputation, Traumatic↗
PubMed2000

Hair disorders.

Disorders of the hair are commonplace in the primary care practice. Among these disorders are male pattern baldness, Telogen effluvium, alopecia areata, Trichotillomania, and fungal infections involving the hair shaft. A review of the normal anatomy and life cycle of hair also is presented.

Alopecia↗
PubMed2000

White paper on herbal products. American College of Clinical Pharmacy.

Individuals increasingly are taking a more active role in their health care, and herbal products have emerged as a common choice among self-care therapies. Pharmacists are active participants in the care of patients who are taking herbal products. Currently, most pharmacists are not educated adequately about herbal products and other types of alternative medicine. Furthermore, good information about many of these products is not available. These combined factors present a challenge for pharmacists as they seek to provide optimal care and counseling to patients who use herbs or supplements. We recommend the following actions to place pharmacists in better positions as effective agents protecting public safety: Regulations should be implemented at a federal level to require basic levels of standardization and quality control in the manufacture of herbal products. Indexing terms in medical bibliographic systems should be expanded to target herbal products. Funding should be increased for scientific research evaluating herbal products. Pharmacy schools should include a competency statement in their curricula regarding herbal medicines. Continuing education in herbal products should be available and encouraged for all pharmacists. Pharmacists should approach the use of all therapeutic interventions with scientific rigor, whether they are traditional or complementary in nature. Patients will benefit as more information is known and widely disseminated. By actively embracing the responsibility for counseling individuals on the appropriate use of herbal products, pharmacists will become a recognized source of expert information in this rapidly growing area, yielding important improvements in the quality of care.

Humans↗
PubMed2000

Variability in code selection using the 1995 and 1998 HCFA documentation guidelines for office services. Health Care Financing Administration.

BACKGROUND: Documentation guidelines have been developed by the Health Care Financing Administration (HCFA) to promote consistent selection of physician evaluation and management (E & M) codes. Our goals were to determine whether medical providers and auditors agree in their assignment of office codes using 1995 and 1998 guidelines and to ascertain if the code levels assigned are affected by auditor experience and training. METHODS: A total of 1,069 established patient charts from private family physician offices were reviewed by a family practice faculty physician, a family practice resident physician, and a professional coder. The main outcome measures were the agreement between the auditors and the medical care provider on code selection and the degree to which documentation supported the code selected. RESULTS: All auditors agreed with the medical provider code selection in only 15.2% (1995 guidelines) and 29.2% (1998 guidelines) of visits. Professional coders were more likely than faculty physicians or resident physicians to agree with the code assigned by the medical provider (51.7% vs 40.7% and 39.6%, P <.001). Documentation adequately supported the most common office code selection, 99213, in 92.7% (1995) and 91.0% (1998) of the charts reviewed. Concurrence among all auditors was only 31.0% (1995) and 44.3% (1998). CONCLUSIONS: Interobserver differences exist in the assignment of E & M codes by auditors using both 1995 and 1998 HCFA guidelines. The 1998 documentation guidelines produce greater agreement among auditors. The documentation supported the level of code billed in the majority of established patient office visits.

Ambulatory Care↗
PubMed1997

Rapid inhalation induction in children: 8% sevoflurane compared with 5% halothane.

Sevoflurane has a lower blood-gas solubility and a less pungent odour than halothane; this may allow more rapid induction of anaesthesia. In a randomized, blinded study, we compared the induction characteristics of maximum initial inspired concentration of 8% sevoflurane and 5% halothane using conventional vaporizers in children aged 3 months to 3 years. There was no statistically significant difference in induction times between the two groups: mean times to loss of consciousness were 1 min 12 s (SD 18 s, range 40 s-1 min 44 s) for sevoflurane and 1 min 16 s (SD 17 s, range 50 s-1 min 52 s) for halothane, although these times were shorter than in previous studies using a gradual increase in vapour concentration. A small number of complications were noted in both groups, although none interfered with induction of anaesthesia. Struggling scores were lower in the sevoflurane group than in the halothane group (chi-square for trends = 6.34, P < 0.02). A significant number (11 of 15) of parents of children in the sevoflurane group who had previous experience of halothane induction preferred sevoflurane (chi-square for trends = 4.03, P < 0.05). We conclude that with this technique, induction was rapid with both sevoflurane and halothane. Our assessment of patient struggling and parents' perceptions suggests that induction with sevoflurane was more pleasant than with halothane.

Anesthesia, Inhalation↗
PubMed1996

A new critical incident monitor for use with the paediatric T-piece. In vitro evaluation and clinical experience with the Magtrak Infanta Electronic Respirometer.

In vitro studies and clinical evaluation suggest that the Magtrak Infanta Electronic respirometer provides a useful additional critical incident monitor for use with the paediatric T-piece. During ventilation with the Nuffield 200 ventilator and Newton valve it provides early warning of leaks or disconnections in the breathing system, airway obstruction and reduction in fresh gas flow. Some of these events may not be detected by conventional monitors.

Airway Obstruction↗
PubMed1996

Management of gestational diabetes by family physicians and obstetricians.

BACKGROUND: Studies suggest that there are differences between family physicians' (FPs) and obstetricians' (OBs) management of women with low-risk pregnancies. This study was conducted to examine outcomes in women with gestational diabetes mellitus (GDM) to see if similar patterns exist between those cared for by FPs and those cared for by OBs. METHODS: A retrospective chart review was undertaken and analyzed by prenatal care provider. Eight hundred thirteen women were identified as having a pregnancy complicated by GDM. Management outcome data of FPs and OBs were compared. RESULTS: Eighteen percent of patients were cared for by FPs. The percentage with a prior history of GDM did not differ between groups. Patient groups were similar demographically except that FPs cared for a significantly higher percentage of patients on public assistance (60% vs 38%, P < .001). Average prepregnancy weight and body mass index were equal, as were average weight gain, gestational week at entrance to care, and number of prenatal visits. Class instruction on diabetes was given to 83% of FP patients and 85% of OB patients. A greater percentage of OB patients were placed on insulin therapy (33% vs 24%, P < .05). Complications of pregnancy, labor, and delivery were equal, but a higher number of OB patients had a cesarean section (33% vs 11% for FPs). Despite the equal occurrence of preterm labor/delivery and low birthweight, OBs used tocolysis in significantly more women than did FPs (10.3% vs 4.7%, P < .03). Average birthweight of infants delivered by FPs and OBs (3259 g and 3356 g, respectively), macrosomia rate (12% and 13%, respectively), length of pregnancy, fetal complication rate, Apgar scores, and length of hospital stays were all equivalent. CONCLUSIONS: Although there are variations in the care of women whose pregnancy is complicated by gestational diabetes mellitus, there are no significant differences in neonatal outcome. There is, however, an overall lower rate of both cesarean section and tocolysis use among women cared for by FPs.

Adult↗