Biomedical subjects
M Smith
Publications and source records attributed to M Smith.
Keeping it normal. A midwife's success story.
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Shoulder dystocia: never easy.
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Scene work.
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Osteochondritis dissecans of the talar dome in a collegiate swimmer: a case report.
OBJECTIVE: To present the case of an intercollegiate swimmer with a stage IV lateral talar dome injury and associated bony fragments. BACKGROUND: Lack of distinct diagnostic symptoms, low index of clinical suspicion, and the difficulty of visualizing the early stages of this injury on standard x-rays cause frequent misdiagnosis of talar dome lesions. DIFFERENTIAL DIAGNOSIS: Ganglion cyst, with inflammatory synovitis secondary to rupture of cyst; loose bodies from previous occult fracture; osteochondral fracture. TREATMENT: Initial treatment with nonsteroidal antiinflammatory drugs and a posterior splint for comfort, followed by arthroscopic excision of loose bodies with abrasion and drilling arthroplasty. UNIQUENESS: Patient presented to the team physician for care of acute left medial ankle pain after the athletic trainer had attempted to rupture a ganglion cyst on the anterolateral aspect of the patient's ankle. CONCLUSIONS: Increased clinical suspicion is necessary to correctly diagnose osteochondral lesions, particularly in the early stages. Aggressive treatment of talar dome lesions has a good success rate and may be an attractive option for competitive athletes.
Data elements for emergency department systems, release 1.0 (DEEDS): a summary report. DEEDS Writing Committee.
Variations in the way that data are entered in emergency department record systems impede the use of ED records for direct patient care and deter their reuse for many other legitimate purposes. To foster more uniform ED data, the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control is coordinating a public-private partnership that has developed recommended specifications for many observations, actions, instructions, conclusions, and identifiers that are entered in ED records. The partnership's initial product, Data Elements for Emergency Department Systems, Release 1.0 (DEEDS), is intended for use by individuals and organizations responsible for ED record systems. If the recommended specifications are widely adopted, then problems--such as data incompatibility and high costs of collecting, linking, and using data--can be substantially reduced. The collaborative effort that led to DEEDS, Release 1.0 sets a precedent for future review and revision of the initial recommendations.
Submucosa 1.0 x 0.1 mm in size is sufficient to count inflammatory cell numbers in human airway biopsy specimens.
Counting of inflammatory cells in human airway biopsy specimens is difficult because immunopositive cells are present in varying density in lung tissue. The goal of our study was to assess the minimal amount of tissue that is necessary for the counting of constant cell numbers. In bronchial biopsy specimens from 5 healthy controls and 5 patients with asthma, we evaluated 20 successive areas of submucosa 0.1 x 0.1 mm in size. We recorded positive and negative changes of more than 10% in the counted numbers of CD4-, CD8-, and EG2-positive cells. We demonstrated that tissue 1.0 x 0.1 mm in size, along 1-mm basement membrane, is sufficient to obtain constant cell numbers.
Laparoscopic splenectomy in a community setting.
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Women and coronary disease: relationship between descriptors of signs and symptoms and diagnostic and treatment course.
BACKGROUND: Heart disease is the No. 1 killer among women in the United States. Differences in the clinical features of coronary heart disease among men and women have been reported, along with various approaches to the diagnostic workup and therapeutic interventions. PURPOSE: To explore the relationship between descriptors of signs and symptoms of coronary heart disease and follow-up care and to investigate any differences between male and female patients. METHODS: Structured interviews with patients and chart audits were used to assess initial signs and symptoms, associated cardiac-related signs and symptoms, and the diagnostic tests and interventions used for treatment. The sample consisted of 98 patients (51 women and 47 men) who were admitted with a medical diagnosis of myocardial infarction. RESULTS: Chest pain was the most common sign or symptom reported by both men and women. The 4 most common associated signs and symptoms were identical in men and women: fatigue, rest pain, shortness of breath, and weakness. However, significantly more women than men reported loss of appetite, paroxysmal nocturnal dyspnea, and back pain. Women were also less likely than men to have angiography and to receive i.v. nitroglycerin, heparin, and thrombolytic agents as part of acute management of myocardial infarction. CONCLUSION: Chest pain remains the initial symptom of acute myocardial infarction in both men and women. However, women may experience some different associated signs and symptoms than do men. Despite these similarities, men still are more likely than women to have angiography and to receive a number of therapies.
Childbirth in women with a history of sexual abuse (II). A case history approach.
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Congruence between patients' and family caregivers' perceptions of symptom distress in patients with terminal cancer.
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Educating doctors in palliative medicine: development of a competency-based training program.
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Linking a medical vocabulary to a clinical data model using Abstract Syntax Notation 1.
We have created a clinical data model using Abstract Syntax Notation 1 (ASN. 1). The clinical model is constructed from a small number of simple data types that are built into data structures of progressively greater complexity. Important intermediate types include Attributes, Observations, and Events. The highest level elements in the model are messages that are used for inter-process communication within a clinical information system. Vocabulary is incorporated into the model using BaseCoded, a primitive data type that allows vocabulary concepts and semantic relationships to be referenced using standard ASN. 1 notation. ASN. 1 subtyping language was useful in preventing unbounded proliferation of object classes in the model, and in general, ASN.1 was found to be a flexible and robust notation for representing a model of clinical information.
Research issues in cancer survivorship: report of a workshop sponsored by the Office of Cancer Survivorship, National Cancer Institute.
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Cryoprecipitate and the plastic blood-bag system: provision of adequate replacement therapy for routine treatment of haemophilia. 1967.
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Liver and renal and platelet counts after delivery in patients with severe pre-eclampsia.
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