Biomedical subjects
Publications and source records attributed to K A Brandt.
Barber's disease is produced by short hairs that penetrate the interdigital spaces of the hands. The following chronic inflammatory reaction causes fistulas or sinuses and cysts. We present the case of a patient with interdigital pilonidal sinuses of all web spaces in both hands. Such an extensive case of this occupational disease has so far not been reported.
The long-term objective of this project is to make health sciences librarians more effective in their role by using emerging technologies to deliver timely continuing education (CE) programs to them regardless of their physical location. The goals of the one-year planning project at the William H. Welch Medical Library are to plan, implement, and evaluate a pilot CE program that includes (1) a three-day general-interest session organized in four tracks: Market Forces and Management, Information Technology and the Internet, Publishing and Copyright, and Education; (2) a one-day special topic session on the Informatics of the Human Genome Project; and (3) an electronic poster session in parallel with the general-interest session. The program will be offered in three simultaneous formats: (1) on-site, in a distance-learning classroom in Baltimore; (2) as a telecourse, in a similar classroom outside Washington, DC; and (3) online, via the World Wide Web. An electronic proceedings of the entire program will be published on the Web to serve as a continuously available CE resource for health sciences librarians. This paper gives an overview of the planning process, presents a status report on the programmatic and technical implementation of the pilot project at its midpoint, and discusses future directions for the program.
The results of a prospective clinical study conducted in three German burn centres are reported. The subject of the evaluation was to show the effectiveness of a new, preshaped, semipermeable burn dressing that is resistant to fluids and bacteria but highly permeable to vapour. The dressing was used in conjunction with 1 per cent silver sulphadiazine cream in treating partial thickness burns of the hand. In 49 patients, 72 partial thickness burned hands were treated. The application proved to be very easy. The time for a dressing change was short (5-10 min). The duration of treatment was 13 days on average. Complications due to infections did not occur. Because of the semipermeable properties of the dressing material, skin macerations occurred in only a few instances (13 per cent) as a result of inappropriate cream application or extremely high exudation rates, and these did not adversely affect the healing process. Patients achieved the ability to perform activities of daily living early with positive results for the patients, the physician and the nursing team.
The indication for operative treatment of third-degree burns, necrectomy and the possibilities for closing the defects are discussed. Special problems have to be considered in the operative therapy of third-degree hand injuries. In cases of extensive burns the donor areas are mostly limited and a biological dressing must be used. Different kinds of wound coverage are available for the final autologous skin reconstruction in these patients. Last but not least, the right postoperative immobilisation of both the patient and the transplanted areas is very important for successful skin grafting.
As part of the required curriculum for medical students, we devised a literature-searching practicum that has been used for two years. In both years, we stressed going beyond the skills needed for using a particular searching program, towards a more conceptual approach to information searching. In the first year, the practicum was taught in a traditional lecture/hands-on format. In the second year, the lecture was replaced by a World Wide Web-based tutorial (http:@www.welch.jhu.edu/Education/tutorials/pra cticum.html). To our knowledge, this is the first Web-based resource intended to teach students about appropriate use of search technology. Comparison of student evaluations showed no difference in attitude toward the two versions of the practicum, and observation of student performance suggested similar levels of proficiency. We conclude that placing these educational materials on the Web (1) makes us practice what we preach; (2) is as effective as traditional teaching methods; and (3) gives students a resource for reinforcement learning.
The GDB Human Genome Data Base refers collectively to GDB and OMIM, Online Mendelian Inheritance in Man. GDB and OMIM are linked databases that provide an international repository for information generated by the Human Genome Initiative. GDB contains human gene mapping data, while OMIM offers the text of Dr. Victor A. McKusick's catalog of genetic disease and phenotype descriptions. These databases, updated and edited continuously, integrate bibliographic and full-text information with several types of mapping data. They are accessible through a flexible interface and are available through SprintNet and the Internet to the scientific community without cost. This paper provides an overview of the context, development, structure, content, and use of these databases.
In third-degree burn injuries vital, functional or esthetic indications require surgical therapy. In order to keep the risk of infection as low as possible it is necessary to begin with the necrectomy as soon as possible. Extent and depth of the damaged tissue, the degree of the wound infection as well as the patient's physical condition decide whether the defect should be covered temporarily or whether an autologous splitskin transplantation should be performed. In addition to stripe transplants meshgraft-transplants of different sizes have proved to be very successful in surgery of burn injuries.
The importance of considering the possibility of later thumb replacement during the primary treatment of the injured thumbless hand is pointed out. Even a functionless long finger or a part of it which can be later used for a thumb reconstruction should be retained, as in such a hand its loss may be otherwise irreplaceable. The rare indication for primary thumb replacement is also demonstrated.
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OBJECTIVE: This study explored the relationship of early postpartum maternal-infant interactions to breastfeeding outcome at 6 weeks postpartum. DESIGN: Prospective, comparative descriptive study. SETTING: Women, Infants, and Children Supplemental Nutrition Program and Comprehensive Perinatal Services Programs in northern California. PARTICIPANTS: Forty-two Latina participants were recruited in the 3rd trimester of pregnancy. Eligibility criteria included age 18 years or older, primiparous at recruitment, antepartum desire to breastfeed 8 weeks or longer postpartum, planned hospital birth, full-term vaginal birth of a healthy newborn, and an uncomplicated, immediate postpartum course for mother and newborn, including being discharged together. MAIN OUTCOME MEASURES: The study examined breastfeeding dyads' early postpartum scores on Barnard's Nursing Child Assessment Feeding Scale (NCAFS) in relation to breastfeeding outcome 6 weeks postpartum. NCAFS tests were performed 28-90 hours postpartum in the participants' homes, and breastfeeding status was assessed by phone contact 6 weeks postpartum. RESULTS: Dyads continuing to breastfeed at 6 weeks postpartum had significantly higher early postpartum NCAFS scores than did dyads who had weaned from the breast by 6 weeks postpartum. CONCLUSIONS: Optimal maternal-infant interactions, as evidenced by higher scores on Barnard's NCAFS, were related to longer breastfeeding duration. Lower scores on the NCAFS, suggesting difficulties in maternal-infant interaction, were related to weaning earlier than planned.