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P A Helm

Publications and source records attributed to P A Helm.

At least 19 recordsLinked to original sources

Persistent organic pollutants and mercury in marine biota of the Canadian Arctic: an overview of spatial and temporal trends.

This review summarizes and synthesizes the significant amount of data which was generated on mercury (Hg) and persistent organic pollutants (POPs) in Canadian Arctic marine biota since the first Canadian Arctic Contaminants Assessment Report (CACAR) was published in 1997. This recent body of work has led to a better understanding of the current levels and spatial and temporal trends of contaminants in biota, including the marine food species that northern peoples traditionally consume. Compared to other circumpolar countries, concentrations of many organochlorines (OCs) in Canadian Arctic marine biota are generally lower than in the European Arctic and eastern Greenland but are higher than in Alaska, whereas Hg concentrations are substantially higher in Canada than elsewhere. Spatial coverage of OCs in ringed seals, beluga and seabirds remains a strength of the Arctic contaminant data set for Canada. Concentrations of OCs in marine mammals and seabirds remain fairly consistent across the Canadian Arctic although subtle differences from west to east and south to north are found in the proportions of various chemicals. The most significant development since 1997 is improvement in the temporal trend data sets, thanks to the use of archived tissue samples from the 1970s and 1980s, long-term studies using archeological material, as well as the continuation of sampling. These data cover a range of species and chemicals and also include retrospective studies on new chemicals such as polybrominated diphenyl ethers. There is solid evidence in a few species (beluga, polar bear, blue mussels) that Hg at some locations has significantly increased from pre-industrial times to the present; however, the temporal trends of Hg over the past 20-30 years are inconsistent. Some animal populations exhibited significant increases in Hg whereas others did not. Therefore, it is currently not possible to determine if anthropogenic Hg is generally increasing in Canadian Arctic biota. It is also not yet possible to evaluate whether the recent Hg increases observed in some biota may be due solely to increased anthropogenic inputs or are in part the product of environmental change, e.g., climate warming. Concentrations of most "legacy" OCs (PCBs, DDT, etc.) significantly declined in Canadian Arctic biota from the 1970s to the late 1990s, and today are generally less than half the levels of the 1970s, particularly in seabirds and ringed seals. Chlorobenzenes and endosulfan were among the few OCs to show increases during this period while summation operatorHCH remained relatively constant in most species. A suite of new-use chemicals previously unreported in Arctic biota (e.g., polybrominated diphenyl ethers (PBDEs), short chain chlorinated paraffins (SCCPs), polychlorinated naphthalenes (PCNs), perfluoro-octane sulfonic acid (PFOS) and perfluorocarboxylic acids (PFCAs)) has recently been found, but there is insufficient information to assess species differences, spatial patterns or food web dynamics for these compounds. Concentrations of these new chemicals are generally lower than legacy OCs, but there is concern because some are rapidly increasing in concentration (e.g., PBDEs), while others such as PFOS have unique toxicological properties, and some were not expected to be found in the Arctic because of their supposedly low potential for long-range transport. Continuing temporal monitoring of POPs and Hg in a variety of marine biota must be a priority.

Animals↗

Modern and historical fluxes of halogenated organic contaminants to a lake in the Canadian arctic, as determined from annually laminated sediment cores.

Two annually laminated cores collected from Lake DV09 on Devon Island in May 1999 were dated using 210Pb and 137Cs, and analyzed for a variety of halogenated organic contaminants (HOCs), including polychlorinated biphenyls (PCBs), organochlorine pesticides, short-chain polychlorinated n-alkanes (sPCAs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), and polybrominated diphenyl ethers (PBDEs). Dry weight HOC concentrations in Lake DV09 sediments were generally similar to other remote Arctic lakes. Maximum HOC fluxes often agreed well with production maxima, although many compound groups exhibited maxima at or near the sediment surface, much later than peak production. The lower than expected HOC concentrations in older sediment slices may be due to anaerobic degradation and possibly to dilution resulting from a temporary increase in sedimentation rate observed between the mid-1960s and 1970s. Indeed, temporal trends were more readily apparent for those compound classes when anaerobic metabolites were also analyzed, such as for DDT and toxaphene. However, it is postulated here for the first time that the maximum or increasing HOC surface fluxes observed for many of the major compound classes in DV09 sediments may be influenced by climate variation and the resulting increase in algal primary productivity which could drive an increasing rate of HOC scavenging from the water column. Both the fraction (F(TC)) and enantiomer fraction (EF) of trans-chlordane (TC) decreased significantly between 1957 and 1997, suggesting that recent inputs to the lake are from weathered chlordane sources. PCDD/Fs showed a change in sources from pentachlorophenol (PeCP) in the 1950s and 1960s to combustion sources into the 1990s. Improvements in combustion technology may be responsible for the reducing the proportion of TCDF relative to OCDD in the most recent slice.

Arctic Regions↗

Temporal and spatial variabilities of atmospheric polychlorinated biphenyls (PCBs), organochlorine (OC) pesticides and polycyclic aromatic hydrocarbons (PAHs) in the Canadian Arctic: results from a decade of monitoring.

The Northern Contaminants Program (NCP) baseline monitoring project was established in 1992 to monitor for persistent organic pollutants (POPs) in Arctic air. Under this project, weekly samples of air were collected at four Canadian and two Russian arctic sites, namely Alert, Nunavut; Tagish, Yukon; Little Fox Lake, Yukon; Kinngait, Nunavut; Dunai Island, Russia and Amderma, Russia. Selected POPs, including polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides, were analyzed in both the gas and particulate phases. This paper summarizes results obtained from this project in the past 5 years. Temporal trends were developed for atmospheric PCBs and OCs observed at Alert using a digital filtration (DF) technique. It was found that trends developed with 5 years of data (1993-1997) did not differ significantly from those determined with 7 years of data (1993-1999). This implies that with the DF technique, long-term trends can still be developed with less than 10 years of data. An acceleration in decline of OC and PCB air concentrations was noted in 1999 for some compounds, although the reason is unknown. Monitoring efforts must continue to assess the effect of this decline on the long-term trends of POPs in the Canadian Arctic. Occasional high trans-/cis-chlordane ratios and heptachlor air concentrations measured at Alert between 1995 and 1997 suggests sporadic fresh usage of chlordane-based pesticides. However, significant decreasing trends of chlordanes along with their chemical signatures has provided evidence that emission of old soil residues is replacing new usage as an important source to the atmosphere. Measurements of OC air concentrations conducted at Kinngait in 1994-1995 and 2000-2001 indicated faster OC removal at this location than at Alert. This may be attributed to the proximity of Kinngait to temperate regions where both biotic and abiotic degradation rates are faster. The PAH concentrations observed at Alert mimic those at mid-latitudes and are consistent with long-range transport to the Arctic, particularly for the lighter PAHs. A decline in particulate PAH was observed, similar to atmospheric sulphate aerosol and can be attributed to the collapse of industrial activity in the former Soviet Union between 1991 and 1995. Spatial comparisons of OC seasonality at Alert, Tagish, Dunai and Kinngait show elevated air concentrations of some compounds in spring. However, elevated spring concentrations were observed for different compounds at different sites. Potential causes are discussed. Further investigation in the atmospheric flow pattern in spring which is responsible for the transport of POPs into the Arctic is required. OC and PCB air concentrations at Alert were found to be influenced by two climate variation patterns, the North Atlantic Oscillation (NAO) and the Pacific North American (PNA) pattern. Planetary atmospheric patterns must be taken into account in the global prediction and modelling of POPs in the future.

Journal Article↗

Polychlorinated naphthalenes in U.K. soils: time trends, markers of source, and equilibrium status.

Polychlorinated naphthalenes (PCNs) have been analyzed in archived soil from the U.K. to investigate historical trends. Samples were obtained from the Broadbalk experiment plots (1944-1986) and Luddington experiment station (1968-1990). Luddington samples also include a set of soils that received a one-time sludge treatment in 1968, and duplicate samples of this archived sludge were also analyzed. Peak residues of sumPCN (sum of all PCN congeners quantified) were approximately 9000 pg g(-1) dry weight in 1956, declining to approximately 300 pg g(-1) in contemporary soils. The one-time sludge application resulted in elevated soil residues that were 1.5-6 times higher than the control plot over the time series. This increase is consistent with the known application rate and the amount of sumPCN in the applied sludge (approximately 250,000 pg g(-1) dry wt). Half-lives forthe Luddington control soil and the sludge-amended soil for the period 1972-1990 were 5.3 and 9.9 years, respectively. Investigation of time trends revealed differences between homologue groups with the higher molecular weight congeners peaking earlier in the time series (pre-1950) and the lower molecular weight congeners peaking later, ca. 1970. Time trends of individual congeners were investigated in terms of their relative mass percent contribution to the sum of their homologue group. Significant (p < 0.05) increasing trends were observed for several congeners associated with combustion sources (CN-29, -51, -52/60, -54, and -66/67) suggesting that combustion related sources are more important now than they were in the past. However, no decreasing trend was observed for congeners that were thought to be susceptible to degradation by photolysis suggesting that this may not be a key elimination pathway of PCNs in the environment. A simple calculation of the fugacity status of PCNs in air and soil showed that the tri-CNs are exhibiting net outgassing, while the penta-CNs are still being deposited to soil. Interestingly, the penta-CNs associated with combustion show the largest gradient for air-to-soil transfer, supporting the notion that combustion sources are important contributors to contemporary air burdens of these congeners.

Air Pollutants↗

Factors affecting the occurrence and enantiomeric degradation of hexachlorocyclohexane isomers in northern and temperate aquatic systems.

Concentrations of (alpha- and gamma-hexachlorocyclohexane (HCH), alpha/gamma-HCH ratios, and enantiomer ratios (ER) of alpha-HCH were measured in lakes in the arctic, subarctic, Great Lakes, Canada, and temperate regions, and temperate and arctic wetlands and streams. The highest concentrations of alpha-HCH were found in cold, large, and oligotrophic lakes such as those in the arctic, subarctic, and the upper Great Lakes, which is attributed to greater inputs from atmospheric deposition and slower loss rates relative to warmer, temperate lakes. High alpha/gamma-HCH ratios in northern systems indicate aged HCH that has undergone long-range transport to high latitude areas, whereas low ratios in the lower Great Lakes and small temperate systems indicate recent gamma-HCH usage and residual alpha-HCH concentrations. Enantioselective degradation (ERs ranged from 0.31 to 0.7) was greatest in small, high arctic lakes and streams and in large lakes in the subarctic in which alpha-HCH concentrations and contact time between chemical and sediments are highest and nutrient concentrations are lowest. Low ERs were found in wetlands and streams in which contact between chemical and sediments was greatest. Conversely, minimal enantioselective degradation occurred in temperate small lakes and wetlands (ERs ranging from 0.77 to 1.06), despite the warmer temperatures, greater microbial populations, and nutrient availability. The results suggest that enantioselective degradation is optimized by maximal contact between chemical and sediment substrates in nutrient-poor waters in which, it is hypothesized, oligotrophic bacteria may act as biofilms.

Biodegradation, Environmental↗

Accuracy of registration methods in frameless stereotaxis.

The accuracy of image to patient registration is a critical issue in the intraoperative use of frameless stereotaxic instruments for surgical guidance. This study was performed to assess the accuracy of image to head phantom registration using several standard registration techniques and a clinical frameless stereotaxic instrument. Two types of radioopaque fiducial markers were fixed to a plastic head phantom, and a computed tomography scan of the phantom was performed in the routine fashion. Image to phantom registration was carried out using fiducial markers, fiducial markers plus surface fit, anatomic landmarks, and anatomic landmarks plus surface fit. After each registration, linear inaccuracy measurements were performed for each of 32 markers. Each registration was performed 10 times, and the overall mean error measurements and anterior and posterior error were computed and compared. The overall mean error was smallest for the fiducial registration alone (2.07 mm). The magnitude of error increased significantly for posterior locations for all other registration techniques, but it was not significantly increased for the fiducial registration method. For this hardware configuration, registration with surface-applied fiducial markers is measurably more accurate than registration with surface anatomic landmarks. The addition of surface points to the fiducial registration does not increase the registration accuracy but, in fact, increases the degree of error.

Computer Systems↗

Contribution of abnormal sarcoplasmic reticulum ATPase activity to systolic and diastolic dysfunction in human heart failure.

Two of the most significant characteristics of failing human myocardium are an increased diastolic [Ca2+]i and a prolonged diastolic relaxation. These abnormalities are more pronounced at higher frequencies of stimulation and may be caused by an altered Ca2+ resequestration into the sarcoplasmic reticulum (SR). The force-frequency relationship was determined in multicellular preparations obtained from non-failing (n=6) and failing human myocardium (n=11). The active force in non-failing tissue increased as a function of the frequency of stimulation. In failing myocardium, an increase in frequency of stimulation (>1 Hz) was accompanied by a decrease in active force. Changes in the frequency of stimulation and active force were also associated with changes in intracellular calcium concentrations. The diastolic force in failing myocardium was augmented following an increase in frequency of stimulation, whereas in non-failing tissue, no increase in diastolic force was observed. Associated with the increase in diastolic force was an increase in intracellular diastolic calcium concentrations. The SR Ca2+ ATPase activity was reduced in failing compared to non-failing myocardium. SR Ca2+ ATPase was positively correlated with diastolic force in non-failing myocardium. The relationship between Ca2+ ATPase activity at 1 micromol/l [Ca2+] and active force between 0.5 and 2.0 Hz was different between failing and non-failing myocardium. The diastolic force demonstrate an inverse relationship with the SR Ca2+ ATPase activity in failing myocardium. These data suggest that a reduction in SR Ca2+ ATPase activity contributes to the impairment in both systolic and diastolic function of failing human hearts.

Adenosine Triphosphatases↗

Gait pattern alteration by functional sensory substitution in healthy subjects and in diabetic subjects with peripheral neuropathy.

OBJECTIVE: To evaluate the ability of diabetic and nondiabetic individuals to learn to use a lower extremity sensory substitution device to cue gait pattern changes. DESIGN: Case-control study. SETTING: Gait laboratory. PARTICIPANTS: Thirty diabetic persons and 20 age- and education-matched nondiabetic controls responded to advertisements for study participation. INTERVENTION: Participants walked on a treadmill at three speeds (1, 2, and 2.5mph) with auditory sensory feedback to cue ground contact greater than 80% duration of baseline. MAIN OUTCOME MEASUREMENTS: The variables measured included gait cycle (steps per minute) and number of times per minute that any step during a trial exceeded 80% duration of ground contacted compared with a measured baseline step length for each speed. RESULTS: Persons in both groups were able to rapidly and significantly alter their gait patterns in response to signals from the sensory substitution device, by changing their gait cycles (nondiabetic group, F(17,124) = 5.27, p < .001; diabetic group, F(5,172) = 3.45, p < .001). Post hoc analyses showed early gait cycle modification and error reduction among both groups. The nondiabetic group learned to use the device significantly more quickly than the diabetic group during the slow (1mph, t = 3.57, p < .001) and average (2mph, t = 2.97, p < .05) trials. By the fast (2.5mph) ambulation trial, both groups were performing equally, suggesting a rapid rate of adjustment to the device. No technical failures from gait trainer malfunction occurred during the study. CONCLUSIONS: Diabetic persons with neuropathy effectively used lower extremity sensory substitution, and the technology is now available to manufacture a durable, effective lower extremity sensory substitution system.

Adult↗

Is contractility depressed in the failing human heart?

Is contractility depressed in the failing human heart? The question must be approached in a stringent manner. Myocardium from failing human hearts has been shown to generate normal physiological force under the ideal conditions of low stimulation and an adequate energy supply. Nevertheless, even when subjected to physiologically conducive conditions, failing myocardium experiences a slowed relaxation, adversely affecting the diastolic properties of the heart. In addition, experiments have shown that increasing the contraction rates of failing hearts clearly results in lowered force and pressure evolution. This information indicates a decrease in contractile reserve in both a systolic and diastolic sense. Not surprisingly, the term end-stage heart failure becomes questionable when applied to myocardium obtained from patients undergoing cardiac transplantation. A number of studies involve such myocardium from feasible regions of the heart perfused within ideal physiological conditions yielding, at times, nonfailing performance. Therefore, it becomes imperative to bear in mind the role of such myocardium within the framework of the entire diseased heart.

Calcium↗

Total-contact casting, sandals, and insoles. Construction and applications in a total foot-care program.

It must be stressed that these tools do not exist in a vacuum and that no single tool is particularly useful unless it is a part of a comprehensive, lifelong foot-care program. A partnership between the health care provider and the patient is essential in making any of these techniques useful. On the positive side, a program incorporating these techniques can be very successful with even the most difficult population. The very successful Parkland Memorial Hospital program provides care for a county hospital population that is often difficult in terms of compliance. Without question, the reasons for incorporating such a program in a public facility are sound. Amputations are avoided; and patients remain or become more functional, thus decreasing hospital cost and patient morbidity and mortality and increasing the patient's potential for contributing to society. Similarly, in private facilities, once the program is established, costs need not run high and considerable amounts can be saved by helping heal and/or prevent the horrendous sequelae of diabetic neuropathies.

Biomechanical Phenomena↗

Burn rehabilitation: dimensions of the problem.

Recent improvements in the mortality rates of burned patients are attributed to the expansion of specialized burn centers. Satellite treatment areas with trained personnel need to be developed, located away from the burn center, and efforts should be made to increase the number of patient programs at existing burn centers. In addition, studies need to be conducted on cost consequences, hypertrophic scarring, peripheral and central nervous system involvement, musculoskeletal changes, sleep deprivation, and the comparison of various treatment techniques to determine what protocols provide the best treatment outcome.

Burn Units↗

Recurrence of neuropathic ulceration following healing in a total contact cast.

Total contact casting has been clearly shown to be an effective technique in the healing of diabetic neuropathic foot ulcerations. The purpose of this study was twofold: (1) to determine the rate of ulcer recurrence in a large population of patients whose ulcerations had healed in a total contact cast, and (2) to determine the reason for which ulcerations had recurred. A random sample of 102 patients was taken from a much larger population, all of whom had healed in a total contact cast. There were 54 men and 48 women, all of whom were diabetics, averaging 50.5 years of age. These patients had an average wound size of 2.6cm by 1.9cm prior to casting and an average healing time of 33.9 days. At the time the sample was drawn, it had been an average of 25 months since casting for this group. Twenty (19.6%) of the 102 patients had ulcer recurrences since initially healing in a cast. Causes of ulcer recurrence were failure to comply with follow-up foot-wear/foot-care protocol (n = 8), biomechanical faults (n = 5), osteophyte or bone fragment (n = 4), osteomyelitis (n = 5), and Charcot joint (n = 4). Some patients had multiple etiologies.

Adult↗

Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location.

This study investigated healing rates of chronic diabetic neuropathic foot ulcerations located on the plantar surface of the forefoot (n = 30) versus those located on other parts of the foot (n = 25). Each type of ulceration was treated with total contact casting. Ulcerations in the first group were located on the metatarsal heads and toes, while ulcerations in the second group were located on the dorsum of the foot, heel, plantar arch, ankle, medial aspect of foot, and toe or transmetatarsal amputation sites. Successfully healed diabetic neuropathic foot ulcerations treated with total contact casting were rated according to patient age, ethnic origin, sex, patient weight, ulcer size, ulcer location, duration of ulcer prior to casting, and ulcer grade. Analysis of variance and posthoc analyses demonstrated that (1) total contact casting was a highly effective method of treatment regardless of ulcer location (forefoot ulcer healing time mean = 30.6 days; nonforefoot ulcer healing time mean = 42.1 days) and (2) forefoot ulcerations healed significantly faster than ulcerations located on other parts of the foot. Complex correlational relationships were explored in this study, and multiple regression equations were developed for each location grouping.

Casts, Surgical↗

New bone formation at amputation sites in electrically burn-injured patients.

Sixty-one amputation sites in 43 electrically injured men were examined for significant new bone formation. Twenty-eight amputations were classified as long bone (6 above knee, 4 below knee, 4 above elbow, 14 below elbow); 28 small bone (9 hand or finger and 19 foot or toe); and 5 disarticulations. Significant new bone formation occurred at the amputation site in 23 (82%) of the 28 long bone cases, but none occurred in the small bone or disarticulation cases. This difference was significant at the 0.0001 level (chi square = 40.53, 2 df). Fourteen (78%) of upper and nine (90%) of lower extremity sites had significant new bone formation. The average time from amputation to diagnosis of new bone was 38 weeks, range from 5 to 110 weeks. Eight of these 23 patients required surgical revision of the stump and/or revision or reconstruction of their prosthesis. Clearly, the ability to predict new bone formation in electrical burn amputees has important clinical and economic applications.

Adolescent↗

Return to work following hand burns.

Time to return to work following hand burns was studied in 70 patients in relation to several variables: 1. total body surface area (TBSA) burned; 2. hand burned; 3. grafting; 4. patient age; 5. occupational category. Return to work data were also compared by meta-analysis to data in prior reports on return to work in nonburn hand injuries. Patients were evaluated during their hospital stay on all independent variables, and at 8 months following discharge as to the date of return to work. Of the 70 patients selected for the study, 52 (74%) had returned to work at the 8-month assessment. The best predictor of time to return to work was TBSA burned, followed by "grafting" and "hand burned." No significant differences or predictors were found for patient age, occupational category, or between nonburn hand trauma patients in prior reports. Conclusions are drawn concerning the usefulness of these results in terms of case management and economic impact in hand-burn injuries.

Adolescent↗

Neuromuscular problems in the burn patient: cause and prevention.

Neuromuscular complications of the burn patient that occur during hospitalization frequently are overlooked. Eighty-eight patients with signs of weakness or complaints of easy fatigability were examined clinically and electrodiagnostically. The most frequently diagnosed neuromuscular abnormality in this study was generalized peripheral neuropathy. Other specific neuromuscular problems, in order of frequency of occurrence, were found to involve the deltoid muscle, peroneal nerve, ulnar nerve, median nerve, and brachial plexus. These lesions are found to be commonly due to (1) poor positioning, both in bed and in the operating room, and (2) heavy bulky dressings over superficial nerves. Thus, it is concluded that many of these injuries offer a significant potential for prevention through attention to physiologic positioning and meticulous patient care.

Adolescent↗

Total contact casting in diabetic patients with neuropathic foot ulcerations.

This study investigated total contact casting in the treatment of diabetic foot ulcerations and factors affecting the rate of ulcer healing. Twenty-two diabetic patients with foot ulcerations were rated on the basis of age, weight, ulcer size, and ulcer grade. After treatment with total contact casting, 16 patients (72.7%) healed in an average of 38.3 days, 3 refused treatment, 1 developed a small tibial ulceration, and the remainder were discontinued due to excessive edema. A significant (p less than 0.01) t test for differences between means was calculated comparing ulcer duration prior to casting to healing rate during casting. All patient variables were intercorrelated, and significant (p less than 0.01) intercorrelations among patient variables were as follows: age with grade, 0.58; grade with healing time, 0.49; size with healing time, 0.50; age with ulcer size, 0.36; weight with ulcer size, 0.37; age with healing time, 0.32. A multiple correlation of 0.69 (p less than 0.01) was found for age, grade, size, and weight with healing time. Ulcer grade and size contributed most directly to the total multiple correlation; age contributed equally to size, grade, and healing time; and weight contributed primarily to ulcer size. These results suggest the following: 1) total contact casting is an extremely valuable method of treatment for diabetic foot ulcerations, and 2) when using this treatment technique associated factors (ulcer size, ulcer grade, patient age, patient weight) may be utilized to help predict patient healing.

Adult↗

Burn injury: rehabilitation management in 1982.

Coincident with the recent development of more effective acute care of burn injured patients, has been the growth of dynamic, integrated rehabilitative efforts. The physical, emotional, and social problems that face the thermally injured patient must be solved in a constructive, coordinated manner within the matrix of total patient care. Most burns are minor burns, which may be optimally treated on an outpatient basis in a physical medicine department. Hospitalized patients, with more extensive and severe burns, should have the benefit of rehabilitative team efforts immediately after injury. We describe a comprehensive approach to the rehabilitative care of the thermally injured, including the techniques of wound management, positioning, splinting, and exercise at all chronologic phases of care. The psychosocial component of patient care is also discussed and the importance of counseling and relaxation methods addressed. Specialized problems and therapeutic techniques associated with hand burns are explained and appropriate splinting methods are illustrated.

Adult↗