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Biomedical subjects

P A Helm

Publications and source records attributed to P A Helm.

26 records · Page 2Linked to original sources
PubMed1981

Lymphedema incidence after specific postmastectomy therapy.

In a retrospective study the incidence of lymphedema was analyzed in 58 women, ages 35 to 81 years, who had received a specific treatment program after radical or modified radical mastectomy for breast carcinoma in a county hospital. Thirty-nine percent (23 patients) had cobalt treatment and 48% (28 patients) had delayed wound healing. Circumferential measurements of both upper limbs were obtained at specific corresponding sites. At the end of the 12 months, 69% of the patients had no lymphedema, 22.4% had slight lymphedema, 5.2% had moderate lymphedema and 3.4% had severe lymphedema. The benefits of close follow-up and specific treatment of mastectomized patients are evidenced in this study by the relatively large group of patients which was free of lymphedema over an extended period of time in spite of wound healing complications.

Adult↗
PubMed1978

Burn rehabilitation-a team approach.

The team concept in the treatment of burned patients is an effective approach in caring for the physical, psychological, and social needs of the patient. Through the initiation of early rehabilitation services, long-term problems can be prevented and a quicker return to a meaningful life style is possible.

Acute Disease↗
PubMedDate not supplied

The problem of Social Security disability determination for the burn patient. A report from the Committee on Rehabilitation of the American Burn Association (ABA).

The ABA Rehabilitation Committee has developed a form to be included in the hospital record at discharge that should facilitate the Social Security disability determination process for the burn patient. This form should aid in the disability determination process by guiding the Social Security disability examiner to the pertinent evidence of limitation and chronicity in the often cumbersome medical record and by emphasizing the multiple body system nature of the severe burn injury.

Burns↗
PubMedDate not supplied

Range of motion of the shoulder performed while patient is anesthetized.

Significant loss of shoulder range of motion (ROM) in the early stages of burn recovery is a common and frustrating complication of burn injury. Pain is a primary reason for decreased motion: it prevents the patient from cooperating in an aggressive therapy program that could minimize contracture formation. To combat loss of movement without inflicting severe pain, the performance of ROM exercises and gentle passive stretching while patients were anesthetized was used as a treatment. A total of 59 treatments were performed on 14 patients who had limited unilateral or bilateral shoulder motion. A significant gain in shoulder ROM was attained when this treatment was performed and resulted in an increase in shoulder ROM when the patient was alert after anesthesia compared with preanesthesia measurements.

Adult↗
PubMedDate not supplied

Return to work after burn injury.

The research literature suggests but does not test the hypothesis that differential factors determine when a patient will return to work after serious burn injury. In this study, factors influencing time before return to work after serious burn injury were investigated prospectively as part of a large burn research project. Sixty-five patients with burns who had returned to work were followed. Several variables were examined, including percent total body surface area burned, total percent of partial-thickness burn, total percent of full-thickness burn, duration of treatment, payment source for treatment, sex, race, type of burn, and age. The most significant predictor of time before return to work was percent total body surface area burned, followed by percent body surface area with full-thickness burns, percent body surface area with partial-thickness burns, and number of weeks of treatment, respectively. Sufficient data were available to develop a regression equation to specifically predict time before return to work. The data presented here are useful in informing patients, families, employers, and health-funding agencies as to the probable delay before return to work that can be expected after serious burn injury. In particular, predictability refinements are possible with the regression equation developed in this study.

Adolescent↗
PubMedDate not supplied

The status of burn rehabilitation services in the United States: results of a national survey.

A survey to determine the status of burn rehabilitation services in the United States was developed and sent to 186 burn treatment facilities. The facilities were divided into four groups based upon number of admissions per year (0 to 80, 81 to 120, 121 to 200, and 200+). Completed surveys were received from 114 facilities. Results indicated that burn facilities of different sizes were consistent with respect to the severity of burn injuries treated, the length of hospitalization for acute injuries, and the duration of physician follow-up after discharge. Burn facilities with more admissions were more likely to report (1) organized outpatient burn rehabilitation programs, (2) available specialized burn rehabilitation personnel, (3) regular interdisciplinary inpatient staffing conferences and outpatient clinics, and (4) structured educational activities for staff and Full-time equivalent burn rehabilitation personnel were equally represented across facilities of different sizes. The overall results suggest that there have been substantial improvements in the comprehensiveness of burn rehabilitation care since a previous survey in 1983. Minimum guidelines for burn rehabilitation are suggested based upon the relative consistency between burn facilities indicated by the survey results.

Burn Units↗
PubMedDate not supplied

[Ca2+]i in human heart failure: a review and discussion of current areas of controversy.

Multiple abnormalities have been reported in the setting of human heart failure. It is unclear whether detected changes reflect adaptive alterations in myocardium subjected to increased and sustained hemodynamic overload or are pathogenic to the disease process. As a result of the observation that the primary defect in heart failure is decreased pump function, investigators have concentrated their efforts on determining systolic [Ca2+]i as a logical corollary and a causative mechanism for contractile dysfunction. A simple cause and effect relationship has therefore been proposed with regard to contractile dysfunction and [Ca2+]i. Yet some investigators have found no difference in peak systolic [Ca2+]i between failing and non-failing human myocardium, whereas others have found peak [Ca2+]i to be significantly reduced in failing hearts. Resting calcium concentrations have been reported either to be elevated in failing human myocardium or not different from non-failing human myocardium. Investigators should now appreciate that the force-calcium relationship is not a simple relationship. One must take into account the prolonged time course and slowed mobilization of [Ca2+]i as opposed to simply peak [Ca2+]i. When put in perspective of mechanisms and determinants of the Ca(2+)-force relationship, we begin to realize that failing human myocardium has the "potential" to generate normal levels of force. Only when stressed by [Ca2+]i overload and/or frequency perturbation does myocardium from patients with end-stage heart disease demonstrate contractile failure. Although [Ca2+]i availability and mobilization are likely to play a role in the systolic as well as diastolic dysfunction reported in human heart failure, it is likely that other mechanisms are involved as well (e.g., myocardial energetics). Myocardial energetics is directly related to [Ca2+]i and mobilization in failing human myocardium, because metabolites, e.g., ADP, inhibit pumps, such as sarcoplasmic reticulum Ca2+ ATPase activity. We therefore conclude that there is a role for intracellular calcium mobilization and myocardial energetics for systolic and diastolic dysfunction seen in human heart failure.

Action Potentials↗