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Biomedical subjects

R L Braddom

Publications and source records attributed to R L Braddom.

32 records · Page 2Linked to original sources
PubMed1977

Esophageal function in diabetes mellitus and its relation to peripheral neuropathy.

Esophageal function was determined in 50 unselected patients with diabetes mellitus (DM). Fourteen age-matched healthy subjects served as controls. The presence of peripheral neuropathy (PN) was determined by a neurological examination and by nerve conduction studies. An intraluminal transducer assembly placed in the distal esophagus measured pressure in the lower esophageal sphincter and body of the esophagus. Esophageal function was studied both before and after edrophonium chloride, 80 microgram per kg intravenously. There was no significant difference in peristaltic amplitude between the controls and diabetics. There was also no difference in amplitude when DM was divided into presence or absence of PN. However, there was a significant decrease in velocity of peristalsis in DM with PN when compared to DM without PN and to controls. Resting lower esophageal sphincter pressure in DM was similar to controls, with no difference with or without PN. Twenty-eight patients (56%) with DM had abnormal motility, characterized by frequent spontaneous contractions, and decreased prevalence of peristalsis. Abnormal motility in DM was associated with PN and was characterized by a dysfunction of esophageal innervation with intact smooth muscle function.

Adult↗
PubMed1977

Diabetic peripheral neuropathy: a correlation of nerve conduction studies and clinical findings.

The electrophysiologic and clinical characteristics of diabetes were studied in 56 patients having diabetes of adult onset. Historical data including age, duration of diabetes, treatment type, family history and clinical symptoms were noted. Nerve conduction studies of the median, ulnar, peroneal, tibial and sural nerves were performed, and the H reflex was determined. Clinical sensory function of vibration, light touch, and two-point discrimination, muscle stretch reflexes in all four extremities and skin temperatures in the lower extremities were recorded. The data indicated a close correlation of clinical and electrophysiologic findings. The data supported the concept that diabetic peripheral neuropathy is progressive. It was concluded that diabetic peripheral neuropathy was present if two of the following three determinations were abnormal: median motor or sensory latency, ulnar sensory latency and sural latency.

Adult↗
PubMedDate not supplied

Curriculum needs in physical medicine and rehabilitation for primary care physicians. Results of a survey.

A 45-item survey assessing the need for knowledge and skills in clinical problems commonly encountered in physical medicine and rehabilitation was sent to 300 randomly selected family practitioners in the state of Indiana. The purpose of this survey was to determine the clinical needs self-perception of these physicians to help design a physical medicine and rehabilitation curriculum that would be the most relevant to medical students in light of today's emphasis on primary care. Another purpose of the study was to compare the responses with those of a similar survey done among Ohio general practitioners in 1974. The family physicians gave the highest scores in terms of overall need to those items most frequently encountered in practice, especially musculoskeletal problems. They tended to rank much lower those clinical problems that they typically refer to other specialists for care. This survey and the one in 1974 showed remarkably similar results. Only a few items showed considerable change in their overall rank or need. Carpal tunnel syndrome and prescription of wheelchairs, canes, and assistive devices both rose in importance in this survey. Items that were ranked lower in importance on this survey than in 1974 included juvenile rheumatoid arthritis; the use of modalities, such as ultrasound, diathermy, and paraffin; cardiac rehabilitation; stroke rehabilitation; and chronic lung rehabilitation. Although this self-assessment tool provides pertinent and very useful information regarding curricular needs, it cannot be the only source of information in this regard.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗
PubMedDate not supplied

Analysis of current practices in recruitment of residents for Physical Medicine and Rehabilitation: survey of PM&R department chairs.

The purpose of this study was to survey the current opinion of Physical Medicine & Rehabilitation (PM&R) chairs on issues of resident recruitment. There was a 92% response rate after two mailings. A majority (62%) of chairs reported more difficulty now than two years ago in obtaining an adequate number of American medical graduates for their residency programs. This was true regardless of program size, type, or location. The three highest ranking reasons for this difficulty were as follows: competition from primary internal medicine; primary care emphasis in medical school curriculums; competition from family medicine. The majority of chairs (87%) reported no increased difficulty in recruiting international medical graduates. The three most frequently used recruiting methods were as follows: clinical rotation electives; using faculty as student advisors; teaching in the physical diagnosis course. The chairs' opinion of the three most important reasons residents choose a specific program include the following: having a committed and interested faculty; having happy current residents; having an established program with successful graduates. A reduction in the number of residents in their programs during the next four years was predicted by 27% of the chairs. The chairs also felt that we currently have too many residency slots, preferring numbers of 600 to 1,300 (mean, 1,010). The chairs had no clear choices in methods to downsize programs if that were to be mandated by the federal government but appeared the least interested in doing so by reducing every program by a flat percentage.

Career Choice↗
PubMedDate not supplied

Palmar cutaneous nerve recording and clarification of median premotor potential generators.

In this study of the median nerve, serial bipolar and referential recordings from the thenar eminence show that the median premotor potential actually consists of two distinct negative waves, an early (N-I) and a late premotor potential (N-II). Anesthetic block of the palmar cutaneous branch of the median nerve eliminated the early premotor potential in all subjects. This suggests that the early premotor potential (N-I) is the sensory nerve action potential of the palmar cutaneous branch of the median nerve. Local anesthesia of the palmar cutaneous branch of the median nerve also defined its area of innervation as circumscribed in our subjects. No normative data concerning the sensory nerve action potential of the palmar cutaneous branch of the median nerve is currently available, because previous studies apparently recorded the late premotor potential. The late premotor potential (N-II) is a negative far field potential seen only on referential recordings. It seems unlikely that the late premotor potential (N-II) can be completely explained as a junctional potential from the thumb as some have proposed. This study demonstrates a positive far field potential (P-I) at the palm-thumb junction, having a latency inconsistent with that of the late premotor potential. The late premotor potential can also be recorded with the reference electrode at an electrically neutral site, questioning previous explanations for its generator. A second traveling wave (N-III) was recorded distal to the area of the palmar cutaneous branch of the median nerve innervation continuing into the thumb. N-III is most likely the median digital sensory nerve action potential.

Action Potentials↗
PubMedDate not supplied

Total hip disarticulation prosthesis with suction socket: report of two cases.

A majority of hip disarticulations are performed in young people, with malignancy being the most common cause. The exoskeletal Canadian Hip Disarticulation prosthesis had been widely used as a standard total hip disarticulation prosthesis until recently when an endoskeletal modular version became the prosthesis of choice. However, the "basket-shaped" socket provided by the standard total hip disarticulation prostheses has been a source of discomfort and a reason for prosthetic rejection by many patients. This report concerns two patients with true lower limb disarticulation at the hip joint. Both of the patients failed to adapt to the standard total hip disarticulation prosthesis but successfully used a new total contact suction socket design. This new prosthesis provided improved suspension, better patient compliance, and enhanced prosthetic acceptance and mobility.

Activities of Daily Living↗
PubMedDate not supplied

Resident versus program director perceptions about PM&R research training.

A survey of all residents and residency program directors in Physical Medicine and Rehabilitation (PM&R) was done to assess perspectives of residents and directors regarding research training, resources, mentorship, and encouragement available to residents. A response rate of 55% was obtained from 1188 resident mailings, and 83% of 77 program directors responded. A number of discrepancies in perceptions of residents v program directors responded. A number of discrepancies in perceptions of residents v program directors were identified. In general, residents perceived that they had less research support and training than directors felt their departments were offering. Only 24% of residents felt that they got adequate training in statistics, 40% for research design, and 26% for writing research papers. The corresponding numbers for residency program directors were 47%, 73%, and 61%. There were similar discrepancies in the perception of the quality of research training. On a 1 to 5 scale, residents registered a mean score of 2.8 (SD 1.0) to the question of how qualified their faculty was to teach principles of research. Program directors' mean response was 3.2 (SD 1.0). Residents were also often not aware of resources available for research in their departments. Only 19% of residents knew of access to a research coordinator/grant writer, 36% for statistical support, and 67% for library assistance. The corresponding numbers for program directors were 31%, 69%, and 97%. Additional results of the survey are summarized, and suggestions for further study to improve the resident research training experience are given.

Attitude of Health Personnel↗