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Biomedical subjects

R P Holm

Publications and source records attributed to R P Holm.

12 recordsLinked to original sources
PubMed1995

Treatment of Aeromonas hydrophila infection in a deep tissue wound.

We report the case of a young woman who sustained a knee laceration in an automobile accident and was subsequently exposed to water. Although properly cleansed and closed, her wound became infected and she was initially treated with a single-dose parenteral cephalosporin. The infection progressed and cultures indicated a polymicrobial infection which included Aeromonas hydrophila. Significant tissue damage ensued and a lengthy hospitalization was required. Aeromonas, although rarely a cause of infection in otherwise healthy individuals, should be suspected in wounds exposed to fresh water.

Accidents, Traffic↗
PubMed1993

DEEP, the South Dakota Medicaid drug use review program. Is the hassle justified?

Governmentally-mandated programs are a fact of life in health care. Such programs are often considered "hassles" by health care providers, who sometimes question whether such programs can justify themselves. The South Dakota Drug Evaluation and Education Program (DEEP) is a federally-mandated program of drug use review for Medicaid patients. While the program does not mandate changes in therapy, review of the program's first year of data indicates it caused change in 68.1% of the cases resulting in benefits which include a reduction in unnecessary/unneeded medication.

Drug Utilization Review↗
PubMed1990

Who can decide?

The constitutionally provided "right of self-determination" can be lost when a individual's mental "capacity to choose" is affected by medical or psychiatric illness. "Competency" is a court-determined definition. However, physicians are expected to know how to determine "capacity to choose". This medical responsibility has become clear in the light of recent United States Supreme Court and South Dakota legislative action. The complexity of this issue is discussed, and a testing method for "capacity" is described.

Decision Making↗
PubMed1983

Behavioral modification in a weight-reduction program.

Previous surveys have shown a high prevalence of obesity in women of low socioeconomic status. This study confirmed the relationship in the Medical Appointment Clinic at Grady Memorial Hospital, Atlanta. Behavioral modification therapy for obesity had not been carefully tested in this type of population. Therefore, a behavioral modification group-oriented weight-reduction method was adapted for 80 participants from this setting. Eighty controls, matched for age, sex, race, and percent ideal body weight, received individualized counseling from a dietitian. Thirty-one matched pairs (62 individuals) had follow-up weights taken more than one year later. Thirteen percent (four) of the behavioral modification group participants versus 6.4% (two) of the control participants maintained a loss of 20 lb. or more during this period. The mean weight loss for the behavioral modification group was 4.6% of their ideal body weight versus 0.9% for the control group. The results of the behavioral modification program were statistically superior to those of the control program (p = 0.058). Overall, for participants whose mean weight was 241 lb., it is difficult to conclude that a mean 5-lb. weight loss represents a meaningful change or that this weight loss was due to behavioral modification. The results of this program among low socioeconomic status women, however, were comparable with the results of similar large, free-living programs among middle class participants.

Adult↗