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Biomedical subjects

P R Bryant

Publications and source records attributed to P R Bryant.

8 recordsLinked to original sources

Acquired limb deficiencies. 1. Acquired limb deficiencies in children and young adults.

UNLABELLED: This self-directed learning module highlights prosthetic treatment considerations and challenges in children and young adults. It is part of the chapter on acquired limb deficiencies in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on prosthetic considerations for a child experiencing a mutilating traumatic amputation, examines the rationale for limb salvage versus surgical amputation for malignant bone tumors, discusses the unique management options available for patients undergoing hip disarticulation due to a tumor, and highlights the complications associated with amputations resulting from trauma and malignancies. OVERALL ARTICLE OBJECTIVE: To summarize prosthetic treatment considerations and challenges in children and young adults.

Adolescent↗

Acquired limb deficiencies. 4. Troubleshooting.

UNLABELLED: This self-directed learning module offers practical analyses of and solutions for common clinical problems of amputees. It is part of the chapter on acquired limb deficiencies in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. The information presented here has been designed to be useful also to other interested professionals, including prosthetists, physical therapists, occupational therapists, and nurses. Topics covered include the management of typical obstacles encountered in upper limb amputees, and the diagnosis and treatment of phantom and residual limb pain. Diagnostic and treatment approaches to skin breakdown in the transtibial amputee and to knee instability in the transfemoral amputee are also presented. OVERALL ARTICLE OBJECTIVE: To analyze common clinical problems of amputees.

Amputation, Surgical↗

Sports and recreation for persons with limb deficiency.

UNLABELLED: Opportunities for persons with limb deficiency to participate in sport and recreational activities have increased dramatically over the past 20 years. Various factors have contributed to this phenomenon, including an increased public interest in sports and fitness as well as improvements in disability awareness. An even more essential element has been a consumer-driven demand for advances in prosthetic technology and design. Whether the activity is a music performance, a friendly round of golf, or a high-level track-and-field competition, the benefits of participation in sports and recreation are numerous both at the individual and at the societal level. This article provides an overview of the development and scope of sport and recreational opportunities available to persons with limb deficiency. In addition, specific prosthetic considerations for several common sport and recreational activities are presented in a case-discussion format. OVERALL ARTICLE OBJECTIVE: To review the development and scope of sport and recreational opportunities available to persons with limb deficiency.

Adolescent↗

Analysis of casualties referred to Army physical medicine services during the Persian Gulf conflict.

This study describes the casualties referred during the Persian Gulf War and underscores the valuable role of Army physical medicine and rehabilitation (PMR) services in evaluation and early rehabilitation of wartime casualties. Data regarding demographics, injury types, medical complications, complications of immobility and functional limitations were collected by military physiatrists at five Army Medical Centers with PMR services. Active duty soldiers injured in the Persian Gulf War who were referred totalled 222. Musculoskeletal injuries occurred in 57%, peripheral nerve injuries in 44%, penetrating wounds in 32%, fractures in 28%, brain injuries in 8%, amputations in 7%, burns in 6% and spinal cord injuries in 3%. The primary referral service was orthopedics (64%). Electrodiagnosis evaluations were performed for 41% of all referrals. Lower limb and upper limb contractures occurred in 10% and 9% of patients, respectively. Ambulatory impairments were seen in 48%. Nerve injuries were associated with penetrating wounds in 68%, with amputations in 67% and with fractures in 58%.

Adult↗

Normal values for the soleus H-reflex in newborn infants 31-45 weeks post conceptional age.

Normal values for the soleus H-reflex were established in 83 preterm and term infants 31 to 45 weeks postconceptional age. Infants at conceptional ages 31 to 34 weeks (n = 30) had a mean H-latency (msec) of 19.2 +/- 2.16; infants 35 to 39 weeks (n = 26), 16.67 +/- 1.48; and infants 40 to 45 weeks (n = 27), 15.94 +/- 1.45. Simple linear regression shows a significant relationship between conceptional age and H-latency (Pearson correlation = .68, R2 = 0.47, f = 71.31, p = .0001). Adjusting H-latency values for leg length, the regression of H-soleus latency/leg length (msec/cm) against conceptional age provides an even stronger relationship (r = 0.81, R2 = 0.66, f = 154.5, p = .0001). These results reflect the degree of myelination in infants of increasing conceptional ages. They can indicate the gestational age of the infants and afford comparative data in the event of peripheral nerve pathology.

Female↗

Potential drug interactions in a physical medicine and rehabilitation clinic.

Potentially preventable adverse drug-drug interactions increase morbidity and financial costs to hospitals and third party payers. This study's purpose is to document the prevalence of potential drug-drug interactions (PDDI) in patients referred to a Physical Medicine and Rehabilitation (PM&R) clinic, to identify risk factors associated with PDDI, and to evaluate physicians' ability to correctly identify these PDDI. Current medication lists were obtained by questionnaire and confirmed by chart review for 121 consecutive new patients. The physician-identified PDDI were compared with computer-identified PDDI. Twenty-seven patients (22%; 95% confidence interval, 15-31%) had PDDI. PDDI were associated with number of medications (P = 0.0011) and PM&R subspecialty clinic (P = 0.012). Twenty-nine of the 46 computer-identified interactions (63%) were not identified by the physicians, and the physicians falsely identified 28 other drug combinations as PDDI. Potential drug-drug interactions occur at high rates in PM&R outpatient populations, and physicians are inadequately prepared to identify these PDDI.

Adolescent↗