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Biomedical subjects

R J Ham

Publications and source records attributed to R J Ham.

At least 19 recordsLinked to original sources
PubMed2002

A novel method of shortening an aortic graft.

We describe a simple method of shortening the abdominal aortic graft during an emergency procedure which is easy to perform and does not unduly delay the completion of the operation.

Aorta, Abdominal↗
PubMed2001

Amputations at the London Hospital 1852-1857.

Between 1852 and 1857 at the London Hospital, 142 amputations were performed in 136 patients. The most common indication was an injury sustained at work. Overall mortality was 46% and the death rate was especially high for lower-limb amputations. Most deaths were due to postoperative sepsis. Those who received chloroform anaesthesia did worse than those who received ether.

Amputation, Surgical↗
PubMed1999

Evolving standards in patient and caregiver support.

It has become increasingly clear that family members and others have enormous potential to contribute positively to the care of the patient suffering from Alzheimer disease (AD). Various methods such as respite services and day care as well as counseling and support groups have been shown to reduce caregiver stress and burnout. Moreover, there are many areas in which the informed, trained caregiver can contribute positively to, and even lead, the interdisciplinary ongoing care of AD patients. For example, the caregiver can help with memory aids, behavioral interventions, the maintenance of exercise and nutrition, healthcare proxies and housing arrangements, decisions about intensity of treatment, and the timely implementation of palliative care approaches. Caregivers skilled in such matters will increase the quality of life of the AD patient and reduce their dependency. Many support services and educational activities are known to help caregivers and their patients, yet their availability is variable, and it is unclear whose responsibility it is to organize and finance them.

Alzheimer Disease↗
PubMed1997

After the diagnosis.

When the words "Alzheimer's disease" are first used regarding a patient with increasing memory and judgment problems, the person involved and his or her family members usually leave the office with sinking hearts. However, Dr. Ham believes that using the term is important, because it gives structure to management and can be the impetus to seek information about the disease and learn about local support organizations. Clarifying the diagnosis is but the first of many ways that primary care physicians can assist families in deciding about home care, intensity of treatment, and long-term placement.

Advance Directives↗
PubMed1995

Photodynamic therapy in a cell culture model of human intimal hyperplasia.

OBJECTIVE: To investigate the effectiveness of photodynamic therapy (PDT) in eliminating proliferating vascular smooth muscle cells (VSMCs). This may have a potential role in reducing restenosis rates clinically. MATERIALS AND METHODS: Human VSMCs were successfully cultured from 15 long saphenous veins (SV) and seven restenotic lesions (RL) removed during revision coronary and peripheral vein graft surgery. Cultured VSMCs were incubated with photofrin at doses of 0-5 micrograms/ml for 48 h, and then exposed to 4 J/cm2 of polychromatic light. Cell destruction was quantified by a colorimetric assay using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. RESULTS: Results are expressed as a mean percentage survival +/- standard error. Cells were minimally affected by either photofrin alone (SV: 95.5% +/- 5.3; RL: 119.8 +/- 4.8) or light alone (SV: 75.38% +/- 3.99; RL: 100.1 +/- 11.0). The combination of 2 micrograms/ml of photofrin and 4 J/cm2 of polychromatic light energy, i.e. PDT, was severely toxic to cells derived from saphenous veins (5.52% +/- 0.85) as well as cells derived from restenotic lesions (9.6 +/- 2.3). These doses are comparable to doses that can be achieved in vivo. CONCLUSION: PDT in the appropriate drug and light doses can eliminate human VSMCs, including those responsible for vascular restenosis.

Cell Division↗
PubMed1994

The signs and symptoms of poor nutritional status.

Many signs and symptoms suggest poor nutritional status, and some have been categorized by consensus of the Nutrition Screening Initiative as "major indicators"; this term implies that, if certain standards of change from the norm in that parameter have occurred, poor nutritional status as a cause must be considered and appropriate steps taken to correct such poor nutritional status if confirmed. Virtually all of the signs and symptoms of poor nutritional status are nonspecific and may be caused or exacerbated by other medical conditions. However, by categorizing them as major or minor indicators and summarizing them, the hope is that practicing health professionals will more frequently note these commonly observed changes, appreciate their nutritional significance, and implement nutritional interventions to correct the problems thus preventing the increased morbidity and mortality known to occur in the malnourished older individual.

Aged↗
PubMed1992

Indicators of poor nutritional status in older Americans.

Physicians need to be alert to indicators of poor nutritional status in older patients. These indicators include physical signs, specific symptoms or sets of symptoms, and measurable parameters that indicate poor nutritional status is already present and is causing some effect (although the effect may not be symptomatic and may not be quantifiable). Indicators of poor nutritional status may be detected by interviewing an elderly patient or his or her caregivers, by observing the patient in his or her environment, or by physically examining the patient and/or making specific measurements, including laboratory tests. Since some of these indicators are sensitive to change in the nutritional status over time, they may be potentially useful in confirming the improvement or deterioration in nutritional status.

Activities of Daily Living↗
PubMed1992

An approach to nutrition screening for older Americans.

The Nutrition Screening Initiative suggests an adaptable, tiered approach to screening for poor nutritional status in older Americans. The first level of screening is a checklist to be completed by elderly individuals or their caregivers. This checklist, which will be widely disseminated, describes the warning signs of poor nutritional status. It is anticipated that individuals will approach their physicians on the basis of scores on this checklist. Also included are two screening tests designed to help clinicians more easily detect poor nutritional status, or risk factors for poor nutrition, in their patients. The level I screen is to be completed by a social service or health care professional, or by other trained personnel. The level II screen focuses on additional information to be obtained following referral to a physician or other qualified health care professional.

Aged↗
PubMed1991

Consensus of the Nutrition Screening Initiative: risk factors and indicators of poor nutritional status in older Americans.

Dietetics professionals must become even more proactive in taking the lead in the nutritional screening and assessment of older Americans. They can do so by encouraging all health care providers to become familiar with each older American's circumstances and needs. In addition, as individuals and as a professional health care association, we should urge our colleagues and institutions to establish regular longitudinal surveillance and continuity of care in nutrition services delivery. The timely, appropriate, and cost-effective delivery of nutritional screening, assessment, and care will improve the health and well-being of this valued segment of the US population. Dietetics professionals are a vital part of this process.

Activities of Daily Living↗
PubMed1990

Alzheimer's disease and the family: a challenge of the new millennium.

I have tried to set a keynote--an emphasis on taking a positive approach to the multiple problems that Alzheimer's presents to the patient, the caregiving family, the health professionals, the health care system and society-at-large. The attempt is to preserve as much function as possible, for as long as possible, and thus to maintain the person in his/her own home, in a familiar environment, the environment in which he/she will be least confused and most productive and calm, for as long as possible; in the environment which is most economical, so that as much as possible of the person's capability and person can still be enjoyed by the family members, despite the presence of this illness. One does not wish to make light of this illness and the tragedy that it represents for many of those whom it afflicts, and particularly for the family members, who are not blessed with the gift of the frequently diminished insight the patient has as the illness progresses. However, pleasure, joy, love, affection, and an appreciation of excitement, reminiscence and beauty, and particularly love and affection and many other life-enhancing qualities are still there to be enjoyed by patient and family member alike. To achieve this, the family member must be well informed, skilled, and, above all, well rested and energetic, if he or she is to be the means of reducing the impact of Alzheimer's on the patient, the family and our society.

Activities of Daily Living↗