Biomedical subjects
A Kelly
Publications and source records attributed to A Kelly.
Low cost automated haematology.
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Deranged DNA synthesis by bone marrow from vitamin B-12-deficient humans.
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Vitamin B12 and folate activity in normal human platelets.
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Haematological indices in a random sample survey of the highlands region of the territory of Papua and New Guinea.
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Letterer-Siwe disease.
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Splenomegaly in New Guinea.
Seeking to determine whether there is a relationship in New Guineans between hepatic sinusoidal infiltration and splenomegaly on the one hand and malaria on the other, the authors studied 24 adults from a village protected from malaria for 5 years by 6-monthly DDT spraying and 34 adults from an unprotected village with hyperendemic malaria.It was found that clinical splenomegaly tended to be associated with greater hepatic sinusoidal infiltration among persons from the malarious village and that higher malaria antibody titres were more common in patients with splenomegaly in this village. In adults in the protected village the prevalence of malaria parasitaemia was much lower than in the malarious village and the sinusoidal infiltrates were also diminished.No associations between parasitaemia, malaria antibody titre, and hepatic sinusoidal infiltration could be demonstrated in the malarious village. The implications of these findings are discussed and the question of malaria being responsible for the marked splenomegaly encountered in tropical practice is discussed.
Coated charcoal assay of erythrocyte vitamin B 12 levels.
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Ovale malaria in eastern New Guinea.
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Automatic erythrocyte volume analysis. Price-Jones curve determination.
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Highlands Region survey of intestinal parasites.
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The potential for drug interactions with statin therapy in Ireland.
BACKGROUND: Seven percent of acute hospital admissions result from adverse drug reactions, of which 25% are due to drug interactions. Adverse effects of statin drugs occur in 3% of patients, mainly due to co-prescribing with other lipid-lowering agents or agents that alter their metabolism. AIM: The aim of this study was to investigate co-prescribing of the frequently-used statin medications with interacting drugs. METHODS: Data from the General Medical Services (GMS) scheme of the Eastern Health Board from January to December 1998 were used in this study. Using the coding index for statins, co-prescribing was identified when concomitant medications were administered under the same GMS claim number. RESULTS: Of 7,602 patients prescribed statins, co-prescribing of simvastatin, atorvastatin and fluvastatin with competing substrates or inhibitors of their metabolism occurred in 32, 26 and 13.4% of prescriptions issued. Thirty-four per cent of patients on simvastatin, 28% on atorvastatin and 16% on fluvastatin were prescribed medications with drug interaction potential. CONCLUSION: Co-prescribing of statins with competing substrates or inhibitors of their metabolism occurred in up to one-third of prescriptions issued. When statins are co-prescribed with recognised inhibitors of drug metabolism, pravastatin, which does not undergo significant hepatic metabolism, is the statin of choice.
Outpatient experiences in acute hospitals.
BACKGROUND: Patient satisfaction surveys are useful in gaining an understanding of users' needs and their perceptions of the service received. AIM; To assess the views of outpatient department (OPD) attendees on the quality of service received. METHODS: OPD attendees were randomly selected from four acute hospitals in one health board region and sent a confidential postal questionnaire to assess their views on their visit. RESULTS: Of 3,037 attendees surveyed, there was a response rate of 75.7%. Levels of satisfaction were high at 94%. Doctors and nurses were perceived as friendly by 61% and 72%, professional by 44% and 30%, rushed by 8% and 7%, and rude by 1% and 1% of patients, respectively. Using logistic regression, age (being older), sex (being male), pain level (no pain), decisions about care (wanting more involvement) and being satisfied with their waiting time from arrival to being seen were significantly associated with a greater likelihood of being satisfied overall. CONCLUSION; Whilst there was a high level of satisfaction with the quality of care received, areas for improvement were highlighted from the patient's perspective.
Using HIPE data as a research and planning tool.
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Using HIPE data as a research and planning tool: limitations and opportunities.
BACKGROUND: The Hospital Inpatient Enquiry (HIPE) system is an important information source for research and health service planning activities. However, as it was not designed explicitly for these purposes, some limitations exist. AIMS: To make recommendations that would increase the value of HIPE as a research and planning tool. METHODS: Experiences of using HIPE for research and planning exercises were analysed so as to identify its limitations and their impact on research and planning. RESULTS: Limitations were identified regarding data quality, policy issues and the general system. CONCLUSIONS: To increase the utility of HIPE as a research and planning tool, a number of changes are recommended, including: expanding the system to cover private hospitals and outpatient and emergency services; adopting routine small area and socio-economic coding; adopting unique personal identifiers; publishing regular detailed reports with in-depth analyses; and considering making hospital identifiers available in certain circumstances.
Socio-economic gradients in self-reported health in Ireland and Northern Ireland.
BACKGROUND: Research and policy related to reducing health inequalities has progressed separately within Ireland and Northern Ireland. This paper describes the first exploration of the socio-economic influences on health on the island of Ireland since 1922. METHODS: Postal survey. RESULTS: The response rate was 52%; 11,870 respondents. Men reported more long-standing illness (LLTI) or poor general health (PGH); depression was more common amongst women. Socio-economic gradients in health were evident in both jurisdictions, with the effects of household income being particularly marked. Overall, morbidity levels were significantly better in Ireland than in Northern Ireland: adjusted odds ratio of 0.79 (95% CI 0.71 - 0.88) for LLTI; 0.64 (0.57 - 0.72) for PGH; 0.90 (0.82 - 0.99) for depression. CONCLUSIONS: There is evidence of strong and similar socio-economic gradients in health throughout the island of Ireland. This would suggest joint policy approaches or at least further comparative evaluation of the initiatives in each jurisdiction.
Premenstrual relapse of puerperal psychosis.
Eight patients suffering from puerperal psychosis rapidly recovered, then relapsed shortly before the onset of their first menstrual period; five of them had repeated premenstrual relapses. This clinical observation supports a hormonal aetiology for post-partum psychosis.