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J A Farley

Publications and source records attributed to J A Farley.

6 recordsLinked to original sources
PubMed2006

Use of transabdominal ultrasonography to determine the location of cryptorchid testes in the horse.

REASONS FOR PERFORMING STUDY: Transrectal ultrasonography is a reliable technique to identify intra-abdominal testes, but can be hazardous or impractical in fractious, juvenile or small equids. The transabdominal approach therefore requires validation. OBJECTIVES: To evaluate the sensitivity and specificity of transabdominal ultrasonography to localise cryptorchid testes. METHODS: Thirty-eight horses admitted for cryptorchidism underwent transabdominal ultrasonography to locate errant testes. Location of the testes was confirmed during surgery (n = 37) or necropsy (n = 1). RESULTS: Horses weighed 175-760 kg. Twenty-two testes were located within the abdomen, 19 in the inguinal space and 3 in a subcutaneous location. In 2 horses, a thick winter coat prevented adequate contact between the probe and the skin, and visualisation of their inguinal testis and one abdominal testis was missed during transabdominal ultrasonography. Excluding the 2 horses with excessive hair, the sensitivity of transabdominal ultrasonography to locate errant testes was 97.6% (93.2% when all horses were included), and its specificity 100%. CONCLUSIONS: Transabdominal ultrasonography is a reliable, safe and immediate technique to diagnose cryptorchidism precisely in horses of all ages, sizes and temperaments. POTENTIAL RELEVANCE: Transabdominal ultrasonography provides an immediate definitive diagnosis of adominal cryptorchidism and should enhance selection of an appropriate surgical approach for their removal.

Animals↗
PubMed1997

The use of clinical practice guidelines (CPGs) to evaluate practice and control costs in ventriculoperitoneal shunt management.

BACKGROUND: As a step toward maximizing the quality and cost-effectiveness of neurosurgical care, we designed clinical practice guidelines (CPGs) for the management of VP shunt malfunctions and infections at a tertiary care pediatric teaching institution. The detailed CPGs determine the use of radiographic studies, laboratory tests, and invasive procedures in the management of this problem. One purpose of the CPGs is to provide clear clinical guidelines for the medical trainee, thereby reducing variability in care and unnecessary utilization of resources. METHODS: The CPGs were developed in stages over a 2-year period. The practice patterns in our institution for the management of shunt malfunctions and infections were articulated. They were compared with those published in the neurosurgical literature, and areas of clinical decision-making variability were identified. Preliminary guidelines were formulated, and data regarding patient care were prospectively collected. Based on this data, final CPGs were formulated and implemented. Total and itemized hospital charges for patients managed according to the CPGs were compared with those for patients in the 3 years before CPG implementation. RESULTS: CPG-managed patients had generally lower total and itemized charges as compared with control patients. Decreased charges per hospital day and charges for shunt films in the CPG group were statistically significant. CONCLUSIONS: The process by which the CPGs were developed and implemented, as well as the CPGs themselves, are described. We also present the clinical, demographic, and financial data that were prospectively collected for all patients managed within the CPGs over an initial 1-year period and compare it with data obtained for control groups of shunt malfunction patients admitted during the 3 years before implementation of the CPGs. We find a trend toward reduction of charges after implementation of the CPG.

Boston↗
PubMed1986

Horrible Harry.

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Adult↗
PubMedDate not supplied

Iatrogenic developmental effects of pediatric intensive care.

Critically ill children in the pediatric intensive care environment are at particular risk for experiencing health care interventions that hinder them from progressing through their normal developmental milestones. Knowledge of the factors that influence iatrogenic developmental insults can help the nurse develop the skills and sensitivity to meet the complex needs of these children and their families.

Adaptation, Psychological↗