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Biomedical subjects

J E Kelley

Publications and source records attributed to J E Kelley.

At least 19 recordsLinked to original sources
PubMed1999

From recipes to recetas: health beliefs and health care encounters in the rural Dominican Republic.

With the growing influx of immigrants from the Dominican Republic entering the U.S. yearly, it is important for nurses to become familiar with their traditional health beliefs and health care experiences. The purpose of this study was: (a) to identify health beliefs of rural Dominicans and (b) to describe health care encounters between rural Dominicans and a visiting team of U.S. nurses. The data on health beliefs were collected in six focus groups and were analyzed using content analysis techniques. Health encounter data were collected from 693 Dominicans as they presented to mobile clinics for care. Findings from the focus group interviews suggested that health beliefs fall into two major categories: physical and spiritual/mystical. The most frequently occurring health problems, summaries of medications dispensed, treatments provided, referrals made, and health teaching information are presented.

Adolescent↗
PubMed1997

Health effects of emotional disclosure in rheumatoid arthritis patients.

This study examined the effects of emotional disclosure of stressful events on the pain, physical and affective dysfunction, and joint condition of patients with rheumatoid arthritis (RA). Patients were randomly assigned to talk privately about stressful events (disclosure group, n = 36) or about trivial topics (control group, n = 36) for 4 consecutive days. Disclosure resulted in immediate increases in negative mood. At 2 weeks the 2 groups did not differ on any health measure, but at 3 months disclosure patients had less affective disturbance and better physical functioning in daily activities. There was no main effect of disclosure on pain or joint condition, but among the disclosure patients, those who experienced larger increases in negative mood after talking demonstrated improvements in the condition of their joints. This study concludes that, among RA patients, verbal disclosure and emotional processing of stressful life events induces an immediate negative mood followed by improved psychological functioning.

Activities of Daily Living↗
PubMed1997

Inflammatory pseudotumor of the liver associated with extrahepatic infection.

We present two cases that support an infectious cause of inflammatory pseudotumor of the liver. Each patient had sepsis due to chronic abdominal abscesses, along with a liver mass. Both patients had exploratory celiotomy, and histologic examination of the liver mass revealed inflammatory pseudotumor of the liver. Evidence of a mixed bacterial/Actinomyces infection was noted in hepatic tissue sections in one patient, and Bacteroides caccae was cultured directly from the liver biopsy in the other patient. This is the first known report of bacteria being cultured from biopsy specimens of a hepatic pseudotumor and the only reported case of Actinomyces within a hepatic pseudotumor. Clinical and pathologic findings in these two cases indicate that an extrahepatic infectious source should be explored as a potential cause of inflammatory pseudotumor of the liver.

Abdominal Abscess↗
PubMed1993

A safe and cost-effective protocol for the management of esophageal coins in children.

Foreign bodies of the esophagus are a common problem in children, with the majority of these foreign bodies being coins. Because there are various methods for managing esophageal coins, we retrospectively reviewed our experience of the past 4 years to establish a safe and cost-effective protocol for their management. From January 1987 to December 1990, 57 children were managed for esophageal coins in our institution. Nineteen children were managed endoscopically under general anesthesia, with a mean patient cost of $1,982 (excluding the surgeon and anesthesiologist charge). Thirty-eight children were managed with Foley balloon extraction or esophageal bougienage in the emergency department with a mean patient cost of $149 (excluding surgeon charge). Both methods were 100% effective, and there were no complications in either group. Rigid criteria were used in selecting patients for balloon extraction and bougienage. These were: (1) duration less than 24 hours; (2) no respiratory distress; and (3) no history of esophageal disease or surgery. Using these criteria, 16 of the 19 patients managed endoscopically could have safely and effectively been managed in the emergency department with a net savings of $1,833 per patient. We conclude that Foley balloon extraction and bougienage of esophageal coins in selected children is both safe and cost-effective. A protocol for managing children with esophageal coins is presented, and the techniques of Foley balloon extraction and esophageal bougienage are reviewed.

Catheterization↗
PubMed1993

Safety, efficacy, cost, and morbidity of laparoscopic versus open cholecystectomy: a prospective analysis of 228 consecutive patients.

Laparoscopic cholecystectomy has become the procedure of choice in most hospitals for the resolution of surgically treatable gallbladder disease. Few reports address the results of laparoscopic cholecystectomy in comparison to open cholecystectomy during the same time interval within the same institution. One hundred ninety-six laparoscopic cholecystectomies were performed from April 1990 through February 1991. Initial patient selection was restricted to elective procedures for chronic cholecystitis with expanded indications as experience was gained. Of the 196 cases, 11 required conversion to open cholecystectomy, leaving 185 laparoscopic cholecystectomies for comparison. During the same period, 82 open cholecystectomies were performed. Thirty-nine of these were complicated cases and would not have been considered for laparoscopic cholecystectomy early in the study, leaving 43 routine open cholecystectomies for comparative purposes. In the laparoscopic group, 1.1 per cent of the patients had major operative complications as opposed to the open group, which had none. There were no common bile duct injuries in either group. To provide a true cost-benefit analysis, a group of patients was identified that would qualify for elective, same-day admission for either an open or laparoscopic procedure. Laparoscopic cholecystectomy (LC) was performed on 70 patients, and open cholecystectomy (OC) was performed on 26 patients. A comparison of data from these groups showed no significant difference in age or sex. Hospitalization costs averaged $5,390 for the LC group versus $5,392 for the OC group. Postoperative hospital stay averaged 1.3 days for the LC group versus 3.7 days for the OC group (P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Cholangiography↗
PubMed1992

Photon beam dosimetry at a blocked beam edge using diffusion approximation.

A simple analytical model is presented for the transport of secondary electrons at a photon beam edge using the energy averaged solution of the Boltzmann equation, originally developed for beta-ray dosimetry at a plane interface. Dose at a point under a block is assumed to be due to secondary electrons and the scattered photons generated from the primary photon beam. The diffusion approximation is used for the secondary electron transport at a virtual plane interface created by the block. The dose from the scattered photon component is treated as decaying exponentially with distance from the beam edge. Comparisons made with the model and measurements are in general agreement for high energy accelerator beams.

Diffusion↗
PubMed1988

Comparison of two screen-film combinations in contact and magnification mammography: detectability of microcalcifications.

A new dual-screen, dual-emulsion-film combination that allows a decrease in radiation dose of approximately 66% was compared with a widely used single-screen, single-emulsion-film system in contact and magnification mammography. Clustered microcalcifications randomly superimposed on a breast phantom were detected, and the location and number of individual calcifications were determined by four observers. The detectability of calcifications, determined with a receiver operating characteristic (ROC) analysis area, was 0.92 for magnification and 0.82 for contact mammography with the single-emulsion-film system, compared with 0.84 and 0.72, respectively, with the dual-emulsion-film system. More clusters were correctly located and more individual calcifications were counted with magnification than with contact mammography. The dual-emulsion-film system with the magnification technique performs as well as the single-emulsion-film system with the contact technique, while retaining a decrease in required dose of approximately 40%.

Breast Diseases↗
PubMed1981

Separation and concentration of murine hematopoietic stem cells (CFUS) using a combination of density gradient sedimentation and counterflow centrifugal elutriation.

To obtain concentrated suspensions of pluripotent hematopoietic stem cells *CFUS) from murine bone marrow, density gradient centrifugal sedimentation (DGCS) was combined with counterflow centrifugal elutriation (CE). This combination provided a 7.6 fold enrichment of the CFUS concentration. For DGCS, Percoll a suspension of silica particles coated with polyvinylpyrrolidone was used. For fractionation by the CE an elutriator rotor (JE-6, Beckman) was used for further concentration of the cells harvested from the DGCS. Bone marrow erythropoiesis was suppressed by transfusion plethora initiated 5-6 days before the bone marrow was harvested. These two physical separation procedures combined with transfusion plethora to suppress erythropoiesis are effective in producing an enriched fraction of CFUS without change in distribution of the histologic type of colonies.

Animals↗