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Biomedical subjects

J Kellett

Publications and source records attributed to J Kellett.

At least 37 records · Page 2Linked to original sources
PubMed1988

Diabetes mellitus type I. Results of a European questionaire.

An anonymous questionaire concerning diabetes type I was circulated through (Young) AEMIE members. Questions were asked regarding available facilities, diagnosis, follow-up and therapy. One hundred and six completed questionaires were available for study: most were from 5 countries, i.e. 20 from the Netherlands (NL), 26 from Great Britain (GB), 16 from France (F), 16 (+2) from Belgium (B) (+ Luxemburg = LUX) and 19 from Ireland (IRL). There was a preponderance of general internists and internist/diabetologists. In Great Britain significantly more participants were internist/diabetologists and they treated significantly more patients than other participants. They also had access to more facilities, especially diabetes nurses. Most patients appeared to perform bloodglucose measurements; only 10 p. 100 of the patients did not measure glucose in blood or urine at all. There is general acceptance that bloodglucose regulation should be as tight as possible. The allowance of sugar under certain conditions was mostly permitted in the Benelux countries. The use of insulin pens exceeded that of insulin pumps. The preference for pens was primarily related to convenience for patient and doctor and low cost. The main indication for their use was bad regulation. This study confirms the impression that there is an increased interest in patient education (i.e. diabetes nurses, educational programmes and home blood glucose monitoring) amongst European physicians and a trend towards using new devices such as insulin pens and pumps in an effort to achieve a tighter blood sugar control.

Blood Glucose↗
PubMed1988

Diabetes clinic attendance and metabolic control. A pilot pan clinic study.

A descriptive analysis made of a total clinic population (127 patients) followed at a newly formed diabetic clinic from 1982 to 1985 the charts of all 127 patients were analysed for age, duration of diabetes and initial mean and last recorded haemoglobin A1C from 1st January, 1982 to 31st December, 1985. During the period of study, 76 patients continued to attend the clinic regularly and 55 patients were classified as "Non-Attenders" since they had failed to attend the clinic for a period of one year or more prior to a formal recall at the end of 1985. "Attenders" and "non-attenders" appeared to have similar ages and mean haemoglobin A1C's. However, there were more smokers, alcoholics and unemployed in the "non-attending" group. When comparison was made between the initial haemoglobin A1C (on the patient's first attendance at the clinic) and subsequent mean haemoglobin A1C's and final haemoglobin A1C's, it was discovered that the diabetic control of many patients that had attended the clinic regularly had not improved (45 out of 76). On the otherhand, a considerable number of the "non-attending" patients had improved spontaneously without clinic attendance (13 out of 38). The patients that had attended the clinic and not improved tended to be younger, were more often school children, unmarried, unemployed and/or smokers. The results reported in this preliminary paper are insufficient to allow full statistic analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1986

Treatment of nickel dermatitis with Trientine.

23 nickel-sensitive patients with hand eczema were treated with Trientine 300 mg daily and a placebo in a double-blind, crossover trial. No significant improvement occurred in the hand eczema. A surprising finding was that there was no detectable increase in urinary nickel excretion, in contrast to animal studies.

Adult↗
PubMed1986

Acute soft tissue injuries--a review of the literature.

The classification, pathology, and management of acute soft tissue injuries are reviewed. Classifications based on etiology and severity are outlined. The pathological processes at a cellular level are described in three phases: acute inflammatory, repair, and remodelling. the management of acute soft tissue trauma is embodied in the acronym RICE for rest, ice, compression, and elevation during the first 48 to 72 h. Additional benefit from anti-prostaglandin medications has not been clearly demonstrated in clinical trials, and if used, these medications should be restricted to the first 3 days. Cryotherapy (crushed ice) for 10 to 20 min, 2 to 4 times/day for the first 2 to 3 days is helpful in promoting early return to full activity. Early mobilization, guided by the pain response, promotes a more rapid return to full activity. Early mobilization, guided by the pain response, promotes a more rapid return to full functional recovery. Progressive resistance exercises (isotonic, isokinetic, and isometric) are essential to restore full muscle and joint function. Rehabilitation is complete when the injured and adjacent tissues are restored to full pain-free functional capacity under competitive conditions in association with the necessary level of cardiovascular respiratory fitness.

Acute Disease↗
PubMed1984

Gas-chromatographic determination of mexiletine with a nitrogen-selective detector.

The authors present a procedure for the determination of mexiletine in serum. The drugs are extracted under basic conditions into n-heptane/isobutanol (96/4 by vol) and then extracted again into 1 mol/L H2SO4. The acidic solution is made basic with sodium hydroxide, reextracted with diethyl ether, and the extract evaporated. The residue is redissolved in ethanol and analyzed by gas chromatography with a nitrogen-selective detector. By use of two internal standards, diphenhydramine and p- chlorodisopyramide , concentration and instrument response are related linearly from 500 micrograms/L to 4.0 mg/L. Interferences from other drugs also are eliminated by using two internal standards. Within-run precision (CV) was 5% at the 1 and 2 mg/L concentration: between-run precision was 10% and 5% at those respective concentrations. Interference studies indicate that most commonly prescribed basic drugs will not interfere with this procedure.

Chromatography, Gas↗
PubMed1983

Psychological and hormonal factors in the treatment of female sexual dysfunction.

Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contrary to expectations from earlier work, there was no benefit attributable to testosterone or to the use of two therapists; self-ratings favoured weekly sessions with one therapist. It was concluded that testosterone (at least in the dosage used) is unlikely to have a useful place in the treatment of sexually unresponsive women, but that weekly counselling sessions with a single therapist is a reasonably effective and economic form of sex therapy. Findings from this research suggest the need for a clearer understanding of aetiological and treatment mechanisms.

Adult↗
PubMed1981

Social skills and somatotype.

The hypothesis that somatotype is closely related to social skills and that the response of patients with social disability to social skills training might also relate to these genetically controlled factors has been supported. Twenty-one subjects seeking treatment for social phobia were assessed by interview, videotape, diary, and somatotype measures. Ectomorphs used less non-verbal communication and endomorphs were more restless. Women used fewer gestures but their speech was less hesitant than men. Social skills training benefited the shorter, plumper physique more than the linear ectomorph and, to some extent, and independently, the older subjects.

Adult↗
PubMed1976

Anorexia nervosa after the menopause.

A patient is described who developed the classical syndrome of anorexia nervosa at the age of 52. Her illness occurred in relation to the marriages of her daughters and showed an extreme preoccupation with her body shape and a determination to slim by diet, purging and vomiting, and the hiding of food to the extent of rendering herself too weak to cope with the demands of her life. It is suggested that anorexia nervosa, though predominantly a disease of onset in adolescence, may present at any age and should be considered in the differential diagnosis of anorexia in patients over the age of 50.

Anorexia Nervosa↗
PubMedDate not supplied

The early diagnosis of acute myocardial infarction. Comparison of a simple algorithm with a computer program for electrocardiogram interpretation.

The sensitivity and specificity of electrocardiographic (ECG) interpretation by a simple algorithm was compared with a computer read ECG machine. Clinical data and ECG findings on 264 consecutive patients admitted to a coronary care unit with suspected acute myocardial infarction were prospectively entered into an algorithm with 13 end-points. These end-points were compared with the interpretations of a computer read ECG machine (Marquette MAC PC). 86 patients (32.5%) had confirmed acute infarction. 85% of those with infarction had some form of ST elevation on their initial ECG. Patients with ST elevation presented earlier (4.9 +/- 4.9 versus 8.0 +/- 9.7 hours after symptom onset, p < 0.001), and were older (66.5 +/- 11.0 versus 62.0 +/- 12.5 years, p < 0.01) than those without infarction. According to the algorithm 94.2% of patients with infarction had some form of ECG abnormality, compared with 55.6% of those without infarction (p < 0.001). The area under the receiver operating characteristic (ROC) curve of the algorithm was 92.3% of the area of the graph. This was more (p < 0.01) than the area under the ROC curve of the interpretations of the computer read ECG machine (83.9%). Marked ST elevation with reciprocal changes was the most specific indicators of infarction (Likelihood ratio 51.7). The algorithm, therefore, was comparatively sensitive and specific in the early diagnosis of acute infarction.

Adult↗
PubMedDate not supplied

Audit of a rural hospital's coronary care unit: comparison of two predictive instruments of acute myocardial infarction mortality.

The purpose of the study was to compare observed mortality of a rural hospital coronary care unit with mortality rates estimated by two predictive instruments of mortality. The mortality rates of 86 consecutive patients with confirmed acute myocardial infarction were compared with those predicted by the presence or absence of eight risk factors for mortality identified by the Thrombolysis in Myocardial Infarction (TIMI) trial, and mortality predicted by a logistic regression equation LRE). Seventeen patients (20 per cent) died within 6 weeks of admission; the number of TIMI risk factors present predicted a mortality of 9.8 per cent, and the instrument of Selker's predicted a mortality of 25.9 per cent. Patients with 3 TIMI risk factors had a significantly higher mortality than predicted (46.2 versus 13.0 per cent, p < 0.01). There were no significant differences between the receiver operating characteristic (ROC) curve of either instrument. The predictions of Selker's instrument, however, showed no significant difference from observed mortality, even when the patients were grouped into quintiles, and the predicted mortality rates were corrected for any presumed benefit from thrombolysis. The predictive instrument of Selker more consistently estimates observed mortality than the presence of risk factors identified by the TIMI trial.

Aged↗