Search PubMed⌕ Search

Biomedical subjects

J P Keating

Publications and source records attributed to J P Keating.

At least 37 records · Page 2Linked to original sources
PubMed1996

The clinical and radiological features of cholecystocolic fistulae.

The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43-85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary-intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.

Adult↗
PubMed1995

Psychological assessment of postdisaster class action and personal injury litigants: a case study.

The case study method is used to describe psychological assessments undertaken with victims of a combined natural/technological disaster for litigation purposes. A class action suit was filed in which the authors determined levels of traumatic stress in 27 plaintiffs as a group and relative to each other. The process was effective--the case was settled out of court in favor of the litigants. Individual litigants were satisfied with monetary awards received.

Adult↗
PubMed1995

Cutaneous presentation of juvenile chronic myelogenous leukemia: a diagnostic and therapeutic dilemma.

Annular, erythematous, circinate plaques were the first manifestation of juvenile chronic myelogenous leukemia (JCML) in an otherwise healthy 2.5-year-old boy who had had these lesions since 6 months of age. The lesions showed an atypical hematopoietic infiltrate on biopsy. Biopsy of a bone marrow specimen and peripheral blood smear were normal six months before leukemic transformation. At 3 years of age the boy developed splenomegaly, thrombocytopenia, and petechiae, and a bone marrow aspirate and cell marker studies were regarded as consistent with, if not diagnostic of, JCML. Four previous cases of cutaneous leukemic infiltrate associated with JCML have been published. Our patient had recurring urticarial-like plaques for two years before the initial bone marrow finding of JCML. Given the poor prognosis and progressively evolving course of JCML, it may be appropriate to consider therapy before bone marrow changes, based on the presence of the cutaneous eruption with the appropriate findings on skin biopsy and an elevated fetal hemoglobin.

Child, Preschool↗
PubMed1995

[Cerebrovascular accidents. Case material based on hospital records].

Perceiving that inaccuracy of clinical records is the rule rather than the exception, the author examines the data base of the Amarante Regional Hospital with particular relevance to the patients who were hospitalized with cerebral vascular accident (CVA) in the Department of Internal Medicine during 1990, 1991 and 1992. The objective is to view the existing computerised hospital database as a source of information for future studies within the clinical field and, at the same time, to be aware of the department's casuistry and to contribute to the epidemiological understanding of the population who lives in the area of influence of this hospital. In this department, 24% of all the hospitalised patients had either a recent CVA or had already had one previously. On the whole, the disease affected both sexes in an equal manner, but females later than males. The mortality rate was greater in patients with CVA (17%) than in those without CVA (9%) and was also greater in CVA-females (19%) than in CVA-males (15%). The intercurrences in the community were the cause of admission in 26% of the hospitalised patients with a CVA, and were mainly respiratory, metabolic and urinary diseases, and appeared to be more serious in males. The mortality rate in patients with intercurrences (19%) was only exceeded by that caused by hemorragic accidents (22%). The author examines and discusses the instances of error during the construction and data gathering of the database and draws his own conclusions.

Age Factors↗
PubMed1994

Glycogen storage disease in adults.

OBJECTIVE: To identify complications amenable to prevention in adults with glycogen storage disease (GSD) types Ia, Ib, and III and to determine the effect of the disease on social factors. DESIGN: Case series and clinical review. SETTING: Referral medical centers in the United States and Canada. PATIENTS: All patients with GSD-Ia (37 patients), GSD-Ib (5 patients), and GSD-III (9 patients) who were 18 years of age or older. MEASUREMENTS: Ultrasound or radiographic studies identified liver adenomas, nephrocalcinosis, or kidney stones. Radiographic studies identified osteopenia. Reports of the clinical examination, serum chemistry results, and social data were obtained. RESULTS: For patients with GSD-Ia, problems included short stature (90%), hepatomegaly (100%), hepatic adenomas (75%), anemia (81%), proteinuria or microalbuminuria (67%), kidney calcifications (65%), osteopenia or fractures or both (27%), increased alkaline phosphatase (61%) and gamma-glutamyltransferase (93%) activities, and increased serum cholesterol (76%) and triglyceride (100%) levels. Hyperuricemia was frequent (89%). Patients with GSD-Ib had severe recurrent bacterial infections and gingivitis. In patients with GSD-III, 67% (6 of 9) had increased creatinine kinase activity. Four of these patients had myopathy and cardiomyopathy. CONCLUSIONS: For GSD-Ia, hyperuricemia and pyelonephritis should be treated to prevent nephrocalcinosis and additional renal damage. For GSD-Ib, granulocyte-colony-stimulating factor may prevent bacterial infections. For GSD-III, more data are required to determine whether the myopathy and cardiomyopathy can be prevented. Most of the patients with GSD-I and GSD-III had 12 or more years of education and were either currently in school or employed.

Adult↗
PubMed1993

Femoral nerve palsy following laparoscopic inguinal herniorrhaphy.

Laparoscopic inguinal herniorrhaphy has undergone a rapid evolution. The technique currently favored by many laparoscopic surgeons places a prosthetic mesh over the myopectineal orifice. We describe a femoral nerve palsy after such an operation and detail the anatomy of the nerves at risk during laparoscopic inguinal herniorrhaphy. We discuss how injury to these structures and the attendant anterior thigh pain and weakness may be avoided.

Adult↗
PubMed1993

Radiology of starch granulomatous peritonitis.

Starch granulomatous peritonitis (SGP) is a rare complication of abdominal surgery that results, in a susceptible individual, from contamination of the peritoneal cavity with starch particles from the surgeon's gloves. It is important to make the diagnosis of SGP without recourse to re-operation as the optimal treatment is non-surgical. A case of SGP that was confirmed only after re-operation and resection of the involved tissues is reported. The first description of an abdominal computed tomography scan in this condition is presented, the significance of which was only recognized postoperatively.

Abdominal Muscles↗
PubMed1992

Idiopathic myelofibrosis with myeloid metaplasia involving the renal pelves, ureters and bladder.

Myeloid metaplasia associated with idiopathic myelofibrosis most commonly involves the reticuloendothelial organs, such as the spleen, liver and retroperitoneal lymph nodes. We report on a patient with myeloid metaplasia (extramedullary hematopoiesis) of the renal pelves, ureters and bladder. The pathogenesis, clinical characteristics, treatment and prognosis of this condition are discussed.

Adult↗
PubMed1991

Oral water intoxication in infants. An American epidemic.

Between 1975 and 1990, a total of 34 patients with water intoxication were treated at St Louis (Mo) Children's Hospital, 24 of these in the last 3 years, indicating a marked increase in incidence of this previously rare condition. Thirty-one were infants living in poverty who ingested excessive amounts of water offered at home by their caretakers. Exhaustion of the supply of infant formula was the most common reason given for this substitution. Infants were treated by a single infusion of hypertonic saline or a slow infusion of isotonic saline. Central pontine myelinolysis was not observed as a complication of hypertonic saline therapy. Modification of the Special Supplemental Food Program for Women, Infants, and Children to provide sufficient formula for the growing infant and better education of mothers as to the hazards of excessive water ingestion might reduce the incidence of this preventable and life-threatening condition.

Disease Outbreaks↗
PubMed1991

Granulocyte colony-stimulating factor corrects the neutropenia associated with glycogen storage disease type Ib.

A young woman with glycogen storage disease, type Ib, and chronic neutropenia had severe recurrent infections. In a life-threatening situation, treatment with granulocyte colony-stimulating factor (G-CSF) resulted in the prompt correction of neutropenia. Subsequently, daily G-CSF therapy has allowed the maintenance of a normal neutrophil count and marked clinical improvement over a period of 18 months. The spectrum of neutropenic conditions which are responsive to G-CSF should include this inherited metabolic disorder.

Adult↗