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Biomedical subjects

K Kelly

Publications and source records attributed to K Kelly.

At least 325 records · Page 18Linked to original sources
PubMedDate not supplied

Colonoscopic impaction in left colon strictures resulting in right colon pneumatic perforation.

Colonic perforation during flexible colonoscopy is a rare but recognized complication. We reviewed 4,593 colonoscopies performed from 1984 to 1989. The perforation rate for diagnostic colonoscopy was 0.17% (6/3,538) and for therapeutic colonoscopy it was 2% (21/1,055). Four perforations of the right colon occurred at a site proximal to the level of the impacted colonoscope. The lesions being evaluated were obstructive in nature: two diverticular strictures (sigmoid colon), one ischemic stricture (descending colon), and one annular carcinoma (descending colon). The four perforations occurred in the right colon and manifested as distension with pneumoperitoneum or retroperitoneal emphysema. Operative management included total abdominal colectomy in two patients (ileoproctostomy in one and ileostomy in one) and right colectomy in two. Outcome was favorable in all cases.

Aged↗
PubMedDate not supplied

Smoking and diabetes: readiness for change and provider advice.

Smoking is a serious health risk, particularly for people with diabetes. This study was designed to examine important aspects of smoking in a large group of individuals with diabetes. A survey was mailed to 2,056 individuals with diabetes. The variables examined were the stages of change for smoking, prevalence of quitting advice given by health care providers, and the patterns of readiness for change. The majority (57.8%) of current smokers were in the precontemplation stage. Comparisons on the stage of change indicated that more individuals with Type 2 diabetes have quit while there are more current smokers among those with Type 1 diabetes. Comparisons on current smokers indicated no differences on stage of change across the Type 1 and Type 2 groups, across three subgroups of individuals with Type 2 diabetes, or across duration of diabetes. Those who reported that they were given cessation advice were further along in the stages of change. These results suggest that the majority of individuals with diabetes who smoke are in the precontemplation stage of change and provider advice is important in moving smokers toward change. The current findings underscore the importance of assessing stage of change and providing stage-matched interventions when working with smokers with diabetes.

Adult↗
PubMedDate not supplied

Functional role for c-myc in mitogenic response to platelet-derived growth factor.

In BALB/c-3T3 cells, expression of the c-myc gene is stimulated by platelet-derived growth factor (PDGF). Using mouse mammary tumour virus promoter: c-myc recombinant plasmids, 3T3 sublines were constructed in which hydrocortisone was the primary determinant of myc mRNA content. The c-myc gene product is an intracellular mediator of the growth response to PDGF though probably not the only one. Both the human and the mouse c-myc genes stimulate clonal growth of 3T3 cells in PDGF-free medium suggesting new strategies for analysis of oncogenes which do not function in focus formation assays.

Animals↗
PubMedDate not supplied

The relationship of cortisol to practice-related gains in intelligence among older persons.

Based on data collected from two separate samples of older adults, the present study explored the role of cortisol in mediating practice-related gains in fluid intelligence (Gf) among older adults. Analyses across samples involved treatment group participants who received stress inoculation training in order to reduce anxiety concerning intellectual performance; waiting list control group participants did not receive training until the experiment(s) were completed. Practice effects were examined for both groups. In Study 1, the sample consisted of a heterogeneous (re: concerns about intellectual performance) group of older adults, and Study 2 participants were older adults who self-reported as being at least moderately anxious or concerned about intellectual performance declines. The two samples differed on health (p < .01), with Study 2 participants being healthier (as determined via self-report). Results indicated that practice, but not training, effects were evident for measures of crystallized ability (Gc) and Gf across both studies. The data also suggested that cortisol mediation was different for the two samples in that it was negatively correlated with Gf in the first sample, and, though not significant, positively correlated with Gf in the second. The same directional relationships were evident for the measure of Gc. Comparisons between studies regarding correlations between cortisol and practice-related gains in performance were significant for Gf (p < .01) and approached significance for Gc (p < .07). These data seem to suggest that for some older persons, higher levels of cortisol interfere with the effects of practice on Gf performance, while for others, higher cortisol facilitates such gains in performance.

Aged↗
PubMedDate not supplied

Innovative programs for children and adolescents with spinal cord injury.

A few innovative programs have enabled children with SCI to surpass traditional levels of independence defined solely on preservation of motor function. Implementation of unique upper extremity and bladder surgical programs has provided children with tetraplegia the ability to manipulate objects without equipment and to independently empty their bladder, respectively. Innovative surgical programs have also restored privacy, dignity, and spontaneity. These are important gains previously unachievable by young persons with tetraplegia. Functional electrical stimulation has advanced children's abilities in upright mobility and has made significant impact on their quality of life by restoring hand and bladder capacities. Nurses play a leadership role in the delivery and integration of these dynamic programs.

Adolescent↗
PubMedDate not supplied

A phase I/II study of idarubicin (Ida) with continuous infusion fludarabine (F-ara-A) and cytarabine (ara-C) for refractory or recurrent pediatric acute myeloid leukemia (AML).

PURPOSE: The goal was to conduct a phase I/II trial of escalating doses of Idarubicin (Ida) in conjunction with the previously established maximum tolerated dose (MTD) of F-ara-A/ara-C in children with refractory or recurrent acute myeloid leukemia (AML). PATIENTS AND METHODS: We conducted a phase I/II trial in parallel with Children's Cancer Group (CCG) study 0922, which involved dose escalation of Ida at levels of mg/m2, 9 mg/m2, and 12 mg/m2 over 15 minutes on days 0, 1, and 2. As phase I safety was documented by CCG, we increased the dose of Ida given on day 0, 1, and 2 of the F-ara-A/ara-C infusion (F-ara-A: 10.5 mg/m2 over 15 minutes and 1.27 mg/m2/hour for 48 hours followed by ara-C: 390 mg/m2 over 15 minutes and 101 mg/m2/hour for 72 hours). RESULTS: Ten of 15 patients achieved remission. There was one toxic death due to adult respiratory distress syndrome. The median time to an absolute neutrophil count (ANC) > 200/microliter was 29 days; ANC > 1,000/microliter was 41 days; and platelets > 100,000/microliter was 45 days. CONCLUSIONS: A dose of 12 mg/m2/day x 3 of Ida did not exceed dose-limiting toxicity with this combination of F-ara-A/ara-C. Substantial activity of this regimen was seen in pediatric patients with AML.

Acute Disease↗
PubMedDate not supplied

Preschool language intervention: a follow-up study.

A follow-up study was undertaken of 38 children who had attended a preschool language unit with detailed assessments of 25 by speech therapists and an educational psychologist. The subjects were assessed in a number of areas (language, learning and social skills) using standardized tests and rating schedules completed by teachers and parents. The initial results are presented in terms of group characteristics. At a mean age of 8.3 years the children were still making progress in all areas of development. Although some 16% of the children were attending specialist schools or classes (language unit, physically handicapped unit, schools for children with severe speech and language problems), the majority (84%) were within the mainstream of education. A continuing language difficulty was apparent on standardized tests. Reading and spelling were slightly depressed, but not significantly so. However, parents and teachers saw the children as differing little from their peers. The conclusion is reached that preschool intervention can prevent later educational failure.

Adaptation, Psychological↗
PubMedDate not supplied

Preschool language intervention--a follow-up of some within-group differences.

A more detailed study was made of the children who had been followed-up by Urwin, Cook & Kelly (1988) 4-8 years after leaving a preschool language group. Children were independently allocated into groups according to their speech and language diagnosis prior to entry to the Unit. There were two major dimensions--receptive/expressive versus expressive only, and phonology versus non-phonology. Comparisons were made between the group as indicated by children's performance at follow-up for measures of ability, achievement, language and social functioning. Conclusions are drawn about the long-term effects of the early language difficulty and preschool intervention. Attention is also drawn to differences in perceiving the effects of language difficulty between the specialist professionals on the one hand and parents and teachers on the other.

Child↗
PubMedDate not supplied

Pulmonary hemorrhage: an often fatal complication of Henoch-Schoenlein purpura.

Two patients with Henoch-Schoenlein purpura developed pulmonary hemorrhage. One patient survived after treatment with intravenous methylprednisolone and cyclophosphamide; the other patient died from cardiopulmonary arrest before therapy could be initiated. Although rare, pulmonary complications of Henoch-Schoenlein purpura can lead to rapid demise unless immediate supportive treatment is initiated.

Adolescent↗
PubMedDate not supplied

In vitro pullout strength of screws inserted in adult equine third metacarpal bone after overdrilling a 4.5-mm threaded insertion hole.

OBJECTIVE: To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. STUDY DESIGN: In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. SAMPLE POPULATION: Two independent cadaver studies each consisting of 14 adult equine MCIII bones. METHODS: Two 4.5-mm cortical screws were placed either in the middiaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5-mm drill bit and had either a 5.5-mm cortical or a 6.5-mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/second until screw or bone failure occurred. RESULTS: In diaphyseal bone, the screws failed in all tests. Tensile breaking strength for 5.5-mm cortical screws (997.5 +/- 49.3 kg) and 6.5-mm cancellous screws (931.6 +/- 19.5 kg) was not significantly different. In metaphyseal bone, the bone failed in all tests. The holding power for 6.5-mm cancellous screws (39.1 +/- 4.9 kg/mm) was significantly greater than 5.5-mm cortical screws (23.5 +/- 3.5 kg/mm) in the metaphysis. There was no difference in the tensile breaking strength of screws in the diaphysis between proximal and distal screw holes; however, the holding power was significantly greater in the distal, compared with the proximal, metaphyseal holes. CONCLUSIONS: Although tensile breaking strength was not different between 5.5-mm cortical and 6.5-mm cancellous screws in middiaphyseal cortical bone, holding power of 6.5-mm cancellous screws was greater than 5.5-mm cortical screws in metaphyseal bone of adult horses. CLINICAL RELEVANCE: If a 4.5-mm cortical bone screw strips in MCIII diaphyseal bone of adult horses, either a 5.5-mm cortical or 6.5-mm cancellous screw, however, would have equivalent pullout strengths. A 6.5-mm cancellous screw, however, would provide greater holding power than a 5.5-mm cortical screw in metaphyseal bone.

Animals↗