Search PubMed⌕ Search

Biomedical subjects

K McCue

Publications and source records attributed to K McCue.

7 recordsLinked to original sources
PubMed2001

Posthysterectomy vault eversion with a large retroperitoneal mass.

A woman with complete vaginal eversion was found to have a large pelvic mass, extending from the rectovaginal septum to the presacral space. This 66-year-old woman with posthysterectomy vaginal eversion complained of pelvic fullness. A pessary provided relief of the prolapse, but the symptom of fullness persisted. Physical examination did not identify a pelvic mass. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a 9 cm tumor of the rectovaginal septum, extending to the presacral space. At laparotomy the patient had a massive neurofibroma arising from the anterior rectal wall. This case is of interest because the complete vaginal prolapse obscured the diagnosis of this large pelvic tumor. CT and MRI were useful in identifying and characterizing the mass. To our knowledge, this is the first reported case of vaginal prolapse with a large pelvic mass.

Aged↗
PubMed1998

The effects of a psychological preparation program on anxiety in children and adolescents undergoing gastrointestinal endoscopy.

BACKGROUND: Like adults, children often experience anxiety associated with medical procedures. The purpose of this study was to investigate the effects of a program of psychological preparation for children undergoing endoscopy. METHODS: Sixty patients aged 6 to 19 years (mean, 12.2 years) were randomized into one of two groups. Group 1 received routine preparation before endoscopy. Group 2 received psychological preparation consisting of demonstration of materials that would be encountered during the procedure, use of a doll as a model, or use of a book with photographs of a child who had previously undergone endoscopy. Patients in both groups completed the Spielberger State-Trait Anxiety Inventory in the clinic and just before endoscopy. The Observational Scale of Behavioral Distress was completed by a blinded observer during each procedure. The attending physician (blinded) assessed patient cooperation. Vital signs were recorded in clinic and just before endoscopy. Parents and patients completed questionnaires after endoscopy. RESULTS: Analysis of the Spielberger State-Trait Anxiety Inventory showed patients in group 2 were significantly less anxious before endoscopy (p < 0.0001). They also required less meperidine (p < eq 0.04) per kilogram body weight and were more cooperative during the examination (p = 0.042). There was significantly less autonomic nervous system stimulation in those who had undergone psychological preparation (change in heart rate, p < 0.001; change in systolic blood pressure, p = 0.04). Statistically significant differences were found in the patients' response to questions after endoscopy regarding perceived anxiety during the procedure (p = 0.003) and the parents' response to questions regarding their own conditions (p = 0.026) and that of their child (p < 0.001). CONCLUSION: Psychological preparation before endoscopy significantly decreases patient and parental anxiety. Such preparation may allow for a reduction in sedative medications and thereby enhance procedural safety.

Adolescent↗
PubMed1991

Labels.

As pediatric care becomes more complex and technical, there is a continuing tendency among health care professionals from all fields to use labels, jargon, and abbreviations when talking about and talking to young patients. This article offers possible explanations for the use of labels and jargon, and provides a summary of the dangers inherent in this sort of communication. Simple suggestions for alternative forms of communication are provided.

Child↗
PubMed1989

Hereditary progressive nodular lipomatosis: a report and selective review of a new syndrome.

Multiple hereditary lipomatosis has been reported very rarely in the literature. The largest number of lipomas previously reported in a single patient was 160. We report on a 45-year-old man who began to experience multiple lipomas at about age 26. The lipomas multiplied until they severely disfigured his entire torso, arms, and upper legs. Both sides of his body were affected to approximately equal degrees. A family history revealed that the patient's father, two brothers, and two nephews have all experienced multiple subcutaneous lipomas, although to a lesser degree. In treating the patient, what appeared to be very large lipomas were in fact found to be subcutaneous clusters of hundreds of small encapsulated lipomas. Lipomas were excised using suction lipectomy to treat different involved areas on eleven separate occasions. A total of 8,475 cc was removed over a two-year period. A modified, slightly less blunt cannula was developed to aspirate the clustered lipomas individually.

Humans↗
PubMed1985

The impact of parental activism on child life programs.

The activist roles that parents play in the establishment and function of child life programs are presented. Five areas of parental activism are identified and discussed, including creation of a child life program, contributions to child life, protest activities, education of child life workers, and emotional support and role validation of workers. The barriers to effective activism are explored as they exist in the parent, the child life worker, and the institution. The summary includes suggestions to facilitate parental activism.

Child↗
PubMed1976

Psychological evaluation and management of pediatric oncology patients in protected environments.

Specific aspects of psychological investigation and management of pediatric patients with widely disseminated solid tumors treated in semiportable, laminar airflow patient isolators are discussed. Information was obtained prospectively from a psychosocial study c-ordinated with a medical investigation of the use of protected environments (PE) employing barrier isolation as an adjunct to intensive anticancer therapy. Included are description of the development of psychological criteria for patient eligibility, psychometric evaluation, longitudinal behavioral observation, pre-entry and predischarge orientation techniques, as well as approaches to the ongoing management of patients and families. No debilitating psychological disturbance has been observed in these patients, and no patients have had to be removed for psychological reasons. Specific transitory psychological changes are noted as are the problems encountered by staff members functioning in such a setting. The adoption of a well-coordinated psychosocial program of investigation and clinical intervention has proved useful in maximizing patient adjustment to prolonged treatment in protected environments.

Adolescent↗