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Biomedical subjects

S Kelly

Publications and source records attributed to S Kelly.

At least 109 records · Page 6Linked to original sources
PubMed1998

Complications in 100 living-liver donors.

OBJECTIVE: A review of 100 living-liver donors was performed to evaluate the perisurgical complications of the procedure and thus to help quantify the risks to the donor. SUMMARY BACKGROUND DATA: Despite the advantages of living-donor liver transplantation (LDLT), the procedure has received criticism for the risk it imposes on healthy persons. A paucity of data exists regarding the complications and relative safety of the procedure. METHODS: One hundred LDLTs performed between November 1989 and November 1996 were reviewed. Donor data were obtained by chart review, anesthesia records, and the computerized hospital data base. Patient variables were compared by Fisher's exact test and the Student's t test. RESULTS: There were 57 women and 43 men with a median age of 29. Donors were divided into two groups: group A (first 50 donors), and group B (last 50 donors). There were 91 left lateral segments and 9 left lobes. There were no deaths. Fourteen major complications occurred in 13 patients; 9 occurred in group A and 5 in group B. Biliary complications consisted of five bile duct injuries (group A = 4, group B = 1) and two cut edge bile leaks. Complications were more common in left lobe resections (55%) than in left lateral segment grafts (10%). Minor complications occurred in 20% of patients. A significant reduction in overall complications (major and minor) was observed between the groups (group A, n = 24 [45%] vs. group B, n = 10 [20%]). In addition, surgical time and hospital stay were both significantly reduced. CONCLUSIONS: Although the procedure is safe, many LDLT donors have a perisurgical complication. Surgical experience and technical modifications have resulted in a significant reduction in these complications, however. To minimize the risks for these healthy donors, LDLT should be performed at institutions with extensive experience.

Adult↗
PubMed1998

Visual identity matching and auditory-visual matching: a procedural note.

After preliminary computerized training on visual-visual identity matching, a 5-year-old boy with autism (Sam) was given visual-visual and auditory-visual matching-to-sample tests with new stimuli. He did well in matching dictated name samples to 20 pictures, 26 printed upper case letters, and 9 single-digit numbers. In matching the visual stimuli (pictures, letters, or numbers) to themselves, however, he did not perform well. We then increased the number of picture comparisons per trial from two to three. In tests after this three-comparison training, Sam correctly matched on 95% of the original 20-stimulus, four-comparison, identity-matching test trials. He went on to demonstrate accurate identity matching of the numbers, letters, and new pictures. In identity-matching tests on the table top, he performed poorly until the stimulus array was made to resemble the stimulus arrangement on the computer. These findings showed that seemingly small procedural changes can influence performance and demonstrated that successful auditory-visual matching does not guarantee proficiency in visual-visual identity matching.

Auditory Perception↗
PubMed1998

Prime time advertisements: repetition priming from faces seen on subject recruitment posters.

Repetition priming is defined as a gain in item recognition after previous exposure. Repetition priming of face recognition has been shown to last for several months, despite contamination by everyday exposure to both experimental and control faces in the interval. Here we show that gains in face recognition in the laboratory are found from faces initially seen in a rather different context--on subject recruitment posters, even when the advertisements make no specific mention of experiments involving face recognition. The priming was greatest when identical pictures were shown in the posters and in the test phase, although different views of faces did give significant priming in one study. Follow-up studies revealed poor explicit memory for the faces shown on the posters. The results of these experiments are used to develop a model in which repetition priming reflects the process of updating representations of familiar faces.

Adult↗
PubMed1998

Fertility among a cohort of male sawmill workers exposed to chlorophenate fungicides.

The purpose of this study was to determine whether exposure to chlorophenate fungicides and their dioxin contaminants is associated with male infertility among sawmill workers. The study was conducted using fertility data compiled from 26,487 sawmill workers in 14 British Columbian sawmills. Our analysis was restricted to workers who had been employed for at least 1 continuous year between 1950 and 1985 and to live-births born at least 1 year after the initiation of employment in the period 1955-1988. We assessed fertility trends by internal comparison using Mantel-Haenszel rate ratios and by calculating standardized fertility ratios using an external and an internal reference population. We identified 19,684 births in the study period. Initially, both external and internal analyses showed that sawmill workers from mills using chlorophenates had lower fertility than workers employed in mills not using chlorophenates. After controlling for time since first hire, however, we found no inverse relation between cumulative exposure to chlorophenate fungicides and fertility. Based on the results of our study, there is little evidence for a reduction in fertility among chlorophenate-exposed sawmill workers in British Columbia. The analyses indicate the importance of time since hire as a potentially strong confounder in this type of investigation.

Adult↗
PubMed1998

Trends in suicide in England and Wales, 1982-96.

This article, the first of two, updates previous analyses of suicides published in Population Trends. Suicide trends in England and Wales are analysed by age and sex. Analyses by method and occupation suggest a link between suicide rates and easy access to effective means of committing suicide. The steadily growing number of cars with catalytic converters may go some way to explain the decreasing suicide rates from 'other gas poisoning' for both men and women since the early 1990s. Indeed, it may also explain to some extent the decline in overall suicide rates for men since this time.

Adolescent↗
PubMed1998

Steady-state bioavailability of estradiol from two matrix transdermal delivery systems, Alora and Climara.

OBJECTIVE: The relative bioavailability of estradiol from two matrix transdermal delivery systems, Alora (0.05 mg/day when applied for 3-4 days) and Climara (0.05 mg/day when applied for 7 days), was evaluated in this two-period, randomized crossover study. DESIGN: A total of 27 healthy, postmenopausal women completed this study. Each subject received four successive doses of Alora every 84 h (3.5 days) and two doses of Climara every 168 h (7 days) in a randomized sequence without a washout period. Serial serum samples were collected over a 7-day period during the second week of each treatment. Samples were analyzed for estradiol and estrone using a validated radioimmunoassay method. Pharmacokinetic analyses were conducted using baseline-corrected parameters. RESULTS: Fluctuations in serum estradiol levels were 44% higher for Climara, as indicated by the ratio of Cmax/Cmin. Because the Cmin values for the two regimens were similar, the differences in fluctuation reflected the difference in their Cmax values (49.8 pg/ml for Alora, 67.7 pg/ml for Climara.) The estradiol AUC for Climara was 124% (95% CI 115.6-133.7) of the value for Alora. CONCLUSIONS: Serum estradiol concentrations were maintained at a more constant level during twice-weekly application of Alora than during once-weekly application of Climara. Both regimens were generally well tolerated and no serious skin or other adverse effects were reported by the subjects. However, Alora exhibited better skin tolerability as indicated by a lower incidence of moderate skin erythema. In addition, there was less adhesive transfer to skin at the application site with Alora.

Adhesives↗
PubMed1998

Geographic variations in suicide mortality, 1982-96.

This article is the second part of a paper which updates previous analyses of suicide published in Population Trends. Suicide trends are analysed by age and sex for the constituent countries of the United Kingdom. Data for England and Wales are presented by region and by local authority. The analyses show substantial variations in suicide rates both across the United Kingdom and within England and Wales.

Adolescent↗
PubMed1998

Drug-related mortality: methods and trends.

Drug-related deaths attract widespread concern and public interest and this is reflected in the number of queries ONS receives on this topic. This article sets out the processes involved in the collection and compilation of data on drug-related deaths in England and Wales to serve as a point of reference for users of ONS mortality data. It also documents recent trends in drug-related deaths, revealing considerable variation in mortality by age, sex and region.

Adolescent↗
PubMed1997

Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial.

OBJECTIVE: To assess the relationship between body temperature and cardiac morbidity during the perioperative period. DESIGN: Randomized controlled trial comparing routine thermal care (hypothermic group) to additional supplemental warming care (normothermic group). SETTING: Operating rooms and surgical intensive care unit at an academic medical center. SUBJECTS: Three hundred patients undergoing abdominal, thoracic, or vascular surgical procedures who either had documented coronary artery disease or were at high risk for coronary disease. OUTCOME MEASURE: The relative risk of a morbid cardiac event (unstable angina/ischemia, cardiac arrest, or myocardial infarction) according to thermal treatment. Cardiac outcomes were assessed in a double-blind fashion. RESULTS: Mean core temperature after surgery was lower in the hypothermic group (35.4+/-0.1 degrees C) than in the normothermic group (36.7+/-0.1 degrees C) (P<.001) and remained lower during the early postoperative period. Perioperative morbid cardiac events occurred less frequently in the normothermic group than in the hypothermic group (1.4% vs 6.3%; P=.02). Hypothermia was an independent predictor of morbid cardiac events by multivariate analysis (relative risk, 2.2; 95% confidence interval, 1.1-4.7; P=.04), indicating a 55% reduction in risk when normothermia was maintained. Postoperative ventricular tachycardia also occurred less frequently in the normothermic group than in the hypothermic group (2.4% vs 7.9%; P=.04). CONCLUSION: In patients with cardiac risk factors who are undergoing noncardiac surgery, the perioperative maintenance of normothermia is associated with a reduced incidence of morbid cardiac events and ventricular tachycardia.

Aged↗
PubMed1997

The Jehovah's Witness family, transfusions, and pediatric day surgery.

The pediatric otolaryngologist and anesthesiologist, when encountering a family of the Jehovah's Witness (JW) faith, should be aware of the potential problems which may arise when deciding to proceed with surgery. Two case reports are presented which illustrate the difficult situations which can occur when unanticipated complications (i.e. profound bleeding) arise perioperatively. An overview of the history and common tenets of the JW faith, previous legal perspectives, pertinent clinical information from the medical literature, and the protocol of The Children's Hospital, Denver, for dealing with this sensitive issue (drafted with the cooperation of the local JW Hospital Liaison Committee) are presented.

Adenoidectomy↗
PubMed1997

Villous adenoma of the distal appendix.

Villous adenoma confined to the distal appendix has not been previously reported in conjunction with acute apendicitis. The presence of an adenoma indicates a need for further investigation due to an association with neoplasia elsewhere.

Acute Disease↗
PubMed1997

Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS.

The leading health status instruments in human immunodeficiency virus (HIV) research are based on the pool of items developed as part of the Medical Outcomes Study (MOS). The measures include the SF-20, MOS-HIV, SF-36, SF-12, SF-56, SF-38 (Patient Reported Status and Experience Survey (PARSE)), SF-21 and HIV Cost and Service Utilization Study (HCSUS) questionnaires. The instrument length ranges from 12 to 56 items, covering two to 11 dimensions. Completion requires from 2 to 14 minutes. Subscales are scored on a 0-100 scale (a higher score indicates better health); physical and mental health or overall summary scores are available for most of the measures. Three of the instruments are available in multiple languages. The instruments have been administered to over 20,000 persons with HIV in descriptive studies and clinical trials and there is substantial evidence for their reliability, construct and predictive validity and responsiveness. In several studies the measures have shown important differences between treatments. Although existing measures do not assess all domains relevant to HIV disease, additional subscales are available from the MOS pool. Some of the subscales may be prone to floor and ceiling effects. However, summary scales that encompass all of the subscales reduce this issue. Selection among MOS measures should be dictated by specific questions, the balance of available time and resources, and practical concerns.

Female↗
PubMed1997

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Leukaemia cutis arises due to cutaneous infiltration of neoplastic leukocytes or their precursors. Recent evidence suggests that this sign does not necessarily herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic lymphatic leukaemia (CLL) who developed a papular eruption on her breast at the site of a recent herpetic eruption. Histology and immunostaining showed a dense dermal B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 6 months without treatment, leaving atrophic scars. The histological features and possible aetiological mechanisms of post-herpetic papular eruptions in CLL are reviewed.

Aged↗
PubMed1997

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Leukaemia cutis arises from cutaneous infiltration by neoplastic leukocytes or their precursors. Recent evidence suggests that this sign does not necessarily herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic lymphatic leukaemia who developed a papular eruption of her breast at the site of a recent herpetic eruption. Histology and immunostaining showed a dense dermal B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 6 months without treatment, leaving atrophic scars. The histological features and possible aetiological mechanisms of post-herpetic papular eruptions in chronic lymphatic leukaemia are reviewed.

Aged↗