PubMed Health⌕ Search

Biomedical subjects

Frank Kelly

Publications and source records attributed to Frank Kelly.

6 recordsLinked to original sources
PubMed2006

Postpartum outcomes in supine delivery by physicians vs nonsupine delivery by midwives.

CONTEXT: Clinically preferred maternal position during childbirth has varied between supine and nonsupine over time and from patient to patient. Preferred maternal birthing position is coming under increasing scrutiny. OBJECTIVE: To compare postpartum maternal and infant outcomes resulting from supine and nonsupine positions maintained during the second stage of labor. DESIGN AND METHODS: Nonrandomized clinical trial comparing low-risk women (N=198) in two separate obstetrics practices. In one practice, parturients (n=100) used only the supine position as their birthing position. In the other practice, parturients (n=98) used any or all of three nonsupine positions (sitting, squatting, or kneeling/hands-and-knees). Data collection took place immediately after birth by provider survey and included: Apgar scores, demographics, estimated blood loss, neonatal weight, perineal integrity, position during second-stage labor and birth, and vulvar edema. RESULTS: Infants born to mothers in nonsupine positions were delivered with significantly less tearing of the perineum (P<.001) and less vulvar edema (P<.001). Although the length of second-stage labor was shorter among the women who were nonsupine, this result lacked statistical significance. There did not appear to be increased risk to the infant from the mother's nonsupine posture. CONCLUSION: Nonsupine positions during labor and delivery were found to have clinical advantages without risk to mother or infant. Enhanced maternal outcomes included improved perineal integrity, less vulvar edema, and less blood loss.

Delivery, Obstetric↗
PubMed2004

Free radical biology - terminology and critical thinking.

What is an antioxidant? Can one, at a cellular level, speak of direct and indirect antioxidants? Can oxidative stress be quantified and characterized? What are the oxidant species that may have regulatory functions in a cell? Since the above concepts have become of frequent use in all Journals, it may be appropriate if some critical thinking outlined in this review could become available to a broad public.

Animals↗
PubMed2004

Vitamin E in preeclampsia.

Preeclampsia is the disorder of pregnancy with the highest rate of both maternal and neonatal morbidity and mortality. The maternal syndrome is characterized by oxidative stress and activation of the vascular endothelium that may originate from placental release of lipid peroxidation products, cytokines, and microparticles leading to an acute inflammatory response. The current understanding of the etiology has allowed the improvement of predictive tests, tests that could make intervention possible from early pregnancy onwards. Although the large secondary intervention antioxidant trials in cardiovascular diseases did not show any beneficial effect of vitamin E and vitamin C, either alone or in combination, knowledge of the nature of the pathogenesis of preeclampsia offers hope for the beneficial use of antioxidants in the prevention of the disorder. Not only has our previous small trial shown that antioxidant prophylactics in high-risk women lowered the prevalence of preeclampsia, but also new evidence has demonstrated multiple other actions of alpha-tocopherol (such as anti-inflammation and inhibition of NAD(P)H oxidase activation) besides its antioxidant properties that could be advantageous in the prevention of the disorder. Several larger trials are under way to investigate the precise role that vitamins C and E can play in the prevention of preeclampsia.

Antioxidants↗
PubMed2003

Biomarkers in breath condensate: a promising new non-invasive technique in free radical research.

Oxidative stress is associated with a range of inflammatory lung diseases including asthma, adult respiratory distress syndrome, idiopathic pulmonary fibrosis, pneumonia, lung transplantation, chronic obstructive pulmonary disease, cystic fibrosis, bronchiectasis and lung cancer. Increased concentrations of reactive oxygen species (ROS) in the airways of such patients are reflected by elevated concentrations of oxidative stress markers in the breath, airways, lung tissue and blood. Traditionally, the measurement of these biomarkers has involved invasive procedures to procure the samples, or examine the compartments. As a consequence, there is a need for less invasive approaches to measure oxidative stress. Analysis of breath hydrocarbons has partly fulfilled this need, however only gas phase volatile constituents can be assessed by this approach. The collection of exhaled breath condensate (EBC) is a simple, non-invasive approach, which comprehensively samples the lower respiratory tract. It is currently used as a research and diagnostic tool in the free radical field, yielding information on redox disturbance and the degree and type of inflammation in the lung. With further technical developments, such an approach may ultimately have a role in the clinic, in helping to diagnose specific lung diseases. EBC can be exploited to assess a spectrum of potential biomarkers, thus generating a "finger print" characteristic of the disease. By assessing the nature of oxidative stress in this manner, the most appropriate therapy can be selected and the response to treatment monitored.

Biomarkers↗
PubMedDate not supplied

The shocking cost of turnover in health care.

Review of turnover costs at a major medical center helps health care managers gain insights about the magnitude and determinants of this managerial challenge and assess the implications for organizational effectiveness. Here, turnover includes hiring, training, and productivity loss costs. Minimum cost of turnover represented a loss of >5 percent of the total annual operating budget.

Academic Medical Centers↗