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Biomedical subjects

G R Kelly

Publications and source records attributed to G R Kelly.

12 recordsLinked to original sources
PubMed1997

Disseminated histoplasmosis with orofacial involvement in HIV-I-infected patients with AIDS: manifestations and treatment.

INTRODUCTION: Histoplasmosis is a deep mycosis which is increasingly seen in HIV disease. It has emerged as a relatively common infection in Argentina, mainly in HIV-infected and other immunocompromised persons, and is often disseminated (DH). OBJECTIVE: The aim of this study was to describe 32 HIV-I-seropositive patients with AIDS who had DH, 21 of whom presented orofacial manifestations, and their treatment. SUBJECTS AND METHODS: A retrospective study of 876 HIV-seropositive patients revealed 32 with a clinical diagnosis of DH confirmed by special stains on histopathologic specimens, or by culture. RESULTS: Thirty-two HIV-infected patients had DH. Two-thirds (21 patients) had oral lesions of histoplasmosis, of which six presented with oral cavity (OC) lesions as the sole orofacial manifestation of disease, nine patients presented oral and facial (OF) lesions and six presented facial lesions only. A unique case of submandibular histoplasmosis is also reported. Antifungal therapy cleared more than 90% of the orofacial and disseminated lesions of histoplasmosis. Over the 7-year period there was a mortality of 85%. CONCLUSION: DH should be considered as a possible diagnosis in HIV patients with chronic ulcerative or nodular orofacial or oral lesions. Itraconazole is an effective and acceptable therapy.

AIDS-Related Opportunistic Infections↗
PubMed1993

Accuracy of ultrasonography in early pregnancy diagnosis in the ewe.

Nonbred and pregnant ewes were examined ultrasonographically at intervals of 4 to 6 days on Days 17 to 34 after estrus. Each ewe was diagnosed as pregnant or nonpregnant, and a score for degree of certainty in the diagnosis was recorded. The goal of the study was to define criteria that could be used for identification and accuracy of diagnosis of an early conceptus and to ascertain the confidence which the operator had in makeing the diagnosis. Pregnancy was retrospectively confirmed by ultrasonographic detection of an embryo proper and by embryonic heartbeat on Days 21 to 34, and later judged against the number of lambs born to each ewe. The percentage of ewes accurately diagnosed pregnant by ultrasonography was not significantly higher than that by guessing (50%) before Day 24, but reached 85% on Days 32 and 34. However, the ability to detect nonpregnant ewes by ultrasonography was higher (P<0.01), with a greater specificity starting on Days 21 to 23 (80%) and reaching 98% by Days 32 to 34. Before Day 24, the diagnosis of pregnancy in many cases was based primarily upon the ultrasonographic appearance of the uterine lumen and location of the uterus in relation to the bladder rather than upon detection of the conceptus. For the certainty score there was a main effect of day (P<0.01) but not for the reproductive status (pregnant vs nonpregnant). The certainty score increased in all ewes among days, and was highest on Days 32 to 34. It was concluded that real time transrectal ultrasonographic scanning of sheep between Days 24 and 34 of gestation offers a safe, accurate and practical means for diagnosing pregnancy.

Journal Article↗
PubMed1990

Medication compliance and health education among outpatients with chronic mental disorders.

Medication noncompliance occurs among as many as one-third to one-half of all medical and psychiatric outpatients. Noncompliance has serious consequences for individuals diagnosed with schizophrenia, often resulting in higher rates of relapse and rehospitalization, and poorer community adjustment. Health education interventions have been shown to be effective in promoting compliance among patients with chronic medical illness such as hypertension or diabetes, but there have been few randomized trials of this approach among patients with chronic psychiatric disorders. This paper presents the results of an application of health education among a group of male psychiatric outpatients. Two interventions were developed which used health education techniques to 1) engage families or significant others as active participants in the aftercare process, and 2) train patients to become effective health care consumers. A total of 418 individuals participated in a six-month trial over a four-year study. Both interventions significantly improved medication compliance among those who received them. The results show that comparatively brief interventions can significantly alter medication compliance behavior and improve the quality of life for patients with chronic psychiatric disorders.

Attitude to Health↗
PubMed1987

Utility of the health belief model in examining medication compliance among psychiatric outpatients.

This study investigates the relationship between health beliefs and medication compliance among a group of psychiatric outpatients who were prescribed antipsychotic drug regimens. The method of study was an interview with 107 outpatients discharged from two Veterans Administration Medical Centers. The health belief model (HBM) served as an organizing framework to explore the relationships among perceptions of illness severity, susceptibility, benefits and barriers of treatment, cues to action, and medication compliance. The results provide a systematic description of health beliefs reported by psychiatric outpatients. Analyses examine the ability of beliefs to predict compliance and affirm the model's theoretical cogency and appropriateness for use with psychiatric outpatients. Regression analysis showed that 20% of the total variance in compliance could be explained when all components of the HBM were examined together. The study supported the concepts that psychiatric outpatients hold identifiable patterns of health beliefs and attitudes and that the health belief framework functions best when utilized as an integrated model to examine compliance.

Adult↗
PubMed1983

Minimizing the adverse effects of mass relocation among chronic psychiatric inpatients.

Recent studies have reported conflicting results on the impact of intrainstitutional relocation on chronic psychiatric patients. As part of a hospital renovation project, 82 patients were assessed over a period of eight months to determine the effects of mass transfer on physical, mental, and social functioning. Twenty-five staff members also assessed the social climate before and after the transfer. The author found that involuntary relocation of living quarters within the same institution did not significantly affect the functioning of the chronic psychiatric patients. He attributes the lack of disruption to continuity of care in a familiar environment and to a continuous schedule of supportive activities conducted outside of the ward.

Adaptation, Psychological↗
PubMed1983

Therapeutic recreation for long-term care patients.

The present study evaluates the impact of a therapeutic recreation program on the life satisfaction and activity level of hospitalized geropsychiatric patients. Sixty-one inpatients from a VA Medical Center were randomly assigned to participate either in a community recreation program for ten consecutive Saturdays or to engage in the regularly scheduled hospital program. Data from four observational instruments established a baseline of activities and confirmed that the study group's life satisfaction appears quite comparable to previously published reports. While the results showed no significant differences among pre-post measures, the clinical staff who accompanied the recreation group reported many unsolicited patient responses indicating consistently high and uniform expressions of satisfaction throughout the trial period. A discussion clarifies how therapeutic evaluation procedures could be made more appropriate for a geropsychiatric population.

Activities of Daily Living↗
PubMed1978

A last link to Pavlov: W. Horsley Gantt reflects.

The work of Dr W. Horsley Gantt, a pioneer in psychophysiology, is reflected in seven books and more than 700 publications. In an interview videotaped in 1976, Gantt commented on his work with Ivan Pavlov, his concepts of schizokinesis and autokinesis, and goals for future scientific investigation within one area of preventive psychiatry.

Conditioning, Classical↗