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Biomedical subjects

K F O'Grady

Publications and source records attributed to K F O'Grady.

6 recordsLinked to original sources
PubMed2005

Respiratory illness during winter: a cohort study of urban children from temperate Australia.

OBJECTIVE: To examine the epidemiology and burden of respiratory illness during winter in urban children from temperate Australia. METHODS: We conducted a cohort study of healthy Melbourne children, aged from 12 to 71 months. Parents kept a daily respiratory symptom diary and recorded resource use when an influenza-like illness (ILI) occurred. RESULTS: One-hundred and eighteen children had 137 ILI episodes over 12 weeks for a rate of 0.53 ILI episodes per child-month (95% CI 0.44-0.61). Risk factors for ILI included younger age, fewer people residing in the household, structured exposure to other children outside the home, and a higher household income. Episodes had a mean duration of 10.4 days with 64 visits to a general practitioner (46.7 GP visits per 100 episodes), 27 antibiotic courses prescribed (19.7 antibiotic courses per 100 episodes), and three overnight hospitalizations (2.2 admissions per 100 episodes). Parents reported an average of 11.7 h excess time spent caring for a child per episode. CONCLUSIONS: Respiratory illnesses are a common and largely neglected cause of illness in Australian children. Pathogen-specific data are required to better assess the likely impact of available and developing vaccines and other treatment options.

Anti-Bacterial Agents↗
PubMed1999

Effects of medialization laryngoplasty on airway resistance: a pilot study.

OBJECTIVE: To investigate the effects of medialization laryngoplasty on laryngeal airway resistance at various clinically relevant flow rates. STUDY DESIGN: This study was conducted using a total of 13 laboratory experiments. Two of the experiments were used to validate the cadaveric model employed. Eleven experiments were used to quantify airway resistance relative to increasing medialization laryngoplasty stent size. METHODS: With autopsy consent the authors obtained 13 consecutive and anatomically complete larynges for experimentation. A thyrotomy window measuring 8 x 6 mm was made on the left side of the thyroid cartilage. A #4 laryngeal mask was secured to the pharyngeal airway with sutures. Eleven experiments were conducted at the same flow rates using increasingly larger stents from 1 mm to 11 mm in size. Using the Bernoulli equation, the pressure measured at the proximal end of the laryngeal mask is representative of the pressure drop across the airway. The experimental model was validated in two experiments using flow rates between 5 and 50 L/min and stents measured at 5, 10, 15, and 20 mm. RESULTS: Average results from the 11 experiments indicate that at increasing levels of medialization, from 0 to 11 mm, there is essentially the same pressure drop across the larynx at a given flow rate. CONCLUSION: At physiologic airflow rates in a cadaveric model, medialization laryngoplasty implants of 11 mm or less seem to have no obvious effect on airway resistance.

Aged↗
PubMed1999

Facial asymmetry: three-dimensional analysis using laser surface scanning.

This study evaluates six different techniques with respect to their ability to quantitatively describe facial asymmetry in three dimensions. Three-dimensional facial images were acquired using a Cyberware 3030RGB laser surface scanner. Image processing was performed on a Silicon Graphics Indigo computer workstation. The following techniques for facial asymmetry analysis were developed: asymmetry in the location of anthropometric landmarks, Euclidean distance matrix analysis (EDMA), scalar measurement of the lower ciliary margin and palpebral fissure area, clearance vector mapping, and determination of the volume of asymmetry. Techniques were applied and validated in three anthropometric models: a perfectly symmetrical plastic head model and a plaster head model with and without a unilateral cheek augmentation. In each of the anthropometric test models, each analytical technique was validated by means of static anthropometric facial models and was evaluated for intraobserver and interobserver reliability. Asymmetries in the location of anthropometric landmarks can be accurately determined to within 2 mm in x, y, and z directions of the Cartesian space. EDMA is a useful technique in describing both size and shape changes of discrete areas of the face. Measurement of the lower ciliary margin and palpebral fissure area is reliable. Clearance vector mapping is especially useful in quantifying facial surface asymmetries in facial areas where anthropometric landmarks are scarce. Volume of asymmetry is potentially useful in those patients for whom the use of injections or implants of known volume may be helpful in correcting unilateral facial deficiencies.

Cephalometry↗
PubMed1985

The impact of cost sharing on emergency department use.

We studied the effect of insurance coverage on the use of emergency department services, using data from a national trial of cost sharing in health insurance. A total of 3973 persons below the age of 62 years were randomly assigned to fee-for-service health insurance plans with coinsurance rates of 0, 25, 50, or 95 per cent, subject to an income-related upper limit on out-of-pocket expenses. Persons with no cost sharing had emergency department expenses that were 42 per cent higher than those for persons on the 95 per cent plan (P less than 0.01) and about 16 per cent higher than those for persons with smaller amounts of cost sharing. Without cost sharing, emergency department visits for less serious diagnoses (e.g., abrasions) increased three times as much as did visits for more serious diagnoses (e.g., lacerations). After control for insurance, persons in the lower third of the income distribution had emergency department expenses that were 64 per cent higher than those in the upper third (P less than 0.001) and received a greater proportion of their ambulatory care in the emergency department. We conclude that the absence of cost sharing results in significantly greater emergency department use than does insurance with cost sharing. A disproportionate amount of the increased use involves less serious conditions.

Ambulatory Care↗
PubMedDate not supplied

Electrosurgery smoke: hazards and protection.

Early discussion regarding smoke produced by both surgical lasers and electrosurgical machines concluded that the smoke produced by these instruments was little more than a malodorous nuisance. Animal and human studies to date, however, have suggested that this smoke is, indeed, dangerous. This smoke has been shown to be mutagenic and can contain bacteria and viruses, the HIV virus being the most notable. Furthermore, these particles are small enough to penetrate deep within the respiratory tract. In response to the concerns raised by these hazards, commercial smoke evacuation systems have been designed to greatly reduce the number of hazardous particles, as well as the noxious odor produced by electrosurgery and laser surgery. The efficacy of these systems, however, is dependent o n usage and placement close to the surgical site. This review paper presents the potential hazards of electrosurgical smoke, along with some guidelines on how to properly protect hospital staff and patients from these hazards.

Air Pollutants, Occupational↗