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Biomedical subjects

K Neely

Publications and source records attributed to K Neely.

14 recordsLinked to original sources
PubMed1997

A measurement of anterior tibial displacement in the closed and open kinetic chain.

Anterior displacement of the tibia during knee extension movement has been identified as a possible factor in anterior cruciate ligament (ACL) reconstruction failure due to the increased stress placed on the graft, leading to a creep response in the healing graft. Nineteen healthy subjects with a unilateral ACL deficiency were evaluated in an open and closed kinetic chain. A KT-1000 was used to measure anterior displacement of the tibia on the femur during isometric open and closed kinetic chain exercise at 30 and 60 degrees. An analysis of variance for repeated measures followed by Newman-Keuls multiple comparison tests were performed to determine the differences between the open and closed kinetic chain for the involved and uninvolved knee. Statistically significant differences were found when comparing the amount of anterior displacement between the open and closed kinetic chain for the involved and uninvolved knee at 30 and 60 degrees. Clinicians utilizing isometric exercise in rehabilitation of the anterior-cruciate-deficient and the anterior-cruciate-reconstructed patient should be aware of the increased amount of anterior tibial displacement when comparing open and closed kinetic chain exercise.

Adult↗
PubMed1994

Altered body composition and increased frequency of diverse malignancies in insulin-like growth factor-II transgenic mice.

The physiological role of insulin-like growth factor (IGF) II (IGF-II) in adult humans is poorly understood. Rather high levels of IGF-II persist in adult human serum, whereas, in rodents, IGF-II levels are very low. To investigate the physiological and carcinogenic effects of persistently elevated IGF-II in adults, we have produced two lines of transgenic mice in which high levels of IGF-II (20- or 30-fold increase above normal) are persistently maintained in the blood. The transgene is driven by the major urinary protein promoter, and it is highly expressed in the liver and perputial glands in both lines. The adult transgenic mice are smaller than controls, and their body composition is altered. Their lean body mass is reduced by 5-8%, whereas fat mass is reduced between 44 and 77%. The mice expressing the highest level of IGF-II (30x) develop hypoglycemia and hypoinsulinemia and IGF-I levels are normal. Mice in the lower expression line (20-fold elevated IGF-II) develop hypoglycemia progressively over their lifetime. Mice from both lines also develop a diverse spectrum of tumors at a higher frequency than controls after 18 months of age, and the most frequent types of tumors are hepatocellular carcinomas and lymphomas. Squamous cell carcinoma, sarcoma, and thyroid carcinomas also occurred in our test group. The long latent period before tumors arise and the wide spectrum of tumor types suggest that IGF-II may function primarily as a tumor progression factor in mice via autocrine and endocrine mechanisms of action.

Animals↗
PubMed1992

Critical incident stress: the role of hospital-based social work in developing a statewide intervention system for first-responders delivering emergency services.

Emotional, cognitive and behavioral stress can negatively affect the performance of fire, rescue and law enforcement personnel responding to emergency situations. Impaired professional performance in these crises not only endangers the incident victims, all involved responders and their families, but potentially the lives and property of entire communities. This article describes the major administrative and clinical leadership of a hospital-based Social Work department in implementing one of the few statewide critical incident stress debriefing teams for emergency service personnel in the United States. It represents a model for program development by other organizations.

Adaptation, Psychological↗
PubMed1990

Patients who initially refuse prehospital evaluation and/or therapy.

The authors performed a retrospective descriptive and analytical cohort study of prehospital patient initial refusal of care (PIRC) cases to characterize the types of patients encountered and to assess factors associated with their dispositions. During a 6-month period, 169 of 1715 (9.9%) base station calls in an urban emergency medical service (EMS) system were for physician involvement in a PIRC. Patients' dispositions were as follows: left at scene against medical advice (53%); taken by ambulance to the hospital (28%); left with friend (13%); other disposition (5%). While police were called to the scene 41 times, they placed a "legal hold" on only 10 patients. Leaving the patient at the scene against medical advice was associated (logistic regression analysis; P less than .05) with the absence of the following factors: family on the scene and a police hold, and with the presence of the following factors: treated hypoglycemia, alcohol use, orientation, and normal speech. The development of statutes that allow police hold placement under the guidance of the base station physician may be necessary. Such statutes would aid transportation of a patient considered by EMS personnel to have impaired mental capacity that may limit the patient's ability to understand medical care decisions.

Cohort Studies↗
PubMed1990

The effect of base station contact on ambulance destination.

Concern has been raised that a single medical control base station serving a metropolitan area may preferentially divert ambulance patients to the base station hospital. Such concern may discourage the development of regional medical control systems. During the first six months of 1988, a retrospective cross-sectional analysis was made of all advanced life support (ALS) ambulance transports and all contacts to the single base station, known as Medical Resource Hospital (MRH). Destinations of all ALS ambulance calls dispatched through the county's 911 dispatch center were analyzed to determine whether the destinations were affected by MRH contact. There were 12,396 transports to 17 area hospitals with 1,272 (10.3%) of these requiring MRH contact. We hypothesized that if MRH contact did not affect destination, the proportion of all non-MRH ALS ambulance patients received by each hospital from the 911-dispatched group would equal the proportion of patients received by each hospital after MRH contact. Five hospitals received a statistically significant (P less than .003) different percentage of MRH contact patients than their proportion of 911-dispatched patients would have predicted. The three that received more were community hospitals in outlying areas. The remaining two were a large referral hospital and a smaller community hospital located in the urban area. The MRH hospital did not have a significantly different percentage of 911-dispatched patients after MRH contact. Similarly, destinations of specific ALS ambulances (two serving in the MRH ambulance catchment area and four in distant catchment areas) were evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗
PubMed1988

Ocular findings in partial trisomy 10q syndrome.

We examined three siblings with partial trisomy 10q born to a mother carrying a balanced translocation between chromosomes 4 and 10. Our patients had many of the phenotypic abnormalities characteristic of this syndrome, and their chromosomal abnormality was confirmed by karyotypes of peripheral blood lymphocytes. Two ophthalmoscopic abnormalities not previously reported in this syndrome were noted in our patients. One child had bilateral enlarged, gray optic disks with elevated, blurred margins and distended retinal vessels. Another child had bilateral punctate yellow deposits scattered around the macula and optic disk.

Adolescent↗
PubMed1984

Staying in control.

Explore the source record for details and available documents.

Allied Health Personnel↗
PubMed1981

Hyperalphalipoproteinemia, birth to age to years.

Interrelationships of high-density lipoprotein cholesterol (C-HDL) with total plasma cholesterol (TC), triglyceride, and low-density lipoprotein cholesterol, as well as longitudinal maintenance of C-HDL rank order (tracking) from birth to age 2 years were assessed in 76 hypercholesterolemic neonates (cord blood, TC greater than 95 mg/dl) with focus upon 34 hyperalphalipoproteinemic neonates who had cord blood C-HDL greater than 61 mg/dl, greater than or equal to the 99th percentile. Cord blood C-HDL correlated closely (P less than 0.01) with C-HDL at 6, 12, and 18 to 24 months (r = 0.32, 0.49, and 0.39, respectively). C-HDL levels at 12 months and 18 to 24 months were closely associated (r = 0.68 and P less than 0.01). C-HDL at birth, 6, and 12 months correlated positively (P less than 0.01) with TC levels (r = 0.28, 0.30, and 0.36, respectively). Conversely, C-HDL at birth, 6 and 12 months correlated inversely with TG (P less than 0.01) (r = -0.41, -0.40, and -0.49, respectively). At birth and at 18 to 24 months, C-HDL correlated inversely (P less than 0.05) with C-LDL (r = -0.36 and -0.31, respectively). Of neonates having cord blood C-HDL in the highest quartile, 38, 56, and 60%, respectively at ages 6, 12, and 18 to 24 months retained C-HDL levels in the highest quartile; 56, 75, and 70%, respectively, retained C-HDL levels greater than the 50th percentile. Of 13 neonates having the highest initial cord blood C-HDL levels, cord blood C-HDL greater than or equal to 69 mg/dl, nine had one or more C-HDL values greater than 70 mg/dl (the 90th percentile for childhood), throughout the 12- to 60-month follow-up period. Moreover, where more than one follow-up measurement was available, there was relative stability of elevated C-HDL measurements. Many infants with cord blood hyperalphalipoproteinemia are likely to have persistent elevations of C-HDL at ages 1 and 2 years. If they maintain elevated C-HDL into adulthood, they may, speculatively, be at reduced risk for coronary heart disease, given the strong inverse association of C-HDL with coronary heart disease.

Cholesterol↗
PubMedDate not supplied

The effect of on-line medical control centralization on ambulance destination.

Controversy regarding the establishment of on-line medical control in a single hospital in a regional Emergency Medical Service System is based, in part, upon the suspicion that ambulances might be diverted to that hospital. Ambulance transports to the University Hospital of Portland, Oregon, were studied over a six year period coinciding with that facilities' assumption of on-line medical control functions. No increases in ambulance transports to that facility could be demonstrated. Other variables resulted in absolute decreases in the number of these transports.

Ambulances↗