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Biomedical subjects

M P Kelly

Publications and source records attributed to M P Kelly.

At least 19 recordsLinked to original sources
PubMed1996

Evaluating ovarian reserve: follicle stimulating hormone and oestradiol variability during cycle days 2-5.

A prospective measurement of follicle stimulating hormone (FSH) and oestradiol between cycle days 2 and 5 was conducted to investigate the intra- and inter-cycle variability in a healthy population of women with regular menstrual intervals. Daily serum samples were obtained from 44 women for a total of 66 cycles on cycle days 2, 3, 4 and 5. FSH concentrations were consistent on all cycle days measured. Oestradiol concentrations on cycle day 2 were not different from cycle day 3, but concentrations on cycle day 4 and cycle day 5 were statistically different from both cycle day 2 and cycle day 3 by analysis of variance (P < or = 0.05). Evaluation of functional ovarian reserved by cycle day 3 FSH measurement has become the standard in most assisted reproductive technology programmes. The recent change in FSH standardization coupled with the inflexibility of cycle day 3 testing has led to a re-evaluation of testing protocols. Cycle day 3 appears to have emerged as a dictum because most ovulation induction protocols are initiated on cycle day 3, 4 or 5. Flexibility of sampling day can be introduced as suggested by these results. The additional information ascertained from oestradiol testing as applied to evaluation of ovarian reserve warrants further investigation.

Adult↗
PubMed1996

Recently recognised microbial enteropathies and HIV infection.

Persistent diarrhoea and small bowel enteropathy are important features of HIV infection. At least 80% of cases of persistent diarrhoea in patients with HIV/AIDS can be attributed to a specific enteropathogen. The coccidian parasites Cryptosporidium parvum, Isospora belli and Cyclospora and the Microsporidia account for at least 50% of cases of persistent diarrhoea in the industrialised and developing world with major contributions from Mycobacterium avium complex and other bacteria and cytomeglovirus. The intracellular protozoa can be detected on faecal microscopy although confirmation may be required by intestinal mucosal biopsies. Although up to 20% of cases of persistent diarrhoea can not be attributed to a specific infection, the question as to whether HIV infection itself can produce enteropathy remains uncertain. Recent developments in the treatment of persistent diarrhoea in HIV include the use of albendazole for microsporidial diarrhoea and co-trimoxazole for the treatment and eradication of Cyclospora.

HIV Enteropathy↗
PubMed1996

The relationship of vitamin B6 status to median nerve function and carpal tunnel syndrome among active industrial workers.

Case reports and small case series suggest that vitamin B6 deficiency is an important etiologic factor in carpal tunnel syndrome (CTS). This hypothesis has never examined in a randomly selected study population, particularly among active workers. We examined 125 randomly selected active workers from two industrial plants. Each worker completed a self-administered symptom questionnaire and underwent electrodiagnostic testing of the median and ulnar sensory nerves. Laboratory biochemical analyses of vitamin B6 status were also performed using the erythrocyte glutamic pyruvic transaminase assay, and quantification of plasma pyridoxal-5'-phosphate. Measurements of vitamin B6 status were unrelated to self-reported symptoms potentially consistent with CTS, electrophysiologically determined median or ulnar nerve function, and CTS defined on the basis of self-reported symptoms and electrophysiologic measurements. These results suggest that CTS among active industrial workers is unrelated to vitamin B6 status. Furthermore, in our opinion, empiric prescription of vitamin B6 to patients with CTS is unwarranted and potentially hazardous.

Adult↗
PubMed1996

Health education, the health promotion movement, and communication.

This paper explores the debate between health education and health promotion. It is argued that each is located in a different philosophical tradition, The Modern and The Post-Modern. The Health Promotion movement can unintentionally undermine the very basis of prevention. It is argued that a skills-based approach is required. Drawing on the work of Habermas, a model for the effective delivery of the public health education message is outlined.

Adaptation, Psychological↗
PubMed1994

Patients' decision making in major surgery: the case of total colectomy.

Qualitative interview data concerning patients' decision making in major surgery (total colectomy and ileostomy) are reported. Unsurprisingly, these procedures are not recommended lightly by the medical profession and the medical and surgical consensus is that patients should be involved in the decision making which leads to the surgery. Data relating to that involvement are presented. It is argued that the decision making is a process which involves changes in identity and self and that the tensions between identity and self account for some of the emotional and other problems attaching thereto.

Adaptation, Psychological↗
PubMed1994

Traumatic injury in patients with neurologic and psychiatric disease.

Our work and multiple other lines of evidence suggest that patients suffering from neurologic and psychiatric disorders are over-represented in the population suffering traumatic injuries. In addition, a premorbid history of such disorders can impact on the severity of injury, as well as present particular problems in the acute management of this population. Constant vigilance, leading to prompt identification of concurrent neurologic and psychiatric illness in trauma victims, is critical for patient management. The interactions of these disorders and their treatments present complex clinical challenges to the traumatologist and the intensivist.

Critical Care↗
PubMed1993

Wechsler Memory Scale-Revised in closed head injury.

This study was undertaken to determine the ability of the Wechsler Memory Scale-Revised (WMS-R) to differentiate a group of closed head injury patients from a group of controls and determine how injury severity and attentional deficits are associated with WMS-R performance. The relationship of WMS-R performance to everyday memory also was assessed. The head injured group performed more poorly than controls on all five WMS-R indices and exhibited greater impairments on tasks that measure retention. In the original sample only the Visual Memory Index correlated with injury severity; in a larger sample, all four memory indices correlated modestly with injury severity. Patients who performed more poorly on the WMS-R also received poorer ratings on an independent assessment of everyday memory.

Adolescent↗
PubMed1993

The four levels of health promotion: an integrated approach.

Four levels of health promotion are identified: environmental, social, organisational and individual. It is argued that health promotion interventions should not be confined to one level but instead an integrated approach should be adopted, in which the relationships between the four levels and the outcomes at all levels ought to be considered and analysed. It is suggested that these four levels are used as a checklist when health promotion interventions are planned.

Environment↗
PubMed1993

A gene differentially expressed in the kidney of the spontaneously hypertensive rat cosegregates with increased blood pressure.

The role of the kidney in initiating hypertension has been much debated. Here we demonstrate that a recently identified gene of yet unknown function, termed SA, which is differentially expressed in the kidney of the spontaneously hypertensive rat, cosegregates with an increase in blood pressure in F2 rats derived from a cross of the spontaneously hypertensive rat with normotensive Wistar-Kyoto rats, accounting for 28 and 21% of the genetic variability in systolic and diastolic blood pressures, respectively. Further, the genotype at this locus appears to determine the level of expression of the gene in the kidney. The findings provide strong evidence for a primary genetic involvement of the kidney in hypertension.

Aging↗
PubMed1993

Substance abuse as a factor in the causality, severity, and recurrence rate of traumatic brain injury.

The effects of substance abuse on the cause, severity, and recurrence of traumatic brain injury in 322 admissions to a large rehabilitation inpatient facility are explored. Study patients tended to be young and predominantly male. Few had completed high school and a significant minority had a history of cerebral dysfunction. Patients tended to have moderate to severe closed head injuries. Motor vehicle crashes were the most common cause of injury, but patients reporting drug or drug and alcohol abuse were more likely to sustain violent injuries (e.g., gunshot wounds).

Accidents, Traffic↗
PubMed1992

The productive use of threat in primary care: behavioural responses to health promotion.

The importance of a scientific understanding of the behavioural change processes involved in certain health promotion interventions is stressed. A model for guiding the behavioural dimensions in health promotion in primary care is presented. This distinguishes between information-giving and -providing skills to facilitate behavioural change. The social factors which impinge upon processes of behaviour change are highlighted. It is suggested that health promotion clinics in primary care may produce a situation with which the client has to cope. The manner of their coping will be a critical factor in determining outcome. Some key organizational issues are underlined.

Adaptation, Psychological↗
PubMed1992

A behavioural modelling approach to curriculum development and evaluation of health promotion for nurses.

This paper outlines the way in which two behavioural science models may be used in the processes of curriculum development and course evaluation. The models are the stress-coping paradigm associated with the work of Lazarus and the theory of self and identity developed from the work of Mead. It is suggested that a clear articulation of the underlying behavioural processes is fundamental in course design and appraisal.

Adaptation, Psychological↗
PubMed1991

Coping with an ileostomy.

This paper reports the results of a study of persons who had undergone surgery to cure the disease ulcerative colitis. All subjects had had their colon removed and were left with an incontinent surgically constructed anus on their abdomen, called an ileostomy. The ways in which ex-patients cope with some of the consequences of surgery are described. The data were collected using semi-structured interviews, which were analysed qualitatively.

Adaptation, Psychological↗