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Search Results: 1 - 10 of 205717 matches for " Marcus P. Kennedy "
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A Case of DIPNECH and Review of the Current Literature  [PDF]
Patrick D. Mitchell, Marcus P. Kennedy, Michael T. Henry
Open Journal of Respiratory Diseases (OJRD) , 2013, DOI: 10.4236/ojrd.2013.32011
Abstract: Diffuse Idiopathic Neuroendocrine Cell Hyperplasia (DIPNECH) is a rare pulmonary disease. It was first described by Aguayo et al. in 1992, and recognised by the World Health Organisation in 2004 as a precursor lesion to the development of pulmonary carcinoid tumour. DIPNECH has been described in several isolated case reports and series. This article describes a case of DIPNECH and summaries the recent literature in an attempt to raise awareness of this disease and management options.
Treatment of bronchial airway obstruction using a rotating tip microdebrider: a case report
Marcus P Kennedy, Rodolfo C Morice, Carlos A Jimenez, George A Eapen
Journal of Cardiothoracic Surgery , 2007, DOI: 10.1186/1749-8090-2-16
Abstract: We report a case a 59-yr-old male with T3N2M1 non-small cell lung cancer with malignant distal left mainstem obstruction treated successfully with a novel elongated rotating tip microdebrider via rigid bronchoscopy with sufficient length to reach distal bronchial lesions.The microdebrider is an excellent addition to the spectrum of interventions available for the management of central airway obstruction with advantages including accuracy and immediate removal of debris without a need for separate suctioning or limitation in oxygenation.The microdebrider is a recent addition to the armeratarium available to the interventional bronchoscopist for central airway occlusion, following the successful application of laryngeal microdebriders for over a decade [1-3]. However, limitations of the microdebrider include maneuverability and length (37 cms) which limits use to the trachea and proximal main-stem bronchi. We report a case of malignant distal left main-stem obstruction treated with a new elongated rotating tip microdebrider (45 cms) via rigid bronchoscopy with sufficient length to reach distal bronchial lesions.A 53-yr-old male with T3N2M1 non-small cell left upper lobe lung cancer with bilateral brain metastases diagnosed one-month prior was referred for management of dyspnea and hemoptysis. The patient had noted a dramatic increase in dyspnea over the prior 3 days. Past medical history was unremarkable and he had a negative smoking history.Physical exam revealed reduced breath sounds in the left lower zone. Chest x-ray demonstrated a left hilar mass with loss of volume and post obstructive pneumonia in the left lower lobe (Figure 1a). Axial Computed tomography (CT) angiogram of the chest also revealed multiple segmental and subsegmental pulmonary emboli and the patient was admitted for anticoagulation with low molecular weight heparin (enoxaparin). The CT study also confirmed total occlusion of the left mainstem bronchus by a tumor invading from the left hilum (Figu
Clinical implications of granulomatous inflammation detected by endobronchial ultrasound transbronchial needle aspiration in patients with suspected cancer recurrence in the mediastinum
Marcus P Kennedy, Carlos A Jimenez, Ashwini D Mhatre, Rodolfo C Morice, Georgie A Eapen
Journal of Cardiothoracic Surgery , 2008, DOI: 10.1186/1749-8090-3-8
Abstract: All 153 consecutive patients undergoing EBUS-TBNA in an academic cancer institution for suspected cancer in the mediastinum (mediastinal lymphadenopathy by CT imaging) were reviewed. Patients with non-caseating granuloma identified by EBUS-TBNA were included.EBUS-TBNA identified non-caseating granuloma in 17/153 (11%) patients. A subset of 8/153 (5.2%) had sarcoid like lymphadenopathy mimicking cancer recurrence (5/5 PET positive). Another 8/153 (5.2%) patients with new mediastinal lymphadenopathy and no prior history of cancer had a clinical syndrome consistent with sarcoidosis. One other patient with a history of breast cancer was diagnosed with non-tuberculous mycobacteria infection. No patient required mediastinoscopy and there were no complications.In an academic cancer institute, at least 5% of patients undergoing EBUS-TBNA have sarcoid-like lymphadenopathy mimicking cancer recurrence. Further studies to define the precise etiology, natural history and prognosis of this phenomenon are warranted.In patients with a history of cancer, the onset of mediastinal adenopathy often heralds a recurrence of their malignancy. However, not all mediastinal adenopathy is due to cancer recurrence and lymph node sampling is warranted. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) allows real time assessment and biopsy of mediastinal lymph nodes and therefore often obviates the need for mediastinoscopy [1,2]. The utility of EBUS-TBNA in the mediastinal nodal staging of lung cancer has been defined [3]. More recently, the ability of EBUS-TBNA to identify granuloma in the work-up of patients with mediastinal adenopathy secondary to suspected sarcoidosis has been reported [4]. Since the beginning of the last century, "local sarcoid reactions" and "sarcoid like lymphadenopathy" with pulmonary and mediastinal involvement have been described in patients with cancer [5-7]. In this report, we describe a group of patients in whom EBUS-TBNA detected granulomatous
Improving antibiotic prescribing for adults with community acquired pneumonia: Does a computerised decision support system achieve more than academic detailing alone? – a time series analysis
Kirsty L Buising, Karin A Thursky, James F Black, Lachlan MacGregor, Alan C Street, Marcus P Kennedy, Graham V Brown
BMC Medical Informatics and Decision Making , 2008, DOI: 10.1186/1472-6947-8-35
Abstract: The management of all patients presenting to the emergency department over three successive time periods was evaluated; the baseline, academic detailing and CDSS periods. The rate of empiric antibiotic prescribing that was concordant with recommendations was studied over time comparing pre and post periods and using an interrupted time series analysis.The odds ratio for concordant therapy in the academic detailing period, after adjustment for age, illness severity and suspicion of aspiration, compared with the baseline period was OR = 2.79 [1.88, 4.14], p < 0.01, and for the computerised decision support period compared to the academic detailing period was OR = 1.99 [1.07, 3.69], p = 0.02. During the first months of the computerised decision support period an improvement in the appropriateness of antibiotic prescribing was demonstrated, which was greater than that expected to have occurred with time and academic detailing alone, based on predictions from a binary logistic model.Deployment of a computerised decision support system was associated with an early improvement in antibiotic prescribing practices which was greater than the changes seen with academic detailing. The sustainability of this intervention requires further evaluation.With the rapidly expanding body of medical knowledge, clinicians need access to appropriate, relevant information to guide their clinical decision making. For many conditions, clinical experts have used available evidence and experience to generate guidelines that endeavour to assist clinicians, and improve patient outcomes. A major problem, however, has been finding the best strategies to implement these guidelines in a busy hospital environment. [1-3] Group lectures, one to one academic detailing, laminated cards and advertising material such as posters have all been tried with variable success. [4-7] With the increasing role played by computers as a source of information in the hospital setting, computerised decision support may pr
The Woods-Saxon Potential in the Dirac Equation
P. Kennedy
Physics , 2001, DOI: 10.1088/0305-4470/35/3/314
Abstract: The two-component approach to the one-dimensional Dirac equation is applied to the Woods-Saxon potential. The scattering and bound state solutions are derived and the conditions for a transmission resonance (when the transmission coefficient is unity) and supercriticality (when the particle bound state is at E=-m) are then derived. The square potential limit is discussed. The recent result that a finite-range symmetric potential barrier will have a transmission resonance of zero-momentum when the corresponding well supports a half-bound state at E=-m is demonstrated.
An antibody present in everybody that attacks malaria infected erythrocytes  [PDF]
James Kennedy
Journal of Biomedical Science and Engineering (JBiSE) , 2013, DOI: 10.4236/jbise.2013.67A1001
Abstract: These malaria targeting antibodies are band 3 antibodies and they recognize a special configuration of a molecule called band 3 that is present on erythrocytes. The special band 3 configuration is present on the surface of senescent erythrocytes, malaria infected erythrocytes, the erythrocytes of certain hemoglobinnopathies such as sickle cell disease and on the erythrocytes of some metabolic disorders such as G6PD. Note that these hemoglobinopathies and metabolic disorders all aid in the survival of falciparum malaria to such an extent that their incidence is increased in falciparum endemic areas [1-3]. Though there are many adhesive molecules involved in the pathology of falciparum malaria and sickle cell anemia, the focus here is on the band 3 molecules.
Power and parameter estimation of complex segregation analysis under a finite locus model
P Uimari, BW Kennedy, JCM Dekkers
Genetics Selection Evolution , 1996, DOI: 10.1186/1297-9686-28-4-345
Abstract:
Time series analysis as input for clinical predictive modeling: Modeling cardiac arrest in a pediatric ICU
Curtis E Kennedy, James P Turley
Theoretical Biology and Medical Modelling , 2011, DOI: 10.1186/1742-4682-8-40
Abstract: We reviewed prediction models from nonclinical domains that employ time series data, and identified the steps that are necessary for building predictive models using time series clinical data. We illustrate the method by applying it to the specific case of building a predictive model for cardiac arrest in a pediatric intensive care unit.Time course analysis studies from genomic analysis provided a modeling template that was compatible with the steps required to develop a model from clinical time series data. The steps include: 1) selecting candidate variables; 2) specifying measurement parameters; 3) defining data format; 4) defining time window duration and resolution; 5) calculating latent variables for candidate variables not directly measured; 6) calculating time series features as latent variables; 7) creating data subsets to measure model performance effects attributable to various classes of candidate variables; 8) reducing the number of candidate features; 9) training models for various data subsets; and 10) measuring model performance characteristics in unseen data to estimate their external validity.We have proposed a ten step process that results in data sets that contain time series features and are suitable for predictive modeling by a number of methods. We illustrated the process through an example of cardiac arrest prediction in a pediatric intensive care setting.Roughly 1-6% of children being cared for in an ICU will experience a cardiac arrest while in the ICU [1,2]. Many of these arrests occur because their vital signs deteriorate to the point where they enter a state of progressive shock [3-5]. These arrests happen despite the fact that they are being continuously monitored by ECG, pulse oximetery, and frequent blood pressure measurements. While there are tools that help identify patients in a non-intensive care setting that are at risk of arrest or have deteriorated to the point where they need to transfer to an ICU[6-21], there are no equivalent
Indicators of nitrate in wetland surface and soil-waters: interactions of vegetation and environmental factors
M. P. Kennedy,K. J. Murphy
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 2004,
Abstract: This paper describes a new bio-indicator method for assessing wetland ecosystem health; as such, the study is particularly relevant to current legislation such as the EU Water Framework Directive, which provides a baseline of the current status of surface waters. Seven wetland sites were monitored across northern Britain, with model construction data for predicting eco-hydrological relationships collected from five sites during 1999. Two new sites and one repeat site were monitored during 2000 to provide model test data. The main growing season for the vegetation, and hence the sampling period, was May–August during both years. Seasonal mean concentrations of nitrate (NO3-) in surface and soil water samples during 1999 ranged from 0.01 to 14.07 mg N l–1, with a mean value of 1.01 mg N l–1. During 2000, concentrations ranged from trace level (<0.01 mg N l–1) to 9.43 mg N l–1, with a mean of 2.73 mg N l–-1. Surface and soil-water nitrate concentrations did not influence plant species composition significantly across representative tall herb fen and mire communities. Predictive relationships were found between nitrate concentrations and structural characteristics of the wetland vegetation, and a model was developed which predicted nitrate concentrations from measures of plant diversity, canopy structure and density of reproductive structures. Two further models, which predicted stem density and density of reproductive structures respectively, utilised nitrate concentration as one of the independent predictor variables. The models were tested where appropriate using data collected during 2000. This approach is complementary to species-based monitoring, representing a useful and simple tool to assess ecological status in target wetland systems and has potential for bio-indication purposes. Keywords: bio-indicators, surface water, water quality, wetland vegetation
Religion in the Modern Netherlands and the Problems of Pluralism
James C. Kennedy,Jan P. Zwemer
BMGN : Low Countries Historical Review , 2010,
Abstract: The religious history of the Netherlands during the last two centuries exhibits some of the same dynamics and tensions as those evidenced in neighbouring countries. This article selects from religious history three historiographical issues salient to transnational patterns. The first pertains to Dutch churchstate relations in the nineteenth century, most notably a relatively early disestablishment. The second theme concerns the so-called ‘pillarization’ (verzuiling) of Dutch society, and to what extent pillarization – to the extent it is a useful concept at all – can be regarded as a quintessentially ‘Dutch’ way to manage religious pluralism. The last theme focuses on secularization, a concept which historians have used to analyse the decline of organized religion in the Netherlands, particularly the sharp decline in religious participation and adherence after 1960. Religion, however, has remained an important focus of debate in recent decades, as the Dutch sought again to renegotiate the politics of pluralism.
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