Cassandra Kelleher - Academia.edu (original) (raw)
Papers by Cassandra Kelleher
JAMA network open, Jul 17, 2023
Investigative Ophthalmology & Visual Science, 1997
Annals of Surgery, Oct 20, 2022
Investigative Ophthalmology & Visual Science, Feb 15, 1996
Journal of The American College of Surgeons, Oct 17, 2022
Journal of Surgical Research, Feb 1, 2014
The New England Journal of Medicine, Mar 29, 2012
Dr. Jennifer C. Hensley (Pediatrics): A 16-year-old boy was admitted to this hospital because of ... more Dr. Jennifer C. Hensley (Pediatrics): A 16-year-old boy was admitted to this hospital because of abdominal pain and a mediastinal mass. The patient had been well until 4 days before admission, when he began to feel vaguely ill. The next day, nonbloody emesis occurred. Two days before admission, epigastric pain, nausea, decreased appetite, and constipation developed. On the morning of admission, he took laxatives and acetaminophen, without relief. He saw his pediatrician; a tentative diagnosis of pancreatitis was made, and the patient was sent to the emergency department at an affiliated hospital. On arrival, he rated the pain at 10 on a scale of 0 to 10 (with 10 indicating the most severe pain). He had not had fever, additional episodes of vomiting, or diarrhea. On examination, the weight was 138.5 kg, the temperature 36.7°C, the blood pressure 155/75 mm Hg, the pulse 88 beats per minute, the respiratory rate 36 breaths per minute, and the oxygen saturation 100% while he was breathing ambient air. The abdomen was soft, with moderate tenderness in the epigastrium and right upper quadrant; the remainder of the examination was normal. Levels of platelets, electrolytes, albumin, alkaline phosphatase, calcium, creatine kinase isoenzymes, and troponin I were normal, as were tests of renal function; other test results are shown in Table 1. An electrocardiogram was normal. Computed tomography (CT) of the abdomen after the administration of intravenous contrast material revealed a cystic mass, 12.4 cm by 6.1 cm by 6.2 cm, in the posterior mediastinum above the gastroesophageal junction, which displaced the inferior vena cava, the heart, and the distal esophagus; hepatic steatosis and trace bilateral pleural effusions were also present. Morphine (5 mg) was administered intravenously with transient improvement (the patient rated the pain at 3 out of 10) within 4 minutes; ranitidine and normal saline were also given. The patient was transferred to this hospital by ambulance for further evaluation; morphine (4 mg) was administered for recurrent pain en route. On arrival, the patient described the pain as sharp; radiating to his back; worsening with movement, deep inspirations, and swallowing; and improving slightly with sitting upright. He reported having the sensation of food sticking in his throat and having a mild cough and sore throat for 2 to 3 days. Blood-pressure recordings and serum levels of glycated hemoglobin and insulin had reportedly been elevated Case 10-2012: A 16-Year-Old Boy with Epigastric Pain and a Mediastinal Mass
Journal of Surgical Research, Mar 1, 2023
American Journal of Surgery, Jun 1, 2022
BACKGROUND Geriatric patients face disparities in prehospital trauma care. We hypothesized that g... more BACKGROUND Geriatric patients face disparities in prehospital trauma care. We hypothesized that geriatric trauma patients are more likely to experience prolonged prehospital scene time than younger adults. METHODS Retrospective analysis of the 2017 National Emergency Medical Services Information System. Patients who met anatomic or physiologic trauma criteria based on national triage guidelines were included (n = 16,356). Geriatric patients (age≥65, n = 3594) were compared to younger adults (age 18-64). The primary outcome was prolonged scene time (>10 min). Multivariable logistic regression was performed, controlling for patient demographics, on-scene treatments, and injury severity. RESULTS Geriatric patients were more likely to experience prolonged scene time than younger adults after controlling for other factors (OR 1.78, 95% CI 1.57-2.04, p < 0.001). The likelihood of prolonged scene time reached OR 2.29 (95% CI 1.85-2.84) for patients age 70-79 and OR 2.66 (95% CI 2.07-3.42) for patients age 80-89, relative to age 18-29. CONCLUSIONS Geriatric trauma patients are more likely than younger adults to have prolonged prehospital scene time. This disparity may be caused by delayed recognition of injury severity or age-related cognitive biases.
Pediatric Anesthesia, Aug 1, 2019
American Journal of Surgery, Oct 1, 2021
BACKGROUND The literature shows that female surgeons have lower operative volumes than male surge... more BACKGROUND The literature shows that female surgeons have lower operative volumes than male surgeons. Since volume is dependent on new patient referrals for most surgeons, inequities in referrals may contribute to this employment disparity. METHODS Using 1997-2018 data from a large medical center, we examined the number of new patient referrals for surgeons. Multivariate linear analysis was performed, adjusting for surgeon race, calendar year, seniority, and clinical subspecialty. RESULTS A total of 121 surgeons across 12,410 surgeon-months were included. Overall, surgeons had a median of 14 new patient referrals per month (interquartile range (IQR) = 7, 27). On adjusted analysis, female surgeons saw 5.4 fewer new patient referrals per month (95% CI -6.4 to -4.5). CONCLUSION Female surgeons, with equal training and seniority, received fewer new patient referrals than their male peers, and this may contribute to female surgeon under-employment. Surgeon gender may be one of the factors contributing to this differential referral pattern.
Journal of Surgical Research, 2019
Pediatric Blood & Cancer, Apr 26, 2018
American Journal of Respiratory Cell and Molecular Biology, Feb 1, 2014
Clinical Obstetrics and Gynecology, Mar 1, 2015
Adnexal masses in children encompass a variety of lesions of the ovaries and fallopian tubes, inc... more Adnexal masses in children encompass a variety of lesions of the ovaries and fallopian tubes, including ovarian cysts and tumors (benign or malignant), fallopian tube cysts and abscesses, paratubal cysts, and endometriomas. When developing a differential diagnosis for adnexal masses in childhood, the clinician must have a broad understanding of adnexal pathology and consider the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s age, presenting complaints, physical examination findings, and imaging results to generate a list of possible diagnoses and the appropriate treatment plan. We review the clinical presentation of these lesions and discuss the current recommendations for their management.
Journal of Pediatric Surgery, Aug 1, 2013
Proceedings of the National Academy of Sciences of the United States of America, Feb 1, 2016
Journal of the Royal Society Interface, Sep 22, 2010
Seminars in fetal & neonatal medicine, Jun 1, 2011
JAMA network open, Jul 17, 2023
Investigative Ophthalmology & Visual Science, 1997
Annals of Surgery, Oct 20, 2022
Investigative Ophthalmology & Visual Science, Feb 15, 1996
Journal of The American College of Surgeons, Oct 17, 2022
Journal of Surgical Research, Feb 1, 2014
The New England Journal of Medicine, Mar 29, 2012
Dr. Jennifer C. Hensley (Pediatrics): A 16-year-old boy was admitted to this hospital because of ... more Dr. Jennifer C. Hensley (Pediatrics): A 16-year-old boy was admitted to this hospital because of abdominal pain and a mediastinal mass. The patient had been well until 4 days before admission, when he began to feel vaguely ill. The next day, nonbloody emesis occurred. Two days before admission, epigastric pain, nausea, decreased appetite, and constipation developed. On the morning of admission, he took laxatives and acetaminophen, without relief. He saw his pediatrician; a tentative diagnosis of pancreatitis was made, and the patient was sent to the emergency department at an affiliated hospital. On arrival, he rated the pain at 10 on a scale of 0 to 10 (with 10 indicating the most severe pain). He had not had fever, additional episodes of vomiting, or diarrhea. On examination, the weight was 138.5 kg, the temperature 36.7°C, the blood pressure 155/75 mm Hg, the pulse 88 beats per minute, the respiratory rate 36 breaths per minute, and the oxygen saturation 100% while he was breathing ambient air. The abdomen was soft, with moderate tenderness in the epigastrium and right upper quadrant; the remainder of the examination was normal. Levels of platelets, electrolytes, albumin, alkaline phosphatase, calcium, creatine kinase isoenzymes, and troponin I were normal, as were tests of renal function; other test results are shown in Table 1. An electrocardiogram was normal. Computed tomography (CT) of the abdomen after the administration of intravenous contrast material revealed a cystic mass, 12.4 cm by 6.1 cm by 6.2 cm, in the posterior mediastinum above the gastroesophageal junction, which displaced the inferior vena cava, the heart, and the distal esophagus; hepatic steatosis and trace bilateral pleural effusions were also present. Morphine (5 mg) was administered intravenously with transient improvement (the patient rated the pain at 3 out of 10) within 4 minutes; ranitidine and normal saline were also given. The patient was transferred to this hospital by ambulance for further evaluation; morphine (4 mg) was administered for recurrent pain en route. On arrival, the patient described the pain as sharp; radiating to his back; worsening with movement, deep inspirations, and swallowing; and improving slightly with sitting upright. He reported having the sensation of food sticking in his throat and having a mild cough and sore throat for 2 to 3 days. Blood-pressure recordings and serum levels of glycated hemoglobin and insulin had reportedly been elevated Case 10-2012: A 16-Year-Old Boy with Epigastric Pain and a Mediastinal Mass
Journal of Surgical Research, Mar 1, 2023
American Journal of Surgery, Jun 1, 2022
BACKGROUND Geriatric patients face disparities in prehospital trauma care. We hypothesized that g... more BACKGROUND Geriatric patients face disparities in prehospital trauma care. We hypothesized that geriatric trauma patients are more likely to experience prolonged prehospital scene time than younger adults. METHODS Retrospective analysis of the 2017 National Emergency Medical Services Information System. Patients who met anatomic or physiologic trauma criteria based on national triage guidelines were included (n = 16,356). Geriatric patients (age≥65, n = 3594) were compared to younger adults (age 18-64). The primary outcome was prolonged scene time (>10 min). Multivariable logistic regression was performed, controlling for patient demographics, on-scene treatments, and injury severity. RESULTS Geriatric patients were more likely to experience prolonged scene time than younger adults after controlling for other factors (OR 1.78, 95% CI 1.57-2.04, p < 0.001). The likelihood of prolonged scene time reached OR 2.29 (95% CI 1.85-2.84) for patients age 70-79 and OR 2.66 (95% CI 2.07-3.42) for patients age 80-89, relative to age 18-29. CONCLUSIONS Geriatric trauma patients are more likely than younger adults to have prolonged prehospital scene time. This disparity may be caused by delayed recognition of injury severity or age-related cognitive biases.
Pediatric Anesthesia, Aug 1, 2019
American Journal of Surgery, Oct 1, 2021
BACKGROUND The literature shows that female surgeons have lower operative volumes than male surge... more BACKGROUND The literature shows that female surgeons have lower operative volumes than male surgeons. Since volume is dependent on new patient referrals for most surgeons, inequities in referrals may contribute to this employment disparity. METHODS Using 1997-2018 data from a large medical center, we examined the number of new patient referrals for surgeons. Multivariate linear analysis was performed, adjusting for surgeon race, calendar year, seniority, and clinical subspecialty. RESULTS A total of 121 surgeons across 12,410 surgeon-months were included. Overall, surgeons had a median of 14 new patient referrals per month (interquartile range (IQR) = 7, 27). On adjusted analysis, female surgeons saw 5.4 fewer new patient referrals per month (95% CI -6.4 to -4.5). CONCLUSION Female surgeons, with equal training and seniority, received fewer new patient referrals than their male peers, and this may contribute to female surgeon under-employment. Surgeon gender may be one of the factors contributing to this differential referral pattern.
Journal of Surgical Research, 2019
Pediatric Blood & Cancer, Apr 26, 2018
American Journal of Respiratory Cell and Molecular Biology, Feb 1, 2014
Clinical Obstetrics and Gynecology, Mar 1, 2015
Adnexal masses in children encompass a variety of lesions of the ovaries and fallopian tubes, inc... more Adnexal masses in children encompass a variety of lesions of the ovaries and fallopian tubes, including ovarian cysts and tumors (benign or malignant), fallopian tube cysts and abscesses, paratubal cysts, and endometriomas. When developing a differential diagnosis for adnexal masses in childhood, the clinician must have a broad understanding of adnexal pathology and consider the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s age, presenting complaints, physical examination findings, and imaging results to generate a list of possible diagnoses and the appropriate treatment plan. We review the clinical presentation of these lesions and discuss the current recommendations for their management.
Journal of Pediatric Surgery, Aug 1, 2013
Proceedings of the National Academy of Sciences of the United States of America, Feb 1, 2016
Journal of the Royal Society Interface, Sep 22, 2010
Seminars in fetal & neonatal medicine, Jun 1, 2011