Otolaryngologists, Plastic Surgery Specialist
25 years of experience
Video profile
Accepting new patients
1066 N Monroe St
Monroe, MI 48162
734-243-6640
Locations and availability (1)

Education ?

Medical School Score Rankings
University of Iowa (1985)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Patients' Choice Award (2008 - 2009, 2011, 2013)
Associations
American Society of Plastic Surgeons
Member

Affiliations ?

Dr. Kelly is affiliated with 7 hospitals.

Hospital Affilations

Score

Rankings

  • ProMedica North Region-Herrick Campus
    500 E Pottawatamie St, Tecumseh, MI 49286
    • Currently 4 of 4 crosses
    Top 25%
  • Henry Ford Wyandotte Hospital
    Otolaryngology
    2333 Biddle Ave, Wyandotte, MI 48192
    • Currently 4 of 4 crosses
    Top 25%
  • Mercy Memorial Hospital System
    Otolaryngology
    718 N Macomb St, Monroe, MI 48162
    • Currently 3 of 4 crosses
    Top 50%
  • Henry Ford Macomb Hospitals - Warren Campus
    Otolaryngology
    13355 E 10 Mile Rd, Warren, MI 48089
    • Currently 3 of 4 crosses
    Top 50%
  • Emma L Bixby Med Ctr, Adrian, Mi
  • Mercy Memorial Hospital, Monroe, Mi
  • Wyandotte General Hospital
  • Publications & Research

    Dr. Kelly has contributed to 22 publications.
    Title Development of a Battery of Functional Tests for Low Vision.
    Date December 2009
    Journal Optometry and Vision Science : Official Publication of the American Academy of Optometry
    Excerpt

    We describe the development and evaluation of a battery of tests of functional visual performance of everyday tasks intended to be suitable for assessment of low vision patients.

    Title The Impact of Long-term Lithium Treatment on Renal Function in an Outpatient Population.
    Date September 2008
    Journal The Ulster Medical Journal
    Excerpt

    AIM: This study aims to compare younger and older populations of lithium-treated patients and to examine the impact of long-term lithium treatment on renal function. METHODS: A retrospective, cross-sectional survey of all patients attending a specialist clinic was carried out. Demographic, clinical and biochemical data from the two groups were compared, and stepwise regression was used to investigate an association between duration of lithium treatment and renal function. RESULTS: The findings reveal a positive association between duration of lithium use and mean serum creatinine levels (t=3.369, p=0.001), and so prolonged lithium treatment may be a risk factor for progressive renal impairment. However, under appropriate supervision this may not be of clinical relevance. CONCLUSION: We conclude that lithium can be safely prescribed over a protracted period of time, even in elderly populations, but should be monitored closely under specialist supervision, to ensure early identification and management of adverse effects.

    Title Acute Tryptophan Depletion Does Not Alter Central or Plasma Brain-derived Neurotrophic Factor in the Rat.
    Date July 2008
    Journal European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
    Excerpt

    Dietary induced acute tryptophan depletion (ATD) is used to reduce central serotonergic function and to investigate the role of serotonin (5-HT) in psychiatric illness. In healthy volunteers ATD produces working memory deficits and decreases mood in some studies. Brain-derived neurotrophic factor (BDNF) plays a role in both cognition and in the regulation of mood; however, the possible contribution of central BDNF changes to the effects of ATD has not been examined. Therefore, using a rat model we have examined the effect of amino acid mixture-induced ATD on plasma and central BDNF protein levels. ATD significantly reduced free-plasma TRP by 79% and central hippocampal 5-HT by 35% when compared to controls. However, plasma or central BDNF protein levels in the hippocampus and midbrain were not significantly altered by ATD. These results suggest that changes in central BDNF do not contribute to the cognitive or mood effects of ATD.

    Title The Mthfr C677t Polymorphism is Associated with Depressive Episodes in Patients from Northern Ireland.
    Date April 2005
    Journal Journal of Psychopharmacology (oxford, England)
    Excerpt

    Low plasma folate and its derivatives have been linked with depressive disorders in studies dating back over 30 years. A thermolabile variant (677C>T) of the enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR) is associated with low serum folate. The present study aimed to explore whether the thermolabile variant of MTHFR is associated with a vulnerability to depressive episodes. MTHFR C677T genotype frequencies in a cohort of patients (mean age 48 years) with depressive disorder (n = 100) were compared with those in age- and sex-matched controls. Serum levels of folate, homocysteine and vitamin B(12) were also compared between groups. The thermolabile variant of MTHFR was significantly more common in the group with a history of depressive disorder (P= 0.03). Serum levels of folate, homocysteine and vitamin B(12) did not differ significantly between groups. A MTHFR C677T genotype is associated with increased risk of depressive episodes in this homogenous patient population.

    Title Role of Cyclooxygenase-2 in Cytokine-induced Beta-cell Dysfunction and Damage by Isolated Rat and Human Islets.
    Date February 2005
    Journal The Journal of Biological Chemistry
    Excerpt

    Type I diabetes mellitus is an autoimmune disease characterized by the selective destruction of the insulin-secreting beta-cell found in pancreatic islets of Langerhans. Cytokines such as interleukin-1 (IL-1), interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha) mediate beta-cell dysfunction and islet degeneration, in part, through the induction of the inducible isoform of nitric-oxide synthase and the production of nitric oxide by beta-cells. Cytokines also stimulate the expression of the inducible isoform of cyclooxygenase, COX-2, and the production of prostaglandin E(2) (PGE(2)) by rat and human islets; however, the role of increased COX-2 expression and PGE(2) production in mediating cytokine-induced inhibition of islet metabolic function and viability has been incompletely characterized. In this study, we have shown that treatment of rat islets with IL-1beta or human islets with a cytokine mixture containing IL-1beta + IFN-gamma +/- TNF-alpha stimulates COX-2 expression and PGE(2) formation in a time-dependent manner. Co-incubation of rat and human islets with selective COX-2 inhibitors SC-58236 and Celecoxib, respectively, attenuated cytokine-induced PGE(2) formation. However, these inhibitors failed to prevent cytokine-mediated inhibition of insulin secretion or islet degeneration. These findings indicate that selective inhibition of COX-2 activity does not protect rat and human islets from cytokine-induced beta-cell dysfunction and islet degeneration and, furthermore, that islet production of PGE(2) does not mediate these inhibitory and destructive effects.

    Title Folic Acid: Neurochemistry, Metabolism and Relationship to Depression.
    Date January 2005
    Journal Human Psychopharmacology
    Excerpt

    The associations of folic acid and its derivatives with depressive disorder are reviewed. Derivatives of folic acid such as biopterins and the synthesis of S-adenosyl methionine (SAM) are known either to be associated with improvement or to have a direct therapeutic effect in depressive disorder. Studies investigating plasma and red cell folic acid levels in depressed patients have used differing assay methodologies which make comparison difficult, although there is substantial evidence of the association between depressive disorder (particularly severe depression) and low folic acid levels. The few studies available suggest folic acid has either antidepressant properties or can act as an augmenting agent for standard antidepressant treatment. A recently discovered genetic variant (5,10 MTHFR) leading to altered folic acid metabolism may explain why some individuals are vulnerable to the effects of folic acid deficiency, despite adequate intake. The links of 5,10 MTHFR to the presence of depressive disorder in the community are being investigated.

    Title Antidepressant Prescribing and Suicide Rate in Northern Ireland.
    Date April 2004
    Journal European Psychiatry : the Journal of the Association of European Psychiatrists
    Excerpt

    PURPOSE: Although antidepressants are the most commonly used treatment for depressive illness, there is uncertainty if their use is associated with a reduction in suicide rate. Antidepressant prescribing in Northern Ireland has increased over fivefold in the decade 1989-1999. The authors sought to explore whether this increase was associated with a reduction in suicide rate taking into account social and political factors thought also to have an influence on suicide. MATERIALS AND METHODS: Factors that have been suggested to influence suicide were entered into a linear regression with frequency of suicide and undetermined deaths (referred to as suicide rate) as the dependent variable. The above factors were antidepressant prescribing, unemployment rate, household alcohol expenditure and persons charged with terrorist offences. The rise in younger suicides, in recent decades, suggests this analysis should be carried out separately for younger (less than 30 years) and older (30 years and above) suicides separately. The predictors in the two models are based on aggregate data for the total group. RESULT: In the younger group there was no association between antidepressant prescribing and suicide. For the older group increased antidepressant prescribing was associated with a reduction in suicide rate over the 10 years of the study. CONCLUSION: Increasing antidepressant prescribing appears to be an effective strategy for reducing suicide. This has been demonstrated in older individuals.

    Title The Effects of Reboxetine, a Noradrenaline Reuptake Inhibitor, on the Plasma Noradrenaline Response to a Cold Pressor Test in Healthy Volunteers.
    Date May 2003
    Journal Journal of Psychopharmacology (oxford, England)
    Excerpt

    Previous studies have shown peripheral abnormalities in noradrenergic activity in depressed melancholic patients. These abnormalities have a relationship with short-term and long-term outcome. Little is known about the effects of antidepressant treatment on these peripheral measures such as plasma noradrenaline (NA) and the plasma NA response to a laboratory stressor, the cold pressor test (CPT). The present study examines the effects of the antidepressant reboxetine, a noradrenaline reuptake inhibitor, on baseline plasma NA and the plasma NA response to a CPT, in nine healthy volunteers compared to placebo. A double-blind crossover design was used, with each agent given for 4 weeks with a 4-week washout period. There was no effect of reboxetine on baseline plasma NA. The plasma NA response to reboxetine, with a CPT, was blunted 3 days after commencing treatment. Reboxetine alters the plasma NA response to a CPT independent of baseline plasma NA.

    Title Isolation of Islets of Langerhans from Rodent Pancreas.
    Date April 2003
    Journal Methods in Molecular Medicine
    Title Deliberate Self-poisoning Presenting at a Rural Hospital in Northern Ireland 1976-1996: Relationship to Prescribing.
    Date November 2000
    Journal European Psychiatry : the Journal of the Association of European Psychiatrists
    Excerpt

    PURPOSE: This study reports on a project to monitor deliberate self-poisoning in a rural area of Northern Ireland over a 20-year period. Comparison is made with reports from large urban centres. In addition, a local prescribing database allows assessment of any association between psychotropic drug prescription and use for deliberate self-poisoning. MATERIALS AND METHODS: Frequency of self-poisoning, demographic details and drugs used were recorded for all episodes of deliberate self-poisoning occurring at Craigavon Area Hospital for the years 1976, 1986, 1991 and 1996. It was possible to compare prescriptions of psychotropic drugs with their use for deliberate self-poisoning between the years 1991 and 1996 in the region served by the hospital, using the Defined Daily Dose (DDD) system. RESULTS: In this rural area the pattern of deliberate self-poisoning has changed, as in urban centres, with a rise in frequency and the male/female ratio approaching unity. The pattern of drug use has altered, with paracetamol overtaking benzodiazepines as the most commonly used agent. More recently, antidepressants have become the second most frequently used drug class for this purpose. Psychotropic medications used for self-poisoning altered in proportion to their prescription between the years 1991 and 1996. CONCLUSIONS: In the face of a continuing rise in deliberate self-poisoning, which is effecting both urban and rural areas, care should be taken to prescribe the least toxic agent available as this is associated with likely frequency of self-poisoning for most classes of psychotropic drug.

    Title Plasma Norepinephrine and Prediction of Outcome in Major Depressive Disorder.
    Date December 1999
    Journal Biological Psychiatry
    Excerpt

    BACKGROUND: Several epidemiologic and clinical factors have been shown to predict long term outcome in major depressive disorder (MDD). The value of biological predictors has not been extensively studied. This study examined whether plasma norepinephrine may be useful in predicting outcome in MDD. METHODS: Forty patients were followed up 8 years after an index major depressive episode. Three outcome variables were assessed: time to first recurrence (the primary outcome measure), the Lee and Murray criteria and the Depression Outcome Scale (DOS). The results were examined against plasma norepinephrine value, at the index episode, using survival analysis and linear regression. RESULTS: High plasma norepinephrine at the index episode was positively and significantly associated with time to first recurrence for patients with nonpsychotic MDD (n = 31, chi 2 = 8.38, on 1 df, p < .01). Similarly, plasma norepinephrine was significantly associated with good global outcome, both using Lee and Murray criteria (n = 34, adjusted R2 = .24, p < .01) and DOS criteria (n = 31, adjusted R2 = .17, p < .01) for this group of patients. In contrast, plasma norepinephrine was not significantly related to outcome for MDD with psychotic features. CONCLUSIONS: Plasma norepinephrine at index episode seems to be a predictor of outcome in MDD.

    Title In Autoimmune Diabetes the Transition from Benign to Pernicious Insulitis Requires an Islet Cell Response to Tumor Necrosis Factor Alpha.
    Date May 1999
    Journal The Journal of Experimental Medicine
    Excerpt

    The islet-infiltrating and disease-causing leukocytes that are a hallmark of insulin-dependent diabetes mellitus produce and respond to a set of cytokine molecules. Of these, interleukin 1beta, tumor necrosis factor (TNF)-alpha, and interferon (IFN)-gamma are perhaps the most important. However, as pleiotropic molecules, they can impact the path leading to beta cell apoptosis and diabetes at multiple points. To understand how these cytokines influence both the formative and effector phases of insulitis, it is critical to determine their effects on the assorted cell types comprising the lesion: the effector T cells, antigen-presenting cells, vascular endothelium, and target islet tissue. Here, we report using nonobese diabetic chimeric mice harboring islets deficient in specific cytokine receptors or cytokine-induced effector molecules to assess how these compartmentalized loss-of-function mutations alter the events leading to diabetes. We found that islets deficient in Fas, IFN-gamma receptor, or inducible nitric oxide synthase had normal diabetes development; however, the specific lack of TNF- alpha receptor 1 (p55) afforded islets a profound protection from disease by altering the ability of islet-reactive, CD4(+) T cells to establish insulitis and subsequently destroy islet beta cells. These results argue that islet cells play a TNF-alpha-dependent role in their own demise.

    Title Plasma Norepinephrine Response to a Cold Pressor Test in Subtypes of Depressive Illness.
    Date March 1999
    Journal Psychiatry Research
    Excerpt

    Noradrenergic systems have been shown to be disordered in depressive illness. The plasma norepinephrine response to a cold pressor test was used to investigate norepinephrine activity in subtypes of depressive illness. Patients with melancholic or psychotic depression, non-melancholic depression, general anxiety disorder and normal control subjects had a cold pressor test carried out under standard conditions. Blood samples were taken to measure plasma norepinephrine during the test. The plasma norepinephrine response to a cold pressor test was reduced in the melancholic/psychotic depressed patients compared to control subjects. No other intergroup comparisons were statistically significant. These results suggest noradrenergic systems are disturbed and subresponsive to stress in melancholic/psychotic depressed patients. This does not appear related to other clinical or biochemical factors.

    Title Differences and Variability in Plasma Noradrenaline Between Depressive and Anxiety Disorders.
    Date November 1998
    Journal Journal of Psychopharmacology (oxford, England)
    Excerpt

    Plasma noradrenaline (NA) levels were compared between two groups of patients with major depressive disorder (melancholic/psychotic and non-melancholic), patients with general anxiety disorders and healthy controls. The melancholic/psychotic depressed group had the highest plasma NA levels. This only reached statistical significance with respect to the control group. Within the depressed group, there was no association between plasma NA levels and age, weight loss, ratings of depression, anxiety or plasma cortisol levels.Variance of plasma NA was greatest in the melancholic/psychotic depressed group. A review of previous studies shows an association between raised plasma NA, depressive illness and alterations in NA variance. This association may be limited to melancholic/psychotic depressed patients. The above findings support a dysregulated noradrenergic system in depressive illness.

    Title An Audit of Acute Psychiatric Admission Bed Occupancy in Northern Ireland.
    Date August 1998
    Journal The Ulster Medical Journal
    Excerpt

    The Northern Ireland Section (Irish Division) of the Royal College of Psychiatrists were requested to investigate apparent increasing pressures on acute psychiatric beds. Information on bed occupancy and associated service activity was collected by clinicians on site in every psychiatric unit in Northern Ireland over the past eight years. Three separate years (1987, 1991 and 1995) were studied. Bed occupancy rose across these three years. There was an associated reduction in the number of acute psychiatric beds, reduction in adult continuing care beds, increased recorded referrals to psychiatric units and evidence of considerable numbers of new long-stay patients and difficulties with community placements. Acute bed occupancy in Northern Ireland is high, frequently over 100% and rising. Occupancy rose between each of the years studied. The problem is not confined to urban areas and several associated service factors may be contributing. Without change, acute bed provision will inevitably fail to match mental health needs.

    Title Potential Role of Resident Islet Macrophage Activation in the Initiation of Autoimmune Diabetes.
    Date March 1998
    Journal Journal of Immunology (baltimore, Md. : 1950)
    Excerpt

    The purpose of this study was to evaluate the effects of resident islet macrophage activation on beta cell function. Treatment of freshly isolated rat islets with TNF-alpha and LPS results in a potent inhibition of glucose-stimulated insulin secretion. The inhibitory actions of TNF + LPS are mediated by the intraislet production and release of IL-1 followed by IL-1-induced inducible nitric oxide synthase (iNOS) expression by beta cells. The IL-1R antagonist protein completely prevents TNF + LPS-induced nitrite production, iNOS expression and the inhibitory effects on glucose-stimulated insulin secretion by rat islets. Resident macrophages appear to be the source of IL-1, as a 7-day culture of rat islets at 24 degrees C (conditions known to deplete islets of lymphoid cells) prevents TNF + LPS-induced iNOS expression, nitrite production, and the inhibitory effects on insulin secretion. In addition, macrophage depletion also inhibits TNF + LPS-induced IL-1alpha and IL-1beta mRNA expression in rat islets. Immunocytochemical colocalization of IL-1beta with the macrophage-specific marker ED1 was used to provide direct support for resident macrophages as the islet cellular source of IL-1. IL-1beta appears to mediate the inhibitory actions of TNF + LPS on beta cell function as TNF + LPS-induced expression of IL-1beta is fourfold higher than IL-1alpha, and Ab neutralization of IL-1beta prevents TNF + LPS-induced nitrite production by rat islets. These findings support a mechanism by which the activation of resident islet macrophages and the intraislet release of IL-1 may mediate the initial dysfunction and destruction of beta cells during the development of autoimmune diabetes.

    Title Plasma Noradrenaline Response to Electroconvulsive Therapy in Depressive Illness.
    Date October 1997
    Journal The British Journal of Psychiatry : the Journal of Mental Science
    Excerpt

    BACKGROUND: Abnormalities of catecholaminergic function have been hypothesised to cause depressive illness. Plasma noradrenaline can be used as a marker of central noradrenergic activity. It is of interest to examine the change in resting plasma noradrenaline in patients with depressive illness over a course of electroconvulsive therapy (ECT) and relate this to their clinical state. METHOD: Patients referred for ECT who suffered from DSM-III-R major depressive disorder or dysthymia were recruited. Blood samples were taken before and after each treatment, during a course of ECT, to measure plasma noradrenaline and cortisol. Clinical ratings were carried out weekly during the course of ECT. RESULTS: Plasma noradrenaline fell significantly in those patients with melancholic/psychotic depressions but increased in those with non-melancholic depressive illness. There was a strong trend indicating that a fall in plasma noradrenaline was associated with improvement in depression ratings in the melancholic/psychotic patients only. CONCLUSIONS: Electroconvlusive therapy decreases plasma noradrenaline in melancholic/psychotic depressive illness and this shows a trend associated with clinical improvement.

    Title 5-hydroxyindoleacetic Acid in Cerebrospinal Fluid and Prediction of Suicidal Behaviour in Schizophrenia.
    Date November 1992
    Journal Lancet
    Excerpt

    Low concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF) are associated with suicidal behaviour in patients with depressive illness, but studies of the relation between CSF 5-HIAA and suicide in schizophrenia have been inconclusive and have not included long-term follow-up. In a prospective study, we measured 5-HIAA in CSF taken from 30 schizophrenic patients in a drug-free state, and followed these patients for 11 years. 10 patients made suicide attempts during follow-up. Suicide attempters had significantly lower concentrations of CSF 5-HIAA at initial evaluation than non-attempters (mean [SE] 6.7 [2.2] vs 23.6 [5.6] ng/ml, p < 0.05). Our findings provide further evidence of the relation between serotoninergic dysfunction and suicide, and suggest a role for drugs with serotoninergic effects in schizophrenia.

    Title Beta 2-adrenoceptor Antagonism in Anxiety.
    Date August 1992
    Journal European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
    Excerpt

    The relative role of beta 1- and beta 2-adrenoceptor antagonism in the management of anxiety symptoms is not clear. We studied the effect of ICI 118,551, a selective beta 2-antagonist, in 51 patients presenting with acute anxiety symptoms and fulfilling DSM-III criteria for anxiety disorder. All patients received placebo during the first week of treatment followed by thrice daily diazepam (2 mg) or ICI 118,551 (50 mg) or placebo for 4 weeks with double-blind, random allocation. Hamilton anxiety scale scores improved on all treatments but there was no significant difference between treatments. Beta 2-adrenoceptor antagonism does not appear to be effective in acute anxiety neurosis. Some earlier literature suggests that beta 1-antagonism may be more important.

    Title Toxic Elevation of Serum Lithium Concentration by Non-steroidal Anti-inflammatory Drugs.
    Date March 1992
    Journal The Ulster Medical Journal
    Title Accuracy of Weightbearing at Three Target Levels During Bilateral Upright Stance in Patients with Neuropathic Feet and Control Subjects.
    Date July 1991
    Journal Perceptual and Motor Skills
    Excerpt

    The purposes of this study were to (1) describe errors in weightbearing at three target levels for patients with neuropathic feet and control subjects, (2) compare the absolute errors at the three target levels between groups, and (3) identify predictor variables of errors in weightbearing by the neuropathic group. The groups of 26 subjects were matched for age and height. Weightbearing was measured with digital scales while subjects attempted to adjust their weight through a designated lower extremity to each target level (25, 50, and 75% of body weight). Analysis of variance indicated no significant difference in the percentage weightbearing between groups at the three target levels. There was a significant difference in errors made in weightbearing by the groups at the three target levels. Mean errors ranged from 8.5 to 9.7% for the neuropathic group and from 2.4 to 6.6% for the control group. The findings cast doubt on the utility (in the absence of feedback) of requesting individuals, particularly those with neuropathic feet, to weightbear at specific target levels.

    Title Plasma Noradrenaline Response to a Cognitive Stressor in Subtypes of Depressive Illness.
    Date
    Journal Human Psychopharmacology
    Excerpt

    Noradrenergic function has been shown to be disrupted in depressive illness. The plasma noradrenaline response to a cognitive stressor (the Stroop test) was used to investigate noradenergic activity in subtypes of depressive illness. A Stroop test was carried out, under standardised conditions, on patients with melancholic or psychotic depression, non-melancholic depression, general anxiety disorder and normal controls. Blood samples were taken during testing for measurement of plasma noradrenaline. Although there was a trend for the plasma noradrenergic response to be reduced in the melancholic/psychotic depressed patients compared to all other groups, this did not reach statistical significance. No other inter-group comparisons were statistically significant. The plasma noradrenaline response to a cognitive stressor does not discriminate subtypes of depressive illness from normal controls. Copyright 2000 John Wiley & Sons, Ltd.

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