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Biomedical subjects

A Murray

Publications and source records attributed to A Murray.

At least 289 records · Page 16Linked to original sources
PubMed1992

Marfan syndrome in a large family: response of family members to a screening programme.

Reaction to medical, social, and genetic implications of Marfan syndrome was evaluated by means of two questionnaires, the first after various tests before discussion of the diagnosis, the second after full discussion of the patient's diagnosis. Thirty-seven members of a family known to be at risk for Marfan syndrome attended for both questionnaires. All patients claimed to be satisfied with the way they were informed of the results of screening; 41% of patients were more worried about their health and 48% were more worried about the future after diagnosis. Apart from 50% of the smokers reducing or stopping their intake of cigarettes there were only very minor changes in lifestyle over the first month despite the increased level of expressed anxiety. If a definitive screening test was available, 96% of patients claimed they would have chosen it, 45% felt it would have an influence on their future plans, and 78% would choose to use a method of prenatal diagnosis for Marfan syndrome if it were available.

Adolescent↗
PubMed1992

Prevention of bacterial infection and sepsis in acute severe pancreatitis.

Between 1984 and 1986 six patients with acute respiratory failure (requiring ventilation for at least 3 days) complicating acute pancreatitis were managed on the intensive care unit (median ventilation period 6 days; range 3-41 days). Between 1987 and 1989 nine similar patients were managed (median ventilation period 35 days, range 4-69 days), and a regimen of enteral tobramycin, polymyxin and amphotericin to selectively decontaminate the digestive tract (SDD) was introduced. Five of six patients treated before 1987 had serious infections (three Gram-negative, one fungal), compared with only one of nine patients treated with SDD (P < 0.05). Clinical signs of sepsis were evident for 62% of the pre-SDD period, compared with 39% of the period during SDD therapy (P < 0.001). Systemic antibiotic prescribing was reduced in the SDD group; however, mortality remained unaffected with only two patients surviving pre-SDD and three during SDD treatment. SDD reduces infection rates and sepsis in patients with acute pancreatitis and may help to improve the prognosis of this life-threatening condition.

Acute Disease↗
PubMed1992

Selection of patients with the antiphospholipid syndrome by serological measurement of lupus anticoagulant activity in conjunction with anticardiolipin antibodies.

The significance of anti-cardiolipin antibodies (ACLA) in patients with a range of autoimmune and infective disorders was investigated in this study. Although lower levels of IgG and IgM ACLA were present in 77 of 400 patients' sera (19%), high antibody levels were found in less than 5% of patients. These latter patients belonged to three clinical categories: patients with connective tissue disease (CTD), infectious mononucleosis or biological false positive serology. An assay was developed to measure lupus anticoagulant (LA) activity in serum: significant LA activity was found in the CTD patients alone (in 6 of 15 tested) and all of these had high titre ACLA. Features of the antiphospholipid syndrome (APS) were present in these six patients but also in three additional CTD patients with normal LA results and high levels of ACLA. In two CTD patients with APS features, the high ACLA were of IgM isotype. These results stress the importance of measuring both ACLA and LA in an investigation of the APS: a high positive ACLA supports the diagnosis of APS, particularly in patients with autoimmune disease, whilst a high positive ACLA in association with LA activity is specific for this syndrome.

Antibodies, Antinuclear↗
PubMed1992

Induction of labour with prostaglandin gel in patients with unfavourable cervices.

151 primigravid patients with Bishop scores of 4 or less were induced with prostaglandin E2 gel using an initial dose of 2 mg followed by 1 mg or 2 mg at 6 hours. Eighty one patients (53.6 per cent) were in established labour or had delivered by 12 hours, and a further 31 (20.5 per cent) had achieved successful ripening of the cervix. Ninety per cent and 64.5 per cent respectively achieved vaginal delivery and although 39 patients failed to respond to this regime, 72 per cent delivered vaginally after augmentation. No case of hypertonus was recorded and only one patient had abdominal delivery for "failed induction". This regime provides an effective means of induction of labour for a difficult group of patients with little worry of overstimulation and low "failed induction" rates.

Administration, Intravaginal↗
PubMed1991

Popliteal artery entrapment syndrome.

Popliteal artery entrapment syndrome is an uncommon cause of peripheral vascular disease in young fit individuals, presenting as progressive claudication or sudden limb ischaemia. It can also present later in life with insidious symptoms relating to popliteal thrombosis or aneurysm. As a local cause of atherosclerosis in the popliteal artery it is probably under-diagnosed, as clinical and radiological features are subtle and varied. Early diagnosis and surgical division of aberrant muscular relations result in an excellent clinical result. Late surgical treatment with vein grafting is less durable. The disease incidence, clinical features, pathology, investigations, treatment and prognosis are reviewed.

Adolescent↗
PubMed1991

Amplification and differentiation of the DNA of an abortigenic (type 1) and a respiratory (type 4) strain of equine herpesvirus by the polymerase chain reaction.

Unpurified DNA derived from cultures of equine fetal kidney cells infected with either equine herpesvirus type 1 or equine herpesvirus type 4 was amplified by the polymerase chain reaction using one pair of oligonucleotide primers. Restriction endonuclease digestion of the amplified segments with PvuII, followed by electrophoresis, revealed restriction fragment length polymorphisms which enabled the two virus types to be differentiated.

Abortion, Veterinary↗
PubMed1991

Properties of fetal heartbeat intervals during labour.

This study was designed to investigate the range of beat-to-beat changes in fetal inter-beat (RR) intervals during routine clinical monitoring in labour. Fetal RR intervals were automatically measured and collected from 10 fetuses. Intervals which were incorrectly measured were excluded, and the remaining 23,510 intervals were used to compile the distribution of beat-to-beat changes. The inter-quartile range of this distribution was 23 ms and the 99th centile fell at approximately 50 ms. No relationship could be established between beat-to-beat changes and the absolute RR interval. These findings differ from the results published by other workers on the basis of data obtained antenatally or during early labour. In addition, the results suggest possibilities for improving algorithms designed to enhance data quality in fetal heart rate monitoring.

Algorithms↗
PubMed1991

Xenopus oocyte maturation does not require new cyclin synthesis.

Progesterone induces fully grown, stage VI, Xenopus oocytes to pass through meiosis I and arrest in metaphase of meiosis II. Protein synthesis is required twice in this process: in order to activate maturation promoting factor (MPF) which induces meiosis I, and then again after the completion of meiosis I to reactivate MPF in order to induce meiosis II. We have used antisense oligonucleotides to destroy maternal stores of cyclin mRNAs, and demonstrate that new cyclin synthesis is not required for entry into either meiosis I or II. This finding is consistent with the demonstration that stage VI oocytes contain a store of B-type cyclin polypeptides (Kobayashi, H., J. Minshull, C. Ford, R. Golsteyn, R. Poon, and T. Hunt. 1991. J. Cell Biol. 114:755-765). Although approximately 70% of cyclin B2 is destroyed at first meiosis, the surviving fraction, together with a larger pool of surviving cyclin B1, must be sufficient to allow the reactivation of MPF and induce entry into second meiotic metaphase. Since stage VI oocytes do not contain any cyclin A, our results show that cyclin A is not required for meiosis in Xenopus. We discuss the possible nature of the proteins whose synthesis is required to induce meiosis I and II.

Animals↗
PubMed1991

Repeatability of dynamic eye pupil response measurement using the Pupilscan instrument.

The repeatability of pupil response measurements made with the Pupilscan instrument has been assessed. Two operators made 32 repeat recordings of the pupil response in each eye of eight normal subjects over four days. A total of 512 recordings were made and the results analysed by variance analysis. Room light levels were carefully controlled. The instrument measured initial pupil diameter, and after a 0.2 s light stimulus measured minimum and final diameters, maximum diameter change, constriction velocity and time to minimum diameter. For all measurements except time to minimum, there were significant differences (P less than 0.001) between the normal subjects. Day-to-day variation was also significant (P less than 0.005), but did not mask the differences between subjects. It is concluded that the average of at least four repeat measurements are made, giving error ranges similar to those observed from day-to-day changes.

Adult↗
PubMed1990

Recurrent disseminated intravascular coagulation and fulminant intra hepatic thrombosis in a patient with the anti-phospholipid syndrome.

We describe a patient with the lupus anti-coagulant who had recurrent episodes, over a 2 year period, of a severe and disseminated intravascular coagulopathy. This patient also had positive serological assays for syphilis and anti-cardiolipin antibodies. Associated with the coagulopathy were co-expressed episodes of liver disease, ultimately terminating in fulminant liver failure. At autopsy the features were characteristic of the Budd-Chiari syndrome. This is the first report to document how consumptive coagulopathy may present as a dominant feature of the anti-phospholipid syndrome. It also clearly describes an immune mediated thrombotic mechanism as a cause of hepatic veno-occlusive disorders. Furthermore, this case highlights the varied clinical spectrum of the anti-phospholipid syndrome and suggests that a high index of suspicion is required to ensure its diagnosis.

Adult↗
PubMed1990

Bromocriptine self-administration and bromocriptine-reinstatement of cocaine-trained and heroin-trained lever pressing in rats.

Rats were trained to lever press for intravenous cocaine (1.0 mg/kg/injection) and then switched to bromocriptine (0.3, 1.0, or 3.0 mg/kg/injection) on a FR-1 reinforcement schedule. Bromocriptine sustained responding at all three doses; hourly drug intake increased linearly with log-dose. In a second experiment, animals were trained to respond for cocaine (1.0 mg/kg/injection) or heroin (0.1 mg/kg/injection) reinforcement; drug was available for the first 2 h of each daily session; saline was substituted for cocaine or heroin for 5 subsequent hours. One hour into each saline substitution session, an intravenous injection of saline or bromocriptine (0.0, 0.5, 1.0, or 2.0 mg/kg) was given. Bromocriptine reinstated both cocaine-trained and heroin-trained lever pressing; under these conditions, the drug was most effective in the heroin-trained animals. Reinforcing doses of clonidine (0.0625 and 0.125 mg/kg), methohexital, and nicotine (0.05 and 0.1 mg/kg), and a sub-intoxicating dose of ethanol (2 g/kg) failed to reinstate cocaine-trained responding. These data indicate that bromocriptine has cocaine-like and heroin-like stimulus and reinforcing effects.

Animals↗
PubMed1990

Monitoring brain function during cardiothoracic surgery in children and adults at two levels of hypothermia.

The EEGs of 9 infants and 9 adults undergoing cardiac surgery were analysed during 2 different temperature ranges. Variance analysis showed that there were very significant interactions between age and temperature effects (P less than 0.01) and between temperature and specific frequency bands (P less than 0.005). These interactions were studied further and the greatest changes were discovered in the infant group when the temperature fell from the upper to the lower hypothermic range: low delta activity increased significantly while those of alpha and theta fell significantly. The significant quantitative differences found in this study agree with qualitative observations from other reports.

Age Factors↗