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Biomedical subjects

B Murphy

Publications and source records attributed to B Murphy.

At least 91 records · Page 5Linked to original sources
PubMed1996

Patient-initiated prevention discussions. Two interventions to stimulate patients to initiate prevention discussions.

BACKGROUND: When patients are active participants in discussions, comprehension and compliance are likely to improve. This study examines the use of two interventions to aid patients in initiating such discussions in the area of health maintenance. METHODS: The study was a randomized controlled trial of adult patients. The first intervention used two cards that listed seven core health maintenance concerns. The second intervention used a brief session with a nurse to help patients identify their health risks and develop a plan for seeking any desired information about these risks. An exit questionnaire and a telephone interview 4 to 6 weeks later assessed the extent to which (1) information seeking by patients was stimulated; (2) patients recalled the information obtained; (3) patients used the information to effect lifestyle changes; and (4) patients felt they participated in the decision to discuss health maintenance. RESULTS: Both interventions stimulated patients to request health maintenance information (both P < .05); the second intervention significantly increased patient recall (P = .018). Neither intervention, however, had a significant impact on lifestyle change or sense of participation in the decision to initiate discussion. Analysis of the second intervention did show that both increasing patients' recall of information (P = .008) and sense of involvement in the decision to discuss health maintenance (P = .003) significantly increases the likelihood of lifestyle change. CONCLUSIONS: Two interventions have been developed that are relatively simple and inexpensive methods to stimulate patients to seek health maintenance, and quite probably other health-related information. The blunted impact of these two interventions, however, raises the question of whether such simple and relatively inexpensive interventions are strong enough to stimulate patients to use this information to initiate change when one seeks to address a wide range of risks.

Adult↗
PubMed1995

The indirect pathway of allorecognition. The occurrence of self-restricted T cell recognition of allo-MHC peptides early in acute renal allograft rejection and its inhibition by conventional immunosuppression.

There is evidence that T cells can "directly" recognize intact allo-MHC molecules on the surface of allogeneic stimulator or target cells, and/or "indirectly" recognize processed allo-MHC peptides presented by self antigen-presenting cells (APCs). We and others have recently demonstrated that in vivo-primed rat CD4+ T cells recognize and proliferate to specific polymorphic amino acid sequences when presented as MHC allopeptides by self APCs. Studies on the mechanisms of indirect T cell recognition of alloantigen are now reported. First, we studied the immunogenicity of 4 synthetic polymorphic class II MHC allopeptides representing full-length sequences of the hypervariable domains of RT1.Du beta (DR or I-E-like) in several responder strains: LEW (RT1(l)), ACI (RT1a), BUF (RT1b), BN (RT1n), and control syngeneic WF (RT1u) strains. Immunogenicity of the individual 25mer allopeptides varied in the different responder strains, indicating that self-restricted T cell recognition of allo-MHC peptides is determined not only by polymorphisms, but also by the responder MHC genotype. Self-restricted CD4+ T cell recognition of processed allo-MHC peptides has been shown to occur during acute skin and cardiac allograft rejection, and there is evidence that this pathway may play an important role in initiating and amplifying the immune response to allografts. T cells from LEW animals primed in vivo by WF (RT1u) vascularized renal allografts were capable of proliferating to the RT1.Du beta peptides as early as 3 days postengraftment, when presented by self APCs. We then tested the effects of various immunosuppressive drugs on self-restricted primed T cell proliferative response to an immunogenic MHC allopeptide in vitro. Methylprednisolone, cyclosporine, and FK506 inhibited the proliferative response of RT1.Du beta 2-primed LEW T cells in a dose-dependent fashion. In addition, a single injection of cyclosporine (25 mg/kg i.m.) to LEW recipients of WF renal allografts on the day of transplantation completely abolished the proliferative response of in vivo-primed T cells to RT1.Du beta 2, indicating the susceptibility of the indirect pathway of allorecognition to conventional immunosuppressive drugs.

Amino Acid Sequence↗
PubMed1995

A potential vulnerability locus for schizophrenia on chromosome 6p24-22: evidence for genetic heterogeneity.

In 265 Irish pedigrees, with linkage analysis we find evidence for a vulnerability locus for schizophrenia in region 6p24-22. The greatest lod score, assuming locus heterogeneity, is 3.51 (P = 0.0002) with D6S296. Another test, the C test, also supported linkage, the strongest results being obtained with D6S296 (P = 0.00001), D6S274 (P = 0.004) and D6S285 (P = 0.006). Non-parametric analysis yielded suggestive, but substantially weaker, findings. This locus appears to influence the vulnerability to schizophrenia in roughly 15 to 30% of our pedigrees. Evidence for linkage was maximal using an intermediate phenotypic definition and declined when this definition was narrowed or was broadened to include other psychiatric disorders.

Chromosomes, Human, Pair 6↗
PubMed1995

Culture methods for the detection of minimal tumor contamination of hematopoietic harvests: a review.

The evaluation of minimal residual disease in patients and hematopoietic cell grafts is of considerable importance for staging disease, determining the response to treatment, and monitoring the efficiency of ex vivo purging or positive selection procedures. The most widely used techniques are immunocytochemical staining and the polymerase chain reaction; however, these assays do not measure the viability or clonogenic capacity of the detected cells. For this purpose, a culture technique must be used. This paper reviews the status, advantages, and limitations of this approach and the detection of tumor cells in bone marrow and peripheral blood.

Bone Marrow Purging↗
PubMed1995

Information for family carers: does it help?

Family carers in Victoria were identified through a statewide telephone survey in 1993. A total of 976 carers was interviewed and a random sample of approximately one in 10 (n = 103) were offered the Carer Support Kit leaflet. The leaflet details the components of the Carer Support Kit (a Federal Government initiative developed in 1992-93) and informs carers how to apply for it through the Victorian Carers' Association. Approximately three-quarters of these carers accepted the offer, and around a third subsequently applied for the kit. Carers who applied for the kit reported significantly more overload and lower life satisfaction than those who did not apply. Only two-thirds of those mailed the kit (just 23 per cent of the eligible study sample) went on to use it. Those who had not used it reported significantly more negative emotions and health problems than those who used it, suggesting that stress and crises could preclude utilisation of the information. A brief evaluation of the components of the kit is presented; however, findings need to be treated with caution in view of the small sample size.

Adult↗
PubMed1995

The role of emotionality and regulation in children's social functioning: a longitudinal study.

Multiple measures of children's emotionality (emotional intensity and negative affectivity), regulation (including attentional and behavioral regulation and coping), and social functioning (teachers' reports of nonaggressive/socially appropriate behavior and prosocial/socially competent behavior; and parents' reports of problem behavior) were obtained for 6-8-year-olds. In addition, emotionality, attentional regulation, and coping were assessed 2 years previously. Social functioning was expected to be predicted by low negative emotionality and high levels of regulation. In general, the data supported the predictions, although the findings for parent reports of problem behavior were primarily for boys. Prediction of social functioning from measures of regulation and emotionality occurred primarily within a given context (school vs. home) rather than across contexts, even though there were relations across reporters within the school or home context. In addition, vagal tone, a marker of physiological regulation, was positively related to competent social functioning and emotionality/regulation for boys, but inversely related for girls.

Affective Symptoms↗
PubMed1995

Prosocial development in late adolescence: a longitudinal study.

Change in prosocial moral reasoning over 15 years, gender differences in prosocial reasoning, and the interrelations of moral reasoning, prosocial behavior, and empathy-related emotional responses were examined with longitudinal data from 17-18- and 19-20-year-olds and data from adolescents interviewed for the first time. Hedonistic reasoning declined in use until adolescence, and then increased somewhat in early adulthood. Needs-oriented and stereotypic reasoning increased until mid-childhood or early adolescence and then declined in use. Direct reciprocity and approval reasoning, which appeared to be on the decline in mid-adolescence in previous follow-ups, showed no decline into early adulthood. Several modes of higher-level reasoning increased in use across adolescence and early adulthood. Females' overall reasoning was higher than males'. Scores on interview and objective measures of prosocial moral reasoning were positively correlated. Consistent with expectations, there was some evidence of relations among prosocial reasoning, prosocial behavior, sympathy, and perspective taking.

Adolescent↗
PubMed1994

A phase I trial of intrahepatic verapamil and doxorubicin. Regional therapy to overcome multidrug resistance.

BACKGROUND: Verapamil can modulate multidrug resistance in vitro, but only at levels that are not tolerable when administered systemically. Regional strategies of drug administration may permit the delivery of high concentrations of a drug to specific areas with lower systemic levels. Colorectal cancers typically express the multidrug resistance phenotype. METHODS: A Phase I trial was performed to determine the maximum tolerable dose (MTD) and dose limiting toxicities of verapamil by hepatic artery infusion, together with doxorubicin, to patients with hepatic metastases of colorectal cancer. Fourteen patients with metastatic colorectal cancer received a 14-hour intrahepatic infusion of verapamil. Six hours after the start of the infusion, a fixed dose of doxorubicin (50 mg/m2) was given, also via the hepatic artery, over a 30-minute period. Patients were followed by cardiac telemetry but were not in an intensive care setting, and no invasive monitoring was used. All patients had received prior intrahepatic chemotherapy. RESULTS: The MTD of intrahepatic verapamil on this schedule in this patient population was 1.2 mg/kg/hour. Hypotension was the dose limiting toxicity. No major objective responses were noted in this heavily pretreated patient population. A dose of 1.0 mg/kg/hour is recommended for Phase II trials. CONCLUSIONS: Based on estimations of normal hepatic artery blood flow, the estimated concentration of verapamil delivered to the hepatic tumors at 1.0 mg/kg/hour is 3.6 micrograms/ml (7.3 microM), which is comparable to concentrations at which an in vitro reversal of MDR is seen. This study demonstrates that the systemic toxicities of an MDR reversal agent can be overcome by regional drug delivery, establishing this approach as an important model system for further study of MDR modulation.

Adenocarcinoma↗
PubMed1994

The response of human dermal microvascular endothelial cells to hypoxia.

Dermal microvascular endothelial cells (DMEC) exposed to hypoxic conditions show a rapid induction of several proteins that do not increase in other cell types placed in a similar environment. These DMEC proteins differ from the well-characterized stress proteins that have been observed in a wide variety of cultured cell types. The DMEC proteins are induced rapidly, within 2-4 h, and are expressed transiently. They include a group of acidic proteins (pI approximately 5-5.2) with molecular weights in the range 100,000-120,000 and at least one glycoprotein (pI 5.1, M(r) 57,000) that is probably expressed on the cell surface. In some primary DMEC cell strains, this response is accompanied by a transient overall increase in protein synthesis. The oxygen-regulated proteins (ORP) that are induced in most other cell types under hypoxic conditions show little variation in their rate of synthesis in DMEC within the first 24 h. The response of DMEC differs from that of umbilical vein endothelial cells (UVEC) and from spindle-shaped cells derived from DMEC, that show a response to hypoxia that is similar to most other cell types. The changes seen in DMEC proteins take place in the same time scale as ischemia-reperfusion injury and may reflect the specialized change of functions of the microvasculature observed under conditions of hypoxic stress in vivo.

Cell Hypoxia↗
PubMed1994

The relations of emotionality and regulation to dispositional and situational empathy-related responding.

The purpose of the present study was to examine the prediction of adults' situational and dispositional empathy-related responses from measures of emotionality (emotional intensity and positive and negative affect) and regulation. A multimethod approach including self-reported, facial, and heart rate (HR) responses was used to assess situational vicarious emotional responding; Ss' (and sometimes friends') reports were used to assess the dispositional characteristics. In general, dispositional sympathy, personal distress, and perspective taking exhibited different, conceptually logical patterns of association with indexes of emotionality and regulation. The relations of situational measures of vicarious emotional responding to dispositional emotionality and regulation varied somewhat by type of measure and gender. Findings for facial and HR (for men) measures were primarily for the more evocative empathy-inducing stimulus. In general, the findings provided support for the role of individual differences in emotionality and regulation in empathy-related responding.

Adolescent↗
PubMed1994

Primary Sjögren's syndrome and gamma heavy chain disease.

We describe a patient who has primary Sjögren's syndrome associated with asymptomatic gamma heavy chain disease and a tubulointerstitial nephritis. Sjögren's syndrome is known to be complicated by lymphoproliferative disorders and tubulointerstitial nephritis but gamma heavy chain disease is rare (approximately 100 cases described). There is one previously reported case of gamma heavy chain disease associated with primary Sjögren's syndrome and 2 cases associated with secondary Sjögren's syndrome. Our patient and the 3 other patients described in the literature did not have evidence of an underlying lymphoproliferative disorder.

Aged↗
PubMed1994

Patient drug education. Improving the working relationship between general practitioners and pharmacists.

Qualitative research with GPs, pharmacists and consumers explored their views of patients' needs for drug information, and perceived difficulties in communication between GPs, patients and pharmacists. Strategies suggested by participants for improving patient drug education were: guidelines for giving information on medication; conventions for writing the prescription; a referral mechanism from the pharmacist to the GP; distribution of patient education materials; professional bodies to reduce ethical and organisational barriers to inter professional communication; and the development of local networks and education programs.

Drug Information Services↗