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Biomedical subjects

D M Murphy

Publications and source records attributed to D M Murphy.

At least 91 records · Page 5Linked to original sources
PubMed1984

Doppler localisation of intrarenal vessels: an experimental study.

The use of the Doppler probe to localise the intrarenal vessels was assessed in 15 dogs. This prevented the need for renal artery clamping and radial nephrotomies were placed in silent areas on the renal surface. Functional studies were performed post-operatively at 48 h and 1 month, using creatinine clearance, microfil casts and cast angiography. There was no significant loss of function when three or six radial nephrotomies were made and the Doppler accurately localised sites for nephrotomy between the intrarenal arteries and veins which were undamaged.

Angiography↗
PubMed1984

Bacteraemia during prostatectomy and other transurethral operations: influence of timing of antibiotic administration.

The relation between the timing of prophylactic antibiotic administration and the occurrence of bacteraemia during transurethral operations was studied in 112 patients whose urine was infected before operation. Blood cultures taken during operation were positive in 15 (60%) of 25 patients who did not receive appropriate antibiotics, in 13 (21%) of 63 patients who were given appropriate antibiotics less than 24 h before operation, and in none of 24 patients in whom antibiotic "cover" was started more than 24 h before operation. In all cases the bacteraemia was transient. No patient developed septicaemia. The implications of these findings for the optimum timing of antibiotic administration to patients with preoperative bacteriuria are discussed.

Anti-Bacterial Agents↗
PubMed1983

Septicemia after transurethral prostatectomy.

Septicemia occurred in 18 of 1,604 patients subjected to transurethral resection (TUR) of the prostate. Six patients died postoperatively, 4 of septicemia. In 11 patients septicemia was provoked by TUR in the presence of urinary infection and in the absence of appropriate antibiotic cover. Septicemia was provoked by catheter removal in 2 similarly infected patients. In the remaining 5 patients the urine was sterile at operation but became infected prior to catheter removal, and this maneuver precipitated septicemia.

Humans↗
PubMed1983

Antimicrobial agents for the prevention of urinary tract infection in transurethral surgery.

Chemoprophylaxis and disinfection of the operation site for the prevention of bacteriuria after a transurethral operation were assessed in controlled, prospective studies in men with sterile urine preoperatively. The majority of the control patients (65 per cent) suffered postoperative bacteriuria compared to 38.6 per cent after perioperative disinfection with chlorhexidine and 10 per cent or less after each of 2 other regimens (intramuscular cephradine followed by oral nitrofurantoin and chlorhexidine disinfection followed by oral nitrofurantoin). The latter regimen is preferred since it avoids the use of agents with systemic action.

Aged↗
PubMed1983

Experience with brain biopsy for suspected herpes encephalitis: a review of forty consecutive cases.

From January 1973 through July 1981, 40 patients underwent brain biopsy for suspected herpes simplex encephalitis at the University of Alabama Medical Center. Biopsy was performed as a component of experimental antiviral studies to ensure correct diagnosis. A tentative diagnosis was made on clinical grounds, and the site of biopsy was chosen on the basis of localizing neurological signs, the electroencephalogram, and/or computed tomographic (CT) scan abnormalities. Patients ranged in age from 15 months to 73 years, with a median age of 19 years. Thirty patients were male, and 10 were female. Brain tissue from 17 of the 40 patients grew herpes simplex virus in tissue culture. There was one biopsy-related complication, a wound dehiscence requiring secondary closure. In no case was death attributable to the brain biopsy procedure. The outlook in patients with proven herpes encephalitis worsened directly with both an increasing interval between the onset of symptoms and the initiation of antiviral therapy and the age of the patient. The presence of a CT scan abnormality before the initiation of therapy was associated with a very poor prognosis. Three patients not included in this series were referred for brain biopsy to rule out herpes simplex encephalitis, but were found to have bacterial infections. Two had subdural empyemas and the third had a brain abscess with overlying subdural empyema. Current technique calls for biopsy of the anterior portion of the inferior temporal gyrus on the affected side.

Adolescent↗
PubMed1983

Spirometric diagnosis of upper airway obstruction.

We evaluated the results of routine spirometry in patients with well-documented upper airway obstruction (UAO) to determine if this readily available form of pulmonary function testing could reliably identify patients with this abnormality. Our results indicate that, although individual standard spirometric indexes could not identify these patients, ratios derived from these indexes provided excellent discrimination between patients with UAO and patients with a variety of lung diseases. A ratio of maximal voluntary ventilation to forced expiratory volume in 1 s of less than 25 was present in ten (66%) of 15 patients with UAO and only one (1%) of 100 comparison patients. A ratio of forced inspiratory flow between 25% and 75% of the vital capacity to forced expiratory flow between 25% and 75% of the vital capacity of less than 1 was found in 12 (80%) of 15 patients with UAO, but in only four (4%) of 100 comparison patients. All patients with UAO had one ratio abnormal. We conclude that spirometry remains a valuable procedure in the diagnosis of UAO.

Adult↗
PubMed1982

Tuberculous stricture of ureter.

Tuberculous stricture of the ureter is not uncommon in centers which treat large numbers of patients with urinary tuberculosis. Ninety-seven such strictures were seen in 92 patients over a twenty-five-year period. All patients were treated with appropriate antituberculous chemotherapy. Transurethral dilatation of the ureteral stricture was done on 80 ureters. Dilatation was successful in 51 ureters (64%) and failed to relieve the strictures in 29. Technical difficulties prevented dilatation of 17 ureters. We believe that transurethral dilatation should be attempted on all tuberculous ureteral strictures and that other procedures should be employed only if dilatation fails.

Adolescent↗
PubMed1982

Ureterovaginal fistula: a report of 12 cases and review of the literature.

Ureterovaginal fistula is an uncommon complication of pelvic operations, seen most often after Wertheim's hysterectomy. We report 12 cases of ureterovaginal fistulas seen during a 20-year period, all of which followed operations for benign gynecologic conditions. Most patients had no urinary symptoms until the sudden onset of incontinence 1 to 4 weeks postoperatively. Diagnosis was established readily by a combination of excretory urography, cystography, cystoscopy, retrograde pyeloureterography and dye studies. In our series only 1 patient was treated by primary nephrectomy, while 11 underwent ureteroneocystostomy: 2 with a Boari flap and 9 by a direct method. Reconstruction failed in 2 patients, 1 of whom required a secondary nephrectomy.

Adult↗
PubMed1982

Effect of simple anthracite pneumoconiosis on lung mechanics.

A respiratory questionnaire was administered to 20 miners with simple anthracite coal workers' pneumoconiosis (CWP) and ten normal subjects. Lung function studies which included lung mechanics and small airways disease measurements were also performed. Seventeen of the miners admitted to having symptoms of bronchitis. No significant differences were demonstrated between the two groups for vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and three seconds (FEV3), midmaximal flow rate (FEF25-75%), and peak flow rate (PEFR). A significant decrease in the maximum expiratory flow rate at 50 percent of vital capacity (V max50%) was detected; however, this was not evident when the flow rate was corrected for lung volume. Also, there were no significant differences in lung volumes, diffusing capacity (DCO) and diffusion coefficient (DCO/TLC). The mean static expired compliance (Cstate) was significantly increased in the anthracite miners, but no difference in specific compliance (Cstate/FRC) could be demonstrated. Also, no significant differences were detected in the mean values of any of the tests of small airways disease. There is little evidence of significant alterations in lung mechanics or small airway narrowing in miners with simple anthracite pneumoconiosis.

Aged↗