Search PubMed⌕ Search

Biomedical subjects

D Murphy

Publications and source records attributed to D Murphy.

At least 415 records · Page 23Linked to original sources
PubMed1968

Routine multipurpose gas chromatographic assay for urinary corticosteroids.

THE USE OF A ROUTINE ASSAY FOR URINARY STEROIDS IS DESCRIBED THAT IS THOUGHT TO SATISFY THE FOLLOWING NEEDS: the measurement of low levels of 17-hydroxycorticosteroid excretion; the assessment of adrenocortical activity during prednisolone therapy; the diagnosis of the adrenogenital syndrome and the monitoring of its treatment using any available urine specimen; the very early diagnosis of pregnancy using any available urine specimen. It may also prove of value in the assessment of progesterone secretion and metabolism during pregnancy.

17-Hydroxycorticosteroids↗
PubMedDate not supplied

Perceived accessibility versus actual physical accessibility of healthcare facilities.

This study addressed how healthcare clinics perceive themselves in regard to accessibility for persons with spinal cord injuries (SCI). All 40 of the clinics surveyed reported that they were wheelchair accessible; however, there was significant variability in the number of sites that actually met the guidelines of the Americans with Disability Act. In general, a person using a wheelchair could enter the building, the examination room, and the bathroom. The majority of sites did not have an examination table that could be lowered to wheelchair level. Most reported limited experience in working with persons with (SCI), yet they claimed to be able to assist with difficult transfers. Only one site knew about autonomic dysreflexia. Problems of accessibility appeared to be seriously compounded by the clinics' perception of how they met physical accessibility guidelines without consideration of the actual needs of persons with SCI. This study addressed the perception of accessibility as reported by clinic managers versus actual accessibility in healthcare clinics in a Midwestern metropolitan area for persons using wheelchairs.

Architectural Accessibility↗
PubMedDate not supplied

Tibial shaft fractures treated with the AO unreamed tibial nail.

BACKGROUND: The AO unreamed tibial nail (UTN) has been used for both open and closed tibial fractures. The reported results have been mixed. We evaluated its outcome in our unit. AIM: To assess the outcome of tibial shaft fractures treated with the AO UTN. METHODS: Forty-eight patients underwent intramedullary nailing between 1995 and 2000 using the AO UTN. Follow-up details were available for 45 patients. RESULTS: Forty-four fractures united (97%). Complications included one non-union (2.2%), 15 delayed unions (33%), nine had either broken or bent interlocking screws (20%), six malunions (13%) and three patients underwent fasciotomy for compartment syndrome (7%). Twenty-one patients underwent at least one additional operation to obtain union (47%). Of these, five underwent exchange nailing (11%). CONCLUSIONS: The AO UTN does have a high complication rate and, should it be used, we feel that early dynamisation or exchange nailing be considered to hasten union and prevent screw breakage.

Adolescent↗
PubMedDate not supplied

Long-term outcomes of treatment of hyperthyroidism in Ireland.

We investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.

Adolescent↗
PubMedDate not supplied

Self-castration.

BACKGROUND: Deliberate genital self-mutilation is rare. Successful self-castration has been reported in a small number of individuals. METHOD: This study reports one such case of self-castration in a transsexual who was dissatisfied with waiting times for sex reassignment surgery (SRS). RESULT AND CONCLUSION: The apparent triggering factor in this case appears to be depression related to the lengthy waiting times for SRS. As neither psychotherapy nor hormonal manipulation is successful, consideration should be given to improving the resources for patients with genuine gender dysmorphism.

Adult↗
PubMedDate not supplied

The utility of a bone scan in the diagnosis of clinical scaphoid fracture.

The incidence of true scaphoid fracture and the value of radionuclide scan was evaluated in a 1-year retrospective review of 54 emergency department patients with a preliminary diagnosis of clinical scaphoid fracture (snuff box tenderness and negative initial X-ray study). All emergency department charts of patients with a discharge diagnosis of clinical scaphoid fracture were reviewed to determine the number ultimately found to have a true scaphoid fracture and to ascertain how the diagnosis was actually achieved. All patients were managed by immobilization in a thumb spica cast for a period of 10-14 d, with repeat clinical assessment and radiographs at that time. The diagnosis of true scaphoid fracture was confirmed radiographically at the time of reassessment or, in the case of persistent tenderness and negative repeat radiographs, by the use of a technetium bone scan. In our study group, only 8 of 54 patients (14.8%) were found to have a final diagnosis of true scaphoid fracture. In 75% (6/8) of these patients, the diagnosis was made by technetium bone scans, as the radiographs remained negative at the time of reassessment. In addition, a bone scan revealed the presence of two previously unsuspected fractures (one distal radius fracture and one triquetral fracture) in two patients with continued clinical tenderness. This study confirms the previously reported low incidence of scaphoid fractures in patients with a diagnosis of clinical scaphoid fracture. It also demonstrates the importance of technetium bone scan as a diagnostic tool of increased sensitivity, as compared to traditional radiographs, in detecting the presence of scaphoid fractures and in detecting other clinically unsuspected fractures in this group of patients.

Adolescent↗