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Biomedical subjects

J Murphy

Publications and source records attributed to J Murphy.

At least 307 records · Page 17Linked to original sources
PubMed1986

Computer-assisted inventory control utilizing ABC inventory analysis and EOQ in a hospital pharmacy.

In this paper, a project whose purpose was to develop and implement a workable inventory control system is discussed. Specific objectives of the project included the avoidance of out-of-stock situations, minimization of total inventory costs, and increased efficiency of the purchasing power. The initial step in the project was the determination of both fixed and variable ordering and carrying costs. Then a micro-computer was enlisted to print an inventory listing according to the total cost based on usage of the item for the past year and the inventory was subsequently classified into A, B and C categories. The economic order quantity (EOQ) was calculated for items in class A, while B and C items were purchased on a min/max basis. Also, a weekly ordering schedule for class A items was developed based on frequency of ordering. Following this schedule, all items to be ordered on a particular week are printed by the computer. The computer maintains a perpetual inventory, and a list of B and C items below minimum quantity is printed upon request. The efficiency of the inventory control increased dramatically (50%) after project implementation. Although cost savings were found, they were not substantial compared to our previous system (less than $5,000). Out-of-stock situations for B and C items occurred almost as frequently as before project implementation. This study demonstrated that the EOQ concept in conjunction with ABC inventory analysis may be an effective inventory control system in hospital pharmacy. Increased efficiency and cost savings were achieved. Protection against unpredictable demand and avoidance of out-of-stock situations can be achieved by closer adherence to stated ordering procedures for B and C items.

Hospital Bed Capacity, 300 to 499↗
PubMed1986

Mechanisms of macrophage activation in rheumatoid arthritis: the role of gamma-interferon.

Gamma-interferon (gamma-IFN) is a potent inducer of surface expression of class II MHC molecules in vitro. Enhanced HLA-DR expression is a characteristic immuno-histological feature of rheumatoid joints. To assess the possible relevance of gamma-IFN to macrophage (M phi) activation in rheumatoid arthritis (RA) we investigated the spontaneous and mitogen-induced production of gamma-IFN by RA lymphocytes using a sensitive radioimmunoassay. Synovial fluids (SF) from a variety of inflammatory and non-inflammatory rheumatic diseases did not contain measurable amounts of IFN. RA lymphocytes from peripheral blood (PBL) and joints failed to show spontaneous gamma-IFN production. RA and control PBL were equally responsive to both mitogen stimulation and to the addition of exogenous interleukin 2 (IL-2) as control PBL. SF lymphocytes from RA patients showed a significantly decreased PHA-stimulated gamma-IFN production and this was in contrast to the SF lymphocytes from patients with other inflammatory joint diseases who showed significantly increased gamma-IFN production compared with matched PB lymphocytes. These results show that gamma-IFN production by peripheral blood and joint cells from patients with RA is normal and it remains to be established whether gamma-IFN is the factor responsible for the macrophage activation seen in the disease.

Adolescent↗
PubMed1986

Biology, primary care, family, and community. A basis for rational geriatric care.

The evolution of health-care policy for the elderly must address existing gaps in the current system, the dilemma of increasing costs, and the problems associated with hospitalization and nursing-home use. A major fault of current approaches is their focus on these latter two institutions and the resultant increasing fragmentation of care. An approach based on the five principles of primary care may be more rational. Primary, secondary, and tertiary prevention, based on an understanding of the biology of aging and imbedded in the framework of primary care, must be a major focus of such policy evolution. The principles of primary care must be combined with two based on context, family sensitivity and community orientation, to provide the basis for policy that is truly responsive to the broad needs of the elderly and their families. Policies evolving from such an orientation may begin to address not only current financial concerns, but also the ethical issues frequently encountered in caring for the elderly.

Aged↗
PubMed1986

Pros and cons of urgent exploratory sternotomy after open cardiac surgery.

To determine whether it is appropriate to perform urgent exploratory sternotomy for potentially life-threatening complications of open-heart procedures, the authors reviewed the charts of 100 such patients managed by exploratory sternotomy between December 1982 and December 1984. Group 1 comprised 32 patients who suffered cardiac arrest (8) or had acute profound hypotension (24). Group 2 included 68 patients with persistent excessive bleeding. Of group 1 patients operated because of acute profound hypotension, 50% had definite evidence of cardiac tamponade. In the remainder the cause was severe myocardial ischemia and left ventricular failure. In group 2 an identifiable correctable site of bleeding was found in 78%. Four of the 8 patients with cardiac arrest and 20 (83%) of the 24 patients with acute profound hypotension survived and left the hospital. In group 2, 58 (85%) of the 68 survived. The mean postoperative stay was higher in group 1 than group 2-20.3 +/- 3.08 days versus 14.2 +/- 1.23 days (p less than 0.1). The duration of ventilatory support in group 1 was also higher - 6.18 +/- 1.32 days versus 2.12 +/- 0.38 days. Postoperatively, sputum cultures gave positive results in 19% of the patients, all of whom had required prolonged ventilatory support. Minor sternal wound infections were present in two and major in four. There was no significant difference in morbidity of the survivors between those who underwent sternotomy in the recovery room or in the operating room.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Atypical central neurilemmoma of the mandible.

Neurilemmomas arising within the jawbones are rare. Most occur in the mandible as slowly growing enlargements that may or may not be painful; radiographically, they are large single or multiloculated radiolucencies mimicking other benign jaw lesions. The histology is characteristic, with Antoni A and B tissues and a well-defined capsule. This article reports an unencapsulated neurilemmoma of the mandible and reviews and summarizes the features of the central neurilemmomas in the literature.

Adult↗
PubMed1985

Evaluation of the use of a protocol in the antimicrobial treatment of intra-abdominal sepsis.

A protocol was established aimed at limiting the duration of antimicrobial therapy in two patient groups with peritonitis. One group had perforated or gangrenous appendicitis and the other non-appendiceal disease. The duration of treatment given to patients treated according to the protocol was compared retrospectively to that of similar patients treated without the protocol. Patients with perforated or gangrenous appendicitis required significantly less antimicrobial therapy than those with peritonitis due to non-appendiceal disease. In non-appendiceal intra-abdominal sepsis the use of the protocol was associated with a significantly reduced duration of antimicrobial therapy, compared with that observed without the protocol.

Adult↗
PubMed1985

The effect of telemetry on urban prehospital cardiac care.

A three-year, controlled trial of the use of telemetry in the prehospital care of cardiac patients was conducted in a major metropolitan area. Five of the ten paramedic squads in the city used telemetry; the other five squads did not. We studied the effect of telemetry on the following: paramedics' abilities to recognize ECGs in a written test; paramedics' abilities to identify ECG arrhythmias in the field; length of time spent by paramedics in the field; survival rates of patients with ventricular fibrillation (VF) cared for by paramedics; abilities of base station physicians to interpret telemetered ECGs; and attitudes of paramedics toward using telemetry. Telemetry was not found to affect the abilities of paramedics to read ECGs in either test or field situations. Paramedics who used telemetry spent more time in the field with their patients than did paramedics who did not use telemetry (P less than .02). We found no statistically significant effect of telemetry on survival rates of VF patients. Using matched ECGs, readings by base station physicians were found to be more accurate than were those by paramedics (P less than .01). Paramedics overwhelmingly reported that telemetry did not help them to save patients' lives, but that it did help them to treat patients with certain arrhythmias. The results suggest that telemetry may not improve either paramedics' abilities to identify arrhythmias or prehospital care for all cardiac patients. The implications for emergency services researchers are discussed.

Allied Health Personnel↗
PubMed1985

Inhibition of HCO(3) Binding to Photosystem II by Atrazine at a Low-Affinity Herbicide Binding Site.

In maize chloroplasts, the ratio of HCO(3) (-) (anion) binding sites to high-affinity atrazine binding sites is unity. In the dark, atrazine noncompetitively inhibits the binding of half of the HCO(3) (-) to the photosystem II (PSII) complexes. The inhibition of binding saturates at 5 micromolar atrazine, little inhibition is seen at 0.5 micromolar atrazine, although the high-affinity herbicide binding sites are nearly filled at this concentration. This means that HCO(3) (-) and atrazine interact noncompetitively at a specific low-affinity herbicide binding site that exists on a portion of the PSII complexes. Light abolishes the inhibitory effects of atrazine on HCO(3) (-) binding. Based on the assumption that there is one high-affinity atrazine binding site per PSII complex, we conclude that there is also only one binding site for HCO(3) (-) with a dissociation constant near 80 micromolar. The location of the HCO(3) (-) binding site, and the low-affinity atrazine binding site, is not known.

Journal Article↗
PubMed1985

Spontaneous infection or vaccination as cause of acute disseminated encephalomyelitis.

This report describes an approach to determine which of 2 possible etiologies could be responsible for a disease, in this instance acute disseminated encephalomyelitis (ADEM). Information about latency periods was obtained from eighteen reference sources in the literature. Analysis of these data indicate that it would be 9-18 times more likely for ADEM to develop 5 days after a wild virus infection (measles, for example) than 28 days after a vaccination.

Encephalomyelitis↗
PubMed1985

Philanthropy in the 80s: changing priorities and targeted giving.

John Murphy, executive director of the Flinn Foundation (the largest private grant-making foundation in Arizona, with assets of $70 million) and a charter trustee of Grantmakers in Health (a recently formed national organization of corporate and private foundation donors to the health care field), recently talked with Trustee about the changing relationship between hospitals and health care philanthropy.

Financial Management↗
PubMed1985

Two hospitals.

Explore the source record for details and available documents.

Arizona↗
PubMed1985

The incidence of wound infection after stapled or sutured bowel anastomosis and stapled or sutured skin closure in humans and guinea pigs.

In a study of antimicrobial prophylaxis in colorectal surgery, a higher incidence of wound sepsis was noted in patients who underwent stapled rather than sutured anastomoses and skin closures. There were six wound infections in 69 patients (8.7%) who underwent nonstapled anastomoses compared with seven in 28 (25%) in whom GIA or EEA staplers were used (p = 0.003). Excluding the EEA-stapled cases, the infection rate was 29% (p = 0.022). In patients who underwent sutured anastomoses, there were no wound infections in 21 whose skin was closed with sutures compared with five in 38 patients (13%) with stapled skin closure (p = 0.082). In an experimental guinea pig model dual incisions were infected with Bacteroides fragilis and Escherichia coli. One incision was then closed with staples, the other with sutures. There was a statistically significant (p = 0.016) advantage to the use of staplers. The possible significance of these results is discussed.

Animals↗