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Biomedical subjects

J Murphy

Publications and source records attributed to J Murphy.

At least 325 records · Page 18Linked to original sources
PubMed1984

Papillomas of the teats and udder of cattle and their causal viruses.

An abattoir survey was carried out on 1657 cattle to determine the incidence and parameters of teat and udder papillomas and their causal viruses. Recent research has characterised six different bovine papillomaviruses of which three have been found to be particularly associated with teat tumours. Of the population studied 37.3 per cent had teat warts and 86.2 per cent of these had multiple infections; 28.4 per cent had papillomas attributed to bovine papillomavirus 1, 88.5 per cent to bovine papillomavirus 5 and 92.3 per cent to bovine papillomavirus 6. There was no predilection site between teats. Herefords and their crosses dominated the breed incidence and showed the highest numbers of warts but it was not possible to make a realistic comparison with other breeds. Dairy cattle were poorly represented. Bovine papillomavirus 4 was never found and from this it was concluded that there is no association between alimentary and teat papillomas. The implications of these findings in terms of prophylaxis and control are discussed.

Animals↗
PubMed1984

Conservative management of pregnancy in diabetic women.

In 1979 the obstetric management of pregnancies in diabetic women in Cardiff was changed from elective delivery at 37-38 weeks to delivery at term. This change was facilitated by home monitoring of blood glucose concentrations and improved techniques for assessing fetal wellbeing. There were 35 pregnancies in insulin dependent diabetics in 1972-8 and 45 in 1979-82. The quality of diabetic control during pregnancy was equally good in both periods. The average gestation at final admission to hospital increased from 30 to 37 weeks. Amniocentesis to assess fetal pulmonary maturity was necessary in 26 patients (74%) in the first period of study and in only four (9%) in the second. Gestational age at delivery increased from 37.4 to 39.4 weeks after the change in policy. The proportion of mothers entering spontaneous term labour and delivering vaginally increased from 14.3% to 37.8%. The mean birth weight of live born, singleton infants increased from 3090 g to 3650 g, the feeding pattern improved, and respiratory problems were less common. Morbidity was reduced and perinatal mortality was not increased with conservative management of pregnancy in diabetic women.

Apgar Score↗
PubMed1984

Reliability of blood glucose monitoring by patients with diabetes mellitus.

Nineteen patients with insulin-dependent diabetes mellitus were evaluated for overall reliability of self-generated data from capillary blood glucose monitoring. For a period of 12 to 14 days, standard reflectance meters used by these subjects were replaced by meters internally modified with memory chips capable of storing all glucose readings by date and time. The subjects were not aware of this modification and were instructed to continue to test capillary blood glucose as they had been and to continue their practice of recording the meter readings in a logbook. To assess reliability of patient-generated data as recorded in the logbook, the addition, deletion, and alteration of test results were determined. A significantly lower (p less than 0.0001) mean blood glucose level was reported in the logbooks than recorded in the memory reflectance meters. Differences in logbooks and memory reflectance meters ranged from 0 to 109 mg/dl. Three fourths of the subjects had reported lower than actual mean blood glucose values. Under-reporting, or omission of memory reflectance meter readings, averaged 10 percent, whereas over-reporting or addition of phantom values averaged 40 percent. An average of 26 percent of the logbook entries were not identical to memory reflectance meter values determined at the corresponding time. Two thirds of the subjects had reported values in such a manner as to obscure hyper- and hypoglycemia, leading to misleading clinical impressions about the fluctuation in metabolic control. Previous glycemic control, patterns of logbook recording, or visits to the clinic were not found to be predictive of the reliability of patient self-monitoring regimens.

Adolescent↗
PubMed1984

Comparison of prophylactic antibiotic regimens in patients undergoing vascular surgery.

An unacceptably high infection rate in patients undergoing vascular surgery prompted two studies on these patients. The first study confirmed the problem and described antibiotic usage which was not standardized. A second double blind randomized study compared antibiotic usage in two groups of patients, receiving vein grafts or synthetic grafts. Patients receiving vein grafts were randomized either to placebo or cefazolin 2 g 1 h pre-operatively and every 6 h for 48 h. Patients receiving synthetic grafts were randomized either to cefazolin 1 g or to cefazolin 2 g 1 h pre-operatively and every 6 h for 48 h. Four of 50 vein graft patients developed a purulent discharge. Two of these infected patients received placebo and two received the cefazolin 2 g protocol. Of 90 patients receiving a synthetic graft, four became infected. Three patients were randomized to the cefazolin 1 g protocol and one to the cefazolin 2 g protocol. No statistically significant differences were observed.

Adult↗
PubMed1984

The haematopoietic response to burning: studies in an animal model.

Changes in haematopoiesis which occur in humans after burning injury may have important effects on morbidity and mortality. Because of the heterogeneity of burn patients we studied the regulation of blood cell formation which occurs in an animal using an established mouse model. Mice received a 20 per cent third degree scald injury on the back. Serial studies of a variety of haematopoietic parameters including stem cell, bone marrow and peripheral blood findings were done post burn. Although anaemia occurred frequently after injury red blood cell survival studies and examination of the stool for occult blood showed that neither haemolysis nor blood loss were primary causes of the anaemia. Bone marrow erythroid stem cells fell markedly post burn and this was associated with the development of a substance in serum capable of inhibiting red cell colony formation but not white cell colony formation of normal marrow cells. Reticulocytosis occurred but was mild and the anaemia was primarily of the aregenerative type. Partial compensation for the depressed marrow erythropoiesis occurred in the spleen with an increase in erythroid colony-forming cells and erythroblasts. Marked granulocytosis occurred in the peripheral blood and bone marrow. There was an increase in splenic granulocytic stem cells post burn. Megakaryocytosis was striking in the bone marrow and spleen and there was an increase in peripheral blood platelet count. Evidence of immune stimulation included an increase in the size of the spleen and an increase in peripheral blood and splenic lymphocytes. Correlations of many of these findings suggested that the events were not occurring at random but that the changes in haematopoiesis were linked together. We speculate that the anaemia was the result of the increase in granulopoietic and thrombopoietic effort seen post burn.

Anemia↗
PubMed1984

Combination chemotherapy with BCNU, vincristine, mitomycin-C and prednisone in refractory breast carcinoma. A pilot study.

21 patients with metastatic breast cancer, refractory to conventional agents, were treated with a combination of BCNU, vincristine, mitomycin-C and prednisone given every 4 weeks. Only three of the nineteen (15.8%) evaluable patients were observed to have a partial remission, whereas four experienced stabilization of tumor. The sites which responded included skin lesions in two patients and a pleural effusion in 1 patient. This combination resulted in moderate to severe thrombocytopenia in five patients, but was otherwise well tolerated. This pilot study therefore suggests that these four agents in the schedule and doses given do not appear to be superior to any of these agents used singly for advanced, refractory breast cancer.

Adenocarcinoma↗
PubMed1984

Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study.

A number of studies have shown short-term hemodynamic and symptomatic improvement in patients with congestive heart failure treated with angiotensin converting-enzyme inhibitors. The long-term efficacy of the oral long-acting converting-enzyme inhibitor enalapril remains to be established in controlled studies. We evaluated this drug in 36 patients with New York Heart Association functional class II to III heart failure who were clinically stable on digoxin and diuretic therapy. After baseline assessment of symptoms, exercise capacity, and results of echocardiographic examination and right heart catheterization, patients were randomly assigned to treatment with 5 mg enalapril twice daily (n = 18) or placebo (n = 18) in a double-blind fashion. The two groups had similar clinical, echocardiographic, and hemodynamic characteristics before treatment. After 3 months of treatment, the enalapril group showed a significant improvement as judged by subjective patient impression, functional class, and exercise duration (9.3 +/- 5.7 vs 17.6 +/- 5.6 min; p less than .001). Diuretic dosage was reduced in six patients and increased in one patient, one patient had died and another had been withdrawn from the study. In the placebo group there was no significant change with respect to patient impression, functional class, or exercise duration; diuretic dosage was increased in seven patients and four patients had died. Echocardiographic left ventricular dimensions were significantly reduced and left ventricular shortening fraction significantly increased in the enalapril group but were unchanged in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Factors involved in artificial caries induction by oral streptococci in extracted human teeth.

This study assesses the abilities of S. mutans GS5 and BHT and S. sanguis G9B to produce subsurface lesions on smooth surfaces of extracted human teeth and examines factors which might be responsible for any differences encountered. Teeth were incubated in Brain Heart Infusion broth containing 2% sucrose and a pure culture of the organism to be tested, the media being changed each day for eight days. Surface and media pH's were measured. The mineral content of both the surface enamel and the subsurface lesions was determined by contact microradiography. Significantly deeper and more demineralized lesions were produced by GS5 than by either BHT or G9B. GS5 also produced a lower surface and medium pH and a more dense coating on the teeth. Similar results were obtained with GS5 and G9B when the BHI broth was replaced with FMC synthetic media. It is concluded that the system described is suitable for studying cariogenic potential and will be useful in measuring the anticariogenicity of suspected therapeutic agents.

Culture Media↗
PubMed1984

Short- and long-term risks after exposure to diagnostic ultrasound in utero.

A total of 425 children exposed to diagnostic ultrasound at three Denver hospitals during the period May, 1968, through August, 1972, and 381 matched control children were studied for adverse effects at birth and again at a special examination between seven and 12 years of age. Apgar scores, gestational age, head circumference, birth weight, length, congenital abnormalities, neonatal infection, and congenital infection were measured at birth. At seven to 12 years of age, measurements included conductive and nerve measurements of hearing, visual acuity and color vision, cognitive function, behavior, and a complete and detailed neurologic examination. No biologically significant differences between exposed and unexposed children were found.

Child↗
PubMed1983

The role of a grief support team following stillbirth.

The loss of a baby through stillbirth is a tragic, devastating experience for a woman and her family. Although well intentioned, physicians and nurses are often ill-prepared to provide essential emotional support. We would like to describe our experience with a multidisciplinary perinatal grief support team. In our hospital, such a team has, in part, corrected deficits in the care of these families and has functioned as an invaluable source of education and support for health care providers.

Fathers↗
PubMed1983

How sensitive is the Papanicolaou smear in the diagnosis of infections with Chlamydia trachomatis?

Fifty-three patients who presented to the sexually transmitted disease clinic at Boston City Hospital had simultaneous cervicovaginal Papanicolaou smears and cultures for Chlamydia trachomatis taken prior to the initiation of antibiotic therapy. Eleven of the chlamydial cultures had positive results. None of the Papanicolaou smears satisfied the morphologic criteria for the diagnosis of chlamydial infection. This suggests that the Papanicolaou smear is an insensitive technic for the diagnosis of chlamydial infection of the cervix.

Chlamydia Infections↗
PubMed1983

Clinical algorithms for prehospital cardiac care.

Algorithms for the prehospital management of cardiac arrhythmias were developed and their use by and value to paramedics evaluated. The algorithms, in booklet form, were distributed to half of the Philadelphia paramedic platoons; paramedics in the other platoons followed a narrative protocol that reflected identical contents. An arrhythmia recognition test given 18 months after the algorithm booklets were introduced showed that paramedics who received the booklets scored significantly higher in identifying life-threatening arrhythmias (p = 0.029) than did their counterparts without the booklets. Survival data for 459 patients in ventricular fibrillation treated by paramedics were collected 1 year before and 7 months after the introduction of the algorithm booklets. The paramedics using the algorithms improved their survival rate from 11.25 to 15.1 per cent, while the survival rate for patients treated by paramedics using the narrative protocols decreased from 12.4 to 7.7 per cent. The likelihood of obtaining a ratio of survival odds of this magnitude when there is no true difference is 0.092. Time-to-death was significantly different (p = 0.04) for the two groups of patients. Thus, the use of algorithm booklets as an inexpensive educational aid for paramedics is recommended.

Allied Health Personnel↗
PubMed1983

Comparison of the B vitamin composition of milk from mothers of preterm and term babies.

Samples of milk were taken at intervals during lactation from 35 mothers of term and 26 mothers of preterm infants and assayed for 8 B complex vitamins. Both term and preterm milks varied widely in vitamin content between mothers. Mean concentrations of thiamin, vitamin B6, nicotinic acid, pantothenic acid, biotin, and folic acid increased progressively over several weeks after parturition but vitamin B12 concentrations declined generally and riboflavin values showed little change. Preterm milk was not richer in vitamins than term milk of the corresponding stage of lactation and it appeared that intake of B vitamins differed widely among preterm infants given their own mothers' milk. These infants may have meagre body reserves and an increased need for vitamins, and breast milk whether from their own mother or from the milk bank may not meet their needs. There is a strong case for supplementing breast milk given to preterm babies with the B complex vitamins.

Colostrum↗
PubMed1983

Increased bone metabolism in rheumatoid arthritis as measured by the whole-body retention of 99Tcm methylene diphosphonate.

Bone metabolism in 21 patients with rheumatoid disease was investigated by measurement of the 24-hour whole body retention (WBR) of 99Tcm methylene diphosphonate (MDP) in parallel with clinical, radiological, and biochemical measurements (urinary excretion of hydroxyproline) of disease activity. Corticosteroid-treated patients of those with other forms of metabolic bone disease were excluded from the study. WBR was increased in the rheumatoid patients as compared with 21 age- and sex-matched controls (p less than 0.05), and there was a significant correlation in the rheumatoid group between WBR and urinary excretion of hydroxyproline (p less than 0.01) and between urinary excretion of hydroxyproline and an articular index (p less than 0.05) and global index (p less than 0.01) of disease activity. The increased WBR of the rheumatoid patients was not explicable by factors such as immobilisation, and the results are interpreted as reflecting an overall increase in bone metabolism which may occur in rheumatoid arthritis as part of the disease process.

Adult↗
PubMed1983

Antenatal glucocorticoid administration: effects on oxygen-hemoglobin affinity and hemoglobin levels in experimental hyaline membrane disease.

Dexamethasone or saline was administered in a randomized fashion to pregnant Macaca nemestrina for 3 days prior to preterm abdominal delivery. The steroid-treated animals demonstrated a greater hemoglobin concentration and a greater mean corpuscular hemoglobin concentration in cord blood. There was no difference between the groups in mean P50 in cord blood. The infants of steroid-treated animals had less frequent and less severe hyaline membrane disease. We conclude that antenatal steroid administration ameliorates postnatal respiratory distress without inducing changes in P50 and with only a small change induced in cord blood hemoglobin.

Animals↗