Search PubMed⌕ Search

Biomedical subjects

J Murtagh

Publications and source records attributed to J Murtagh.

At least 19 recordsLinked to original sources
PubMed2006

A qualitative investigation into the levers and barriers to weight loss in children: opinions of obese children.

BACKGROUND: The alarming increase in the worldwide prevalence of childhood obesity is now recognised as a major public health concern. Failure to isolate and understand the external and internal factors contributing to successful weight loss may well be contributing to the ineffectiveness of current treatment interventions. AIM: To identify the physical and psychological levers and barriers to weight loss experienced by obese children using qualitative techniques. METHODS: 20 participants were randomly selected from a population of clinically obese children (7-15 years old) attending a weight-loss clinic for >3 months. The children expressed their opinions in a series of interviews and focus group sessions. Data were recorded, semitranscribed and analysed using the thematic framework analysis technique and behavioural-change models. RESULTS: Children described the humiliation of social torment and exclusion as the main reasons for wanting to lose weight, although initiation of behavioural change required the active intervention of a role model. The continuation of action was deemed improbable without continual emotional support offered at an individual level. Behavioural sacrifice, delayed parental recognition and previous negative experiences of weight loss were recognised as barriers to action. Participants identified shortcomings in their own physical abilities, the extended time period required to lose weight and external restrictions beyond their control as barriers to maintaining behavioural change. DISCUSSION: This study identifies the important levers and barriers experienced by obese children in their attempt to lose weight. Dealing with these levers and barriers while acknowledging the complex interplay of social and emotional factors unique to the individual may well promote successful weight control.

Adolescent↗
PubMed2006

Radiofrequency neurotomy for lumbar pain.

(1) Chronic lumbar (lower back) pain, which affects many Canadians, imposes a large economic burden. (2) Symptoms may occur in the vertebral facet joints of 15% to 40% of patients with lower back pain. (3) Medial branch radiofrequency neurotomy is a minimally invasive outpatient procedure that reduces pain by interrupting the nerve supply to painful facet joints. (4) Four systematic reviews of this procedure offer disparate conclusions. (5) One small well designed observational study has shown positive results, but no equally rigorous randomized controlled trial has been conducted.

Canada↗
PubMed2006

Transient elastography (FibroScan) for non-invasive assessment of liver fibrosis.

(1) Liver fibrosis is associated with significant morbidity and mortality. The major cause is hepatitis C, which affects 240,000 Canadians. (2) Assessing the degree of liver fibrosis is critical to its management. Liver biopsy, an invasive procedure, is considered to be the diagnostic gold standard. (3) FibroScan is a rapid, non-invasive technology that uses low frequency vibration and ultrasound to assess the stiffness of liver tissue. (4) The diagnostic performance of FibroScan is good for identifying severe fibrosis or cirrhosis, but it is less accurate for milder presentations. (5) FibroScan is a promising technology, but large multi-centre trials comparing a range of emerging non-invasive fibrosis staging technologies are required.

Biopsy↗
PubMed2006

Photoselective vaporization for benign prostatic hyperplasia.

(1) In photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH), laser energy is used to vaporize prostatic tissue rapidly and bloodlessly. (2) Studies suggest that PVP performs well in the short term. (3) Randomized controlled trials (RCTs) and longterm follow-up are required to determine PVP's place in the management of BPH.

Aged↗
PubMed2005

Ventrogluteal area--a suitable site for intramuscular vaccination of infants and toddlers.

Buttock vaccination has lower reactogenicity and similar immunogenicity to the two other recommended paediatric vaccination sites (deltoid and anterolateral thigh). Safety concerns about buttock injection derived from injections with neurotoxic agents, like penicillin but not vaccines, have become entrenched. However, the ventrogluteal area is considered safe for intramuscular injection. This study outlines the development of the ventrogluteal area as a suitable site for intramuscular vaccination of infants and toddlers. Measurement was made in 642 children, aged 2-18 months and age-specific templates were prepared. These were used in an untrasonographic study of 57 children aged 2-18 months to determine the tissue composition of the ventrogluteal area compared with the recommended anterolateral thigh vaccination site. The ventrogluteal area was found to be clearly defined by the template and suitable for intramuscular injection. Subsequent vaccination studies with the area showed that it was:

Buttocks↗
PubMed2005

Vaccines for prevention of human papillomavirus infection.

(1) High risk types of human papillomavirus (HPV) are the causal agents of cervical cancer. The prevention of HPV infection can reduce the incidence of this cancer. (2) Five phase II clinical trials have been published, and several large phase III trials are underway. (3) Trials have shown marked reductions in HPV infection. Most studies did not evaluate the effect of the vaccines on cancer because of lengthy time spans between HPV infection and the development of cancer. (4) Injection site pain, headache, and fatigue are the most common adverse events reported. (5) Important considerations include vaccine efficacy; acceptability; integration into existing vaccine schedules; cost; role of cervical screening programs; and access, particularly for people in the developing world.

Adolescent↗
PubMed2003

Comparative reactogenicity and parental acceptability of pertussis vaccines administered into the ventrogluteal area and anterolateral thigh in children aged 2, 4, 6 and 18 months.

The importance of site of injection of combined pertussis/diphtheria/tetanus vaccines was investigated in two single blind studies. In the pilot study, in which the research instrument was trialed, 283 children aged 2-18 months received whole cell pertussis vaccine (DTPw) by the intramuscular route either into the anterolateral thigh or the ventrogluteal site. In the larger randomised study, 566 children aged 2-18 months were similarly injected with acellular pertussis vaccine (DTPa). Adverse reactions monitored after 24h showed the same lower rates for both vaccines with ventrogluteal injection compared with anterolateral thigh injection for systemic reactions (irritability (P<0.0001), perceived fever (P<0.0001), persistent crying/screaming (P<0.0001) and local reactions (bruising (P<0.0001) and redness/swelling (P<0.0001)). The Haemophilus influenzae type b vaccine (HibTITER) given concurrently in the contralateral site to the pertussis vaccine showed the same lower rates in both studies for ventrogluteal injection compared with anterolateral thigh injection for local reactions (redness/swelling both studies (P<0.0001) and bruising DTPw study (P<0.0001) and DTPa study (P<0.0004)).Parental acceptability was greater (P<0.0001) in both studies for ventrogluteal injection compared with anterolateral thigh injection.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed2002

Comparative immunogenicity of hepatitis B vaccine administered into the ventrogluteal area and anterolateral thigh in infants.

OBJECTIVE: To compare the immunological response of hepatitis B vaccine given by intramuscular injection into the anterolateral thigh and ventrogluteal site of infants up to 10 months old at initiation of vaccination. METHODS: An open, randomized study of 200 healthy infants recruited from a single practice in a small regional town in New South Wales was carried out. Infants were vaccinated with hepatitis B vaccine (Engerix-B 10 microg) using a 0 months, 1 month, 6 months regimen, with venous blood being collected from children 4-6 weeks after the last dose of vaccine for quantitative determination of hepatitis B surface antibody (anti-HBs) titre. Infants with anti-HBs titre > or = 100 m IU/mL were considered to be 'good' responders and were unlikely to acquire clinically significant hepatitis B infection. Infants with anti-HBs titre < 100 m IU/mL were considered to be 'poor' responders and were given a booster dose of Engerix-B 20 micro g; serology was repeated for anti-HBs titre 2-3 months after this injection. RESULTS: Quantitative anti-HBs titre was obtained from 177 infants: 171 4-6 weeks after the last dose of vaccine; 87 at the ventrogluteal site (46 boys, 41 girls); and 84 at the anterolateral thigh site (38 boys, 46 girls). Good antibody response (anti-HBs titre > or = 100 m IU/mL) was not significantly different for the two sites (ventrogluteal 96.6%, anterolateral thigh 93.2%), and antibody geometric mean titres (GMT) for anti-HBs were comparable for the two sites (ventrogluteal 2071.2 +/- 5.8m IU/mL, anterolateral thigh 2073.2 +/- 5.2m IU/mL). CONCLUSION: The ventrogluteal and anterolateral thigh vaccination sites in infants are immunologically comparable for hepatitis B vaccine. Presumably the variance of this study with studies of adults reflected the uniform injection of vaccine antigen into muscle tissue in infants.

Analysis of Variance↗
PubMed2001

Renal colic and recurrent urinary calculi. Management and prevention.

BACKGROUND: Urinary calculi are a relatively common problem and up to 80% of patients with calculi who are untreated will experience one or more recurrences within five years. OBJECTIVE: This paper outlines the causes of urinary calculi and presents evidence for the less conventional treatment of renal colic with NSAIDs such as intramuscular diclofenac in preference to traditional pethidine injections. The paper also deals with ways to prevent recurrence of stone formation. DISCUSSION: Effective treatment requires a clear understanding of the cause, and investigations need to be directed toward establishing this. Prevention is the cornerstone of management and requires patients to have a clear understanding of the problem. Follow up of these patients is essential.

Australia↗
PubMed2001

The patient perspective survey. Can consultations for complex health problems be enhanced?

BACKGROUND: Patients with complex health problems pose particular difficulties due to the interaction between psychosocial factors and physical disease. The aim of this study is to investigate the usefulness of a paper based instrument (the Patient Perspective Survey, or PPS) to enhance general practitioner-patient communication and patients' self reported coping skills. METHODS: A previously validated questionnaire was modified and distributed to a self selected group of 21 GPs. They recruited 77 patients with complex health problems and asked them to complete a PPS questionnaire. The patients then returned for an extended consultation to discuss the results of the questionnaire with the GP. Patients and GPs subsequently completed PPS evaluation forms. RESULTS: The PPS was useful for patients with chronic conditions with mixed physical and psychological components. It appeared to enhance the GP-patient relationship and gave patients a better understanding of their coping skills. DISCUSSION: Patients with complex health problems can use paper based questionnaires to improve the quality of communication between themselves and their GPs.

Adaptation, Psychological↗
PubMed2001

The rotation flap.

Explore the source record for details and available documents.

Basal Cell Carcinoma↗
PubMed2001

Paediatric vaccination practice in a division of general practice.

BACKGROUND: Currently the National Health and Medical Research Council (NH&MRC) recommend the use of a 23 gauge, 25 mm long needle inserted 45-60 degrees into the anterolateral thigh for paediatric vaccination. AIM: To assess the compliance of general practitioners (GPs) in a rural practice division with vaccination practice (site and needle size and gauge) prescribed for infants and toddlers by the NH&MRC. METHOD: In 1999, a questionnaire survey was sent by the divisional office to all 150 GPs in the Hunter Rural Division of General Practice. The questionnaire collected demographic data (age, gender, university of graduation, number of paediatric vaccines administered per week) and elicited responses about the site of vaccination and the size and gauge of needle to be used for children 2-18 months and 18 months and older. RESULTS: Completed questionnaires were available from 112 GPs (74.6% completion rate). There was a high level of compliance with the NH&MRC proscription of buttock vaccination with only 4.3% and 4.1% of responses to the question of vaccination site at 2-18 months and 18 months and older respectively nominating this site. The anterolateral thigh was the favoured site for vaccination in children 2-18 months old (77.5% of responses) with the deltoid being the favoured site in children 18 months and older (59.2% of responses). There was a very low level of compliance with the NH&MRC recommended standard needle (23 gauge, 25 mm long, blue hub needle) (3.5% of responses). The orange hub needle (25 gauge, 16 mm long needle) was most favoured (48.7% of responses) with additional strong support for the 25 gauge, 25 mm long needle (40.2% of responses). CONCLUSION: In the Hunter Rural Division of General Practice there was good compliance with the NH&MRC's recommendations for site of vaccination, but not needle size and gauge to be used in infants and small children. Imprecise wording of these recommendations has created apparent uncertainty about the site of vaccination of children at 18 months of age.

Adult↗
PubMed2000

The doctor's bag. What do you really need?

BACKGROUND: The doctor's bag should contain essential drugs to treat life threatening emergencies and other serious medical conditions. Practitioners may require these drugs for treating patients in their offices, on home visits and particularly in rural practice for emergency home and roadside calls. OBJECTIVE: To evaluate which medications and equipment need to be included in the doctor's bag. DISCUSSION: The selection of the most appropriate drugs provided by the Pharmaceutical Benefits Scheme (PBS) is discussed. Oral and inhaler preparations for certain specific conditions are also included. Storage and safe keeping of drugs is an important consideration.

Administration, Inhalation↗