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Biomedical subjects

K J Murphy

Publications and source records attributed to K J Murphy.

At least 91 records · Page 5Linked to original sources
PubMed1988

Maternal mortality in British Columbia in 1971-86.

We reviewed the 56 maternal deaths in British Columbia in 1971-78 and 1979-86 identified through the provincial Ministry of Health and compared the findings with data for the two preceding 8-year periods. The maternal death rate, defined as the number of deaths directly or indirectly related to pregnancy or delivery per 100,000 live births, decreased from 42 in 1955-62 to 5 in 1979-86. In the same interval the number of direct obstetric deaths decreased from 100 to 10 and the number of indirect deaths from 29 to 8. The number of deaths due to abortion decreased from 32 to 1. There was no change in the number of deaths among North American Indians. There was also no change in the number of deaths due to hypertension, most of which were avoidable; these findings have stimulated intensive teaching efforts to increase recognition and improve management of the problem. Review of maternal deaths can help identify deficiencies in the quality of care and can direct measures aimed at further reducing the maternal death rate.

British Columbia↗
PubMed1987

Pelvic exenteration.

Exenteration, or complete excision of the pelvic viscera, is an ultra-radical surgical procedure intended for curative treatment of the patient with advanced pelvic malignancy--primary or recurrent. At the time of introduction of this procedure, enthusiasm for its use was marred by the high incidence of serious surgical morbidity and mortality, which approached the five-year survival rate. With more careful physiological and psychological selection of patients, concentration of this kind of procedure in centres familiar with its use, improved urinary conduit techniques and careful attention to covering the pelvic floor with omentum and/or synthetic materials, the morbidity and mortality rate has been significantly reduced thus making exenteration a more acceptable treatment option to a wider spectrum of patients. More sophisticated haemodynamic monitoring, both intra- and postoperatively, intravenous hyperalimentation, prophylactic antibiotics and low-dose heparin are undoubtedly important adjuncts to the improvements in surgical technique and judgment. Psychosexual 'rehabilitation' in the broadest sense must be an integral part of patient care for those undergoing exenteration and in most instances necessitates involvement of the patient's partner. Exenteration has only a very limited role in palliation and all attempts should be made to avoid this procedure when cure is clearly not a possibility.

Female↗
PubMed1987

Predictive value of CA 125 for ovarian carcinoma in patients presenting with pelvic masses.

Between November 1984 and May 1986, 56 patients presenting with a pelvic mass to the Gynecologic Oncology Service of McMaster University and the Hamilton Regional Oncology Center underwent laparotomy for possible ovarian cancer. All patients had blood drawn for CA 125 three days before operation. Levels above 35 U/mL were considered positive; CA 125 had a positive predictive value of 60%. False positives occurred in patients with nongynecologic malignancies and with benign gynecologic conditions. On the other hand, CA 125 had a negative predictive value of 100%, suggesting that this test may be useful in identifying those patients with pelvic masses at higher risk for malignancy, who may require transfer for surgery at a tertiary care center.

Adolescent↗
PubMed1985

Cervical cancer screening. Who needs a Pap test? How often?

Cancer of the cervix and its preinvasive forms are ideally suited to control by means of cytologic screening programs. Ample evidence shows that widespread use of such programs markedly reduces both the incidence and mortality of clinically invasive carcinoma of the cervix. Thus, physicians should encourage female patients to participate in a cervical cytologic screening program. In addition, family practitioners and internists, when seeing female patients for nongynecologic problems, should not miss the opportunity to obtain a Pap smear whenever appropriate.

Adolescent↗
PubMed1983

Primary invasive carcinoma of the vagina.

Data are presented from 97 patients treated for invasive primary epithelial carcinoma of the vagina between 1950 and 1980. The disease is primarily one of the elderly as 63% were found to be older than 60 years of age. Eleven of the 97 patients either refused or were unable to complete treatment because of poor medical condition or advanced stage of disease. Combined external and intracavitary radiation was the most common form of treatment. The overall two-year survival rate was 47%, or 59% when corrected for deaths due to other causes. Patients with stages I and II disease had corrected survival rates of 75% and 68%, respectively. Our results indicate that stage of disease is the most significant prognostic factor. Optimal results will be obtained with early diagnosis and individualized treatment.

Adenocarcinoma↗
PubMed1982

Delayed rupture of the left ventricle after mitral valve replacement: report of two survivors.

Two patients, a man and a woman, with rupture of the left ventricular wall after mitral valve replacement are described. The postoperative course of the woman was complicated by respiratory and renal insufficiency from which she recovered; however, she developed fungal endocarditis and died. Both patients are reported as survivors of "delayed" rupture to show that such patients are occasionally salvageable, and to suggest that bypass grafting to the circumflex system distal to the site of injury will benefit immediate and long-term survival.

Journal Article↗
PubMed1981

Career choices of young graduates: A need for more GP training.

A survey of fourth year (first clinical year) medical students at the University of Western Australia in 1977 showed that 48% of them wanted to be general practitioners. When interviewed again as interns in 1980, the same group showed a 61% preference for general practice. In 1977, 57% of interns and junior RMOs had wished for a career in general practice. During the last five years the proportion of graduates entering the Family Medicine programme has reached as high as 68% in the third year after graduation. In the 25 years since the first medical graduates qualified in Perth the percentage entering general practice has climbed from 15 to 80; the percentage entering the specialties has declined from 85 to 20. This survey is a valuable tool in planning postgraduate training programmes.

Australia↗
PubMed1976

Bilateral renal calculi in patients receiving methyldopa.

Two patients with bilateral kidney stones had been taking methyldopa for 8 years and 10 years respectively. Their urine contained a brown pigment which darkened and precipitated on standing. This substance was identified as methlydopa. No other cause for stone formation was found, so it is suggested that the methyldopa, because of its poor solubility, provided a nidus for stone formation.

Adult↗
PubMed1975

Liver dysfunction and tea eating.

A case report is presented of a patient who had liver fibrosis, splenomegaly and ascites, associated with the habit of nibbling tea leaves. The splenomegaly and the ascites remitted when she ceased eating tea, but liver fibrosis is still present 15 years later. No other cause for the liver disorder was found.

Female↗
PubMed1975

Metastatic basal cell carcinoma with squamous appearances in the naevoid basal cell carcinoma syndrome.

A patient with the naevoid basal cell carcinoma syndrome developed a secondary carcinomatous deposit in the pelvis. Persisting tumour in the skull and the secondary deposit in the pelvis contained areas of squamous differentiation. This confirms that the appearances of baso-squamous (or transitional or metatypical-cell) carcinoma can develop from typical basal cell carcinoma which had not been subjected to radiotherapy or to more than one surgical excision.

Bone Cysts↗
PubMed1975

Subcutaneous bone formation in the naevoid basal-cell carcinoma syndrome: normal urinary cyclic AMP response to parathyroid hormone infusion.

A patient with the naevoid basal-cell carcinoma syndrome had subcutaneous bone formation in the areas other than those occupied by the carcinomata. The patient did not show a significant phosphaturic response after parathyroid hormone infusion, but this extract produced a normal excretion of cyclic AMP. This proves that the subcutaneous bone does not signify an affinity to pseudo-hypoparathyroidism.

Adult↗