The role of macrophage- and dendritic cell-derived IL12 in Th1 phenotype development.
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Animals↗
Biomedical subjects
K Murphy
Publications and source records attributed to K Murphy.
Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments.
Attention deficit hyperactivity disorder (ADHD) is increasingly recognized as a legitimate adult diagnostic category. Yet the nature of and comorbidities and adaptive impairments associated with adult ADHD have received little scientific investigation. The present study, therefore, compared 172 adults diagnosed with ADHD with 30 adults referred to the same adult ADHD clinic who were not so diagnosed. The ADHD group showed a significantly greater prevalence of oppositional, conduct, and substance abuse disorders, and greater illegal substance use than control adults. Moreover, adults with ADHD displayed greater self-reported psychological maladjustment, more driving risks (speeding violations), and more frequent changes in employment. Significantly more ADHD adults had experienced a suspension of their driver license, had performed poorly, quit, or been fired from their job, and had a history of poorer educational performance and more frequent school disciplinary actions against them than adults without ADHD. Multiple marriages were more likely in the ADHD group as well. Contrary to previous studies, anxiety and mood disorders were not found to be more prevalent in the ADHD than in the control group. Results suggest that ADHD in adults is associated with relatively specific risks for disruptive behavior disorders, school and job performance problems, and driving risks.
Achievement↗
Language production and comprehension in an adult with ACoA syndrome.
This study explored the prediction that cases with anterior communicating artery (ACoA) syndrome will exhibit deficits in higher-level language production and comprehension. A 65-year-old adult male with a history of ACoA syndrome was tested on higher-level linguistic tasks. The patient's performance on discourse comprehension. discourse production, and linguistic ambiguity comprehension tasks was impaired.
Aphasia↗
Uterine artery embolization: the role in obstetrics and gynecology.
OBJECTIVE: Evaluation of the studies for the use of uterine artery embolization in various conditions in both obstetrics and gynecology. DESIGN: Literature review. RESULTS: Uterine artery embolization was successful in controlling postpartum hemorrhage in 94.9% of the cases. It was effective in controlling the bleeding in 96% of cases with uterine arteriovenous malformations and in 100% of the cases with abdominal and cervical pregnancies. Recently, it has been introduced as a line of treatment for uterine fibroids. It controlled bleeding in 82-92% of cases, and lead to 20-64% reduction in size of fibroids. CONCLUSIONS: Uterine artery embolization is of significant value in treating certain hemorrhagic conditions in obstetrics and gynecology including postpartum hemorrhage, ectopic pregnancy, and arteriovenous malformations. Its use in treatment of uterine fibroids is new and needs more collaborative studies by gynecologists and intervention radiologists to evaluate issues related to necrosis of the tumor, sepsis, and the long-term effect on size and recurrence rate.
Arteries↗
Experimental autoimmune gastritis: mouse models of human organ-specific autoimmune disease.
Experimental autoimmune gastritis (EAG) is an excellent model of human autoimmune gastritis, the underlying cause of pernicious anaemia. Murine autoimmune gastritis replicates human gastritis in being characterized by a chronic inflammatory mononuclear cell infiltrate in the gastric mucosa, destruction of parietal and zymogenic cells, and autoantibodies to the alpha-and beta-subunits of the gastric H+/K+ ATPase. Disease is induced strain specifically in gastritis-susceptible BALB/c mice by methods with a greater variety than those for most other experimental autoimmune diseases. The disease is induced in the regional gastric lymph node in which pathogenic CD4+ T cells are recruited. The model provides an excellent illustration of regulation by CD4+CD25+T cells, and, indeed, the removal of such regulatory cells, e.g., by neonatal thymectomy, is thought to be a major mechanism by which disease can develop. The culprit T helper type 1 (Th1) CD4+ T cells recognize either the alpha- or beta-subunits of the gastric H+/K+ ATPase, but the beta-subunit appears to be the initiating autoantigen, while the alpha-subunit may have a role in perpetuating disease. Since no specific environmental modifiers are identifiable, the origins of the disease are intrinsic; this is illustrated by the capacity of a cytokine (GM-CSF)-dependent inflammatory stimulus in the stomach to initiate EAG, according to a transgenic model in which thymectomy is dispensible. Thus, EAG is an exquisite model for a reductionist analysis of the multiple elements that in combination induce autoimmunity in humans.
Anemia, Pernicious↗
Planting mangoes for the future in Tibet.
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Agriculture↗
The Diabetes Center home care nurse: an integral part of the diabetes team.
The changing face of health care and the widely variable needs of families have forced practitioners to change the traditional education approaches for pediatric patients with diabetes. Initial management and education for pediatric patients with newly diagnosed type 1 diabetes is now moving to the outpatient setting. The Diabetes Center for Children (DCC) at The Children's Hospital of Philadelphia has created an innovative program using a diabetes home care nurse as its coordinator. The role of the home care nurse is to manage and coordinate all of the diabetes education done by the field nurses in the Children's Hospital home care department. This program has enabled the DCC to manage and educate families during an initial 3-day inpatient stay, providing a safe transition to home. With follow-up by trained home care nurses, the families receive advanced education and support in their homes. The evolution of this program over the last several years has shown that patient care can be moved safely from a complete inpatient format to one that includes a large outpatient component.
Child↗
AIDS focus. Nutritional support: a practical approach.
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Acquired Immunodeficiency Syndrome↗
Customer needs, expectations, and satisfaction with clinical neurophysiology services in Ireland: a case for tele-neurophysiology development.
Although equitable access to services should be based on need, geographical location of patients and their clinicians can give rise to inequalities in healthcare delivery. Development of tele-medicine services can improve equity of access. The specialty of Clinical Neurophysiology (CN), currently under-developed in Ireland provides an example of such potential. This study aimed to determine the needs, expectations, and satisfaction of CN customers, namely patients and referring clinicians. The goal was to examine geographical impediments to access that might be addressed by the introduction of tele-neurophysiology. Two customer surveys were conducted: CN referring clinicians and CN patients. Thirty-one North Western Health Board (NWHB) consultant clinicians responded to a postal survey. Distance and delays caused by long waiting lists were felt to deter or make CN referral irrelevant. Ninety-seven percent believed the lack of a local service negatively impacts on patient management and 93% would welcome the introduction of a tele-neurophysiology service. The geographical location of patient's residence and/or the location of the referring clinician's practice influenced waiting lists for CN. Fifty-eight (105/182) percent of patients living in a region with a CN service compared to 39% (50/128) of those living in a region with no service received an appointment within one month. In addition to the current insufficient CN service capacity in Ireland, these surveys highlighted geographical inequities. Tele-neurophysiology has the potential to speed-up diagnosis, result in more patients being appropriately investigated and be fairer to patients.
Consumer Behavior↗
Reflective practice (continuing education credit).
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Education, Nursing, Continuing↗
Labor and delivery in nulliparous women who present with an unengaged fetal head.
OBJECTIVE: We assessed the relation of fetal station in early labor to subsequent patterns of dilation and descent and to the probability of cesarean delivery. STUDY DESIGN: We evaluated 132 nulliparous women who were in spontaneous latent-phase labor with singleton, vertex-presenting, term fetuses. For each participant, pertinent variables relating to labor characteristics and mode of delivery and newborn characteristics were recorded. Labor curves were drawn and analyzed. RESULTS: Of the 132 participants, 29 (22%) presented with an engaged fetal head, and 103 (78%) presented with an unengaged fetal head. In the unengaged group, 15 (11%) presented with a floating fetal head (-3 station or above), and 88 (67%) presented with a dipping fetal head (-2 or -1 station). A floating head in latent-phase labor conferred a longer second stage (p = 0.02), a trend to more active-phase labor disorders (p = 0.06), and a greater risk of cesarean delivery. Overall, 12 patients (9%) underwent primary cesarean section: 2 (6.9%) from the engaged group, 6 (6.8%) from the dipping group, and 4 (27%) from the floating group (p = 0.042). CONCLUSION: Most nulliparous women in this study presented in labor with an unengaged fetal head. Those with a floating fetal head demonstrated higher rates of cesarean section than those with dipping or engaged heads in early labor.
Adolescent↗