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Biomedical subjects

K Murphy

Publications and source records attributed to K Murphy.

At least 163 records · Page 9Linked to original sources
PubMed1994

Use of palliative end points to evaluate the effects of mitoxantrone and low-dose prednisone in patients with hormonally resistant prostate cancer.

PURPOSE: This phase II study was designed to assess the effects of mitoxantrone with prednisone in patients with metastatic prostate cancer who had progressed on hormonal therapy. The methods of assessment included quality-of-life analyses, pain indices, analgesic scores, and the National Prostatic Cancer Project (NPCP) criteria. PATIENTS AND METHODS: Patients received mitoxantrone 12 mg/m2 intravenously every 3 weeks plus prednisone 10 mg orally daily. All had a castrate serum testosterone and Eastern Cooperation Oncology Group (ECOG) performance status < or = 3, and had not received prior chemotherapy. Every 3 weeks, analgesic intake was scored, and a present pain intensity (PPI) record and visual analog scale (VAS) describing pain were collected. Every 6 weeks, the European Organization for Research and Treatment of Cancer (EORTC) core quality-of-life questionnaire plus a prostate-specific module were completed. A palliative response was defined as a decrease in analgesic score by > or = 50% or a decrease in PPI by > or = two integers without any increase in the other. RESULTS: Twenty-seven patients were entered onto the study. Nine of 25 (36%) assessable patients achieved a palliative response maintained for > or = two cycles (range, two to eight or more). Improvements in mean PPI and VAS pain scores after each cycle of therapy (P < .05) were seen. Quality-of-life analysis showed improvements in social and emotional functioning, and in pain and anorexia. Using NPCP criteria, one patient achieved a partial response (PR) and 12 had stable disease; one of seven patients with measurable disease had a PR. No serious nonhematologic toxicity was experienced, and there were no episodes of febrile neutropenia. CONCLUSION: Mitoxantrone with low-dose prednisone is a well-tolerated treatment regimen that has some beneficial effects on disease-related symptoms and quality of life for patients with advanced prostate cancer.

Aged↗
PubMed1994

What about language?

Explore the source record for details and available documents.

Educational Measurement↗
PubMed1994

Informed consent: an evaluation of patients' understanding and opinion (with respect to the operation of transurethral resection of prostate).

The ability of patients to understand and recall information given prior to obtaining written consent was assessed in 55 patients who were due to undergo the operation of transurethral resection of prostate. The patients were also asked their opinion on informed consent. Most patients knew the position of the prostate and the purpose of the operation. Some aspects of the postoperative management and complications were less well remembered. In particular, 18% of the patients could not remember the possibility of retrograde ejaculation despite efforts to emphasize this. Of the patients who returned their questionnaires, 41% did not mind what happened to them provided they were made better; 54% trusted their doctor to do the right thing and did not think detailed explanation was important; 62% felt that consent forms are to protect the doctor's right; still most patients felt that consent forms were necessary. Sub-groups comparison showed no relationship between patients' attitude and their ability to recall information.

Aged↗
PubMed1993

T-cell subsets in autoimmunity.

Although differential cytokine production has been best characterized in CD4+ T cells, it is becoming clear that CD8+ T cells may also be heterogeneous at the level of cytokine production, and that this determines whether they exhibit inflammatory- or suppressor-type properties. Compelling evidence has accumulated in the past few years that cytokines such as interleukin-4, interleukin-10 and transforming growth factor-beta may serve as regulators of cell-mediated immunopathologies by inhibiting the development or effector function of inflammatory T cells that produce cytokines such as interferon-gamma or lymphotoxin.

Animals↗
PubMed1993

Factor analyses of pooled hand questionnaire data are of questionable value.

A number of researches have used factor analyses and principal components analyses on handedness questionnaire data in order to learn something about handedness. However, these researchers have analyzed pooled data from righthanders and lefthanders. The practice of pooling groups that are known in advance to be heterogeneous is highly questionable because it is not possible to disentangle the sources of variance that are contributed by within group differences from those that arise from between group differences. The factor structure and item loadings that result from pooled data are misleading and cannot inform meaningfully about the relation of hand preference to handedness. Similar problems can be anticipated in other neuropsychological applications of factor analysis, where data from heterogeneous groups is pooled.

Adult↗
PubMed1993

Nurses' experiences of caring for ethnic-minority clients.

This paper describes a research study designed to explore the experiences of nurses caring for ethnic-minority clients and to identify any specific problems nurses encounter when caring for these clients. Data were collected through a process of in-depth interviews with 18 trained nurses. The findings of the study suggest that nurses caring for ethnic-minority clients share many common experiences, problems and challenges. Difficulties in communication with clients and a lack of knowledge about cultural differences were highlighted by all respondents. The lack of holistic care and the inability to develop a therapeutic relationship were identified as major areas of frustration and stress. The study demonstrates that there is an urgent need to develop cultural knowledge in nurse education programmes and that nurses need help and support with communication difficulties. Interpreting services and dietary facilities available for ethnic-minority clients were also found to be inadequate and it is suggested that there is a need to review these facilities within hospitals.

Attitude of Health Personnel↗
PubMed1993

Reflection: a review of the literature.

This paper is a review of the literature on reflection. The purpose was to unravel and make sense of the complex literature, and to identify the skills required to engage in reflection. An analysis of the literature revealed that differences between authors' accounts of reflective processes are largely those of terminology, detail and the extent to which these processes are arranged in a hierarchy. Key stages of reflection are identified and represented by a model. Skills required to engage in reflection were found to be implicit in the literature and these are identified. Methodological issues related to empirical literature are discussed. It is suggested that reflection is an important learning tool in professional education and that the skills required for reflection need to be developed in professional courses.

Humans↗
PubMed1993

Regional cerebral blood flow during volitional expiration in man: a comparison with volitional inspiration.

1. Positron emission tomographic (PET) imaging of regional cerebral blood flow (rCBF), using a new 3-dimensional technique of data collection, was used to identify areas of neuronal activation associated with volitional inspiration and separately with volitional expiration in five normal male subjects. A comparison of the activated areas was also undertaken to isolate regions specific for one or other active task. 2. Scans were performed during intravenous infusion of H2(15)O under conditions of (a) volitional inspiration with passive expiration, (b) passive inspiration with volitional expiration and (c) passive inspiration with passive expiration. Four measurements in these three conditions were performed in each subject. Breathing pattern was well matched between conditions. 3. Regional increases in brain blood flow, due to increased neural activity associated with either active inspiration or active expiration, were derived using a pixel by pixel comparison of images obtained during the volitional and passive ventilation phases. Data were pooled from all runs in all subjects and were then processed to detect statistically significant (P < 0.05) increases in rCBF comparing active inspiration with passive inspiration and active expiration with passive expiration. 4. During active inspiration significant increases in rCBF were found bilaterally in the primary motor cortex dorsally just lateral to the vertex, in the supplementary motor area, in the right lateral pre-motor cortex and in the left ventrolateral thalamus. 5. In active expiration significant increases in rCBF were found in the right and left primary motor cortices dorsally just lateral to the vertex, the right and left primary motor cortices more ventrolaterally, the supplementary motor area, the right lateral pre-motor cortex, the ventrolateral thalamus bilaterally, and the cerebellum. 6. Using this modified and more sensitive PET technique, these findings essentially replicate those for volitional inspiration obtained in a previous study. For volitional expiration the areas activated are more extensive, but overlap with those involved in volitional inspiration. 7. The technique used has been successful in demonstrating the regions of the brain involved in the generation of volitional breathing, and probably in the volitional modulation of automatic breathing patterns such as would be required for the production of speech.

Abdominal Muscles↗
PubMed1993

Changes in global cerebral blood flow in humans: effect on regional cerebral blood flow during a neural activation task.

1. The primary objective of this study was to examine in man, how induced changes in global cerebral blood flow (gCBF) affected a regional cerebral blood flow (rCBF) increase resulting from a neural activation task (opening of eyes). A secondary objective was to quantify how such induced changes in gCBF were distributed between representative regions of either predominantly grey matter or white matter. 2. Positron emission tomography with intravenous infusion of H2(15)O, was used to measure gCBF in six normal males. Concomitant measures of rCBF were obtained in three different regions of interest (ROI): a representative area of predominantly grey matter, a representative area of predominantly white matter and an area of visual cortex. 3. Cerebral blood flow was altered by establishing steady-state changes in PCO2 at a near constant ventilation of approximately 30 l min-1. The mean PET,CO2 (+/- S.D.) levels (mmHg) that resulted were: low, 21.8 +/- 1.8; normal, 39.8 +/- 1.0, and high, 54.8 +/- 1.2. The normal and high levels were obtained by adding appropriate amounts of CO2 to the inspirate. The corresponding mean gCBF levels across all six subjects with eyes closed were: low, 24.2 +/- 4.6; normal, 37.2 +/- 3.9 and high, 66.8 +/- 7.6 ml min-1 dl-1. 4. Blood flow in grey matter (insular cortex) and white matter (centrum semiovale) at normal levels of PCO2 averaged 56.8 +/- 10.1 and 20.3 +/- 3.4 ml min dl-1 respectively. As PCO2 rose, the increase in rCBF to grey matter was approximately three times greater than that to white matter. 5. An activation state of eyes open in a brightly lit room was compared to a baseline state of eyes closed in a darkened room at the three levels of PCO2 (and hence at three levels of gCBF). Over the whole gCBF range a significant (P = 0.028) effect of increasing rCBF in the visual cortex ROI was found in response to opening the eyes; the effect of this activation on rCBF was not significantly dependent (P = 0.34) on the PCO2 (and hence gCBF) level. The effect of the activation on the rCBF was apparently 'additive' to the rise of rCBF associated with PCO2-related gCBF increase. 6. The results confirm the need to normalize for changes in gCBF during studies of rCBF in response to an activation protocol. They also provide support for the use of an 'additive' model to achieve such normalization provided that other cortical areas behave in a similar manner to that of the visual cortex.

Adult↗
PubMed1993

Intensive care in an Irish district general hospital--a three year review.

The International Missionary Training Hospital is a 340-bed acute general hospital with maternity and paediatric units. It serves a population of 120,000 people within the North Eastern Health Board Area and has approximately 14,000 admissions each year. This report retrospectively reviews the activity of a three bedded, Intensive Therapy Unit (ITU) over the three year period July 1987-June 1990. 805 patients (1.9% of hospital admissions) with an average age of 55 +/- 22 years (mean +/- SD, range 14-94 years) were admitted to the unit. There were 458 males (57%) and 347 females (43%). 68% of the patients were admitted from the general wards and the remainder from the accident unit. 59% of the admissions were immediate postoperative cases. 82% of patients had APACHE scores less than 20. There was a wide diversity of medical and surgical diagnoses requiring treatment. 219 cases required one or more systems to be supported and 586 (73%) were admitted as high dependency cases. For those requiring ventilation, the average ventilation time was 3.2 days (range 0.5-23 days). The average length of stay within in the unit was 2.3 days (range 1-23 days). 86% of the patients were discharged to the wards, 11% died and 3% were transferred to external specialist care facilities. ITU's in district general hospitals serve as both critical care areas and high dependency units. In our opinion they produce a positive contribution to progressive patient care for high risk medical and surgical patients.

Adolescent↗
PubMed1993

Do elderly patients mind how doctors address them?

A survey was carried out in the Geriatric Unit at Cork Regional Hospital to determine how elderly patients would like to be addressed by their doctor. Two hundred patients over the age of 65 were given a Questionnaire asking them to state their preference. Only a minority (4.5%) expressed a definite preference for the formal mode of address. The remainder either did not mind (38%) or preferred to be addressed by their first name (57.5%). We concluded that most elderly patients do have a preference and this should be established on admission.

Aged↗
PubMed1992

Spontaneous cessation of umbilical blood flow in the acardiac fetus of a twin pregnancy.

The acardiac fetus is a rare entity found only in monozygotic multiple pregnancy. Although the acardiac fetus is non-viable, the perinatal mortality rate for the normal fetus may be as high as 50 per cent, and is usually associated with fetal heart failure and hydrops fetalis, or as the result of prematurity. In this communication, we describe a case of spontaneous cessation of blood flow to an acardiac fetus and discuss the management of this condition with special reference to optimizing the outcome for the normal fetus.

Abnormalities, Severe Teratoid↗
PubMed1992

Cluster analysis reveals at least three, and possibly five distinct handedness groups.

Multivariate techniques have used data from hand preference questionnaires to group hand preference items, but no attempt has been made to date to use multivariate analyses to group individuals in terms of handedness groups. This study analyzed the responses of 645 subjects on the Waterloo 60-item handedness questionnaire with a cluster analysis (BMDP) in order to determine the grouping of individuals in terms of hand preference patterns. Five distinct handedness groups were recognized by this procedure and a Discriminant Function Analysis revealed a very high accuracy of assigning individuals to the five groups. A cluster analysis of a shorter 14-item questionnaire suggested three distinct handedness groups, and the degree of accuracy of assigning individuals to these groups was also very high. As is the case with all multivariate techniques in neuropsychology, the question of whether the clusters form meaningful groupings awaits an answer in terms of their different neuropsychological properties.

Adult↗