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Biomedical subjects

M A Murphy

Publications and source records attributed to M A Murphy.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

A controlled trial of stimulant medication in children with the fragile X syndrome.

Attentional deficits and hyperactivity frequently are major problems for fra(X) boys. This study evaluated the effectiveness of 2 stimulant medications, methylphenidate and dextroamphetamine compared to placebo in 15 children (13 males, 2 females) with the fra(X) syndrome. A double-blind crossover design was used with outcome measures which included parent and teacher behavior checklists, a controlled observation period, continuous performance tasks and an actometer measure of movement. When the children were treated with methylphenidate only, improvement was seen in socialization skills and attention span according to teacher checklists. Ten children were clinically considered responders and treatment was continued after the study was completed.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Clinical management of blunt trauma patients with unilateral rib fractures: a randomized trial.

Optimal pain management is essential in blunt trauma patients sustaining significant chest trauma. The purpose of this randomized prospective trial was to measure the difference in pulmonary function in nonintubated patients with unilateral multiple rib fractures receiving two modalities of pain relief: systemic narcotic medications alone or local anesthetics given by intrapleural catheter (IPCs). Forty-two patients were randomized to receive systemic narcotic medications or IPCs for pain control. The patients with IPCs statistically had more compromised pulmonary function as measured by forced vital capacity (FVC) on admission; however, they tended toward a greater objective improvement of FVC on discharge. When analyzing a cohort of severely impaired patients (initial FVC < 20%), half of the systemic medication patients compared to only 10% of the IPC group failed and required another mode of therapy. Catheter complications were minor and did not contribute to overall morbidity. The IPC patients had fewer failures than the systemic medication patients.

Analgesia↗
PubMedDate not supplied

A brief history of pediatric nurse practitioners and NAPNAP 1964-1990.

The pediatric nurse practitioner movement began in 1964 and is now 25 years old. Anniversaries are a good time for pausing to look backward and look forward. This brief history reports some early pediatric nurse practitioner adventures and a few of the beginning episodes of the National Association of Pediatric Nurse Associates and Practitioners. These special highlights make a remarkable statement about an elite cohort of nurses.

History, 20th Century↗
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Attention deficit hyperactivity disorder in children: diagnosis, treatment, and follow-up.

Hyperactive, and fidgeting behavior in children, is not a new syndrome, but has been present in children for centuries. Only in recent years have health providers begun to observe these features and behaviors in children and recommend some therapies. Children labeled with Attention Deficit Hyperactivity Disorder (ADHD) display the symptoms of inattention, impulsivity, and hyperactivity; however, these behaviors are seen in a variety of conditions. This article describes some of the symptoms associated with ADHD, as well as the evaluation, therapeutic modalities (behavioral, psychodynamic and pharmacological), and the follow-up of children with ADHD.

Aftercare↗
PubMedDate not supplied

Cost-benefit comparison: holmium laser versus electrocautery in arthroscopic acromioplasty.

This prospective study was designed to measure the costs and benefits of using a laser rather than electrocautery for soft tissue resection during arthroscopic shoulder decompression. Forty-nine shoulders with refractory Neer stage II impingement (persistent fibrosis and tendinitis) were divided into 2 groups. The composition of the 2 groups was similar with regard to sex, worker's compensation status, dominant arm involvement, duration of symptoms, and length of conservative treatment. In one group, electrocautery was used to ablate the bursa and periosteum, release the coracoacromial ligament, and maintain hemostasis. In the other group, a laser was used in place of electrocautery. Patients had been evaluated preoperatively with 2 functional scoring systems. The patients were reexamined at 1 week and at 1, 2, 3, 6, and 12 months after surgery. There were no differences between the groups with regard to functional outcome or satisfaction. There was also no difference in terms of estimated blood loss or operative time. However, there was a statistically significant difference in total hospital charges between groups, with the laser group having a 23% higher hospital bill. On the basis of these results, it is concluded that there was no medical benefit to laser-assisted arthroscopic subacromial decompression but there was an increased monetary cost.

Adult↗
PubMedDate not supplied

The composition of the radiologic report.

In order to understand and evaluate fully the composition of the radiologic report, an experiment was performed in which eight readers each read the same 100 chest radiographs. The reports were dissected into individual statements, each of which was analyzed for accuracy, statement type (descriptive or etiologic), confidence, and specificity. In addition, each report was evaluated for stylistic factors of succinctness, orderliness, and the use of supplemental comments. Detailed analysis showed the radiologic report to be a series of largely descriptive statements in which confidence level, specificity, and orderliness were associated with the presence of errors in film interpretation. These factors can serve as important markers for identifying error-laden films. The use of specific, etiologic diagnoses in these film readings was limited. The composition of the report was not related to the length of radiologic training beyond the first year of residency. The implications of these findings concerning report composition in light of present day radiologic practice and new, automated radiologic reporting systems were discussed.

Diagnostic Errors↗
PubMedDate not supplied

The crying infant.

Explore the source record for details and available documents.

Colic↗