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Biomedical subjects

P Murray

Publications and source records attributed to P Murray.

At least 19 recordsLinked to original sources
PubMed2000

Whiplash injury--are current head restraints doing their job?

It is generally accepted that the incidence of whiplash associated disorders is increasing in all industrialised countries, despite the almost universal fitment of head restraints in at least the front seats of cars. This is usually attributed to the fact that few people can be observed to follow the standard recommendations as regards head restraint positioning, that is, level with the head vertically and as close to the head as possible horizontally. This study set out to determine whether any other factors, in addition to head restraint adjustment, could be found which would influence the severity of whiplash injury. This was done by linking medical assessment of real-world accident victims with engineering assessment of the accident vehicles. A random sample of road accident victims suffering from whiplash associated disorder was studied. The vehicles they had been travelling in were examined to assess impact severity and, where possible, measurements were made of seat and head restraint adjustment with the subject sitting in the vehicle. All subjects were interviewed to assess the disability resulting from their injuries, and their progress was followed for 12 months. The results were subjected to statistical analysis to try to determine relationships between severity of injury (as measured by resultant disability) and a number of occupant- and vehicle-related factors. A significant proportion of the sample had suffered lumbar strain injury in addition to whiplash, and these were excluded from the present analysis. Frontal impact victims suffered symptoms indistinguishable from those of rear impact victims. The beneficial effects of good head restraint adjustment could not be clearly demonstrated, and some trends, especially in rear impacts, where the benefits of a well-adjusted restraint should have been very clear, indicated that larger distances from head to restraint were associated with lower disability. The paper discusses these counter-intuitive results and their implications.

Accidents, Traffic↗
PubMed1999

Neuropathic pain.

Explore the source record for details and available documents.

Acetates↗
PubMed1999

Absence of basement membranes after targeting the LAMC1 gene results in embryonic lethality due to failure of endoderm differentiation.

The LAMC1 gene coding for the laminin gamma1 subunit was targeted by homologous recombination in mouse embryonic stem cells. Mice heterozygous for the mutation had a normal phenotype and were fertile, whereas homozygous mutant embryos did not survive beyond day 5.5 post coitum. These embryos lacked basement membranes and although the blastocysts had expanded, primitive endoderm cells remained in the inner cell mass, and the parietal yolk sac did not develop. Cultured embryonic stem cells appeared normal after targeting both LAMC1 genes, but the embryoid bodies derived from them also lacked basement membranes, having disorganized extracellular deposits of the basement membrane proteins collagen IV and perlecan, and the cells failed to differentiate into stable myotubes. Secretion of the linking protein nidogen and a truncated laminin alpha1 subunit did occur, but these were not deposited in the extracellular matrix. These results show that the laminin gamma1 subunit is necessary for laminin assembly and that laminin is in turn essential for the organization of other basement membrane components in vivo and in vitro. Surprisingly, basement membranes are not necessary for the formation of the first epithelium to develop during embryogenesis, but first become required for extra embryonic endoderm differentiation.

Animals↗
PubMed1999

Fundamental issues in questionnaire design.

The questionnaire is probably the most common form of data collection tool used in nursing research. There is a misconception that anyone with a clear grasp of English and a modicum of common sense can design an effective questionnaire. Contrary to such common belief, this article will demonstrate that questionnaire design is a complex and time consuming process, but a necessary labour to ensure valid and reliable data is collected. In addition, meticulous construction is more likely to yield data that can be utilized in the pursuit of objective, quantitative and generalizable truths, upon which practice and policy decisions can be formulated. This article examines a myriad of fundamental issues surrounding questionnaire design, which encompass question wording, question order, presentation, administration and data collection, amongst other issues.

Data Collection↗
PubMed1999

Effect of material deprivation on Epstein-Barr virus infection in Hodgkin's disease in the West Midlands.

We have used Townsend scores from postcode data to compare levels of material deprivation and Epstein-Barr virus (EBV)-positivity for 223 patients diagnosed with Hodgkin's disease (HD) in the period 1981-1997. The presence of EBV in HD tumours was determined using in situ hybridization to target the abundantly expressed EBV early RNAs. EBV was detected in the malignant Hodgkin and Reed-Sternberg cells in 47/223 HD cases (21%). There was found to be a tendency for higher Townsend scores (indicative of higher levels of material deprivation) in EBV-positive HD patients, but this association was not statistically significant. When various subgroups of patients from the study were examined separately the indication of higher Townsend scores in EBV-positive patients was found to be more marked for patients with mixed cellularity disease (P = 0.09) and for females (P = 0.03). The results of this study suggest that differences in the level of material deprivation are important in determining the likelihood of EBV-positive HD in the UK, particularly for certain subgroups of patients. It is not known what specific socioeconomic factors are responsible for these differences, although alterations in the timing or rate of primary EBV infection, or decline in the level of EBV-specific immunity, may be important.

Adolescent↗
PubMed1999

Molecular investigations implicate human endogenous retroviruses as mediators of anti-retroviral antibodies in autoimmune rheumatic disease.

Polymerase chain reaction using specific primers, failed to detect HTLV-I amplicons in patients with rheumatic diseases previously shown to possess antibodies to retroviral products. However, by employing broad spectrum oligonucleotide primers, 135 bp amplicons were generated from peripheral blood mononuclear cells and synovial fluid cells. Subsequent cloning and DNA sequencing revealed homology to a number of exogenous and human endogenous retroviruses (HERVs). Furthermore, in combining the presence of type B and C related endogenous retroviruses, a significant association (p=0.014) was apparent for chronic autoimmune rheumatic diseases as compared to controls. Reverse transcription polymerase chain reaction of RNA derived from patients, healthy controls and cell lines (U937, BJAB, human endothelial lung fibroblasts) demonstrated ubiquitous expression of HERV-K10 and RTVL-H2. Furthermore messenger RNA expression of HERV-K10 was enhanced in fibroblasts infected with human cytomegalovirus. It is plausible that subsequent production of HERV peptides could explain the presence of anti-retroviral antibodies in cohorts of patients with autoimmune rheumatic diseases.

Antibodies, Viral↗
PubMed1999

Classification, diagnostic criteria, and treatment recommendations for orofacial manifestations in HIV-infected pediatric patients. Collaborative Workgroup on Oral Manifestations of Pediatric HIV Infection.

The criteria for diagnosis of HIV-related oral lesions in adults are well established, but corresponding criteria in the pediatric population are not as well defined. The Collaborative Workgroup on the Oral Manifestations of Pediatric HIV infection reached a consensus, based upon available data, as to the presumptive and definitive criteria to diagnose the oral manifestations of HIV infection in children. Presumptive criteria refer to the clinical features of the lesions, including signs and symptoms, whereas definitive criteria require specific laboratory tests. In general, it is recommended that definitive criteria be established whenever possible. Orofacial manifestations have been divided into three groups: 1) those commonly associated with pediatric HIV infection; 2) those less commonly associated with pediatric HIV infection; and 3) those strongly associated with HIV infection but rare in children. Orofacial lesions commonly associated with pediatric HIV infection include candidiasis, herpes simplex infection, linear gingival erythema, parotid enlargement, and recurrent aphthous stomatitis. In contrast, orofacial lesions strongly associated with HIV infection but rare in children include Kaposi's sarcoma, non-Hodgkin's lymphoma, and oral hairy leukoplakia. Treatment recommendations, specific for this age group, have been included for some of the more common HIV-related orofacial manifestations.

AIDS-Related Opportunistic Infections↗
PubMed1998

Femoral cementing techniques in total hip replacement.

Clinical studies have shown that second-generation femoral cementing techniques at total hip replacement result in a superior fixation of the femoral stem. In an effort to determine what benefits further developments in cementing techniques would provide, we compared the morphology of the cement mantles produced by traditional finger-packing and gun-insertion techniques. The porosity of the cement mantles was quantified using computerised image analysis. The finger-packing technique caused large air inclusions that resulted in large pores in the substance of the cement mantle, whereas the cement-gun technique did not result in any individual pore with an equivalent diameter greater than 3 mm. The mean porosity of cement mantles prepared using the finger-insertion technique was 8.3%, whereas the mean porosity in gun-prepared mantles was 1.7%. The use of a cement gun significantly reduced the porosity of femoral cement mantles (P = 0.02). Reduction of defects in the substance of the cement mantle may account for the increased survival of femoral prostheses inserted when second-generation techniques were used. Further reduction of the porosity of the cement mantle could not be expected to produce as dramatic a clinical improvement in prosthesis fixation.

Arthroplasty, Replacement, Hip↗
PubMed1998

Challenges for delivering healthcare education through telematics.

Within the context of the education of professional healthcare providers, the authors give an overview of the challenges faced by those wishing to introduce telematics as both a mechanism for content delivery and as subject content itself. After presenting a brief overview of the current state of telematics applications to healthcare education, focusing on the European sphere, the authors outline the challenges before discussing the collaborative and communicative issues in detail. The authors conclude by suggesting that, while the authors believe that telematics is a necessary direction for the future development of healthcare education for professionals, the collaboration and communication challenges are of greater importance than the technical and policy challenges and that there is a need to educate the majority of educators, based in the experiences of the enthusiasts.

Communication↗
PubMed1998

Differences in p53 and Bcl-2 expression in relation to cell proliferation during the development of human embryos.

AIMS: To study the patterns of p53 and Bcl-2 expression in relation to cell proliferation during human embryogenesis in order to help elucidate their potential roles in the regulation of cell proliferation and apoptosis during morphogenesis. METHODS: Immunohistochemistry for p53, Bcl-2, and proliferating cell nuclear cell antigen (PCNA) proteins was performed, using a variety of monoclonal antibodies, on paraffin was embedded sections of tissues from 68 human embryos and fetuses of between 4 and 30 weeks gestation. RESULTS: Positive relations between sites of proliferative activity (as detected by PCNA expression) and p53 expression were found in the kidney, early developmental stages of intestine and lungs, liver, pancreas, heart, and in embryonic osteoblasts. On the other hand, positive relations between proliferative activity and Bcl-2 expression were found in the gonads, adrenal glands, in the cells of the dental lamina, hair follicles, syncytiotrophoblast, chondrocytes, and more advanced stages of intestinal development. In tissues of the central nervous system, p53 and Bcl-2 were co-expressed at the same sites but there was an inverse relation between p53/Bcl-2 expression and proliferative activity. CONCLUSIONS: These data suggest that p53 and Bcl-2 have tissue specific and stage specific functions during embryogenesis.

Cell Division↗
PubMed1998

Bilateral femoral component breakage in total hip replacement: a case report.

Breakage of the femoral component of a total hip replacement prosthesis is an uncommon occurrence with modern prostheses. The authors report what appears to be the only case of bilateral prosthetic fracture. A 65-year-old man, who was physically active, suffered bilateral femoral stem fractures 3 and 5 years after total hip replacement. The bilateral cemented hip replacements remained asymptomatic until catastrophic failure of the femoral component occurred. Both prostheses were titanium (Biomet; Warsaw, Ind.) with chrome cobalt modular femoral heads. The authors stress the importance of maintaining an adequate cement mantle in Gruen zones 1 and 7 because failure to do so may result in micromotion and subsequent stem fracture.

Aged↗
PubMed1997

An evaluation of the factors affecting neurological recovery following spinal cord injury.

We reviewed 71 consecutive spinal cord injuries to determine the factors influencing neurological recovery. Sixty-three (35 tetraplegics and 28 paraplegics) were available for follow-up at a mean of 29.6 months. The American Spinal Injury Association (ASIA) scoring system was used on admission and at follow-up to determine change in neurological status. Treatment with corticosteroids or surgical intervention had no significant effect on outcome. Tetraplegics, both complete and incomplete, had a significantly better outcome than paraplegics (p < 0.02). Incomplete cord injury carried a better prognosis of motor recovery (p < 0.0001). Pattern of injury was an important determinant of recovery in the complete tetraplegia group. We conclude that many factors influence recovery following spinal cord injury and the effect of treatment may be difficult to demonstrate.

Adolescent↗