Search PubMed⌕ Search

Biomedical subjects

P Murray

Publications and source records attributed to P Murray.

At least 73 records · Page 4Linked to original sources
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↗
PubMed1997

Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years. Medical Subcommittee of the UK Soap and Detergent Industry Association.

This study was undertaken to examine the long term relationship between lung function, smoking and exposure to enzymes in the detergent industry. A total of 731 male workers from five locations in the United Kingdom were subject to respiratory health surveillance including lung function testing over a period of 4-20 years. Exposure groups were defined by job history. Significantly different rates of fall in FEV1 and FVC with time were found by geographical location and by smoking habit, but there were no consistent trends with enzyme exposure.

Adult↗
PubMed1997

Sparing of sensation to pin prick predicts recovery of a motor segment after injury to the spinal cord.

We have reviewed 59 patients with injury to the spinal cord to assess the predictive value of the sparing of sensation to pin prick in determining motor recovery in segments which initially had MRC grade-0 power. There were 35 tetraplegics (18 complete, 17 incomplete) and 24 paraplegics (19 complete, 5 incomplete), and the mean follow-up was 29.6 months. A total of 114 motor segments initially had grade-0 power but sparing of sensation to pin prick in the corresponding dermatome. Of these, 97 (85%) had return of functional power (> or = grade 3) at follow-up. There were 479 motor segments with grade-0 power but no sparing of sensation to pin prick and of these only six (1.3%) had return of functional power. Both of the above associations were statistically significant (chi-squared test, p < 0.0001). After injury to the spinal cord, the preservation of sensation to pin prick in a motor segment with grade-0 power indicated an 85% chance of motor recovery to at least grade 3.

Chi-Square Distribution↗
PubMed1996

Identification of the antigen recognized by the monoclonal antibody BU31 as lamins A and C.

The murine monoclonal antibody BU31 binds to the nuclear membrane of many cell types. The expression of the BU31 antigen has previously been shown to have an inverse correlation with the proliferative index in lung tumours, defined by Ki67 staining. The distribution of BU31-positive cells is now shown to parallel the distribution of non-dividing cells in a range of normal human and rat tissues, although neuroendocrine cells and germ cells in the testis show no reactivity. Cells grown in culture and induced to undergo growth arrest show a higher level of labelling with BU31 than their proliferating counterparts. Confocal laser scanning microscopy reveals that the BU31 antigen is distributed predominantly along the nuclear lamina, with occasional internal foci. This distribution is very similar to that of the nuclear membrane proteins lamin A and lamin C, suggesting that the BU31 antigen and lamins A and C could be one and the same. Immunoblotting using recombinant lamin proteins confirmed this proposal. Moreover, a monoclonal antibody to the non-proliferation-associated antigen, statin, also recognizes lamins A and C. These data indicate that the demonstration of lamins A and C can be used to provide information on the proliferative activity of normal and neoplastic tissues. These data also suggest a role for nuclear lamins A and C during cellular quiescence, possibly through the reorganization and maintenance of nuclear structure, or more directly through interactions with the retinoblastoma gene product or related proteins.

3T3 Cells↗
PubMed1996

Recovery, Inc., as an adjunct to treatment in an era of managed care.

As capitation increasingly limits professional mental health services, self-help organizations may play an expanding role. Recovery, Incorporated, is an internationally active mental health self-help organization developed in the late 1930s by Abraham A. Low, M.D. The author reviews concepts about mental illness and health developed since Low's time, such as locus of control, learned helplessness, defense theory, and Antonovsky's salutogenic model. He describes how these concepts support many of the principles developed by Low, in particular the idea that optimal health is achieved when a person assumes responsibility for his or her failure or success. In the structured format that Low designed for Recovery, Inc., meetings, members learn to identify self-defeating and illness-promoting thoughts and impulses and counter them with self-endorsing thoughts and wellness-promoting actions. The author suggests that professionals should become familiar with self-help organizations in their communities, promote relevant research, and facilitate referral to these groups.

Combined Modality Therapy↗
PubMed1995

Human stress protein hsp70: overexpression in E coli, purification and characterization.

The gene encoding the stress-inducible member of human heat shock protein hsp70, was expressed in E. coli using the bacteriophage T7 RNA polymerase-based gene expression system. Recombinant hsp70 (R-hsp70) was purified from inclusion bodies after solubilization and refolding, using a combination of ATP-agarose affinity chromatography and ion-exchange chromatography. R-hsp70 was shown to be monomeric and free of its structurally similar E. coli counterpart, DnaK. In addition, R-hsp70 is functional as demonstrated by its ability to bind to peptides and to ATP. The availability of pure, correctly folded R-hsp70 in sufficient quantity will assist in the structural and functional characterization of hsp70. Furthermore, an understanding of the cytoprotective function of hsp70 and its role in immune responses during infections will be facilitated by the availability of pure R-hsp70.

Adenosine Triphosphate↗
PubMed1995

Continuous axillary brachial plexus blockade for reflex sympathetic dystrophy.

Reflex sympathetic dystrophy is one of the commoner neurogenic pain syndromes; the typical onset follows peripheral trauma and is characterised by diffuse burning pain and hyperalgesia, accompanied by variable vasomotor and dystrophic changes. Successful treatment of an established reflex sympathetic dystrophy may be difficult. A case is reported describing the successful use of a series of continuous axillary brachial plexus blocks for the treatment of this syndrome.

Accidents, Traffic↗
PubMed1994

Ramipril prevents hypersensitivity to phenylephrine in aorta from streptozotocin-induced diabetic rats.

This study investigated the protective effect of the angiotensin converting enzyme inhibitor, ramipril, on endothelium-dependent responses in arteries from control (CON) and streptozotocin-induced (STZ) diabetic rats. Three hypotheses were tested: 1) there is an endothelium-dependent component to the increased alpha-adrenergic responsiveness characteristic of diabetes; 2) endothelium-dependent, acetylcholine-induced relaxation is attenuated in aorta from diabetic rats; and 3) ramipril (3 mg/kg daily in the food, 12-15 weeks) will prevent functional vascular changes in diabetic rats. Vascular function was assessed in aortic rings using standard muscle bath procedures for measurement of isometric force. Sensitivity to phenylephrine was increased in aortic rings from diabetic compared to control values [pD2 values (-log ED50): CON = 6.22 +/- 0.12, STZ = 7.54 +/- 0.11), and removal of the endothelium (-Endo) increased phenylephrine sensitivity (CON-Endo = 7.40 +/- 0.11, STZ-Endo = 8.32 +/- 0.18). The magnitude of the shift in responsiveness following endothelium removal was greatest in control rats. Ramipril treatment (Ram) partially normalized phenylephrine responsiveness in intact (STZ + Ram = 6.55 +/- 0.11) and denuded (STZ-Endo + Ram = 7.75 +/- 0.10) vessels. Vasodilatation to acetylcholine and nitroglycerin was not altered in diabetic rats nor was it affected by ramipril treatment. Diabetes increases contractile sensitivity to phenylephrine but not to vasodilators and chronic ramipril treatment prevents this increase in contractile sensitivity. Ramipril treatment did not alter the hyperglycaemic condition induced by streptozotocin. The changes in phenylephrine sensitivity appear to involve an endothelial and a smooth muscle component.

Acetylcholine↗
PubMed1994

National survey of pediatric fever management practices among emergency department nurses.

INTRODUCTION: Management of pediatric fever is controversial. Although many nursing texts advocate aggressive fever management, research provides evidence that fever is a normal physiologic process with beneficial effects. We sought to describe emergency nurses' pediatric fever management practices, their rationales for practice, and their practice consistency. METHODS: A researcher-developed tool was mailed to a systematic random sample of approximately 5% of ENA members. Surveys were mailed to 1136 nurses nationally; 731 surveys were returned (64% response rate). RESULTS: Temperature at which nurses initiate fever interventions varied from 37.8 degrees C (100 degrees F) to 40.6 degrees C (105 degrees F). Most frequently identified rationales for intervention were prevention of fever increase (83.3%), fever reduction (76.9%), comfort (74.7%), and seizure prevention (65.3%). Most nurses (79.8%) employ tepid sponging to reduce fever; 31% sponge routinely. Nurses reported sponging for temperatures higher than 38.9 degrees C (102 degrees F) to 40.6 degrees C (105 degrees F). Rationales for sponging included seizure prevention (58%), rapid cooling (56.8%), and treatment of fevers unresponsive to antipyretics (45.6%). Factors influencing rationales for practice included departmental standards of care (67.2%), physician practices (65.8%), and common sense (64.2%). DISCUSSION: The results of this nationwide survey demonstrate that fever management practices vary. ED nurses are practicing in a manner consistent with that advocated in many nursing texts but not necessarily the research literature. We believe that clinical trials of commonly used fever treatments are indicated. Standards of care could then be revised to reflect the research literature.

Adult↗
PubMed1994

Alcohol use, self-esteem, depression, and suicidality in high school students.

In this study of both high school and college students under 21 years of age, it was found that alcohol use and misuse was positively associated with depression, as expected, but also with self-esteem, opposite to what was expected. It was also found that alcohol use and misuse were associated with depression in college students 21 years of age and older.

Adolescent↗
PubMed1994

A simple inpatient psychiatric clinical information system designed and developed by clinicians.

OBJECTIVE: The growth of computer technology allows clinicians to develop a separate information system to replace inefficient paper-based approaches to documenting clinical care. METHODS: A clinician team developed a system to replace standard paper forms using computer software running on 486 PC computer. Clinicians, directing the project at every step, refined handwritten forms to create a complete word processor application merging information from an individual database. RESULTS: A system developed outside the traditional hospital information system simplifies the generation of a variety of required inpatient documents (treatment plans, progress notes, patient lists, and treatment summaries). A wide variety of clinicians converted from a traditional paper-based approach to the computer system. CONCLUSIONS: Computer technology allows the local development of an information system oriented toward clinical needs. Hospital clinical information systems will benefit from the input of clinicians with experience designing a computerized solution.

Clinical Medicine↗
PubMed1994

Detection of deep venous thrombi and pulmonary embolus with technetium-99m-DD-3B6/22 anti-fibrin monoclonal antibody Fab' fragment.

UNLABELLED: Technetium-99m-labeled anti-fibrin DD-3B6/22 Fab' monoclonal antibody fragments, which specifically target human cross-linked fibrin with high affinity, were evaluated in humans for safety and their capacity to detect deep vein thrombi and pulmonary embolism. METHODS: Twenty patients with proven deep-vein thrombosis, documented by contrast venography, or venous duplex scan, were injected with a 600 MBq (0.5 mg) dose of antibody. Planar images of the lower limbs were recorded at 0, 2, 6 and 24 hr and chest scintigrams were recorded at 6 and 24 hr. RESULTS: All venography documented thrombus sites, calves, popliteal and femoral, were detected with the radioimmunoconjugate. For the venous duplex scan-proven thrombus sites, all except two calf thrombi in two patients with bilateral disease and other positive sites were detected. Five patients had bilateral deep-vein thrombosis with multiple sites being visualized with the radioimmunoconjugate in the calf, popliteal and femoral regions. One case of pulmonary embolus was also definitively demonstrated. Documented thrombus sites were detected at 2 and 6 hr postinjection. Nineteen patients were on heparin. No adverse reactions to the injected dose were observed and one low titer human anti-mouse antibody response may have occurred. CONCLUSION: The results indicate that 99mTc-DD-3B6/22 Fab' has potential for noninvasive detection of deep-vein thrombosis and pulmonary embolism.

Adult↗