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Biomedical subjects

L Murphy

Publications and source records attributed to L Murphy.

At least 55 records · Page 3Linked to original sources
PubMed1998

Migration decisions among settler families in the Ecuadorian Amazon: the second generation.

The authors use survey data collected in 1990 from 418 household heads of recent settlements in the Ecuadorian Amazon to study the extent of and reasons for out-migration of the settlers' children. "Our research identifies the types and incidence of out-migration of young adults from settler households in the Ecuadorian Amazon, as well as the effects of individual and household-level factors of out-migration. Important gender differences in both the levels and patterns of migration and in the factors affecting migration decisions are documented."

Adolescent↗
PubMed1997

Applying what burn survivors have to say to future therapeutic interventions.

Statements by caregivers can be beneficial to paediatric burn patients, facilitating their psychological adaptation. However, the concerns of the burned child are not always obvious, and caregivers may flounder, not knowing how to elicit the concerns of the patient. The purpose of this paper is to examine whether universal concerns of the postburn survivor can be detected through one type of psychological assessment tool, a sentence completion task. Sixty paediatric burn survivors, ages 6-19, were administered a 30-item Incomplete Sentences measure. Five major aspects of postburn life were identified and proscribed the following descriptive labels: (1) preoccupation with health; (2) the struggle for internal acceptance; (3) reconstruction of one's life map; (4) changing relationships; and (5) redefining the world. These five dimensions of postburn life are discussed, as well as applications for each.

Adaptation, Psychological↗
PubMed1997

Psychosocial factors and prediction of headaches in college adults.

The current study evaluated psychosocial variables that may contribute to the experience of headache in college adults. One hundred ninety-nine participants, 103 women and 96 men, completed head pain logs for 4 weeks after completing measures assessing psychosocial variables. Multiple regression analyses indicated that level of emotional functioning, perception of stress, and gender were predictive of future headache frequency, intensity, and duration. Family history and health habits did not predict headache activity. These findings are consistent with research investigating psychosocial variables and headache activity.

Adult↗
PubMed1997

Resting metabolic rate in obese, premenopausal black women.

In the United States, obesity is more prevalent in black than in non-Hispanic white women. Because low resting metabolic rate (RMR) has been suggested as a risk factor for weight gain, we compared RMR in 22 black and 20 white obese [body mass index (BMI; in kg/m2) range: 28.9-48.6 and 26.9-44.1, respectively], weight-stable, premenopausal, nondiabetic women. RMR was measured on two or three different occasions within a 1-wk period. The black and white groups did not differ significantly in age, degree of fitness, BMI, fat mass, or fat-free mass (FFM). In each group, RMR was predicted independently by FFM but not by age, degree of fitness, body fat mass, or body fat distribution. The slopes of the equations predicting RMR from FFM in black and white groups were not significantly different. However, the black women had significantly lower RMRs than the white women after adjustment for FFM measured by five body-composition models: dual-photon X-ray absorptiometry (DXA), hydrodensitometry, total body water, a three-compartment model, a four-compartment model, as well as for the absolute total-body potassium content as a measure of metabolically active FFM. By each analysis, the black women had significantly lower (P < 0.01) FFM-adjusted RMR than the white women; this difference ranged from 671 to 889 kJ/d depending on the body-composition method used to estimate FFM. This could contribute to the difference in the prevalence of obesity in the populations represented by these groups.

Adipose Tissue↗
PubMed1997

Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women.

Our previous finding that a waist-to-hip ratio (WHR) >0.85 was not associated with similar health risks in black, compared with white, obese premenopausal non-diabetic women of similar fatness is attributed to either 1) a different relationship between WHR and visceral adiposity or 2) differences in the relationship between visceral adiposity and the metabolic abnormalities of obesity. We measured visceral (VAT) and subcutaneous adipose tissue (SCAT) areas at midwaist in 25 black and 25 white obese nondiabetic pre-menopausal women with similar BMI, percentage body fat, and wide range of WHR (0.7-0.95 for black women and 0.7-0.9 for white women) and then compared insulin sensitivity index (SI), glucose and insulin areas under the 2-h curve (AUCs) during an oral glucose tolerance test (OGTT), and blood lipids in the two groups before and after adjustments for total body and visceral adiposity. After adjusting for total body fat mass (FM), obese black women had significantly less VAT (by 32 cm2) and lower VAT/SCAT for any given WHR. The regression equations predicting the SI the glucose and insulin AUCs, and the triglyceride and HDL cholesterol levels from regional adipose tissue measurements (VAT, SCAT, or VAT/SCAT) and from total body fat (FM or percentage body fat) had slopes that were not significantly different for black and white women. LDL cholesterol levels were independently related to VAT in black but not in white women. The black women had a similar SI insulin AUC, and triglyceride levels but significantly lower glucose AUC and higher HDL cholesterol levels (P < 0.001), after adjusting for VAT and FM. Regression analysis of the pooled data showed that high VAT and high VAT/SCAT, but not SCAT, predicted lower SI higher glucose and insulin AUCs during OGTT, and higher triglyceride levels, independent of total adiposity. We conclude that while increases in VAT and VAT/SCAT adversely affect metabolism in both black and white obese premenopausal women, similar levels of total body and visceral adiposity are associated with different metabolic risk factors in these groups.

Adipose Tissue↗
PubMed1996

Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit.

OBJECTIVE: To identify the number of patients who were misdiagnosed as being in the vegetative state and their characteristics. DESIGN: Retrospective study of the clinical records of the medical, occupational therapy, and clinical psychology departments. SETTING: 20 bed unit specialising in the rehabilitation of patients with profound brain damage, including the vegetative state. SUBJECTS: 40 patients admitted between 1992 and 1995 with a referral diagnosis of vegetative state. OUTCOME MEASURES: Patients who showed an ability to communicate consistently using eye pointing or a touch sensitive single switch buzzer. RESULTS: Of the 40 patients referred as being in the vegetative state, 17 (43%) were considered as having been misdiagnosed; seven of these had been presumed to be vegetative for longer than one year, including three for over four years. Most of the misdiagnosed patients were blind or severely visually impaired. All patients remained severely physically disabled, but nearly all were able to communicate their preference in quality of life issues-some to a high level. CONCLUSIONS: The vegetative state needs considerable skill to diagnose, requiring assessment over a period of time; diagnosis cannot be made, even by the most experienced clinician, from a bedside assessment. Accurate diagnosis is possible but requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities. Recognition of awareness is essential if an optimal quality of life is to be achieved and to avoid inappropriate approaches to the courts for a declaration for withdrawal of tube feeding.

Awareness↗
PubMed1996

Cisplatinum enhancement of myocardial Mg2+ transport.

Cisplatinum in a concentration (4.3 x 10(-6) M) corresponding to the therapeutic plasma concentration for cancer patients was found to cause a marked enhancement of magnesium efflux and uptake in perfused frog myocardium. The magnesium content of the perfused frog ventricle is increased from 6.66 +/- 0.34 mumol/g wet wgt to 8.03 +/- 0.38 mu mol/g wet wgt. Cisplatinum had a negative inotropic action reducing contractile force to 46 +/- 8% of initial force after 40 min of perfusion. The corresponding control contractile force was reduced to 74 +/- 7%. Removal of calcium and magnesium from the perfusion solution containing 0.5 mM EDTA for 10 minutes caused contractile force to be reduced to 0 after 6 beats at 24 min-1. After ten minutes of perfusion with EDTA, 1.87 mu mol/g wet wgt of magnesium was lost from control ventricles. Cisplatinum increased the loss to 4.08 +/- 0.34 mu mol/g wet wgt. The magnesium lost during EDTA perfusion was completely recovered after 5 minutes of perfusion in Ringer or Tyrode solution by both control and cisplatinum treated frog ventricles. The contractile force also recovered to the level prior to perfusion with EDTA Ringer. The rate of Mg2+ efflux in EDTA Ringer is largest during the first 3 minutes and was 0.170 +/- 0.051 p mol cm-2 sec-1 for controls and 0.798 p mol cm-2 sec-1 for the cisplatinum treated ventricles. During the last 7 min of perfusion in EDTA Ringer the Mg2+ efflux was reduced to 0.057 +/- 0.005 p mol cm-2 sec-1 for control ventricles and 0.170 p mol cm-2 sec-1 for the cisplatinum treated ventricles. Cisplatinum increased both magnesium efflux and influx and influx in the frog myocardium, increased magnesium content to a higher level and reduced contractile force. The effect of cisplatinum on magnesium transport is attributed to an increase in the charged form of cisplatinum that accumulates inside the cell where chloride content is low and the chloride of cisplatinum is displaced to form a positively charged cisplatinum.

Animals↗
PubMed1996

Some observations on the subjective experience of neophyte group therapy trainees.

Neophyte group therapy trainees often encounter significant difficulties in their initial experiences as group therapists. In this article, we report and discuss the results of a semistructured interview conducted with each of 16 neophyte group therapy trainees in an academic training program. The interview focused on the trainees' subjective experiences related to their initial training and group therapy clinical practice, with particular emphasis on their satisfaction with their training, and the role and impact of supervision. All trainees reported strong emotional reactions to their group experience and numerous technical concerns. However, trainees reported a broad range of degrees of satisfaction with their training Overall satisfaction with training strongly paralleled satisfaction with supervision and the supervisory relationship. Recommendations for improving the group therapy training experience that emerge from the evaluation of the trainees' subjective experiences are suggested.

Education, Medical, Graduate↗
PubMed1996

Triple primer polymerase chain reaction. A new way to quantify truncated mRNA expression.

The most practical method to quantify mRNA expression within small tumor samples is reverse transcription (RT) followed by quantitative polymerase chain reaction (PCR). One approach, known as "competitive RT-PCR" allows absolute quantitation by reference to synthetic RNA standards but is time-consuming and requires multiple manipulations that limit its usefulness as a screening assay. We describe here a new approach to quantify truncated type mRNAs relative to the wild-type transcripts in small amounts of tissue. This technique, called RT-triple primer-PCR, consists of coamplification of wild-type and truncated cDNAs using three primers in the PCR. To validate this approach, a truncated estrogen receptor variant (clone 4) was quantified relative to the wild-type estrogen receptor using plasmid preparations. The ratio of triple primer-PCR products obtained was directly related to the initial ratio of input cDNAs. RT-triple primer-PCR was then used to compare the relative expression of clone 4 mRNA in frozen sections of normal human breast tissue and human breast tumors with characteristics of good prognosis. The statistically significant difference (P = 0.03) observed between normal and tumor tissues suggests that elevated expression of the clone 4 variant may be associated with early steps of tumorigenesis. This technique provides a useful alternative to already described quantitative RT-PCR techniques for the quantification of truncated mRNA within small amounts of biological material.

Base Sequence↗
PubMed1996

Organizational and operational redesign: if we should, then how?

Health care leaders and clinical professionals are reconfiguring their environments. However, restructuring of management, reengineering of work, and redesigning process work flows and care delivery modalities contribute to demands that are inherent in an industry that deals with multiple variables of the human condition. After approximately 7 years of health care reengineering and redesign, fundamental tenets are being validated regarding leadership attributes, employee preparation and involvement, and commitment to the process of ongoing redesign and improvement.

Decision Making, Organizational↗
PubMed1996

Phase II trial of heparin prophylaxis for veno-occlusive disease of the liver in children undergoing bone marrow transplantation.

Veno-occlusive disease (VOD) of the liver is an early complication of bone marrow transplantation (BMT). The initial event has been hypothesized to be an injury to the endothelial cells eventually resulting in post-sinusoidal obstruction and hepatic failure. The role of anticoagulants for the prevention of VOD is controversial. Continuous infusion of heparin has been reported to be effective in preventing VOD in adults undergoing myeloablative therapy and BMT. An unblinded, historical controlled study was carried out to assess the safety and efficacy of continuous infusion of low-dose heparin in prevention of VOD in children undergoing BMT following myeloablative therapy. Fifty consecutively BMT-treated children (10 months to 18 years 7 months) were enrolled into the study group and received continuous heparin infusion (100 units/kg/day) from the first day of the preparative regimen to day +30 or until discharge, whichever occurred earlier. These were compared with a control group of 70 patients who received BMT for a variety of disorders. Patient groups were similar with respect to primary diagnosis, age, sex, and baseline organ functions. Heparin was well-tolerated, with only minor grade I-II hemorrhagic episodes occurring in 28 patients (56%), compared to 50 patients in the control group (71%) (P = 0.184). Bleeding was significantly less following autologous BMT compared to allogeneic BMT (P < 0.05). VOD was diagnosed in five patients (10%) compared to 18 of 70 in the control group (25.7%) (P < 0.05). Analysis of risk factors demonstrated a significantly higher incidence of VOD in patients undergoing allogeneic BMT (matched related, mismatched related and matched unrelated), patients older than 15 years of age, and patients with advanced disease (> or = 2 CR). In summary, this phase II trial has demonstrated that continuous heparin infusion can be safely used prophylactically in children undergoing myeloablative therapy and BMT. The incidence of moderate and serious VOD was significantly less compared to historical controls. A future randomized, double-blinded, placebo-controlled phase III trial is, however, required to determine the efficacy of heparin in preventing VOD in children undergoing myeloablative therapy and BMT.

Adolescent↗
PubMed1995

Collection and transfusion of blood and blood components in the United States, 1992.

BACKGROUND: Studies were conducted to measure the state of the United States' national blood resource in 1992 and changes therein from 1989. STUDY DESIGN AND METHODS: With data supplied by the American Red Cross and the American Association of Blood Banks, as well as data from a stratified random-sample survey of 3350 non-American Association of Blood Banks hospitals, statistical methods were applied to estimate national blood activities in 1992. RESULTS: The total US blood supply in 1992 was 13,794,000 units, a decrease of 3.1 percent from 1989. Some 11,307,000 red cell units were transfused to 3,772,000 patients, an average of 3.0 units per transfused patient. Preoperative autologous blood deposits totaled 1,117,000 units, a 70-percent increase over 1989. Of this number, 566,000 units (50.7%) were transfused, 5,000 (4.4%) transferred to the allogeneic supply, and 546,000 (48.9%) discarded. Of 436,000 directed-donation units, 136,000 (31.2%) were transfused, 57,000 (13.1%) transferred to allogeneic supply, and 243,000 (55.7%) discarded. The total allogeneic blood supply, including imports, decreased by 7.4 percent from 1989, and allogeneic blood transfusions, including those to children, decreased by 8.6 percent. Over 8,300,000 platelet units were transfused; of these, some 3,600,000 were apheresis platelets. In addition, 2,255,000 units of plasma and 939,000 units of cryoprecipitate were transfused. CONCLUSION: While the US blood supply was adequate for transfusion needs in 1992, blood collections and red cell transfusions had decreased substantially since 1989.

Blood Banks↗
PubMed1995

Arachidonic acid-dependent phosphorylation of troponin I and myosin light chain 2 in cardiac myocytes.

Recent evidence has suggested that arachidonic acid (AA) may be an important signaling molecule in cardiac excitation-contraction coupling. We previously showed that AA and endothelin-1 (ET) inhibit distinct K+ channels via protein kinase C-dependent pathways in rat ventricular myocytes. In addition, we demonstrated that Ca2+ transients in populations of fura 2-loaded myocytes were potentiated by AA and ET via activation of protein kinase C. In this study, we have used suspensions of [32P]orthophosphate (32Pi)-labeled rat ventricular myocytes to study the effects of AA and ET at the level of the myofilaments. After a 10-minute incubation of the labeled cells with phorbol 12-myristate 13-acetate (PMA), AA, or ET in the presence or absence of the protein kinase C inhibitor calphostin C, the myofibrillar proteins were separated by PAGE. Measurement of unloaded cell shortening using video edge detection in single electrically stimulated myocytes was also used to assess the effects of AA and ET on myocyte contractility. Incubation with either PMA, AA, or ET resulted in similar increases in 32Pi incorporation into troponin I (TnI) and myosin light chain 2 (MLC2), which was inhibited by preincubation with the protein kinase C antagonist calphostin C. In addition, the ability of these agonists to stimulate phosphorylation of TnI or MLC2 did not require extracellular Ca2+ or intact intracellular Ca2+ stores. The effects of AA and ET together on phosphorylation of TnI or MLC2 were not additive.(ABSTRACT TRUNCATED AT 250 WORDS)

Actin Cytoskeleton↗
PubMed1995

Identification of Genes Predisposing to Clinically Severe Obesity: An Approach.

BACKGROUND: Familial correlations, twin studies and adoption studies have all indicated that human obesity has a substantial genetic component. To date, obesity genes have only been identified using mouse models. METHODS: In an attempt to identify human obesity genes large numbers of multigenerational families, in whom extreme obesity segregates, are currently being collected. RESULTS AND CONCLUSIONS: Relative risk estimates and models of genetic heterogeneity indicate that at least 500 affected sibling pairs will need to be collected to identify major genes.

Journal Article↗
PubMed1994

Crystallization and preliminary crystallographic data for the azurin mutant End-121 from Pseudomonas aeruginosa.

Pseudomonas aeruginosa azurin has been crystallized from a mutant where residues from Met 121 to Lys128 have been deleted from the protein. The crystals form pale-blue well formed prisms in the orthorhombic space group P2(1)2(1)2(1), with cell dimensions a = 60.79 (5), b = 123.47 (5), c = 187.77 (5) A. The crystals diffract to 3.0 A and there are eight molecules in the asymmetric unit.

Journal Article↗