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Biomedical subjects

L Murphy

Publications and source records attributed to L Murphy.

119 records · Page 7Linked to original sources

Evaluating the psychosocial adjustment of 2- and 3-year-old pediatric burn survivors.

Very little information has been published about 2- and 3-year-old children who have experienced major burns. This study used a standardized instrument to measure the behavioral adjustment of these young burn survivors, and the results were compared with those of a nonclinical normative sample. Thirty-three pediatric burn survivors with 50%+/-28% total body surface area burns were evaluated 1.2+/-0.7 years postburn. Parental observations were assessed with the use of the Child Behavior Checklist for 2- and 3-Year-Olds, a 99-item standardized checklist designed to identify behavior problems. Forty of the questions are specific to 2- and 3-year-olds, and the scores of male and female children are not differentiated. The raw scores of the children with burns were statistically compared with the reported normative sample for this version of the Child Behavior Checklist. Pediatric burn survivors in this sample exhibited significantly more internalizing behaviors than the children in the normative group. Parents reported children who had been burned to be more depressed and to have more somatic complaints and sleep problems. Determining the relationship of behavior problems to posttrauma sequelae and preburn environmental factors would assist with the establishment of appropriate psychosocial interventions.

Adaptation, Psychological↗

Leukemic ophthalmopathy detected by ultrasound.

Contact A- and B- scan ultrasonography was performed on 40 patients with acute lymphocytic leukemia at initial diagnosis, during therapy, during remission, and in patients with recurrences. This technique simply and consistently reveals tumor in the choroid, despite the fact that leukemic involvement may cause only 1-2 mm of choroidal thickening. Leukemic involvement may be diffuse or localized, detected with or without visual symptoms, and can be monitored repeatedly. Leukemic involvement of the choroid is difficult to see ophthalmoscopically, but easy to detect with contact ultrasound.

Choroid Neoplasms↗

Papillary carcinoma of the thyroid with manifestations resembling Graves' disease.

OBJECTIVE: To describe a case of papillary carcinoma of the thyroid that mimicked a diffuse toxic goiter. METHODS: We present a detailed case report, review related cases in the literature, and discuss the possible role of autoantibodies in promoting the growth of papillary thyroid tumor. RESULTS: A 28-year-old woman had a 6-month history of weight loss, palpitations, increased anxiety, and enlargement of her thyroid gland. Laboratory studies confirmed the presence of hyperthyroidism. A 1-cm nodule was identified at the left upper pole of the thyroid. Fine-needle aspiration biopsy of this nodule revealed papillary carcinoma of the thyroid. Total thyroidectomy and a modified radical neck dissection were performed. Microscopic examination showed that the entire gland was replaced by a papillary carcinoma with a predominantly follicular pattern of growth. Of 44 lymph nodes tested, 31 were positive for metastatic papillary thyroid carcinoma. The presence of thyroid antibodies may have had a role in the aggressiveness of the patient's disease. CONCLUSION: To our knowledge, this is the first published report of a papillary thyroid cancer with manifestations resembling Graves' disease.

Adult↗

Donation--a difficult but most important discussion.

Organ and tissue donation is an important topic that needs to be discussed with each family before, during or after the loss of a loved one. Currently in Michigan there are more than 2,400 people waiting for an organ or cornea transplant and many more in need of heart valves, bone, vein or skin grafts. Donation gives a grieving family a choice that could be the one positive outcome to a tragic or untimely death--saving or greatly improving the quality of someone's life.

Altruism↗

Probiotics: from myth to reality. Demonstration of functionality in animal models of disease and in human clinical trials.

The enteric flora comprise approximately 95% of the total number of cells in the human body and are capable of eliciting immune responses while also protecting against microbial pathogens. However, the resident bacterial flora of the gastrointestinal tract (GIT) may also be implicated in the pathogenesis of several chronic conditions such as inflammatory bowel disease (IBD). The University College Cork-based Probiotic Research Group has successfully isolated and identified lactic acid bacteria (LAB) which exhibit beneficial probiotic traits. These characteristics include the demonstration of bile tolerance; acid resistance; adherence to host epithelial tissue; and in vitro antagonism of potentially-pathogenic micro-organisms or those which have been implicated in promoting inflammation. The primary objective of this report is to describe the strategy adopted for the selection of potentially effective probiotic bacteria. The study further describes the evaluation of two members of the resulting panel of micro-organisms (Lactobacillus salivarius subsp. salivarius UCC118 and Bifidobacterium longum infantis 35624) under in vitro conditions and throughout in vivo murine and human feeding trials. Specifically, an initial feeding study completed in Balb/c mice focused upon (i) effective delivery of the probiotic micro-organisms to the GIT and evaluation of the ability of the introduced strains to survive transit through, and possibly colonise, the murine GIT; (ii) accepting the complexity of the hostile GIT and faecal environments, development of a method of enumerating the introduced bacterial strains using conventional microbiological techniques; and (iii) assessment of the effects of administered bacterial strains on the numbers of specific recoverable indigenous bacteria in the murine GIT and faeces. Additional research, exploiting the availability of murine models of inflammatory bowel disease, demonstrated the beneficial effects of administering probiotic combinations of Lactobacillus salivarius UCC118 and Bifidobacterium longum infantis 35624 in prevention of illness-related weight loss. A further ethically-approved feeding trial, successfully conducted in 80 healthy volunteers, demonstrated that yoghurt can be used as a vehicle for delivery of Lactobacillus salivarius strain UCC118 to the human GIT with considerable efficacy in influencing gut flora and colonisation.

Animals↗

Reconstructive goals for children with burns: are our goals the same?

It is often difficult if not impossible to include a pediatric patient in the planning of burn reconstruction. To give the patient greater input into his or her reconstructive plan, we developed a survey tool to evaluate the different reconstructive goals of the patient, the parent, and the physician. Each patient, parent, and physician were requested to complete a separate goal form. Each form consisted of a simple line drawing of a child that shows both anterior and posterior views. The patient, the parent, and the physician were each asked to circle the desired reconstruction site or sites. The responses were collated and compared by sex, age, size of burn, and evaluator (patient, parent, or physician). Patients indicated fewer and different desired reconstruction sites than the physicians or the parents. Before reconstruction is planned, the patient should be consulted. The desires of the parents and the physician may differ significantly from those of the patient.

Adolescent↗

Caring for the orthopaedic patient with sickle cell disease.

Sickle cell disease (SCD) is an inherited, chronic, painful condition seen primarily in blacks and populations from the Mediterranean and Caribbean areas. The crescent or sickle shaped red blood cells have a shorter lifespan causing severe anemia; they are sticky and easily clump together causing intravascular occlusions which eventually damage vital organs. Providing nursing care for patients with sickle cell disease can be very challenging because of the chronic nature of the illness. Understanding the disease phenomena can facilitate nursing assessments and help nurses individualize care for these clients.

Adaptation, Psychological↗

Job-sharing a clinical teacher's position: an evaluation.

The aim of this study was to evaluate the effects on staff of having two teachers share one clinical teaching position in their intensive care unit (ICU). Three, six and 12 months after the job-sharing arrangement was initiated, an 11 item questionnaire was distributed to 26 students in post-registration critical care courses, 41 clinical staff in ICU and 9 RN-managers with responsibilities for the unit. The overall response rate to the three questionnaires was 58%. All groups agreed that job-sharing was a viable alternative to full-time work. Three months after the shared position was initiated, there was uncertainty about the consistency of the teachers' performance and the adequacy of communication between them. Nine months later, there was a high level of positive responses to all areas of the teachers' performance. Most respondents felt they could approach either teacher and that more diverse ideas were generated by having two people in the teaching position.

Education, Nursing, Continuing↗