PubMed Health⌕ Search

Biomedical subjects

N M Murphy

Publications and source records attributed to N M Murphy.

8 recordsLinked to original sources

An outreach programme for patients with an exacerbation of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is a common clinical condition characterised by airflow obstruction. The clinical course of the disease is characterised by intermittent exacerbations. In Ireland exacerbations of chronic obstructive pulmonary disease are a common cause of admission to acute medical hospitals. The Beaumont Hospital COPD Outreach Programme was designed to provide care at home for patients with an exacerbation of COPD that would otherwise require hospitalisation. Patients recruited to the programme were discharged home within 72 hours of admission and reviewed by the Outreach Team over a two week period. In addition to monitoring clinical progress the Team provided education, smoking cessation and medication advice. Analysis of the outcome of the first 100 patients recruited to the study show that one third of patients admitted to Hospital with an exacerbation of COPD are eligible for this programme and the average length of Hospital stay was 2.6 days. During the fourteen day follow up there was one death (non-respiratory) and six patients were re-admitted to hospital. Forty percent of smokers had abstained from smoking at the end of three months. In summary, the COPD Outreach programme is a safe and effective alternative to acute hospital care for selected patients with exacerbations of COPD.

Home Care Services, Hospital-Based↗

The effect of minimal exercise on fitness in elderly women after hip surgery.

To determine the effect of minimal exercise on functional fitness following total hip replacement in elderly women, 20 women (13 exercisers, 7 controls) who had undergone unilateral or bilateral hip replacement surgery for primary osteoarthritis were studied. An exercise treadmill test with respiratory gas and blood lactate analyses, and a field test of walking speed on a measured course, were administered before and after a twice weekly exercise programme of three months' duration. Markers of cardiorespiratory fitness, including peak achieved oxygen uptake (VO2) and ventilatory and lactate thresholds were measured. Maximum self-selected walking speed was also measured over a flat course. Peak VO2 increased in the exercise group when compared to baseline (P < 0.05) but did not differ from the control group. The exercise group significantly improved their walking speed by 10.1% compared with non-exercising controls (1.41 vs 1.20 m/sec, P < 0.05), and increased VO2 at lactate threshold. The improvements occurred despite the twice weekly exercise sessions being below the recommended frequency of exercise for improving cardiorespiratory fitness. Minimal exercise in elderly women after hip surgery can substantially improve submaximal exercise capacity, as well as walking speed.

Aged↗

Applied hand anatomy: its importance in accident & emergency.

Hand injuries account for 10-20% of an Accident & Emergency department's workload. Early recognition of serious injury is vital to ensure appropriate management. This is only possible with a good working knowledge of hand anatomy. Forty consecutive A&E senior house officers (SHOs) were assessed on their knowledge of basic hand anatomy. The results are discussed as are the implications for undergraduate and post-graduate training.

Anatomy↗

Ice-skating injuries to the hand.

166 patients with injuries due to ice-skating were seen in the local accident and emergency department over a six-month period; 60% of these involved the upper limb. 28 of the upper limb injuries were closed fractures and 24 were lacerations, almost all to the dorsum of the hand. The use of protective gloves would help to prevent these potentially avoidable injuries. "On-site" first-aid facilities help to reduce the demand on the local accident service.

Adult↗

Resuscitation training for cardiac patients and their relatives--its effect on anxiety.

It is feared by many doctors that teaching basic life support (BLS) to high risk cardiac patients or a member of the family increases their anxiety. We trained a group of patients with recurrent ventricular tachycardia in BLS together with a friend or family member. Measurement of anxiety before and three months after training demonstrated a reduction in anxiety in both groups. This suggests that basic life support training can be targeted to high risk groups without fear of increasing anxiety.

Anxiety↗

Objective verification of tetanus immune status in an apparently non-immune population.

Patients who are not known to be immunised to tetanus are considered to be non-immune. The appropriate treatment is the commencement of active immunisation with a course of three tetanus toxoid inoculations; if the wound is considered to be tetanus-prone, 250 IU of human anti-tetanus immunoglobulin is given concurrently. This study determined the true immune status of 166 patients who were considered to be non-immune on the basis of the available history. The majority (90 of 166) had protective levels of immunoglobulin (greater than 0.06 IU/ml) and further treatment was not indicated. Only two patients were non-immune. The remainder had protective levels (between 0.01 and 0.06 IU/ml) and required a tetanus toxoid booster.

Aged↗