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Biomedical subjects

R B Murray

Publications and source records attributed to R B Murray.

17 recordsLinked to original sources
PubMed1996

Transcendence: the meaning of great-grandmothering.

Great-grandparents are increasing in number in the United States. This case study examined how eight African-American and eight Caucasian community dwelling great-grandmothers found transcendence in their great-grandmotherhood. Subjects, who ranged in age from 75 to 89 years, indicated that family was the common factor which influenced the transcendence of great-grandmothering. Five domains, connectedness, religion, being wise, values, and stories, generated the meaning of transcendence. Domains evolved into one cultural theme: By finding opportunities to influence great-grandchildren, the great-grandmother enhances possibilities for meaning and transcendence. Nurses can help great-grandmothers enhance family relationships to promote transcendence.

Aged↗
PubMed1996

Needs and resources. The lived experience of homeless men.

1. Interviews were conducted with 150 homeless men, who were in a situational crisis, were severely and persistently mentally ill, or were alcohol/drug dependent, about their perceived needs and resources. 2. The most pressing needs for men in all groups were for permanent housing, a job, and income. 3. A variety of approaches or community resources were utilized to meet needs for food, sleep, elimination, clothing, hygiene/laundry, safety, privacy, and income.

Adult↗
PubMed1996

Stressors and coping strategies of homeless men.

1 Major stressors commonly encountered by homeless men are violence to self, theft of belongings, inability to meet basic needs, inconsistent enforcement of rules by shelter staff, and other people's dehumanization or humiliation caused by behavior toward the men. 2 Cognitive, sociocultural, and spiritual coping strategies were frequently used and found to be effective in coping with stressors by homeless men who were either in crisis or alcohol/drug dependent. 3 Severely and persistently mentally ill men had lower mean scores for both use and effectiveness of coping strategies in physical, cognitive, psychological, sociocultural, and spiritual strategies. 4 The longer the duration of homelessness, the lower the mean scores for frequency and effectiveness of use of coping strategies in any of the dimensions.

Adaptation, Psychological↗
PubMed1993

Use of therapeutic milieu in a community setting.

1. Many of the same components that contribute to the success of milieu therapy in inpatient facilities also promote treatment success for clients living in the community. 2. Treatment goals at the Rosati Center, a transitional residential program for chronically mentally ill homeless persons in St. Louis, generally include supporting residents as they secure their own permanent housing; helping residents apply for entitlements so that they can support themselves upon discharge; connecting residents with outpatient psychiatric treatment; and assisting residents to structure their time and activities as a means to improving coping skills. 3. Program evaluations of the transitional living program at the Rosati Center revealed that implementation of therapeutic milieu concepts (in combination with case management concepts) can be successful. The facility served 228 persons during a 5 1/2-year period. Nearly half of those persons were discharged having fully met the objectives of the transitional program.

Adult↗
PubMed1992

Colorectal leiomyosarcomas: a pathobiologic study with long-term follow-up.

Colorectal leiomyosarcoma (CLM) is an uncommon tumour. Reports of its occurrence have been published mostly as single cases or small series. This study documents 12 cases of CLM that were seen over a 28-year period in Saskatchewan. The annual incidence of CLM was 0.45 per million people and constituted 0.12% of all colorectal malignant tumours seen during the study period. CLMs had a predilection for the rectum and sigmoid and commonly were associated with rectal bleeding or abdominal pain. More than half the tumours were detected by sigmoidoscopy. A correct preoperative or intraoperative histologic diagnosis of leiomyosarcoma was made in only two out of six cases. A potentially curative surgical procedure was done in 10 of the 12 patients. The mean follow-up was 6.9 years. Eight patients had tumour recurrence or metastasis, or both. From the findings of this study the authors recommend wide excision of colorectal smooth-muscle tumours whenever there is a suggestion of malignancy.

Adult↗
PubMed1987

Naloxone, ethanol, and the chlorpropamide alcohol flush.

The effects of ethanol and subsequent administration of intravenous naloxone were studied in double-blind, placebo-controlled fashion with a group of six male chlorpropamide alcohol flushers (CPAF) and a group of 13 nonflushing males. The effect of ethanol intoxication on fine motor control was measured by a typing test. When sober, the two groups performed in comparable fashion. When intoxicated, the CPAF group displayed significantly greater impairment than the nonflushing group as measured by typing errors committed in 3 min (CPAF: 55.4 +/- 10.1 errors, n = 12; vs. nonflushing: 15.6 +/- 2.3, n = 32; p = 0.0000015 by Student's unpaired t test). Chlorpropamide alcohol flushers appeared to be more sensitive to ethanol. Naloxone reversed this effect for individuals in the CPAF group (saline treatment: 51.0 +/- 11.7 errors per minute; vs. naloxone treatment: 23.7 +/- 4.2; p = 0.034 by Student's paired t test, n = 6). Naloxone had no effect in the nonflushing group. Unlike the normal, nonflushing group, the CPAF group demonstrated an increased sensitivity to ethanol that was partially antagonized by naloxone.

Adult↗
PubMed1983

The pupillary effects of opioids.

Morphine's miotic action on the pupil is an easily recognizable and quantifiable effect in man. The neural pathways responsible for regulating pupil size are reasonably well defined. Yet, the mechanisms behind this and related effects of opioids on the eye in humans and laboratory animals have just begun to be explored. In this review, we have attempted to organize the available information on pupillary actions of opioids, emphasizing the dynamic nature of the responses, their species specificity, possible mechanisms of action, and the recently discovered development of tolerance to these actions. Our current knowledge regarding differences among the opioids, the effects of endogenous opioid peptides and the role of the various opiate receptor subtypes in pupillary effects is also summarized.

Animals↗
PubMed1982

Pupillographic analysis of morphine action in the rabbit: role to the autonomic nervous system.

Pupillary response of albino rabbits were recorded using an infrared video pupillometer. The transient response to an i.v. injection of morphine (1-12 mg/kg) consists of three phases. Phase 1 is a brief mydriasis of 20 s duration. Phase 2 is a miosis that reaches a maximum within 2-4 min and is the only dose-related endpoint observed. Time-averaged pupil size is not decreased by morphine in a dose-related manner when measured 5 min after injection. Phase 3 is large amplitude fluctuation that reaches peak amplitude within 20 min and may last for several hours. Thus, dynamic pupillography reveals that the terms "miosis' and "mydriasis' may be insufficient to fully describe opiate-induced pupillary effects. All three phases are blocked by naloxone (0.1 mg/kg i.v.) and by topical pretreatment with scopolamine. These results are consistent with the theory that morphine alters pupil size by interaction with opiate receptors that are involved in the control of parasympathetic output to the iris.

Animals↗
PubMed1981

Use of programmable protocol timer and data logger in the monitoring of animal behavior.

The quantitative assessment of animal behavior by continuous or intermittent observation often requires much time and intense concentration. We have developed an accurate and convenient system which allows one observer to monitor up to four animals and record two types of behavior simultaneously. The system uses an inexpensive portable microcomputer including keyboard, video monitor, and cassette recorder. A program written in BASIC generates timed visible and audible cues, and tabulated data entered through the keyboard. The total number of occurrences of a particular behavior (e.g., "wet dog" shakes) and the frequency of a second behavior (e.g., grooming) may be measured. Frequency data, bases on intermittent observations, is processed for histogram display. The results may be copied from the video display or recorded on tape for further statistical analysis. The system has provided a convenient way to time experiments and collect data on drug-induced behavior in over 800 rats.

Animals↗
PubMed1981

Infrared video pupillometry: a method used to measure the pupillary effects of drugs in small laboratory animals in real time.

Pupillometry in clinical investigation and in basic research often requires dynamic measurement of pupil size. Static methods, i.e. direct observation and still photography, are often used because of the high cost of commercial infrared pupillometers and problems with pupil-iris contrast in small animals. This report describes an improved infrared video pupillometer (IVP) which accurately measures the pupil area of small animals in real time (30 samples/sec). Two components of the pupillometer were designed and built by the authors: a "bright-pupil" infrared illumination system and a digital video signal processor (VSP). The use of a standard closed-circuit television camera to produce the pupil image signal results in a device that is relatively economical to construct. The IVP is sensitive enough to accurately track pupil are in the study of the pupil light reflex or pupillary oscillations. Several applications for the IVP are illustrated, including analysis of the transient response to light flashes and intravenous injections of drug, and analysis of the spontaneous and drug-induced pupillary fluctuation. Pupillography has been applied in the bioassay of various psychopharmacologic compounds and in the assessment of narcotic dependency. This IVP is being used in this laboratory to study the pupillary action of opiates in the rabbit and rat.

Animals↗
PubMed1980

Mandibular sagittal subapical osteotomy: a case study.

A case involving mandibular sagittal subapical osteotomy has been demonstrated. When the patient presented initially I was unaware of this particular operation. Prior to surgical intervention there was significant improvement in the previously abused lower labial tissues, but an impasse developed with respect to limiting treatment to orthodontic means alone. Along with lower tissue recovery, unexpected benefits resulted, namely, bite opening, establishment of excellent occlusion, and dramatic facial improvement. Etiologically, it would appear that apparently a severe forward rotational growth pattern with muscular imbalance had produced an adverse facial configuration in an otherwise reasonable craniofacial complex. As a result of this experience, it was brought home more conclusively than ever that it is well to realize before entering into presumably minor or compromise treatment procedures for many orthodontic problems, particularly in advanced skeletal malocclusions, that the possibility of orthognathic surgery exists and one would be wise to explore thoroughly and advise those involved of such possibilities before becoming clinically involved.

Adult↗
PubMed1979

A scale for assessing the severity of diseases and adverse drug reactions. Application to drug benefit and risk.

Physicians were interviewed to assess their willingness to risk adverse drug reactions among patients. These untoward reactions were ranked according to severity and weighted against the primary illness being treated. A specially designed questionnaire in the form of a matrix was used. Severity was divided into seven classes denoted by progressively increasing numerical scores, W1 to W7, whose values could be calculated from analysis of the completed questionnaires. The questionnaires presented several cases, in each of which an illness of specified severity was to be treated with a drug whose untoward reactions differ in severity from that of the primary illness. Each case involved a different permutation of the severities. Analysis of the completed questionnaires yielded the mean values of the scores which were found to range from W1 = 1.00 (the mildest case) to W7 = 817 (the most serious case). It is our opinion that this type of scale is preferable to nonnumerical descriptions of severity such as "mild" or "serious," since, when combined with data on frequency of occurrence, a numerical scale permits a determination of expectation of both benefit and risk.

Attitude of Health Personnel↗
PubMed1979

Teratomas of the nasopharynx.

The case of an infant with a large nasopharyngeal teratoma is presented. The tumor completely obstructed the airway and necessitated immediate intubation. It was excised the day of birth and the child's postoperative course has been satisfactory. A review of the literature reveals dermoid tumors to be relatively common but teratomas occur considerably less frequently. Four previously reported cases with successful surgical excision were found. The etiology of these lesions is unknown. They probably arise from uncontrolled growth of a pleripotential cell originating in the region of the embryonic notochord. Dermoid tumors often present in the adolescent or adult. Teratomas however, generally present in the neonate and are incompatible with life without surgical excision which provides the only chance of survival for these infants.

Airway Obstruction↗
PubMed1977

Miosis and fluctuation in the rabbit pupil: effects of morphine and naloxone.

In the unanesthetized rabbit, morphine (12-16 mg/kg i.v.) produced a miosis that was not sustained. The response to the narcotic was a pupillary constriction that became maximal within 2 minutes following i.v. administration, after which time the pupil size fluctuated appreciably. The magnitude of the fluctuation, typically as high as 40% of control diameter, was much larger than can be attributed to "noise." The fluctuations occurred within a frequency of approximately 0.5 to 2/min. The miosis and subsequent fluctuation seen with 12 and 16 mg/kg of morphine was blocked by naloxone (0.5 mg/kg i.v.), but 128 mg/kg of morphine overcame the block. Cumulative dose-response curves for morphine and for morphine after naloxone yielded the value pA2=6.8 which is in agreement with the values obtained using other effects and species. Administration of morphine after exposure to high intensity light produced less miosis than that seen under normal illumination.

Animals↗