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Biomedical subjects

S T Murphy

Publications and source records attributed to S T Murphy.

At least 19 recordsLinked to original sources
PubMed2002

Online sales: profit without question.

OBJECTIVES: To examine the ease with which underage smokers can purchase cigarettes online using money orders and to evaluate the effectiveness of internet filtering programs in blocking access to internet cigarette vendors (ICVs). DESIGN: Four young people purchased 32 money orders using 32 different names to buy one carton of cigarettes for each named individual. Each money order was subsequently mailed to a different ICV in the USA. No age related information accompanied these online orders. Two internet filtering programs ("Bess" and filtertobacco.org) were tested for their relative efficacy in blocking access to ICV sites. RESULTS: Of the 32 orders placed, four orders never reached the intended ICV. Of the remaining 28 orders, 20 (71%) were filled despite a lack of age verification. Only four (14%) of the orders received were rejected because they lacked proof of age. "Bess" blocked access to 84% and filtertobacco.org to 94% of the ICV sites. CONCLUSIONS: Although underage smokers can easily purchase cigarettes online using money orders, access to these sites can be largely blocked if appropriate filtering devices are installed.

Adolescent↗
PubMed2001

Effects of ring diameter and wire tension on the axial biomechanics of four-ring circular external skeletal fixator constructs.

OBJECTIVE: To determine relative effects of ring diameter and wire tension on axial biomechanical properties of 4-ring circular external skeletal fixator constructs. SAMPLE POPULATION: 4-ring circular external skeletal fixator constructs and artificial bone models. PROCEDURE: 4-ring constructs were assembled, using 50-, 66-, 84-, or 118-mm-diameter rings. Two 1.6-mm-diameter fixation wires were attached to opposing surfaces of each ring at intersection angles of 90 degrees and placed through a gap-fracture bone model. Three examples of each construct were loaded in axial compression at 7 N/s to a maximum load of 400 N at each of 4 wire tensions (0, 30, 60, and 90 kg). Response variables were determined from resulting load-displacement curves (construct stiffness, load at 1 mm of displacement, displacement at 400 N). RESULTS: Ring diameter and wire tension had a significant effect on all response variables and had a significant interaction for construct stiffness and displacement at 400 N. Significant differences within all response variables were seen among all 4 ring diameters and all 4 wire tensions. As ring diameter increased, effect of increasing wire tension on gap stiffness and gap displacement at 400 N decreased. Ring diameter had a greater effect than wire tension on all response variables. CONCLUSIONS AND CLINICAL RELEVANCE: Although effects of wire tension decrease as ring diameter increases, placing tension on wires in larger ring constructs is important because these constructs are inherently less stiff. The differential contribution of ring diameter, wire tension, and their interactions must be considered when using circular external skeletal fixators.

Animals↗
PubMed2000

Subliminal mere exposure: specific, general, and diffuse effects.

The present research examined the possibility that repeated exposure may simultaneously produce specific and diffuse effects. In Study 1, participants were presented with 5-ms exposures of 25 stimuli each shown once (single-exposure condition) or with five repetitions of 5 stimuli (repeated-exposure condition). Participants in the repeated-exposure condition subsequently rated their own mood more positively than those in the single-exposure condition. Study 2 examined whether affect generated by subliminal repeated exposures transfers to unrelated stimuli. After a subliminal exposure phase, affective reactions to previously exposed stimuli, to new but similar stimuli, and to stimuli from a different category were obtained. Previously exposed stimuli were rated most positively and novel different stimuli least positively. All stimuli were rated more positively in the repeated-exposure condition than in the single-exposure condition. These findings suggest that affect generated by subliminal repeated exposure is sufficiently diffuse to influence ratings of unrelated stimuli and mood.

Adult↗
PubMed2000

Preaching to the choir: preference for female-controlled methods of HIV and sexually transmitted disease prevention.

OBJECTIVES: This study assessed interest in female-controlled methods of HIV and sexually transmitted disease (STD) prevention. METHODS: Surveys were conducted with 168 African American women, aged 18 to 32 years, who had had unprotected sex and at least 3 sexual partners in the last 2 years. RESULTS: Of 44 potential features, "female control" (where women control the method by either wearing or applying it) ranked 22nd in average importance. Women who rated female control as highly important had fewer sex partners and fewer STDs and were more likely to use existing prevention methods frequently. CONCLUSIONS: Female control may be of less interest to women most at risk for HIV and other STDs. This underscores the need to take the priorities and preferences of women into consideration when developing new prevention methods.

Adult↗
PubMed2000

The impact of anemia correction on cardiovascular disease in end-stage renal disease.

Cardiovascular disease is a major cause of mortality and morbidity in patients with end-stage renal disease. Anemia, a result of erythropoietin deficiency, is associated with increased all-cause and cardiovascular mortality in this population, and predisposes patients to the development of symptomatic heart disease. Anemia is also associated with the development and progression of left ventricular echocardiographic disorders, which strongly predict cardiac failure and death. Left ventricular dilatation with compensatory hypertrophy, the major pattern of echocardiographic disease progression in hemodialysis patients, is a particularly strong predictor of late mortality. Partial correction of anemia with recombinant human erythropoietin likely reduces left ventricular mass and volume. Complete correction of anemia may prevent progressive left ventricular dilatation in patients with normal left ventricular volumes. A recent trial, however, reports excess mortality and vascular access loss in patients with preexisting symptomatic heart disease when anemia was completely corrected. Consequently, hematocrit target ranges above 32% to 36% cannot be recommended in this population. In patients without symptomatic heart disease, it is not possible to conclude that potential benefits derived from a normalized hematocrit will outweigh potential risks.

Anemia, Iron-Deficiency↗
PubMed1999

Radiographic evaluation of elbow joints before and after surgery in dogs with possible fragmented medial coronoid process.

OBJECTIVE: To determine the usefulness of 5 radiographic projections of the elbow joint for identification of fragmented coronoid process (FCP) and associated secondary degenerative changes in dogs. DESIGN: Longitudinal clinical study. ANIMALS: 19 dogs suspected of having FCP (7 dogs, 1 elbow joint; 12 dogs, both elbow joints). PROCEDURE: 5 radiographic projections were obtained before and after surgery for all elbow joints on which exploratory arthrotomy was performed because of suspected FCP. Radiographs obtained before surgery were compared with radiographs obtained after surgery and radiographs taken of the excised fragments. Each projection was evalated for its utility in definitively identifying FCP and 7 specific degenerative changes. Interevaluator agreement, use of each radiographic projection for definitively identifying a feature, and ability of the 4 evaluators to definitively identify a feature were analyzed. RESULTS: The craniolateral-caudomedial oblique (Cr15L-CdMO) projection had a significantly higher sensitivity for definitively identifying FCP, compared with the other 4 projections. Interevaluator and kappa agreement for the 5 projections did not differ significantly among the 7 degenerative changes evaluated. The radiographic projection with the highest sensitivity and specificity for detection of a particular degenerative change varied by feature. CLINICAL IMPLICATIONS: Of the 5 radiographic projections evaluated, the Cr15L-CdMO projection provided the highest sensitivity and was the best projection to use for definitively identifying FCP. The craniocaudal, Cr15L-CdMO, and mediolateral projections most reliably allowed for identification of secondary degenerative changes.

Animals↗
PubMed1999

Ethnicity and attitudes towards life sustaining technology.

The ethical and legal implications of decisions to withhold and withdraw life support have been widely debated. Making end-of-life decisions is never easy, and when the cultural background of doctor and patient differ, communication about these issues may become even more difficult. In this study, we examined the attitudes of people aged 65 and older from different ethnic groups toward foregoing life support. To this end, we conducted a survey of 200 respondents from each of four ethnic groups: European-American, African-American, Korean-American and Mexican-American (800 total), followed by in-depth ethnographic interviews with 80 respondents. European-Americans were the least likely to both accept and want life-support (p < 0.001). Mexican-Americans were generally more positive about the use of life-support and were more likely to personally want such treatments (p < 0.001). Ethnographic interviews revealed that this was due to their belief that life-support would not be suggested if a case was truly hopeless. Compared to European-Americans, Korean-Americans were very positive regarding life-support (RR = 6.7, p < 0.0001); however, they did not want such technology personally (RR = 1.2, p = 0.45). Ethnographic interviews revealed that the decision of life support would be made by their family. Compared to European-Americans, African-Americans felt that it was generally acceptable to withhold or withdraw life-support (RR = 1.6, p = 0.06), but were the most likely to want to be kept alive on life-support (RR = 2.1, p = 0.002). Ethnographic interviews documented a deep distrust towards the health care system and a fear that health care was based on one's ability to pay. We concluded that (a) ethnicity is strongly related to attitudes toward and personal wishes for the use of life support in the event of coma or terminal illness, and (b) this relationship was complex and in some cases, contradictory.

Black or African American↗
PubMed1999

Erythropoietin therapy in chronic uremia: the impact of normalization of hematocrit.

The target hematocrit to be achieved when treating anemia in hemodialysis patients with erythropoietin is controversial. Current evidence-based recommendations suggest a target hematocrit range of 33% to 36%. Small studies suggest that normalization of hematocrit with erythropoietin may benefit hemodialysis patients in terms of brain function, physical performance, quality of life, and prevention of progressive left ventricular dilatation. However a recent study of the effects of erythropoietin-induced normalization of hematocrit in hemodialysis patients with symptomatic heart disease has shown an increase in both mortality and the rate of vascular access thrombosis. Currently, normalization of hematocrit in patients with symptomatic heart disease is not recommended, nor is it possible to conclude that possible benefits of normalization of hematocrit will outweigh risks in hemodialysis patients without symptomatic heart disease.

Anemia↗
PubMed1998

A discourse of relationships in bioethics: patient autonomy and end-of-life decision making among elderly Korean Americans.

A two-year, multidisciplinary study (N = 800) was conducted on attitudes about end-of-life decision making among elderly individuals in four ethnic groups (African American, European American, Korean American, and Mexican American). On a quantitative survey, Korean Americans reported negative attitudes about the use of life-sustaining technology for themselves but positive attitudes about its use in general. This article reports on an interview with a 79-year-old typical Korean American respondent to explain the contradiction in the survey data. Expectations among elderly Korean Americans include protecting family members with a life-threatening illness from being informed of their diagnosis and prognosis, and doing everything to keep them alive. Two conclusions, one substantive and the other methodological, are drawn: First, the bioethics discourse on individual rights (patient autonomy) is insufficient to explain the preferences of many Korean Americans and must be supplemented with a discourse on relationships. Second, the rigorous use of qualitative, narrative methods clarifies quantitative data and should not be dismissed as "anecdotal."

Advance Directives↗
PubMed1998

Effect of radiographic positioning on interpretation of cubital joint congruity in dogs.

OBJECTIVE: To ascertain effects of x-ray beam centering and limb position on apparent congruity of a normal cubital joint (elbow). ANIMALS: 6 skeletally mature male Treeing Walker Coonhounds without physical, radiographic, or gross evidence of elbow abnormalities. PROCEDURE: Relative movement among humerus, radius, and ulna and measured joint space width on mediolateral and craniocaudal radiographic views was compared, using various x-ray beam centering and limb positions. RESULTS: Highest agreement and greatest certainty on subjective determination of congruity was for the flexed 90 degrees mediolateral radiographic view with the x-ray beam centered on the elbow. Distortion artifact of the proximal ulnar measurements was significant when the x-ray beam was centered on the midpoint of the radius. On the mediolateral view, the humeroradial joint space became significantly wide when the elbow was flexed. On the craniocaudal view, maximal humeroradial joint space width was obtained when the x-ray beam bisected the angle of the joint or was angled +30 degrees toward the humerus. CONCLUSIONS: Artifact distortion of joint width affected objective and subjective assessment of elbow congruity when the limb was placed in extreme flexion or extension or when the x-ray beam was not centered over the area of interest. Optimal visualization of the humeroradial joint space on the craniocaudal view was achieved when the x-ray beam bisected the angle of the elbow or was slightly angled toward the humerus. CLINICAL RELEVANCE: Elbow congruity was best assessed on the flexed 90 degrees lateral radiographic view with the x-ray beam centered on the joint.

Animals↗
PubMed1997

Pulmonary lobectomy in the management of pneumonia in dogs: 59 cases (1972-1994).

OBJECTIVE: To evaluate the risk and efficacy of pulmonary lobectomy in dogs with pneumonia. DESIGN: Retrospective study. ANIMALS: 59 dogs with pneumonia. PROCEDURE: Review of medical records and telephone conversations. RESULTS: 54.2% of dogs had resolution of pneumonia after lobectomy, 20.3% died in the perioperative period, and 25.4% survived the perioperative period but pneumonia did not resolve. Pneumonia was caused by bacteria (25 dogs), fungi (12), foreign bodies (8), parasites (1), viruses (1), and allergies (1). In 11 dogs, the etiologic agent was not isolated. Bacterial or fungal pneumonias were significantly less likely to resolve compared with foreign body pneumonia or when an etiologic agent was not isolated. Perioperative mortality rate increased significantly with an increase in number of pulmonary lobes removed. Complications during surgery significantly increased perioperative mortality rate. Surgical era (1972 to 1983 vs 1984 to 1994) was a significant predictor of mortality, with the odds of dying in the perioperative period being 11 times greater between 1972 to 1983. The odds of failure to resolve pneumonia was 3 times greater during 1972 to 1983. CLINICAL IMPLICATIONS: Number of pulmonary lobes removed and complications during surgery significantly affect perioperative mortality rate. Identification of etiologic agents may help in predicting dogs likely to resolve pneumonia after surgery.

Animals↗
PubMed1997

Osteosarcoma following total hip arthroplasty in a dog.

Osteosarcoma involving the distal right femur was diagnosed in a nine-year-old female neutered Rottweiler seven years after total hip arthroplasty had been performed on that limb. The findings were consistent with a primary bone tumour and pathological fracture of the right femoral condyle with loosening of the orthopaedic implant and fracture of the polymethylmethacrylate at the distal aspect of the femoral component. Possible hypotheses to explain the association of osteosarcoma with total hip arthroplasty suggest that the neoplastic process was the result of some derangement of host tissue and the healing process or that the implants or their by-products were carcinogenic. Given the large number of total hip arthroplasties that are routinely performed in dogs, the development of a malignant lesion appears to be an extraordinary complication and may be completely coincidental.

Animals↗
PubMed1997

Pulmonary lobectomy in the management of pneumonia in five cats.

Five cats underwent lobectomy for the management of pneumonia. The mean presurgical duration of treatment was eight months. A potentially immunosuppressive disease process was present preoperatively in two of the five cats. Preoperatively, two of the cats had radiographically diffuse pneumonia, while three had focal pneumonia. A single pulmonary lobe was removed in four cats, with one cat having two pulmonary lobes removed. There were no life-threatening complications and no clinical recurrence noted during a mean follow-up period of 37.8 months. The benefit of pulmonary lobectomy in focal pneumonia may lie in removing the nidus of infection. In diffuse, chronic or medically refractory pneumonia, obtaining an aetiological diagnosis may be the main benefit of lobectomy. Selective lobectomy for the treatment of pneumonia may be beneficial but a thorough preoperative evaluation is warranted.

Animals↗
PubMed1995

Ethnicity and attitudes toward patient autonomy.

OBJECTIVE: To study differences in the attitudes of elderly subjects from different ethnic groups toward disclosure of the diagnosis and prognosis of a terminal illness and toward end-of-life decision making. DESIGN: Survey. SETTING: Thirty-one senior citizen centers within Los Angeles County, California. RESPONDENTS: A stratified quota sample of 200 subjects aged 65 years and older self-identified as being from each of four ethnic groups: European American, African American, Korean American, or Mexican American (N = 800). MAIN OUTCOME MEASURES AND RESULTS: Korean Americans (47%) and Mexican Americans (65%) were significantly less likely than European Americans (87%) and African Americans (88%) to believe that a patient should be told the diagnosis of metastatic cancer. Korean Americans (35%) and Mexican Americans (48%) were less likely than African Americans (63%) and European Americans (69%) to believe that a patient should be told of a terminal prognosis and less likely to believe that the patient should make decisions about the use of life-supporting technology (28% and 41% vs 60% and 65%). Instead, Korean Americans and Mexican Americans tended to believe that the family should make decisions about the use of life support. On stepwise multiple logistic regression, ethnicity was the primary factor related to attitudes toward truth telling and patient decision making. CONCLUSIONS: Korean-American and Mexican-American subjects were more likely to hold a family-centered model of medical decision making rather than the patient autonomy model favored by most of the African-American and European-American subjects. This finding suggests that physicians should ask their patients if they wish to receive information and make decisions or if they prefer that their families handle such matters.

Black or African American↗
PubMed1995

Additivity of nonconscious affect: combined effects of priming and exposure.

Affect deriving from 2 independent sources--repeated exposure and affective priming--was induced, and the combined effects were examined. In each of 4 studies, participants were first shown 72 Chinese ideographs in which the frequency of exposure was varied (0, 1, or 3). In the second phase participants rated ideographs that were primed either positively, negatively, or not at all. The 4 studies were identical except that the exposure duration--suboptimal (4 ms) or optimal (1 s)--of both the initial exposure phase and the subsequent priming phase was orthogonally varied. Additivity of affect was obtained only when affective priming was suboptimal, suggesting that nonconscious affect is diffuse. Affect whose source was apparent was more constrained. Interestingly, increases in liking generated through repeated exposures did not differ as a function of exposure duration.

Adult↗
PubMed1994

Heterocyst-forming filamentous cyanobacteria encode proteins that resemble eukaryotic RNA-binding proteins of the RNP family.

Heterocyst-forming cyanobacteria have multiple genes encoding proteins that are similar to the RNP family of eukaryotic RNA-binding proteins. Three genes from two strains of cyanobacteria (Anabaena and Chlorogloeopsis) have been sequenced. All three putative gene products contain a single RNA Recognition Motif (RRM) that includes the highly conserved RNP1 and RNP2 regions and all three have an auxiliary motif consisting either of a short glycine-rich carboxy-terminal tail or a carboxy-terminal tail rich in both asparagine and glycine. RNA-binding protein genes are abundant in heterocyst-forming filamentous cyanobacteria but are not abundant in non-heterocyst-forming filamentous or unicellular cyanobacteria suggesting that the cyanobacterial proteins may play a role in gene expression during heterocyst differentiation. The cyanobacterial gene products share a significant degree of similarity with the RNP family of RNA-binding proteins which includes snRNP proteins, hnRNP proteins, nucleolins, as well as some regulatory proteins and some plant chloroplast proteins. Although the exact function of the cyanobacterial gene products is not yet known, their similarity to eukaryotic proteins suggests that they may play a role in RNA processing and metabolism. Finally, the presence of these genes in cyanobacteria has implications for the evolution of RNA binding proteins and RNA processing.

Amino Acid Sequence↗