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Kourinov I, Ealick SE, Capel M, Banerjee S, Murphy F, Neau D, Perry K, Rajashankar K, Schuermann J, Sukumar N. NE-CAT crystallography beamlines for challenging structural biology research. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311087770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Good M, Clegg T, Murphy F, More S. The comparative performance of the single intradermal comparative tuberculin test in Irish cattle, using tuberculin PPD combinations from different manufacturers. Vet Microbiol 2011; 151:77-84. [DOI: 10.1016/j.vetmic.2011.02.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tebbutt NC, Murphy F, Zannino D, Wilson K, Cummins MM, Abdi E, Strickland AH, Lowenthal RM, Marx G, Karapetis C, Shannon J, Goldstein D, Nayagam SS, Blum R, Chantrill L, Simes RJ, Price TJ. Risk of arterial thromboembolic events in patients with advanced colorectal cancer receiving bevacizumab. Ann Oncol 2011; 22:1834-8. [PMID: 21273347 DOI: 10.1093/annonc/mdq702] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Bevacizumab is an antiangiogenic mAb with efficacy against several cancers, but it is associated with risk of arterial thromboembolism (ATE). Further data are needed to determine the safety of bevacizumab. PATIENTS AND METHODS We recorded grade 3, 4, or 5 ATE events and other data (including age, baseline cardiovascular risk factors, history of ATE, and aspirin use) from 471 patients with metastatic colorectal cancer in the MAX (Mitomycin, Avastin, Xeloda) trial of capecitabine monotherapy versus capecitabine with bevacizumab with or without mitomycin C. RESULTS Bevacizumab-treated patients had 12 grade 3, 4, or 5 ATEs (3.8% incidence). ATEs occurred in 2.1% of patients >65 years, 5% of those with a history of ATE, and 5% of those with cardiac risk factors. Age, history of ATE, or vascular risk factors did not increase risk. Aspirin users had a higher incidence than nonusers (8.9% versus 2.7%) but had higher rates of vascular risk factors. CONCLUSIONS Bevacizumab was associated with a modestly higher risk of ATE, but safety was not significantly worse in older patients or patients with a history of ATE or vascular risk factors. The effect of aspirin in preventing ATE in patients receiving bevacizumab could not be determined from this study.
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Murphy F, Cochran D, Thornton S. Impact of a Bereavement and Donation Service incorporating mandatory ‘required referral’ on organ donation rates: a model for the implementation of the Organ Donation Taskforce’s recommendations. Anaesthesia 2009; 64:822-8. [DOI: 10.1111/j.1365-2044.2009.05932.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Terkeltaub R, Sundy JS, Schumacher HR, Murphy F, Bookbinder S, Biedermann S, Wu R, Mellis S, Radin A. The interleukin 1 inhibitor rilonacept in treatment of chronic gouty arthritis: results of a placebo-controlled, monosequence crossover, non-randomised, single-blind pilot study. Ann Rheum Dis 2009; 68:1613-7. [PMID: 19635719 PMCID: PMC2732898 DOI: 10.1136/ard.2009.108936] [Citation(s) in RCA: 235] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Recent studies suggest that blockade of the NLRP3 (cryopyrin) inflammasome interleukin 1β (IL1β) pathway may offer a new treatment strategy for gout. Objective: To explore the potential utility of rilonacept (IL1 Trap) in patients with chronic active gouty arthritis in a proof-of-concept study. Methods: This 14-week, multicentre, non-randomised, single-blind, monosequence crossover study of 10 patients with chronic active gouty arthritis included a placebo run-in (2 weeks), active rilonacept treatment (6 weeks) and a 6-week post-treatment follow-up. Results: Rilonacept was generally well tolerated. No deaths and no serious adverse events occurred during the study. One patient withdrew owing to an injection-site reaction. Patients’ self-reported median pain visual analogue scale scores significantly decreased from week 2 (after the placebo run-in) to week 4 (2 weeks of rilonacept) (5.0 to 2.8; p<0.049), with sustained improvement at week 8 (1.3; p<0.049); 5 of 10 patients reported at least a 75% improvement. Median symptom-adjusted and severity-adjusted joint scores were significantly decreased. High-sensitivity C-reactive protein levels fell significantly. Conclusions: This proof-of-concept study demonstrated that rilonacept is generally well tolerated and may offer therapeutic benefit in reducing pain in patients with chronic refractory gouty arthritis, supporting the need for larger, randomised, controlled studies of IL1 antagonism such as with rilonacept for this clinical indication.
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Larkin C, Murphy F, Browne I. Anaesthetic management of pregnancy complicated by a symptomatic arachnoid cyst. Int J Obstet Anesth 2009; 18:291-2. [DOI: 10.1016/j.ijoa.2009.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 02/03/2009] [Indexed: 12/01/2022]
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McCann M, Einarsdóttir H, Van Waeleghem JP, Murphy F, Sedgewick J. Vascular access management 1: an overview. J Ren Care 2008; 34:77-84. [PMID: 18498572 DOI: 10.1111/j.1755-6686.2008.00022.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vascular access for renal replacement therapy (RRT) is seen as one of the most challenging areas confronting the nephrology multidisciplinary team. The vascular access of choice is the arterio-venous fistula (AVF) followed by the arterio-venous graft (AVG) and central venous catheter (CVC). A successful vascular access programme requires forward planning ensuring that enough time is available for the preservation of the access site, its creation and maturation. Successful cannulation of the vascular access requires on the part of the nephrology nurse, clinical expertise and knowledge on the management of different types of vascular access including different cannulation techniques.
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Kourinov I, Ealick E, Capel M, Lynch E, Murphy F, Rajashankar K, Sukumar N, Unik P, Withrow J. NorthEastern Collaborative Access Team (NE-CAT) beam lines at the Advanced Photon Source. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308094300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sirohi B, Cunningham D, Powles R, Murphy F, Arkenau T, Norman A, Oates J, Wotherspoon A, Horwich A. Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma. Ann Oncol 2008; 19:1312-1319. [PMID: 18356139 DOI: 10.1093/annonc/mdn052] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess prognostic factors and outcome of patients with relapsed/refractory Hodgkin's lymphoma (HL) who received high-dose chemotherapy and autologous stem-cell transplant (ASCT). PATIENTS AND METHODS Data on 195 patients who received ASCT between 1985 and June 2005 were reviewed. Median time from first treatment to ASCT was 2.6 years (0.4-27.3). Demography at ASCT was 61% stage IV, median age 31 years (18-69), median prior treatment (tx) regimens 3 (2-7), median Hasenclever index 3 (0-6); 150 patients had responding disease [54 complete remission (CR), 96 partial remission (PR)], and 45 patients had untested relapse/refractory disease. RESULTS Post-ASCT, 61% (119/195) patients attained CR with an overall response (CR + PR) of 85%. Twelve patients had nonrelapse mortality. Of 119 patients attaining CR, 27 relapsed: 3 after attaining CR for >5 years and 1 after attaining CR for >10 years. Median overall survival (OS)/progression-free survival (PFS) from ASCT was 9 years/2.9 years. Five-year OS/PFS was 55% of 44% and 10-year OS/PFS was 49.4% of 37% for whole group. Twenty (10%) patients developed second cancer (seven secondary acute myeloid leukaemia (AML)/myelodysplastic syndrome (MDS)). Probability of developing second cancer at 10 years was 14.7% (95% confidence interval 8.9% to 23.8%) and 24.8% at 19 years. CONCLUSION These data provide the longest follow-up reported for patients receiving ASCT for relapsed/refractory HL. In addition to previously described prognostic factors, our data show that Hasenclever index <3 influences outcome favorably and attaining CR at ASCT leads to a better outcome.
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Jiaravuthisan MM, Sasseville D, Vender RB, Murphy F, Muhn CY. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J Am Acad Dermatol 2007; 57:1-27. [PMID: 17572277 DOI: 10.1016/j.jaad.2005.07.073] [Citation(s) in RCA: 197] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Revised: 06/14/2005] [Accepted: 07/23/2005] [Indexed: 10/23/2022]
Abstract
Psoriasis is a chronic skin disease that affects millions of people throughout the world. Even though cutaneous signs and symptoms are the most common clinical manifestations, the nails can be involved in up to 50% of cases, and their involvement remains an important yet often overlooked aspect of the disease. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting and loosening of the nail plate to the less frequent discoloration and splinter hemorrhages seen in the nail bed. This article discusses the normal anatomy and embryology of the nail unit as well as the current understanding of the pathogenesis of the disease. It also provides an extensive review of the existing literature with respect to psoriatic nail therapy. Although there have been many recent advances in the treatment of the cutaneous form of the disease-most notably in the field of immunotherapies-the options for nail psoriasis are far more limited. While a number of treatment alternatives currently exist for nail disease, the general paucity of clear evidence regarding these choices often makes it difficult to select the most efficient, safe, and optimal treatment for the patient. Even though the current literature has shown some support for the use of topical, intralesional, radiation, systemic, and combination therapies for nail psoriasis, the available studies lack sufficient power to extrapolate a standardized therapeutic regimen. Therefore, until better-documented evidence validating the treatment options emerges within the literature, clinicians and patients are left with a vague and relatively unproven approach to psoriatic nail disease.
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Sandford RM, Bown MJ, Fishwick G, Murphy F, Naylor M, Sensier Y, Sharpe R, Walker J, Hartshorn T, London NJ, Sayers RD. Duplex Ultrasound Scanning is Reliable in the Detection of Endoleak Following Endovascular Aneurysm Repair. Eur J Vasc Endovasc Surg 2006; 32:537-41. [PMID: 16875850 DOI: 10.1016/j.ejvs.2006.05.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 05/23/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the value of duplex ultrasound scanning (DUSS) in the routine follow up of patients following EVAR. METHODS Imaging was reviewed for 310 consecutive patients undergoing EVAR at a single centre. Concurrent ultrasound and CT scans were defined as having occurred within 6 months of each other. There were 244 paired concurrent DUSS and CT scans which were used for further analysis. These modalities were compared with respect to sensitivity, specificity, positive and negative predictive values and level of agreement (by Kappa statistics) using CT as the 'gold standard'. RESULTS DUSS failed to detect a number of endoleaks which were seen on CT and the sensitivity of this test was therefore poor (67%). However, the specificity of DUSS compared more favourably with a value of 91%. Positive predictive values ranged from 33-100% but negative predictive values were more reliable with values of 91-100% at all time points post operatively. There were no type I leaks, or endoleaks requiring intervention which were missed on DUSS. Overall, there was a 'fair' level of agreement between the two imaging modalities using Kappa statistics. CONCLUSION Although DUSS is not as sensitive as CT scanning in the detection of endoleak, no leaks requiring intervention were missed on DUSS in this study. DUSS is much cheaper than CT and avoids high doses of radiation. DUSS therefore remains a valuable method of follow up after EVAR and can reduce the need for repeated CT scans.
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Sandford R, Bown M, Fishwick G, Murphy F, Naylor M, Sensier Y, Sharpe R, Walker J, Hartshorn T, London N, Sayers R. Duplex Ultrasound Scanning is Reliable in the Detection of Endoleak Following Endovascular Aneurysm Repair. J Vasc Surg 2006. [DOI: 10.1016/j.jvs.2006.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Leach W, Reid J, Murphy F. Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year. Knee Surg Sports Traumatol Arthrosc 2006; 14:922-6. [PMID: 16489477 DOI: 10.1007/s00167-006-0042-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Accepted: 08/09/2005] [Indexed: 12/19/2022]
Abstract
We have carried out a prospective randomised, single blind clinical trial to investigate the effect of continuous passive motion on range of knee flexion, lack of extension, pain levels and analgesic use after total knee replacement surgery. 85 subjects were randomly allocated to control or study group. All subjects followed the existing rehabilitation protocol, which permits immediate active range of motion exercises and mobilisation with the study group using continuous passive motion for 1 h, twice a day. Outcome measures employed were range of motion, pain assessed on a visual analogue scale and analgesic use according to the WHO ladder. Blinded evaluation was carried out preoperatively, at time of discharge from hospital, 6 weeks, 6 and 12 months postoperation. No significant difference was observed between groups at all time intervals for each outcome variable using Wilcoxon Rank sum tests. The results substantiate previous findings that short duration continuous passive motion following total knee arthroplasty does not influence outcome of range of motion or reported pain.
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Murphy F. Assessment and management of patients with surgical cavity wounds. Nurs Stand 2006; 20:57-8, 60, 62 passim. [PMID: 16881591 DOI: 10.7748/ns2006.07.20.45.57.c4469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article explores the management of surgical cavity wounds. The effectiveness of healing depends on wound assessment and constant re-evaluation of the management strategy adopted. Management strategies should be holistic and take into account the wound bed and local and systemic barriers to healing, as well as patients' thoughts and concerns about their wound. Nurses have a pivotal role in wound management and dressing selection, and should aim to keep up to date in this dynamic specialty.
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Hanson RN, El-Wakil H, Murphy F, Scott Wilbur D. Synthesis and evaluation of 82Br and 77Br labeled (17α, 20E)-21-bromo-19-norpregna-1,3,5(10),20-tetraene-3,17β -diol. J Labelled Comp Radiopharm 2006. [DOI: 10.1002/jlcr.2580270602] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Porter S, Anderson L, Chetty A, Dyker S, Murphy F, Cheyne H, Latto D, Grant A, McLachlan M, Wild P, McDonald A, Kettles AM. Operational competency development in E and F grade nursing staff: preparation for management. J Nurs Manag 2006; 14:384-90. [PMID: 16787473 DOI: 10.1111/j.1365-2934.2006.00628.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is limited literature for operational management competency development in E and F grade nursing staff. These grades of nursing staff have to take over from G grade nurses ward managers on a regular basis. With human resources doing less of the operational management and taking more of an advisory role, nursing staff are now required to deal with disciplinary procedures and other management issues in a more consistent manner. Therefore, this development programme in a Scottish primary care NHS psychiatric service was designed to enable E and F grade nurses to take over from ward managers and to enable ward managers to 'succession plan' for times when they will be absent. The literature is reviewed, the background to the development programme described and the design of the development programme is explained. The results from both the pilot study (n=13) and first group (n=8) through the course are presented, evaluated discussed.
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Murphy F, Norman A, Christmas T, Andreyev H, Eeles R, Khoo V. Assessing the Incidence of Bowel Incontinence in Patients with Urological Cancers Who Have and Have Not Received Pelvic Radiotherapy using the Vaizey and RTOG: Interim Results. Clin Oncol (R Coll Radiol) 2006. [DOI: 10.1016/j.clon.2006.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Murphy F. An investigation into stress levels amongst renal nurses. EDTNA/ERCA JOURNAL (ENGLISH ED.) 2004; 30:226-9. [PMID: 15835416 DOI: 10.1111/j.1755-6686.2004.tb00373.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A qualitative study was designed to explore renal nurses' perception of stress within their unit. This study collected information from ten staff nurses through semi structured taped interviews. Using content analysis, interviews were coded and categories and themes were identified. Findings indicate that stress was derived from the following categories: job content, resource issues, professional concerns, professional working relationships, extrinsic factors, and coping mechanisms. The actual words of the nurses were included to provide depth and substance to the categories and themes. A discussion was held regarding the relationship of these findings to theory. These findings have implications for nursing practice, administration and education. Recommendations are also made for future studies.
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Hu X, Murphy F, Karwautz A, Li T, Freeman B, Franklin D, Giotakis O, Treasure J, Collier DA. Analysis of microsatellite markers at the UCP2/UCP3 locus on chromosome 11q13 in anorexia nervosa. Mol Psychiatry 2002; 7:276-7. [PMID: 11920154 DOI: 10.1038/sj.mp.4001044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Murphy F, Nightingale A. Accident and emergency nurses as researchers: exploring some of the ethical issues when researching sensitive topics. ACCIDENT AND EMERGENCY NURSING 2002; 10:72-7. [PMID: 12400181 DOI: 10.1054/aaen.2001.0342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The breadth and complexity of accident and emergency (A&E) services is potentially a fruitful area for nursing and interdisciplinary research. A significant proportion of potential areas for research in A&E settings could be considered as 'sensitive topic areas'. Sensitive topic research raises many challenges; in particular, it raises specific ethical issues. This paper defines and identifies examples of sensitive topic area research in A&E and discusses some of the ethical issues to be considered before embarking on such research in A&E settings.
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Kang H, Magee C, Mahan C, Lee K, Murphy F, Jackson L, Matanoski G. Pregnancy outcomes among U.S. Gulf War veterans: a population-based survey of 30,000 veterans. Ann Epidemiol 2001; 11:504-11. [PMID: 11557183 DOI: 10.1016/s1047-2797(01)00245-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We evaluated an association between veterans' Gulf War service and reported adverse pregnancy outcomes. METHODS We conducted a health survey in which selected reproductive outcomes of a population-based sample of 15,000 Gulf War veterans representing four military branches and three unit components (active, reserve, and National Guard) were compared to those of 15,000 non-Gulf veteran controls. RESULTS Male Gulf veterans, compared with their non-Gulf veteran controls, reported a significantly higher rate of miscarriage (odds ratio [OR] = 1.62; 95% confidence interval [CI] = 1.32-1.99). Female Gulf veterans also reported more miscarriages than their respective controls, although their excess was not statistically significant (OR= 1.35; CI = 0.97-1.89). Both men and women deployed to the Gulf theater reported significant excesses of birth defects among their liveborn infants. These excess rates also extended to the subset of "moderate to severe" birth defects [males: OR= 1.78 (CI = 1.19-2.66); females: OR = 2.80 (CI = 1.26-6.25)]. No statistically significant differences by deployment status were found among men or women for stillbirths, pre-term deliveries or infant mortality. CONCLUSION The risk of veterans reporting birth defects among their children was significantly associated with veteran's military service in the Gulf War. This observation needs to be confirmed by a review of medical records to rule out possible reporting bias.
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Murphy F. Understanding the humanistic interaction with medical imaging technology. Radiography (Lond) 2001. [DOI: 10.1053/radi.2001.0328] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Murphy F. Observations on FMD-infected sheep in Ireland. Vet Rec 2001; 148:791. [PMID: 11465274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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McManus T, McConville J, Collery P, Murphy F. Diagnosis of the first two outbreaks of FMD in Ireland. Vet Rec 2001; 148:486-7. [PMID: 11334079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Rosenthal D, Murphy F, Gottschalk R, Baxter M, Lycka B, Nevin K. Using a topical anaesthetic cream to reduce pain during sharp debridement of chronic leg ulcers. J Wound Care 2001; 10:503-5. [PMID: 12964231 DOI: 10.12968/jowc.2001.10.1.26042] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This multicentre, double-blind, placebo-controlled, parallel-group study assessed the efficacy and safety of using Emla (lignocaine/prilocaine) anaesthetic cream to achieve pain control during sharp debridement of chronic leg ulcers of arterial, venous or arteriovenous aetiology. A total of 101 patients (51 Emla, 50 placebo), aged 29-99 years, who had experienced pain associated with previous debridement were included. Patients with an amide anaesthetic allergy, anaesthetic diabetic ulcers, or ulcers > 50 cm2 were excluded. Debridement was initiated approximately 30 minutes after the application of a thick layer of Emla or placebo cream to an ulcer occluded with a plastic wrap. The patient and investigator assessed the pain associated with debridement on a 100 mm visual analogue scale (VAS). The median patient VAS scores were 18 mm and 53.5 mm in the Emla and placebo groups, respectively (p < 0.0001). The corresponding investigator values in the two groups were 20 mm and 49.5 mm, respectively (p = 0.004). Local reactions were mainly transient and mild, and were observed in roughly the same percentage of placebo and Emla-treated patients. After a 30-minute application Emla cream significantly reduced the pain of debridement compared with the placebo.
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