Publications by authors named "Rory Murphy"

The transformative potential of genetic engineering in ophthalmology is remarkable, promising new treatments for a wide range of blinding eye diseases. The eye is an attractive target organ for genetic engineering approaches, in part due to its relatively immune-privileged status, its accessibility, and the ease of monitoring of efficacy and safety. Consequently, the eye has been at the forefront of genetic engineering advances in recent years.

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Smart Spine Implants.

Neurosurg Clin N Am

April 2024

Smart spine implants promise to stimulate healing and provide objective information about healing progression. The ability of implants to accelerate healing and provide objective data could help guide postoperative care, foster better outcomes, and reduce complications. Real-time monitoring, remote control and programming, and data analytics are actively being developed and translated into clinical practice.

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Study Design: Cross-sectional survey.

Objective: Currently there is limited evidence and guidance on the management of mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC). Anecdotal evidence suggest variance in clinical practice.

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Article Synopsis
  • Shared decision-making (SDM) in health care enables patients and clinicians to collaborate on personalized, evidence-based decisions, especially crucial for managing chronic conditions like degenerative cervical myelopathy (DCM).
  • The study aims to create a core information set (CIS) to educate patients at diagnosis and a process map outlining the DCM care workflow, enhancing understanding of key decision points.
  • Both the CIS and process map will be developed through collaboration with stakeholders, facilitated by Myelopathy.org, to improve patient-centered care and clinical outcomes.
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Background: Degenerative cervical myelopathy (DCM) is a chronic neurological condition estimated to affect 1 in 50 adults. Due to its diverse impact, trajectory and management options, patient-centred care and shared decision making are essential. In this scoping review, we aim to explore whether information needs in DCM are currently being met in available DCM educational resources.

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Article Synopsis
  • - A postpartum woman experienced sudden left eyelid swelling and severe pain, leading to findings like exophthalmos, ophthalmoplegia, and vision loss in her left eye during a clinical examination.
  • - CT scans indicated a hemorrhage in the left lateral rectus muscle, triggering emergency surgical interventions, including a lateral canthotomy and later an exploratory orbitotomy to evacuate the hematoma.
  • - Post-surgery, the woman's vision improved significantly within a few days, returning to normal (6/6), and follow-up imaging showed almost complete resolution of the hematoma.
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Study Design: Literature Review (Narrative).

Objective: To introduce the number one research priority for Degenerative Cervical Myelopathy (DCM): Raising Awareness.

Methods: Raising awareness has been recognized by AO Spine RECODE-DCM as the number one research priority.

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Purpose: Extracellular matrix stiffening is characteristic of both aging and glaucoma, and acts as a promoter and perpetuator of pathological fibrotic remodeling. Here, we investigate the role of a mechanosensitive transcriptional coactivator, Yes-associated protein (YAP), a downstream effector of multiple signaling pathways, in lamina cribrosa (LC) cell activation to a profibrotic, glaucomatous state.

Methods: LC cells isolated from glaucomatous human donor eyes (GLC; n = 3) were compared to LC cells from age-matched nonglaucomatous controls (NLC; n = 3) to determine differential YAP expression, protein levels, and proliferation rates.

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Article Synopsis
  • The study is a prospective multi-center trial examining complications related to modest systemic hypothermia in patients with acute cervical spinal cord injuries (SCI) across five trauma centers in the U.S.
  • Patients were divided into two groups: one receiving hypothermia treatment and the other receiving standard care, with their complications tracked for six weeks post-injury.
  • Results showed no significant difference in complication rates between the hypothermia and control groups, suggesting that modest hypothermia does not increase the risk of complications in the early weeks after acute cervical SCI.
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Almost 100 years ago experiments involving electrically stimulating and recording from the brain and the body launched new discoveries and debates on how electricity, movement, and thoughts are related. Decades later the development of brain-computer interface technology began, which now targets a wide range of applications. Potential uses include augmentative communication for locked-in patients and restoring sensorimotor function in those who are battling disease or have suffered traumatic injury.

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Crustaceans are important ecosystem bio-indicators but their response to pollutants such as polyaromatic hydrocarbons (PAHs) remains understudied, particularly in freshwater habitats. Here we investigated the effect of phenanthrene (at 0.5, 1.

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The primary biomechanical driver of pathological glaucomatous cupping remains unknown. Finite element modeling indicates that stress and strain play key roles. In this article, primarily a review, we utilize known biomechanical data and currently unpublished results from our lab to propose a three-stage, tissue stiffness-based model to explain glaucomatous cupping occurring at variable levels of translaminar pressure (TLP).

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Mechanisms driving the initiation of brain folding are incompletely understood. We have previously characterized mouse models recapitulating human -related brain overgrowth, epilepsy, dysplastic gyrification and hydrocephalus (Roy et al., 2015).

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Objective: To assess the impact of the magnitude of preoperative and postoperative corneal astigmatism on refractive outcomes in patients undergoing cataract surgery or lens exchange with an extended depth of focus intraocular lens. To compare visual outcomes of steep and temporal on-axis corneal incisions.

Setting: Department of Ophthalmology, Blackrock Clinic, Dublin, Ireland.

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Despite 253,000 spinal cord injury (SCI) patients in the United States, little is known about how SCI affects brain networks. Spinal MRI provides only structural information with no insight into functional connectivity. Resting-state functional MRI (RS-fMRI) quantifies network connectivity through the identification of resting-state networks (RSNs) and allows detection of functionally relevant changes during disease.

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Promising treatments are being developed to promote functional recovery after spinal cord injury (SCI). Magnetic resonance imaging, specifically Diffusion Tensor Imaging (DTI) has been shown to non-invasively measure both axonal and myelin integrity following traumatic brain and SCI. A novel data-driven model-selection algorithm known as Diffusion Basis Spectrum Imaging (DBSI) has been proposed to more accurately delineate white matter injury.

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Background: A number of clinical tools exist for measuring the severity of cervical spondylotic myelopathy (CSM). Several studies have recently described the use of non-invasive imaging biomarkers to assess severity of disease. These imaging markers may provide an additional tool to measure disease progression and represent a surrogate marker of response to therapy.

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Many procedures in modern clinical medicine rely on the use of electronic implants in treating conditions that range from acute coronary events to traumatic injury. However, standard permanent electronic hardware acts as a nidus for infection: bacteria form biofilms along percutaneous wires, or seed haematogenously, with the potential to migrate within the body and to provoke immune-mediated pathological tissue reactions. The associated surgical retrieval procedures, meanwhile, subject patients to the distress associated with re-operation and expose them to additional complications.

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Study Design: A prospective cohort study.

Objective: In this study, we employed diffusion basis spectrum imaging (DBSI) to quantitatively assess axon/myelin injury, cellular inflammation, and axonal loss of cervical spondylotic myelopathy (CSM) spinal cords.

Summary Of Background Data: A major shortcoming in the management of CSM is the lack of an effective diagnostic approach to stratify treatments and to predict outcomes.

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Background: Optimal use of stereotactic radiosurgery (SRS) vs external beam radiation therapy (EBRT) for treatment of residual/recurrent atypical meningioma is unclear.

Objective: To analyze features associated with progression after radiation therapy.

Methods: Fifty radiation-naive patients who received SRS or EBRT for residual and/or recurrent atypical meningioma were examined for predictors of progression using Cox regression and Kaplan-Meier analyses.

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Nonhemorrhagic neurological deficits are underrecognized symptoms of intracranial dural arteriovenous fistulas (dAVFs) having cortical venous drainage. These symptoms are the consequence of cortical venous hypertension and portend a clinical course with increased risk of neurological morbidity and mortality. One rarely documented and easily misinterpreted type of nonhemorrhagic neurological deficit is progressive dementia, which can result from venous hypertension in the cortex or in bilateral thalami.

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Background: The objective of this study is to validate the safety of hyperacute stabilization.

Methods: Patient demographics, American Spinal Injury Association (ASIA) grade on initial evaluation and serial follow up grades, hospital length of stay, Intensive Care Unit length of stay, intraoperative blood loss, postoperative length of stay, comorbidities, Injury Severity Score and complications of recumbency were recorded.

Results: Corroborating previous studies, our study shows polytrauma patients undergoing a hyperacute stabilization of a spinal fracture displayed a trend towards better neurological outcome and decreased hospital stays while having a similar complication rate to those operated on in a delayed fashion.

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Purpose: We performed a literature synthesis to identify the full spectrum of compounds implicated in drug-induced, bilateral secondary angle-closure glaucoma (2° ACG).

Methods: Systematic PubMed literature review identified relevant bilateral 2° ACG case reports. We evaluated these reports with both the Naranjo adverse drug reaction probability scale to assess the causality of reported drug reactions and a 2° ACG scale scoring system we developed to determine the likelihood that the event represented bilateral 2° ACG.

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OBJECT External ventricular drains (EVDs) are commonly used for CSF diversion but pose a risk of ventriculitis, with rates varying in frequency from 2% to 45%. Results of studies examining the utility of prolonged systemic antibiotic therapy for the prevention of EVD-related infection have been contradictory, and no study to date has examined whether this approach confers additional benefit in preventing ventriculitis when used in conjunction with antibiotic-coated EVDs (ac-EVDs). METHODS A prospective performance analysis was conducted over 4 years to examine the impact of discontinuing systemic antibiotic prophylaxis after insertion of an ac-EVD on rates of catheter-related ventriculitis.

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Background: The efficacies of adjuvant stereotactic radiosurgery (SRS) and external beam radiation therapy (EBRT) for atypical meningiomas (AMs) after subtotal resection (STR) remain unclear.

Objective: To analyze the clinical, histopathological, and radiographic features associated with progression in AM patients after STR.

Methods: Fifty-nine primary AMs after STR were examined for predictors of progression, including the impact of SRS and EBRT, in a retrospective cohort study.

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