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  1. Article: Treatment of Anticholinergic Delirium with Oral Rivastigmine: A Case Report.

    Karousatos, Christopher / Murphy, Lauren

    The Journal of emergency medicine

    2024  

    Abstract: Background: Anticholinergic toxicity is commonly encountered in the emergency department. However, the availability of physostigmine, a central acetylcholinesterase inhibitor used to reverse anticholinergic delirium, has been significantly limited due ... ...

    Abstract Background: Anticholinergic toxicity is commonly encountered in the emergency department. However, the availability of physostigmine, a central acetylcholinesterase inhibitor used to reverse anticholinergic delirium, has been significantly limited due to national drug shortages in the United States. Several articles have explored the viability of rivastigmine as an alternative treatment in these patients.
    Case report: A 33-year-old man presented to the emergency department after a suspected suicide attempt. The patient was found with an empty bottle of diphenhydramine at the scene. On arrival, he was tachycardic and delirious, with dilated and nonreactive pupils and dry skin. As the clinical picture was highly suggestive of anticholinergic toxicity, the patient was treated with oral rivastigmine at a starting dose of 4.5 mg to reverse his anticholinergic delirium. Although a repeat dose was required, his delirium resolved without recurrence. Why Should an Emergency Physician Be Aware of This? Oral rivastigmine has been applied successfully here and in other case reports to reverse anticholinergic delirium with the benefit of prolonged agitation control. Emergency physicians may consider this medication in consultation with a specialist, with initial doses starting at 4.5-6 mg, if encountering anticholinergic delirium when physostigmine is not available.
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2024.03.017
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  2. Article: Refractory Hailey-Hailey disease cleared with upadacitinib.

    Murphy, Lauren / Ch'en, Peter / Song, Eingun James

    JAAD case reports

    2023  Volume 41, Page(s) 64–67

    Language English
    Publishing date 2023-09-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2834220-3
    ISSN 2352-5126
    ISSN 2352-5126
    DOI 10.1016/j.jdcr.2023.09.011
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  3. Article ; Online: Familial thrombocytopenia: The long and short of it.

    Murphy, Lauren / Mead, Adam J

    The Journal of experimental medicine

    2021  Volume 218, Issue 6

    Abstract: In this issue, Wahlster, Verboon, and colleagues (2021. J. Exp. Med.https://doi.org/10.1084/jem.20210444) describe a multigenerational family with inherited thrombocytopenia where the causal variant was not identified using conventional genome sequencing ...

    Abstract In this issue, Wahlster, Verboon, and colleagues (2021. J. Exp. Med.https://doi.org/10.1084/jem.20210444) describe a multigenerational family with inherited thrombocytopenia where the causal variant was not identified using conventional genome sequencing approaches. Long-read sequencing and RNA sequencing revealed a complex structural variant, causing overexpression of a pathogenic gain-of-function WAC-ANKRD26 fusion transcript.
    MeSH term(s) Humans ; Thrombocytopenia/genetics
    Language English
    Publishing date 2021-05-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 218343-2
    ISSN 1540-9538 ; 0022-1007
    ISSN (online) 1540-9538
    ISSN 0022-1007
    DOI 10.1084/jem.20210604
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  4. Article ; Online: A pilot randomized control trial of topical capsaicin as adjunctive therapy for nausea and vomiting of pregnancy.

    Murphy, Lauren M / Whelan, Anna R / Griffin, Laurie B / Hamel, Maureen S

    American journal of obstetrics & gynecology MFM

    2023  Volume 5, Issue 7, Page(s) 100997

    Abstract: Background: Nausea and vomiting is one of the most common complications of pregnancy, affecting 50% to 80% of pregnant persons. Moreover, despite its prevalence, it remains a challenging condition to treat. Treatment often involves oral and intravenous ... ...

    Abstract Background: Nausea and vomiting is one of the most common complications of pregnancy, affecting 50% to 80% of pregnant persons. Moreover, despite its prevalence, it remains a challenging condition to treat. Treatment often involves oral and intravenous medications with potential side effects, particularly when taken in combination. Capsaicin cream is proven to decrease nausea and vomiting in cyclic vomiting syndrome; however, its use has not been well studied among pregnant patients.
    Objective: This study aimed to test the feasibility of the off-label use of capsaicin for the treatment of nausea and vomiting in pregnancy.
    Study design: This was a double-blinded randomized controlled trial of pregnant individuals in their first trimester of pregnancy seeking care at a tertiary care hospital for nausea and vomiting. Consenting participants were randomized to abdominal application of topical capsaicin vs placebo. All participants received intravenous hydration and metoclopramide. The primary outcome, total treatment time, was recorded for all participants. In addition, symptom severity was assessed every 30 minutes using a visual analog scale. Data were analyzed using the Wilcoxon rank-sum test for continuous variables and the Fisher exact test for binary variables.
    Results: Of the 38 eligible individuals approached, 30 were randomized. There was a trend toward decreased mean treatment time in the capsaicin group compared with the placebo group (79.9 vs 97.3 minutes; P=.1). There was no significant difference in visual analog scale scores at any time point between groups. Furthermore, capsaicin was well tolerated, with only 1 individual requesting the medication be removed.
    Conclusion: This study demonstrated that capsaicin is an acceptable treatment of nausea and vomiting in pregnancy and additional explorations of its use as treatment are feasible. A larger randomized controlled trial is needed to determine the efficacy of capsaicin in this population.
    MeSH term(s) Pregnancy ; Female ; Humans ; Antiemetics/adverse effects ; Capsaicin/adverse effects ; Pilot Projects ; Vomiting/chemically induced ; Vomiting/drug therapy ; Vomiting/prevention & control ; Nausea/chemically induced ; Nausea/drug therapy ; Nausea/prevention & control
    Chemical Substances Antiemetics ; Capsaicin (S07O44R1ZM)
    Language English
    Publishing date 2023-06-02
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2023.100997
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  5. Article ; Online: Man With Decreased Consciousness.

    Lewis, Ruth / Murphy, Lauren / Saylor, Regina / Gibbons, Ryan

    Annals of emergency medicine

    2022  Volume 79, Issue 5, Page(s) 496–502

    MeSH term(s) Consciousness ; Humans ; Male
    Language English
    Publishing date 2022-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2021.11.009
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  6. Article: Damage to Orbitofrontal Areas 12 and 13, but Not Area 14, Results in Blunted Attention and Arousal to Socioemotional Stimuli in Rhesus Macaques.

    Murphy, Lauren E / Bachevalier, Jocelyne

    Frontiers in behavioral neuroscience

    2020  Volume 14, Page(s) 150

    Abstract: An earlier study in monkeys indicated that lesions to the mid-portion of the ventral orbitofrontal cortex (OFC), including Walker's areas 11 and 13 (OFC11/13), altered the spontaneous scanning of still pictures of primate faces (neutral and emotional) ... ...

    Abstract An earlier study in monkeys indicated that lesions to the mid-portion of the ventral orbitofrontal cortex (OFC), including Walker's areas 11 and 13 (OFC11/13), altered the spontaneous scanning of still pictures of primate faces (neutral and emotional) and the modulation of arousal. Yet, these conclusions were limited by several shortcomings, including the lesion approach, use of static rather than dynamic stimuli, and manual data analyses. To confirm and extend these earlier findings, we compared attention and arousal to social and nonsocial scenes in three groups of rhesus macaques with restricted lesions to one of three OFC areas (OFC12, OFC13, or OFC14) and a sham-operated control group using eye-tracking to capture scanning patterns, focal attention and pupil size. Animals with damage to the lateral OFC areas (OFC12 and OFC13) showed decreased attention specifically to the eyes of negative (threatening) social stimuli and increased arousal (increased pupil diameter) to positive social scenes. In contrast, animals with damage to the ventromedial OFC area (OFC14) displayed no differences in attention or arousal in the presence of social stimuli compared to controls. These findings support the notion that areas of the lateral OFC are critical for directing attention and modulating arousal to emotional social cues. Together with the existence of face-selective neurons in these lateral OFC areas, the data suggest that the lateral OFC may set the stage for multidimensional information processing related to faces and emotion and may be involved in social judgments.
    Language English
    Publishing date 2020-09-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2452960-6
    ISSN 1662-5153
    ISSN 1662-5153
    DOI 10.3389/fnbeh.2020.00150
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  7. Article ; Online: Message in a platelet: decoding platelet transcriptomes in myeloproliferative neoplasms.

    Shapiro, Susan / Murphy, Lauren / Psaila, Bethan

    Cell reports. Medicine

    2021  Volume 2, Issue 10, Page(s) 100433

    Abstract: Platelets are anucleate but contain a rich repertoire of mRNAs. In this issue ... ...

    Abstract Platelets are anucleate but contain a rich repertoire of mRNAs. In this issue of
    MeSH term(s) Blood Platelets ; Humans ; Myeloproliferative Disorders/genetics ; Neoplasms ; RNA, Messenger ; Transcriptome
    Chemical Substances RNA, Messenger
    Language English
    Publishing date 2021-10-19
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2666-3791
    ISSN (online) 2666-3791
    DOI 10.1016/j.xcrm.2021.100433
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  8. Article ; Online: Acute bilateral retinal artery occlusion causing sudden blindness in 25-year-old patient.

    Murphy, Lauren / Carroll, Gerard

    The American journal of emergency medicine

    2018  Volume 36, Issue 6, Page(s) 1124.e3–1124.e4

    Abstract: A 25-year-old male patient presented to the emergency department with the chief complaint of sudden blindness and was found to have suffered bilateral central retinal artery occlusion (CRAO). This process is most commonly the result of a thrombus or ... ...

    Abstract A 25-year-old male patient presented to the emergency department with the chief complaint of sudden blindness and was found to have suffered bilateral central retinal artery occlusion (CRAO). This process is most commonly the result of a thrombus or embolus that occludes the retinal artery, and normally presents in a single eye in patients older than 65 who are predisposed to vascular disease. Diagnosis relies most heavily upon funduscopic exam. Potential treatments involve ocular massage, acetazolamide, anterior chamber paracentesis and systemic or local fibrinolysis. Despite these interventions vision is often significantly and permanently impaired. This case underscores the importance of the emergency physician's ability to promptly perform and interpret the funduscopic exam in order to diagnose and evaluate CRAO.
    MeSH term(s) Adult ; Anti-Inflammatory Agents/therapeutic use ; Antibiotics, Antineoplastic/therapeutic use ; Blindness/diagnostic imaging ; Blindness/drug therapy ; Blindness/physiopathology ; Humans ; Male ; Mycophenolic Acid/therapeutic use ; Prednisone/therapeutic use ; Retinal Artery Occlusion/diagnostic imaging ; Retinal Artery Occlusion/physiopathology ; Thrombolytic Therapy ; Tomography, Optical Coherence ; Treatment Outcome
    Chemical Substances Anti-Inflammatory Agents ; Antibiotics, Antineoplastic ; Mycophenolic Acid (HU9DX48N0T) ; Prednisone (VB0R961HZT)
    Language English
    Publishing date 2018-03-06
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2018.03.013
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  9. Article ; Online: Toxicologic Confounders of Brain Death Determination: A Narrative Review.

    Murphy, Lauren / Wolfer, Hannah / Hendrickson, Robert G

    Neurocritical care

    2020  Volume 34, Issue 3, Page(s) 1072–1089

    Abstract: The aim of this narrative review is to describe the toxicologic confounders of brain death currently reported in the literature to offer guidance for physicians assessing brain death after a toxic exposure. We established an a priori definition of a " ... ...

    Abstract The aim of this narrative review is to describe the toxicologic confounders of brain death currently reported in the literature to offer guidance for physicians assessing brain death after a toxic exposure. We established an a priori definition of a "brain death mimic" as an unresponsive, intubated patient missing some, but not all brainstem reflexes. We completed a review of the literature utilizing MEDLINE and EMBASE to find case reports of patients of all ages in English, French, and Spanish meeting the criteria and hand searched the references of the results. We recorded xenobiotic dose, duration of physical exam suggesting brain death, and how the cases failed to meet full brain death criteria, when available. Fifty-six cases representing 19 different substances met the a priori definition of brain death mimic. Xenobiotic toxicities included: snake envenomation (13), baclofen (11), tricyclic antidepressants (8), bupropion (7), alcohols (4), antiepileptic agents (3), barbiturates (2), antidysrhythmics (2), organophosphates (2), and one case each of magnesium, succinylcholine, tetrodotoxin, and zolpidem. All patients except one survived to discharge and the majority at their baseline physical health. The most common means by which the cases failed brain death examination prerequisites was via normal neuroimaging. The xenobiotics in this review should be considered in cases of poisoning resulting in loss of brainstem reflexes and addressed before brain death determination. Brain death diagnosis should not be pursued in the setting of normal cerebral imaging or incomplete evaluation of brain death prerequisites.
    MeSH term(s) Baclofen ; Brain ; Brain Death ; Humans ; Neuroimaging ; Neurologic Examination
    Chemical Substances Baclofen (H789N3FKE8)
    Keywords covid19
    Language English
    Publishing date 2020-09-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-020-01114-y
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  10. Article ; Online: Osteopathic Considerations for the Pregnant Patient with COVID-19.

    Gray, Kendra M / Murphy, Lauren / Buckner, Brian

    The Journal of the American Osteopathic Association

    2020  

    Abstract: In any given year, approximately 130 million babies are born worldwide. Previous research has shown that pregnant women may be more severely affected and vulnerable to contracting emerging infections, making them a particularly high-risk population. ... ...

    Abstract In any given year, approximately 130 million babies are born worldwide. Previous research has shown that pregnant women may be more severely affected and vulnerable to contracting emerging infections, making them a particularly high-risk population. Therefore, special considerations should be given to treatment methods for pregnant women with COVID-19. In this narrative review, the authors evaluate scholarly journal articles and electronic databases to determine what is known about the pathophysiology of COVID-19 in pregnancy and the associated mortality rate. Osteopathic manipulative treatment techniques to mitigate the underlying pathology were identified, and modifications for use in pregnancy and the critical care setting are described.
    Keywords covid19
    Language English
    Publishing date 2020-08-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 410350-6
    ISSN 1945-1997 ; 0003-0287 ; 0098-6151
    ISSN (online) 1945-1997
    ISSN 0003-0287 ; 0098-6151
    DOI 10.7556/jaoa.2020.112
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