Search Results - (Author, Cooperation:T. S. Walsh)

2012-03-27

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Alleles ; Amino Acid Sequence ; Animals ; Cytokines/immunology ; England/epidemiology ; Gene Deletion ; Humans ; Influenza A Virus, H1N1 Subtype/classification/growth & development/pathogenicity ; Influenza A Virus, H3N2 Subtype/classification/growth & development/pathogenicity ; Influenza A virus/classification/growth & development/*pathogenicity ; Influenza B virus/classification/growth & development/pathogenicity ; Influenza, Human/complications/epidemiology/mortality/virology ; Leukocytes/immunology ; Lung/pathology/virology ; Membrane Proteins/chemistry/deficiency/genetics/*metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Molecular Sequence Data ; Orthomyxoviridae Infections/complications/*mortality/pathology ; Pneumonia, Viral/etiology/pathology/prevention & control ; Polymorphism, Single Nucleotide/genetics ; RNA-Binding Proteins/chemistry/genetics/*metabolism ; Scotland/epidemiology ; Virus Replication

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Summary We measured oxygen consumption using a new noninvasive modular metabolic monitor, M-COVX™, in ventilated critically ill patients. Oxygen consumption was measured continuously as part of routine monitoring for up to 24 h following mechanical ventilation in 27 patients admitted to a general intensive care unit. We explored several possible sources of error. Most errors related to inaccurate tidal volume measurement, which resulted in rejection of a median 14% (interquartile range 8–34%) of data. Water accumulation in the pneumotachograph was responsible and occurred more frequently with water bath humidifiers. After manual removal of erroneous data mean oxygen consumption values were virtually identical to calculated values in 24 of 27 patients. We conclude that in most ventilated patients averaging of continuous oxygen consumption data with the M-COVX module results in small errors.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Bottom-up costs of sedative, analgesic and neuromuscular blocking drugs used in the intensive care unit have not been reported. We performed a prospective audit of the cost of these drugs using a bottom-up approach by prospectively recording the daily amount of drugs administered to patients over a 3-month period. Of 172 admissions, complete data were collected for 155 (92%). Propofol and alfentanil were the drugs most commonly used, being administered to 136 (88%) and 106 (68%) patients, respectively. The total cost was £14 070, which was 81% of the pharmacy figure (based on central purchasing). Ninety-four per cent of the cost was for drugs administered to the 50% of patients who stayed in the intensive care unit longer than 48 h. The median (interquartile range [range]) cost per day was £9.30 (3.60–20.10 [0–61.20]). This represents less than 1% of reported total daily cost of intensive care per patient.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Cystic fibrosis occurs in I in 2000 children and the majority now reach adulthood. The disease is a complex multisystem disorder which is likely to challenge anaesthetists with increasing frequency. In this review the presentation and genetics of the disease are briefly described, followed by a detailed account of the pathophysiology relevant to anaesthesia. The pre-operative assessment and conduct of anaesthesia are discussed and some suggestions made regarding management.

Electronic Resource

1432-1238

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1238

Key words Fulminant hepatic failure ; Peripheral blood mononuclear cells ; Lipopolysaccharide ; C-reactive protein ; Tumour necrosis factor ; Interleukin-6

Springer Online Journal Archives 1860-2000

Medicine

Abstract Objective: To study the relationship between interleukin-6 (IL-6), tumour necrosis factor (TNF) and the acute phase protein C-reactive protein (CRP) in patients with fulminant hepatic failure (FHF) and to investigate the potential of peripheral blood mononuclear cells (PBMC) isolated from these patients to stimulate CRP production by isolated human hepatocytes in vitro. Setting: Patients with FHF were studied at the time of their admission to the intensive care unit. Study design: Serum TNF and IL-6 were measured in 12 patients with FHF. PBMC from 6 of these patients were then cultured in the presence and absence of lipopolysaccharides (LPS). TNF and IL-6 in serum and supernatants were measured by ELISA. PBMC supernatants were added to isolated human hepatocytes and CRP production was measured. Results: Serum IL-6 (348 ± 172 pg/ml) and TNF (118.5 ± 15.5 pg/ml) were elevated compared with healthy controls (not detected) and these observations were matched by elevated serum CRP in patients with FHF (38.9 ± 7 mg/l). Both the production of IL-6 and TNF by PBMC isolated from patients with FHF and the potential of supernatants from these cells to stimulate CRP production by hepatocytes in vitro was significantly reduced compared with controls. Conclusions: Despite the observation that patients with FHF have an elevated hepatic acute phase response, PBMC from patients with FHF have reduced potential to produce IL-6 and TNF and elicit an acute phase response in vitro by the time of patient admission to the intensive care unit. One explanation for this observation is early activation and exhaustion of PBMC in vivo.

Electronic Resource