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Biomedical subjects

M Irving

Publications and source records attributed to M Irving.

136 records · Page 8Linked to original sources
PubMedDate not supplied

Urinary 3-methylhistidine:creatinine ratio in patients on long-term parenteral nutrition.

The urinary 3-methylhistidine (3-MH) and creatine excretion were measured serially in two patients on total parenteral nutrition for 201 and 225 days, respectively. Variations in excretion were related to clinical events, such as sepsis; 3-MH excretion and the 3-MH:creatinine ratio were raised in association with some episodes of infection, but not all. It is concluded that, although infection is often associated with increased myofibrillar protein breakdown, this is not always the case. It is suggested that in susceptible patients a high 3-MH:creatine ratio may indicate occult infection not detectable by other means.

Adult↗
PubMedDate not supplied

Opiate and sedative dependence predicts a poor outcome for patients receiving home parenteral nutrition.

BACKGROUND: Home parenteral nutrition (HPN) is used to treat intestinal failure. A minority of HPN patients are dependent on opiates and benzodiazepines to control pain and anxiety. The aim of this study was to determine what effects such drug dependence had on patient outcomes. METHODS: Ten dependent patients were prospectively compared with 10 well-matched, nondependent HPN patients for the same 12-month period. Episodes of line sepsis and other complications were documented and the cost of treatment estimated. Health status was measured using the SF36 and EuroQol instruments. RESULTS: The dependent group had significantly more episodes of central line sepsis (p = .0007) as well as other complications (p = .0002). This led to significantly longer periods of inpatient care (p = .0004) and therefore higher costs of treatment. Health status was lower in the dependent group; they reported more pain (p = .04) and less energy (p = .04). CONCLUSIONS: The complication rate and increased cost of treatment for opiate- and sedative-dependent patients receiving HPN significantly detract from the overall outcome of this therapy.

Adult↗
PubMedDate not supplied

TNF alpha and IL-6 involvement in surgical trauma. II. In vitro cytokine production.

The study aimed to correlate TNF alpha and IL-6 dynamics during surgical trauma as well as the changes which appear in the circulating monocytes' response after LPS stimulation in vitro. Three patients with major abdominal operations were chosen and serial blood samples were taken before, during and after the operation. Normal unmatched individuals were used as control group during a two hours bed resting period. Both TNF alpha and IL-6 in vitro production showed similar patterns with an initial drop and almost full recovery 24 hours after the operation. We propose a model for TNF alpha and IL-6 role in trauma induced inflammation.

Abdominal Cavity↗