1
|
Fogarty J, Sturm M, Carnley B, Prentice D. Mesenchymal stromal cells as a clinical therapy for tissue repair. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
2
|
Stanley SM, Rhoades GK, Loew BA, Allen ES, Carter S, Osborne LJ, Prentice D, Markman HJ. A Randomized Controlled Trial of Relationship Education in the U.S. Army: 2-Year Outcomes. Fam Relat 2014; 63:484-495. [PMID: 25419027 PMCID: PMC4237282 DOI: 10.1111/fare.12083] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study examined the effectiveness of an evidence-based, community-delivered adaptation of couple relationship education (CRE; specifically, PREP, The Prevention and Relationship Enhancement Program) delivered at two Army installations. The study is a randomized controlled trial with two years of follow-up, examining marital quality and stability. Sample composition was 662 married couples with a spouse in the U.S. Army. Analyses yielded no evidence of overall enduring intervention effects on relationship quality but couples assigned to intervention at the higher risk site were significantly less likely than controls to be divorced at the two-year follow-up (8.1% vs. 14.9%, p < .01). This effect was moderated by ethnic minority status. Specifically, the impact of the intervention on divorce was strongest for minority couples. The findings add to the literature on who may benefit most from CRE.
Collapse
|
3
|
Loh NK, Lucas M, Fernandez S, Prentice D. Successful treatment of macrophage activation syndrome complicating adult Still disease with anakinra. Intern Med J 2013; 42:1358-62. [PMID: 23253002 DOI: 10.1111/imj.12002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 07/15/2012] [Indexed: 11/26/2022]
Abstract
A previously healthy 20-year-old man presented with adult Still disease (ASD). He developed life-threatening macrophage activation syndrome (MAS), which was refractory to standard immunosuppression but responded dramatically to the IL-1 receptor antagonist anakinra. Subsequent immunological investigations included assessment of the perforin expression of natural killer (NK) cells and CD8+ T cells, which confirmed MAS.
Collapse
Affiliation(s)
- N K Loh
- Department of Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.
| | | | | | | |
Collapse
|
4
|
|
5
|
Wenz JR, Garry FB, Lombard JE, Elia R, Prentice D, Dinsmore RP. Short communication: Efficacy of parenteral ceftiofur for treatment of systemically mild clinical mastitis in dairy cattle. J Dairy Sci 2006; 88:3496-9. [PMID: 16162523 DOI: 10.3168/jds.s0022-0302(05)73034-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate the effect of intramuscular (i.m.) ceftiofur (2.2 mg/kg) on important outcomes of systemically mild clinical mastitis episodes in lactating dairy cattle. Cows with clinical mastitis were randomly assigned to a treatment group: pirlimycin intramammary (i.m.m.) (n = 35), pirlimycin i.m.m. and ceftiofur i.m.m. (n = 36), cephapirin i.m.m. (n = 40), cephapirin i.m. and ceftiofur i.m. (n = 33). Sixty-nine, 22, and 9% of initial cultures were gram-negative, gram-positive, and mixed, respectively. Logistic regression analysis showed no significant associations between treatment groups and loss of quarter, recurrence, or culling. Mixed infections, positive milk culture at 7 d after leaving hospital pen, decreased rumen motility, and absence of udder firmness were associated with increased odds of mastitis recurrence. The results suggest that i.m. ceftiofur treatment has no beneficial effects on the outcome of systemically mild clinical mastitis.
Collapse
Affiliation(s)
- J R Wenz
- Integrated Livestock Management, Department of Clinical Sciences, Colorado State University, Fort Collins 80523, USA.
| | | | | | | | | | | |
Collapse
|
6
|
Affiliation(s)
- J Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | | |
Collapse
|
7
|
Prentice D, Hathaway M. Responding to a death from meningococcal disease: a case study. Nurs N Z 2001; 7:16-7. [PMID: 12012895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
8
|
Prentice D, Hathaway M. The deathly progress of meningococcal disease. Nurs N Z 2001; 7:18. [PMID: 12012896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
9
|
Prentice D, Heywood J. Migraine and hypertension. Is there a relationship? Aust Fam Physician 2001; 30:461-5. [PMID: 11432020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Migraine and hypertension are common conditions that frequently coexist. The relastionship between the two is usually coincidental, but some evidence suggests that poor control of blood pressure may exacerbate the frequency and severity of migraine. OBJECTIVE To review the relationship between migraine, other headaches and blood pressure and to discuss guidelines for suitable therapy for both conditions when they occur together. DISCUSSION Establishing the blood pressure should be a routine task in the assessment of all headache patients. Severe hypertension in the setting of new acute headache may indicate a serious underlying cause and requires urgent investigation. In patients with migraine and established hypertension, good control of blood pressure may be beneficial in controlling their headache. Many of the drugs used to treat hypertension may cause headache and some agents used to treat migraine can exacerbate hypertension and so careful consideration of the therapeutic options is important.
Collapse
Affiliation(s)
- D Prentice
- Migraine and Hypertension Services, St Vincent's Hospital, Melbourne, Victoria.
| | | |
Collapse
|
10
|
Prentice D, Boon K, Hourani S. Relaxation of mouse isolated aorta to adenosine and its analogues does not involve adenosine A(1), A(2) or A(3) receptors. Eur J Pharmacol 2001; 415:251-5. [PMID: 11275007 DOI: 10.1016/s0014-2999(01)00841-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Relaxations to adenosine and analogues were investigated in the mouse aorta in the presence of the adenosine A(1) receptor-selective antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX, 30 nM), which did not affect relaxations to adenosine or its analogue N(6)-R-phenylisopropyladenosine (R-PIA) but abolished contractile adenosine A(1) receptor-mediated responses to these agonists. Relaxations to adenosine, 5'-N-ethylcarboxamidoadenosine, R-PIA, 2-[p-(2-carbonylethyl)-phenylethylamino]-5'-N-ethylcarboxamidoadenosine (CGS 21680), and N(6)-(3-iodobenzyl)-adenosine-5'-N-methyluronamide (IB-MECA) were unaffected by the adenosine A(1)/A(2) receptor antagonist 8-sulphophenyltheophylline (100 microM). IB-MECA relaxations were unaffected by the adenosine A(3) receptor-selective antagonist 3-ethyl-5-benzyl-2-methyl-6-phenyl-4-phenylethynyl-1,4-(+/-)-dihydropyridine-3,5-dicarboxylate (MRS1191, 30 microM) and R-PIA relaxations were unaffected by N(G)-nitro-L-arginine methyl ester (100 microM) and endothelium removal. In conclusion, relaxant responses to adenosine and analogues do not involve adenosine A(1), A(2) or A(3) receptors and are endothelium- and nitric oxide-independent.
Collapse
Affiliation(s)
- D Prentice
- School of Biomedical and Life Sciences, University of Surrey, Guildford, UK.
| | | | | |
Collapse
|
11
|
Abstract
The pulmonary artery catheter (PAC) has been in use for more than 30 years. The amount and detail of hemodynamic information provided by the PAC cannot be matched by any other single technology. Whether or not this information makes a difference in the clinical outcomes of critically ill patients is uncertain, however. The Pulmonary Artery Catheter Consensus Conference scrutinized the available research data on the catheter and provided guidelines for clinicians on its use. This article summarizes the controversy and the guidelines available for use of the PAC. It notes the need for further research on patient outcomes.
Collapse
Affiliation(s)
- D Prentice
- Barnes-Jewish Hospital, St Louis, Missouri, USA
| | | |
Collapse
|
12
|
Kollef MH, Ward S, Sherman G, Prentice D, Schaiff R, Huey W, Fraser VJ. Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med 2000; 28:3456-64. [PMID: 11057801 DOI: 10.1097/00003246-200010000-00014] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the impact of scheduled changes of antibiotic classes, used for the empirical treatment of suspected or documented Gram-negative bacterial infections, on the occurrence of inadequate antimicrobial treatment of nosocomial infections. DESIGN Prospective observational study. SETTING Medical (19-bed) and surgical (18-bed) intensive care units in an urban teaching hospital. PATIENTS A total of 3,668 patients requiring intensive care unit admission were prospectively evaluated during three consecutive time periods. INTERVENTIONS During each time period, one antibiotic class was selected for the empirical treatment of Gram-negative bacterial infections as follows: time period 1 (baseline period) (1,323 patients), ceftazidime; time period 2 (1,243 patients), ciprofloxacin; and time period 3 (1,102 patients), cefepime. MEASUREMENTS AND MAIN RESULTS The overall administration of inadequate antimicrobial treatment for nosocomial infections decreased during the course of the study (6.1%, 4.7%, and 4.5%; p = .15). This was primarily because of a statistically significant decrease in the administration of inadequate antibiotic treatment for Gram-negative bacterial infections (4.4%, 2.1%, and 1.6%; p < .001). There were no statistically significant differences in the overall hospital mortality rate among the three time periods (15.6%, 16.4%, and 16.2%; p = .828) despite a significant increase in severity of illness as measured with Acute Physiology and Chronic Health Evaluation (APACHE) II scores (15.3 +/- 7.6, 15.7 +/- 8.0, and 20.7 +/- 8.6; p < .001). The hospital mortality rate decreased significantly during time period 3 (20.6%) compared with time period 1 (28.4%; p < .001) and time period 2 (29.5%; p < .001) for patients with an APACHE II score > or = 15. CONCLUSIONS These data suggest that scheduled changes of antibiotic classes for the empirical treatment of Gram-negative bacterial infections can reduce the occurrence of inadequate antibiotic treatment for nosocomial infections. Reducing inadequate antibiotic administration may improve the outcomes of critically ill patients with APACHE II scores > or = 15.
Collapse
Affiliation(s)
- M H Kollef
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | |
Collapse
|
13
|
Calder L, Hampton L, Prentice D, Reeve M, Vaughan A, Vaughan R, Harrison A, Voss L, Morris AJ, Singh H, Koberstein V. A school and community outbreak of tuberculosis in Auckland. N Z Med J 2000; 113:71-4. [PMID: 10855581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AIM To describe a school and community outbreak of tuberculosis in South Auckland in 1997/8. METHODS Cases were diagnosed according to national guidelines at Middlemore, Green Lane and Starship Hospitals. Public health follow-up was conducted by Auckland Healthcare. RESULTS Twelve cases were diagnosed during the outbreak. Nine cases were from the same South Auckland secondary school; six reported no association outside school. Three cases were in younger children who had close household contact with two of the school cases. Nine cases (including eight from the school) had identical Mycobacterium tuberculosis isolates on restriction fragment length polymorphism testing. No microbiological culture was obtained from the three remaining cases. Contact investigation detected five of the cases. Chemoprophylaxis was prescribed for twenty-six school students, two adult staff, and nine household contacts. CONCLUSION This is the first published account of a tuberculosis outbreak in a New Zealand school setting for decades. Recognition of the outbreak was delayed. DNA fingerprinting played a valuable role in the investigation. The source case may have been a school student. The social impact of the outbreak and preventability with routine adolescent BCG vaccination are discussed.
Collapse
Affiliation(s)
- L Calder
- Community Services, Auckland Healthcare
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Prentice D. Nurse in profile. Daniel Prentice. Qld Nurse 2000; 19:5. [PMID: 11022577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
|
15
|
Brook AD, Ahrens TS, Schaiff R, Prentice D, Sherman G, Shannon W, Kollef MH. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999; 27:2609-15. [PMID: 10628598 DOI: 10.1097/00003246-199912000-00001] [Citation(s) in RCA: 764] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare a practice of protocol-directed sedation during mechanical ventilation implemented by nurses with traditional non-protocol-directed sedation administration. DESIGN Randomized, controlled clinical trial. SETTING Medical intensive care unit (19 beds) in an urban teaching hospital. PATIENTS Patients requiring mechanical ventilation (n = 321). INTERVENTIONS Patients were randomly assigned to receive either protocol-directed sedation (n = 162) or non-protocol-directed sedation (n = 159). MEASUREMENTS AND MAIN RESULTS The median duration of mechanical ventilation was 55.9 hrs (95% confidence interval, 41.0-90.0 hrs) for patients managed with protocol-directed sedation and 117.0 hrs (95% confidence interval, 96.0-155.6 hrs) for patients receiving non-protocol-directed sedation. Kaplan-Meier analysis demonstrated that patients in the protocol-directed sedation group had statistically shorter durations of mechanical ventilation than patients in the non-protocol-directed sedation group (chi-square = 7.00, p = .008, log rank test; chi-square = 8.54, p = .004, Wilcoxon's test; chi-square = 9.18, p = .003, -2 log test). Lengths of stay in the intensive care unit (5.7+/-5.9 days vs. 7.5+/-6.5 days; p = .013) and hospital (14.0+/-17.3 days vs. 19.9+/-24.2 days; p < .001) were also significantly shorter among patients in the protocol-directed sedation group. Among the 132 patients (41.1%) receiving continuous intravenous sedation, those in the protocol-directed sedation group (n = 66) had a significantly shorter duration of continuous intravenous sedation than those in the non-protocol-directed sedation group (n = 66) (3.5+/-4.0 days vs. 5.6+/-6.4 days; p = .003). Patients in the protocol-directed sedation group also had a significantly lower tracheostomy rate compared with patients in the non-protocol-directed sedation group (10 of 162 patients [6.2%] vs. 21 of 159 patients [13.2%], p = .038). CONCLUSIONS The use of protocol-directed sedation can reduce the duration of mechanical ventilation, the intensive care unit and hospital lengths of stay, and the need for tracheostomy among critically ill patients with acute respiratory failure.
Collapse
Affiliation(s)
- A D Brook
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
This project had three purposes: to determine the test/retest reliability of three thermometers--an infrared ear thermometer, an oral electronic predictive thermometer, and an oral mercury-in-glass thermometer (MIGT); determine the validity (accuracy) of the first two thermometers using the MIGT as the gold standard; and calculate the thermometers' sensitivity and specificity for detecting fever using 37.5 degrees C on the MIGT as the criterion. The MIGT had the best reliability, followed by the electronic predictive and infrared ear thermometer (for validity, the former was more accurate than the latter). Little difference existed in the latter two thermometers' sensitivity and specificity. However, the confidence intervals were wide, and further studies with larger samples need to be done to elucidate the thermometers' diagnostic properties.
Collapse
Affiliation(s)
- D Prentice
- McMaster University, Hamilton, Ontario, Canada
| | | |
Collapse
|
17
|
Abstract
The purpose of this retrospective evaluation study was to compare outcomes related to two distinct processes for screening people referred for admission to a geriatric rehabilitation program at a chronic care hospital in southern Ontario. Data were collected through chart review and focus group methods. The results were unexpected in that the projected outcomes associated with the newer referral screening process did not materialize. For both referral screening processes, findings are discussed in terms of the percentage of achieved patient rehabilitation goals. The average lengths of patient stay associated with both screening processes were also compared. No statistically significant differences between the two processes were found in terms of either the percentage of goals achieved or the length of patient stay. Focus group sessions were held to elicit team members' perceptions of the effectiveness of each of the referral processes. Participants in the focus groups were supportive of the newer referral screening and admission process although the evidence gathered from the chart review did not demonstrate improvements in patients' length of stay or an increase in the percentage of rehabilitation goals achieved.
Collapse
|
18
|
Prentice D, Woods S. Implementing case management in a geriatric rehabilitation setting. Perspectives 1998; 22:25-6. [PMID: 9709112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
19
|
Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation. Chest 1998; 114:541-8. [PMID: 9726743 DOI: 10.1378/chest.114.2.541] [Citation(s) in RCA: 660] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVE To determine whether the use of continuous i.v. sedation is associated with prolongation of the duration of mechanical ventilation. DESIGN Prospective observational cohort study. SETTING The medical ICU of Barnes-Jewish Hospital, a university-affiliated urban teaching hospital. PATIENTS Two hundred forty-two consecutive ICU patients requiring mechanical ventilation. INTERVENTIONS Patient surveillance and data collection. MEASUREMENTS AND RESULTS The primary outcome measure was the duration of mechanical ventilation. Secondary outcome measures included ICU and hospital lengths of stay, hospital mortality, and acquired organ system derangements. A total of 93 (38.4%) mechanically ventilated patients received continuous i.v. sedation while 149 (61.6%) patients received either bolus administration of i.v. sedation (n=64) or no i.v. sedation (n=85) following intubation. The duration of mechanical ventilation was significantly longer for patients receiving continuous i.v. sedation compared with patients not receiving continuous i.v. sedation (185+/-190 h vs 55.6+/-75.6 h; p<0.001). Similarly, the lengths of intensive care (13.5+/-33.7 days vs 4.8+/-4.1 days; p<0.001) and hospitalization (21.0+/-25.1 days vs 12.8+/-14.1 days; p<0.001) were statistically longer among patients receiving continuous i.v. sedation. Multiple linear regression analysis, adjusting for age, gender, severity of illness, mortality, indication for mechanical ventilation, use of chemical paralysis, presence of a tracheostomy, and the number of acquired organ system derangements, found the adjusted duration of mechanical ventilation to be significantly longer for patients receiving continuous i.v. sedation compared with patients who did not receive continuous i.v. sedation (148 h [95% confidence interval: 121, 175 h] vs 78.7 h [95% confidence interval: 68.9, 88.6 h]; p<0.001). CONCLUSION We conclude from these preliminary observational data that the use of continuous i.v. sedation may be associated with the prolongation of mechanical ventilation. This study suggests that strategies targeted at reducing the use of continuous i.v. sedation could shorten the duration of mechanical ventilation for some patients. Prospective randomized clinical trials, using well-designed sedation guidelines and protocols, are required to determine whether patient-specific outcomes (eg, duration of mechanical ventilation, patient comfort) can be improved compared with conventional sedation practices.
Collapse
Affiliation(s)
- M H Kollef
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | |
Collapse
|
20
|
Kollef MH, Shapiro SD, Boyd V, Silver P, Von Harz B, Trovillion E, Prentice D. A randomized clinical trial comparing an extended-use hygroscopic condenser humidifier with heated-water humidification in mechanically ventilated patients. Chest 1998; 113:759-67. [PMID: 9515854 DOI: 10.1378/chest.113.3.759] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVE To determine the safety and cost-effectiveness of mechanical ventilation with an extended-use hygroscopic condenser humidifier (Duration; Nellcor Puritan-Bennett; Eden Prairie, Minn) compared with mechanical ventilation with heated-water humidification. DESIGN Prospective randomized clinical trial. SETTING Medical and surgical ICUs of Barnes-Jewish Hospital, St. Louis, a university-affiliated teaching hospital. PATIENTS Three hundred ten consecutive qualified patients undergoing mechanical ventilation. INTERVENTIONS Patients requiring mechanical ventilation were randomly assigned to receive humidification with either an extended-use hygroscopic condenser humidifier (for up to the first 7 days of mechanical ventilation) or heated-water humidification. MEASUREMENTS Occurrence of ventilator-associated pneumonia, endotracheal tube occlusion, duration of mechanical ventilation, lengths of intensive care and hospitalization, acquired multiorgan dysfunction, and hospital mortality. RESULTS One hundred sixty-three patients were randomly assigned to receive humidification with an extended-use hygroscopic condenser humidifier, and 147 patients were randomly assigned to receive heated-water humidification. The two groups were similar at the time of randomization with regard to demographic characteristics, ICU admission diagnoses, and severity of illness. Risk factors for the development of ventilator-associated pneumonia were also similar during the study period for both treatment groups. Ventilator-associated pneumonia was seen in 15 (9.2%) patients receiving humidification with an extended-use hygroscopic condenser humidifier and in 15 (10.2%) patients receiving heated-water humidification (relative risk, 0.90; 95% confidence interval=0.46 to 1.78; p=0.766). No statistically significant differences for hospital mortality, duration of mechanical ventilation, lengths of stay in the hospital ICU, or acquired organ system derangements were found between the two treatment groups. No episode of endotracheal tube occlusion occurred during the study period in either treatment group. The total cost of providing humidification was $2,605 for patients receiving a hygroscopic condenser humidifier compared with $5,625 for patients receiving heated-water humidification. CONCLUSION Our findings suggest that the initial application of an extended-use hygroscopic condenser humidifier is a safe and more cost-effective method of providing humidification to patients requiring mechanical ventilation compared with heated-water humidification.
Collapse
Affiliation(s)
- M H Kollef
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | |
Collapse
|
21
|
|
22
|
Napoli J, Prentice D, Niinami C, Bishop GA, Desmond P, McCaughan GW. Sequential increases in the intrahepatic expression of epidermal growth factor, basic fibroblast growth factor, and transforming growth factor beta in a bile duct ligated rat model of cirrhosis. Hepatology 1997; 26:624-33. [PMID: 9303492 DOI: 10.1002/hep.510260314] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic hepatic regeneration constitutes an important part of the cirrhotic process. The factors regulating chronic hepatic regeneration, however, remain unclear. We therefore analyzed the intrahepatic messenger RNA (mRNA) expression of growth factors (epidermal growth factor [EGF], basic fibroblast growth factor [bFGF], hepatocyte growth factor [HGF], transforming growth factor [TGF]-alpha, and TGF-beta) at progressive time points (postoperative days 2, 7, 14, and 21) in a rat bile duct-ligated (BDL) model of cirrhosis versus sham controls. Intrahepatic growth factor mRNA expression was quantitatively assessed by polymerase chain reaction (PCR) using a dot-blot hybridization technique. Cirrhosis was associated with statistically significant (P < .05) progressive increases in the intrahepatic mRNA expression of bFGF (80-fold), EGF (25-fold), and TGF-beta (fourfold) in BDL animals versus controls. Furthermore, immunohistochemistry of hepatic sections showed a progressive up-regulation of bFGF protein in areas of bile duct proliferation. These areas also showed a dramatic increase in the number of hepatic stellate cells (HSC). In contrast, the intrahepatic expression of hepatocyte growth factor (HGF) mRNA was only significantly increased at postoperative days 7 and 14 in BDL animals before returning to control levels as cirrhosis developed. There were no significant differences found at any timepoint in the expression of TGF-alpha in BDL animals versus controls. In conclusion, the development of cirrhosis in this BDL rat model was associated with a progressive increase in the intrahepatic expression of EGF, bFGF, and TGF-beta. Early increased expression of HGF was not maintained in established cirrhosis. The findings suggest that these growth factors may play important roles in the pathogenesis of chronic hepatic regeneration in cirrhosis.
Collapse
Affiliation(s)
- J Napoli
- A. W. Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, University of Sydney, New South Wales, Australia
| | | | | | | | | | | |
Collapse
|
23
|
Kollef MH, Von Harz B, Prentice D, Shapiro SD, Silver P, St John R, Trovillion E. Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia. Chest 1997; 112:765-73. [PMID: 9315813 DOI: 10.1378/chest.112.3.765] [Citation(s) in RCA: 158] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVE To determine whether patient transport out of the ICU is associated with an increased risk of developing ventilator-associated pneumonia. DESIGN Prospective cohort study. SETTING ICUs of Barnes-Jewish Hospital, a university-affiliated teaching hospital. PATIENTS Five hundred twenty-one ICU patients requiring mechanical ventilation for > 12 h. INTERVENTION Prospective patient surveillance and data collection. MEASUREMENTS AND RESULTS The primary outcome measure was the development of ventilator-associated pneumonia. A total of 273 (52.4%) mechanically ventilated patients required at least one transport out of the ICU while 248 (47.6%) patients did not undergo transport. Sixty-six (24.2%) of the transported patients developed ventilator-associated pneumonia compared with 11 (4.4%) patients in the group not undergoing transport (relative risk=5.5; 95% confidence interval [CI]=2.9 to 10.1; p<0.001). Multiple logistic regression analysis demonstrated that a preceding episode of transport out of the ICU was independently associated with the development of ventilator-associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p<0.001). Other variables independently associated with the development of ventilator-associated pneumonia included reintubation, presence of a tracheostomy, administration of aerosols, and male gender. CONCLUSIONS We conclude that patient transport out of the ICU is associated with an increased risk for the development of ventilator-associated pneumonia.
Collapse
Affiliation(s)
- M H Kollef
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | |
Collapse
|
24
|
Kollef MH, Prentice D, Shapiro SD, Fraser VJ, Silver P, Trovillion E, Weilitz P, von Harz B, St John R. Mechanical ventilation with or without daily changes of in-line suction catheters. Am J Respir Crit Care Med 1997; 156:466-72. [PMID: 9279225 DOI: 10.1164/ajrccm.156.2.9612083] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to determine the safety and cost-effectiveness of not routinely changing in-line suction catheters for patients requiring mechanical ventilation. Patients were randomly assigned to receive either no routine in-line suction catheter changes (n = 258) or in-line suction catheter changes every 24 h (n = 263). The main outcome measure was the incidence of ventilator-associated pneumonia. Other outcomes evaluated included hospital mortality, acquired organ system derangements, duration of mechanical ventilation, lengths of intensive care and hospital stay, and the cost for in-line suction catheters. Ventilator-associated pneumonia was seen in 38 patients (14.7%) receiving no routine in-line suction catheter changes and in 39 patients (14.8%) receiving in-line suction catheter changes every 24 h (relative risk, 0.99; 95% CI, 0.66 to 1.50). No statistically significant differences for hospital mortality, lengths of stay, the number of acquired organ system derangements, death in patients with ventilator-associated pneumonia, or mortality directly attributed to ventilator-associated pneumonia were found between the two treatment groups. Patients receiving in-line suction catheter changes every 24 h had 1,224 catheter changes costing a total of $11,016; patients receiving no routine in-line suction catheter changes had a total of 93 catheter changes costing $837. Our findings suggest that the elimination of routine in-line suction catheter changes is safe and can reduce the costs associated with providing mechanical ventilation.
Collapse
Affiliation(s)
- M H Kollef
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Prentice D, Schofield SR. An evaluation of a self-directed program for feeding certification. Perspectives 1997; 21:2-4. [PMID: 9287828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- D Prentice
- Rehabilitation Program, St. Peter's Hospital, Hamilton, Ontario
| | | |
Collapse
|
26
|
Kollef MH, Shapiro SD, Silver P, St John RE, Prentice D, Sauer S, Ahrens TS, Shannon W, Baker-Clinkscale D. A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med 1997; 25:567-74. [PMID: 9142019 DOI: 10.1097/00003246-199704000-00004] [Citation(s) in RCA: 525] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare a practice of protocol-directed weaning from mechanical ventilation implemented by nurses and respiratory therapists with traditional physician-directed weaning. DESIGN Randomized, controlled trial. SETTING Medical and surgical intensive care units in two university-affiliated teaching hospitals. PATIENTS Patients requiring mechanical ventilation (n = 357). INTERVENTIONS Patients were randomly assigned to receive either protocol-directed (n = 179) or physician-directed (n = 178) weaning from mechanical ventilation. MEASUREMENTS AND MAIN RESULTS The primary outcome measure was the duration of mechanical ventilation from tracheal intubation until discontinuation of mechanical ventilation. Other outcome measures included need for reintubation, length of hospital stay, hospital mortality rate, and hospital costs. The median duration of mechanical ventilation was 35 hrs for the protocol-directed group (first quartile 15 hrs; third quartile 114 hrs) compared with 44 hrs for the physician-directed group (first quartile 21 hrs; third quartile 209 hrs). Kaplan-Meier analysis demonstrated that patients randomized to protocol-directed weaning had significantly shorter durations of mechanical ventilation compared with patients randomized to physician-directed weaning (chi 2 = 3.62, p = .057, log-rank test; chi 2 = 5.12, p = .024, Wilcoxon test). Cox proportional-hazards regression analysis, adjusting for other covariates, showed that the rate of successful weaning was significantly greater for patients receiving protocol-directed weaning compared with patients receiving physician-directed weaning (risk ratio 1.31; 95% confidence interval 1.15 to 1.50; p = .039). The hospital mortality rates for the two treatment groups were similar (protocol-directed 22.3% vs. physician-directed 23.6%; p = .779). Hospital cost savings for patients in the protocol-directed group were $42,960 compared with hospital costs for patients in the physician-directed group. CONCLUSION Protocol-guided weaning of mechanical ventilation, as performed by nurses and respiratory therapists, is safe and led to extubation more rapidly than physician-directed weaning.
Collapse
Affiliation(s)
- M H Kollef
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Sinclair RD, Rotstein H, Clemmens L, Prentice D, Rode J, Breen K. Methotrexate hepatotoxicity and the role of routine liver biopsy: a collective opinion. Australas J Dermatol 1995; 36:228-9. [PMID: 8593119 DOI: 10.1111/j.1440-0960.1995.tb00985.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
28
|
Prentice D, Theriault K. Clinical comment on the Dermapulse Wound Management System [corrected]. Perspectives 1995; 19:7-8. [PMID: 7572000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
29
|
Roe FJ, Lee PN, Conybeare G, Kelly D, Matter B, Prentice D, Tobin G. The Biosure Study: influence of composition of diet and food consumption on longevity, degenerative diseases and neoplasia in Wistar rats studied for up to 30 months post weaning. Food Chem Toxicol 1995; 33 Suppl 1:1S-100S. [PMID: 7713457 DOI: 10.1016/0278-6915(95)80200-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The 1200-rat Biosure Study had six interrelated aims: (1) To see whether dietary restriction (80% ad lib.) reduces the age-standardized incidence of fatal or potentially fatal neoplasia before the age of 30 months. (2) To see whether the beneficial effects of diet restriction can be achieved by (a) limiting the daily period of access to food to 6 hr, or by (b) limiting the energy value of the diet. (3) To see whether reduced calorie intake between weaning and age 4 months influences survival and/or incidence of non-neoplastic and neoplastic diseases. (4) To compare effects of food consumption, energy intake and protein intake on survival and disease. (5) To study the relationships between body weight at different ages with eventual survival and disease incidence. (6) To provide a database for studying relationships between various in-life measurements and eventual survival and disease incidence in individual animals. Twelve groups of SKF Wistar rats consisting of 50 animals of each sex were fed according to different dietary regimens from when they were weaned at the age of 3 wk until they died, or had to be killed because they were sick, or until the experiment was terminated at 30 months. For five of the 12 dietary regimens, satellite groups consisting of 30 animals per sex were maintained in parallel and used to supply information on the effect of diet on circulating hormone levels during the course of the study. During the 13 wk post weaning a Standard Breeder diet (SB) was provided either ad lib. (four groups), 80% ad lib. (three groups), or with access to food limited to 6 hr per day (one group). During this same period two other groups were fed a Low Nutrient Breeder diet (LB) ad lib. A further group was fed a Low Nutrient Maintenance (high fibre) diet (LM) ad lib. Finally, one group was fed the high protein Porton Rat diet (PR) ad lib.(ABSTRACT TRUNCATED AT 400 WORDS)
Collapse
Affiliation(s)
- F J Roe
- Sandoz Pharma Ltd., Basle, Switzerland
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
Pulmonary complications can be the result of direct chest trauma or can occur from indirect trauma outside of the thorax. Understanding the mechanism of pulmonary function in determining intrapulmonary shunt and physiologic deadspace can assist the clinician in assessing the severity and monitoring the progression of pulmonary injury in patients. This article reviews assessment parameters, physiology, and treatment of direct and indirect pulmonary trauma.
Collapse
|
31
|
Roe FJ, Lee PN, Conybeare G, Tobin G, Kelly D, Prentice D, Matter B. Risks of premature death and cancer predicted by body weight in early adult life. Hum Exp Toxicol 1991; 10:285-8. [PMID: 1679652 DOI: 10.1177/096032719101000408] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In a study of 30 months duration, involving 600 male and 600 female Wistar rats fed on 12 different diets/dietary regimes, none of which involved deliberate exposure to any known genotoxic carcinogen, highly significant between-group differences were observed in survival and incidence of various neoplastic and non-neoplastic diseases. A full report of the findings is being prepared. Here we report that, irrespective of diet or dietary regime, there were highly significant correlations of body weight at 29 weeks of age with premature death (P less than 0.0001 in both males and females), with development of benign or malignant neoplasm of any site (P less than 0.0001 in males and P less than 0.01 in females) and with development of malignant neoplasm at any site (P less than 0.0001 for sexes combined). Numerous kinds of neoplasm contributed to these overall correlations. The most significant were pituitary tumour (P less than 0.0001), mammary gland tumour (P less than 0.0001), squamous or anaplastic carcinoma of the jaw (P less than 0.001), and subcutaneous mesodermal tumours (P less than 0.05). The 20% of rats that were heaviest at 29 weeks were more than twice as likely to die prematurely than the lightest 20% (2.56 times--males, and 2.11 times--females), and almost twice as likely to develop a malignant tumour (1.87 times for the sexes combined). These findings have important implications for the design and interpretation of carcinogenicity tests in rodents and of laboratory and human studies of relationships between diet, ageing-related degenerative diseases, and cancer.
Collapse
Affiliation(s)
- F J Roe
- Department of Physiology, University of Leeds, UK
| | | | | | | | | | | | | |
Collapse
|
32
|
Prentice D. Career Structure for Consultants. West J Med 1967. [DOI: 10.1136/bmj.2.5544.116-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
33
|
Prentice D. Mental Subnormality and Divorce. West J Med 1965. [DOI: 10.1136/bmj.1.5428.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
34
|
|
35
|
|
36
|
|