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Biomedical subjects

A L Brennan

Publications and source records attributed to A L Brennan.

5 recordsLinked to original sources
PubMed2006

Hyperglycaemia is associated with poor outcomes in patients admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease.

BACKGROUND: Hyperglycaemia is associated with poor outcomes from pneumonia, myocardial infarction and stroke, but the effect of blood glucose on outcomes from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been established. Recent UK guidelines do not comment on measurement or control of blood glucose in AECOPD. A study was therefore undertaken to determine the relationship between blood glucose concentrations, length of stay in hospital, and mortality in patients admitted with AECOPD. METHODS: Data were retrieved from electronic records for patients admitted with AECOPD with lower respiratory tract infection in 2001-2. The patients were grouped according to blood glucose quartile (group 1, <6 mmol/l (n = 69); group 2, 6.0-6.9 mmol/l (n = 69); group 3, 7.0-8.9 mmol/l (n = 75); and group 4, >9.0 mmol/l (n = 71)). RESULTS: The relative risk (RR) of death or long inpatient stay was significantly increased in group 3 (RR 1.46, 95% CI 1.05 to 2.02, p = 0.02) and group 4 (RR 1.97, 95% CI 1.33 to 2.92, p < 0.0001) compared with group 1. For each 1 mmol/l increase in blood glucose the absolute risk of adverse outcomes increased by 15% (95% CI 4 to 27), p = 0.006. The risk of adverse outcomes increased with increasing hyperglycaemia independent of age, sex, a previous diagnosis of diabetes, and COPD severity. Isolation of multiple pathogens and Staphylococcus aureus from sputum also increased with increasing blood glucose. CONCLUSION: Increasing blood glucose concentrations are associated with adverse clinical outcomes in patients with AECOPD. Tight control of blood glucose reduces mortality in patients in intensive care or following myocardial infarction. A prospective study is now required to determine whether control of blood glucose can also improve outcomes from AECOPD.

Acute Disease↗
PubMed2005

New insights into the glucose oxidase stick test for cerebrospinal fluid rhinorrhoea.

Rhinorrhoea is a clinical sign of cerebrospinal fluid (CSF) leakage in patients with skull fracture, but can also be attributable to respiratory secretions or tears. Laboratory tests confirming the presence of CSF are not sufficiently rapid to support clinical decision making in the emergency department and may not be universally available. Detection of glucose in nasal discharge was traditionally used to diagnose CSF leak at the bedside, but has fallen into disuse as it has poor positive predictive value. We propose an algorithm to improve the diagnostic value of this test taking into consideration factors we have found to affect the glucose concentration of respiratory secretions. In patients at risk of CSF leak, nasal discharge is likely to contain CSF if glucose is present in the absence of visible blood, if blood glucose is <6 mmol x L(-1), and if there are no symptoms of upper respiratory tract infection.

Algorithms↗
PubMed1996

Tracking student progress in a baccalaureate nursing program: academic indicators.

Identification of students "most likely to succeed" has long been a goal of educational institutions, from the perspective of both identifying valid and reliable admission criteria and decreasing attrition rates within a program. In this study, scholastic performance prior to admission to a baccalaureate nursing program was examined in relation to students' level of achievement in courses and their progression in the first two years of the program. Although their incoming averages indicated that both classes of students were at "low risk" for failure in university, only 60% of the 89 students in the two classes were progressing without interruption. Students who did well in high school tended to continue to do well in prerequisite university courses and later in nursing. Students who were behind in their class at the end of Year 1 or Year 2 in the nursing program had significantly lower mean averages on high school credits and on prerequisite university courses. These findings have implications for the admission and counselling of students and lead to the recommendation that similar studies across nursing programs and a prospective longitudinal study within the sampled program be carried out to validate and expand upon study findings.

Adult↗
PubMed1996

Nutrition as a risk for cardiovascular disease in women: dietary intakes of nursing students.

The purpose of this study was to examine dietary intakes of female, baccalaureate nursing students, and to compare their intakes of those nutrients thought to influence cardiovascular health with the Canadian Recommended Nutrient Intakes. Forty-three subjects between the ages of 19-24 completed 3-day dietary records. Although energy intake was low, the student's dietary intakes of fat, protein, and carbohydrates were within acceptable limits. Intakes of sodium and cholesterol were similar to those found in previous studies of young women. Six of the students had BMIs over 27 placing them at increased risk for cardiovascular disease. Longitudinal studies are recommended to provide for a better understanding of nursing students' dietary habits and to establish a basis for education regarding modification of cardiovascular risk.

Adult↗