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Biomedical subjects

J R Thorburn

Publications and source records attributed to J R Thorburn.

8 recordsLinked to original sources
PubMed1991

Comparison of bacteraemic community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae in an intensive care unit.

In a study of 41 consecutive patients with bacteraemia-associated community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae an attempt was made to determine whether distinguishing criteria of disease due to these organisms could be identified according to demographic features and the results of initial clinical and laboratory investigations. Such information would aid in the early initiation of appropriate antimicrobial therapy. The most significant difference between the two groups of patients was the lower platelet count in the K. pneumoniae group (p less than 0.005). In addition leucopenia (p less than 0.05), higher serum albumin (p less than 0.05), and the male sex (p less than 0.05) featured with an increased frequency in patients with pulmonary infection due to K. pneumoniae. Initial antimicrobial therapy in critically ill patients with community-acquired lobar pneumonia and thrombocytopenia, particularly when associated with leucopenia and in male patients, should include agents effective against K. pneumoniae.

Adult↗
PubMed1989

Community-acquired pneumonia of diverse aetiology: prognostic features in patients admitted to an intensive care unit and a "severity of illness" core.

In a retrospective study of 73 patients with community-acquired lobar pneumonia of diverse aetiology admitted to an intensive care unit, an attempt was made to identify those factors among the demographic and clinical features and results of initial laboratory investigations that were predictive of the ultimate outcome. A lower mean white cell count (p = 0.03), platelet count (p = 0.02), total serum protein (p = 0.005) and albumin (p = 0.02) and a higher mean serum creatinine (p = 0.03) and phosphate level (p = 0.02) appeared to be predictive of a poor prognosis. The most significant variable predictive of mortality, was the presence of bacteraemia (p = 0.0005). Severity of illness scoring systems by omitting microbiological data appear to underestimate predicted patient mortality. The mortality rate of critically ill patients with community-acquired lobar pneumonia remains high, despite advances in antimicrobial chemotherapy and intensive care unit facilities, particularly in the presence of certain negative prognostic factors of which the presence of bacteraemia is the most important.

Adult↗
PubMed1987

Acute respiratory failure in active tuberculosis.

We describe 15 patients whose acute respiratory failure associated with pulmonary tuberculosis necessitated their ICU admission during a 42-month period. There was a 1.5% incidence of respiratory failure in hospitalized tuberculosis patients. Eleven of the 15 patients required ventilatory assistance for a mean 17.3 days. Five patients died in ICU (early mortality = 33%), and two others died within 3 months of discharge (total mortality = 47%). We began specific anti-tuberculous chemotherapy in these patients within 3 +/- 4 (SD) days after hospital admission. Pulmonary histology was available in five cases. Despite the clinical and radiologic features compatible with the adult respiratory distress syndrome in these patients, histology showed confluent tuberculous bronchopneumonia with no evidence of the syndrome.

Acute Disease↗
PubMed1986

Anaesthetic management of Takayasu's arteritis.

A case of type IV Takayasu's arteritis in whom a renal autotransplant was performed is presented. Extensive cardiovascular measurements were made, which enabled the assessment of vascular responsiveness to various anaesthetic manipulations. The management of the condition is discussed and certain recommendations made in light of the experience gained.

Adult↗
PubMed1986

Comparison of the effects of atropine and glycopyrrolate on pulmonary mechanics in patients undergoing fiberoptic bronchoscopy.

The effects of atropine and glycopyrrolate on forced vital capacity (FVC), forced expired volume in one second (FEV1), the FEV1/FVC ratio, and peak expiratory flow (PFL) were compared in 44 patients undergoing fiberoptic bronchoscopy under general anesthesia. Both anticholinergic agents improved pulmonary function equally before general anesthesia, but in both groups there was a small and again equal deterioration in pulmonary function after the procedure. The protective effects of the two drugs were not significantly different. Because of the lower incidence of undesirable side effects, glycopyrrolate is recommended as the anticholinergic agent of choice for bronchoscopy.

Atropine↗