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Biomedical subjects

A Munro

Publications and source records attributed to A Munro.

At least 19 recordsLinked to original sources
PubMed1992

Safety of fibreoptic endoscopy: analysis of cardiorespiratory events.

Cardiorespiratory function during upper gastrointestinal endoscopy and colonoscopy was studied prospectively in 164 patients. Cardiorespiratory events, which were defined as oxygen saturation < 90 per cent, electrocardiographic changes, heart rate < 50 or > 100 beats/min and systolic blood pressure < 100 mmHg, occurred in 111 patients. In 24 of these, changes were attributed solely to intravenous sedation. In the remaining 140 patients, events were noted in 34 (52 per cent) of 66 upper gastrointestinal endoscopies and during 53 (72 per cent) of 74 colonoscopies. One patient suffered a myocardial infarction during colonoscopy. Although cardiorespiratory events were common (111 of 164; 68 per cent), the actual morbidity rate was low (one of 164; 0.6 per cent). Cardiorespiratory events were significantly more common in patients with a history of cardiac disease for both upper gastrointestinal endoscopy and colonoscopy (overall chi 2 = 7.41, 1 d.f., P < 0.05) and more common for oesophageal dilatation than for diagnostic endoscopy (chi 2 = 5.56, 1 d.f., P < 0.05). It is recommended that patients with a history of cardiac problems undergoing upper gastrointestinal endoscopy or colonoscopy and all those requiring therapeutic endoscopy should be monitored carefully to allow early detection of cardiorespiratory events, and that oxygen should be administered routinely.

Adult↗
PubMed1992

Surveillance after orchidectomy for patients with clinical stage I nonseminomatous testis tumors.

PURPOSE: This study was designed to determine the proportion of patients with clinical stage I nonseminomatous germ cell tumors of the testis (NSGCTT) managed with surveillance after orchidectomy who have more advanced disease and, therefore, require further treatment, the time to progression, the sites of progression, and the efficacy of treatment delayed until progression was recognized. PATIENTS AND METHODS: One hundred five patients were observed prospectively without further treatment after orchidectomy and full clinical staging. Treatment was given immediately upon detection of marker-positive, clinical, or radiologic evidence of disease. RESULTS: Thirty-seven patients (35.2%) have required further therapy for disease progression, occurring from 2 to 21 months after diagnosis. Thirty-six patients have been successfully treated. Overall, 104 patients (99%) remain alive and free of disease at 12 to 121 months after orchidectomy. Progression occurred in the retroperitoneum in 25 of 37 patients who developed further disease on surveillance. The presence of vascular invasion in the primary tumor was predictive of an increased risk of progression. CONCLUSION: Surveillance is a valid alternative to immediate retroperitoneal lymph node dissection in patients with clinical stage I NSGCTT but should be recommended only under the close supervision of physicians experienced in the diagnosis and treatment of testicular cancer.

Adolescent↗
PubMed1991

Body dysmorphic disorder and the DSM-IV: the demise of dysmorphophobia.

Dysmorphophobia is a controversial term. It is not a phobia, reliable data on it are few, and many authors write about it without attempting to define it. DSM-III-R introduced the term "body dysmorphic disorder" to describe a non-psychotic condition in which there is pathological preoccupation with physical appearance and with the intention of replacing the term "dysmorphophobia". However, psychiatrists continue to use the word dysmorphophobia, often unaware that it may have several distinct meanings. This article, 1. demonstrates the current confusion in terminology, 2. elaborates on DSM-III-R's concept of body dysmorphic disorder, and 3. suggests refinements for the DSM-IV description.

Adolescent↗
PubMed1991

A plea for paraphrenia.

Clinicians who deal with psychotic patients see individuals whose illness is similar to schizophrenia, but whose symptoms are less florid, and deterioration less severe, than in schizophrenia. The diagnosis of atypical psychosis or psychotic disorder NOS is not satisfactory since it lumps disparate conditions together, whereas the term "paraphrenia" can include such illnesses. Paraphrenia is a well-established concept that was ignored in the DSM-III and the DSM-III-R and may be excluded from the ICD-10. There is a need to re-establish the diagnosis, for accurate diagnostic purposes and for future research of the paranoid/delusional disorders.

Chronic Disease↗
PubMed1991

Ultrasonic detection of parathyroid adenomas.

High-resolution real time sonography was used to evaluate patients with suspected primary hyperparathyroidism. A total of 12 consecutive patients was scanned pre-operatively. The sensitivity of the procedure was 92% and the specificity 97%. In our hospital sonography is the procedure of choice for localizing enlarged parathyroid glands prior to surgical exploration.

Adenoma↗
PubMed1990

Activation of potassium efflux from Escherichia coli by glutathione metabolites.

The mechanism by which N-ethylmaleimide (NEM) elicits potassium efflux from Escherichia coli has been investigated. The critical factor is the formation of specific glutathione metabolites that activate transport systems encoded by the kefB and kefC gene products. Formation of N-ethyl-succinimido-S-glutathione (ESG) leads to the activation of potassium efflux via these transport systems. The addition of dithiothreitol and other reducing agents to cells reverses this process by causing the breakdown of ESG and thus removing the activator of the systems. Chlorodinitrobenzene, p-chloromercuribenzoate and phenylmaleimide provoke similar effects to NEM. lodoacetate, which leads to the formation of S-carboxymethyl-glutathione, does not activate the systems but does prevent the action of NEM. It is concluded that the KefB and KefC systems are gated by glutathione metabolites and that the degree to which they are activated is dependent upon the nature of the substituent on the sulphydryl group.

Biological Transport↗
PubMed1989

Technical training in surgery: the trainee's view.

A questionnaire designed to investigate the technical training of general surgical trainees was distributed throughout Scotland. A total of 222 questionnaires were sent out and 179 (81 per cent) were returned. Of the responders, 38 per cent felt that the overall operative workload was too small and the majority thought that there was too little emphasis on supervised operating. Two-thirds of trainees were generally satisfied with the amount of unsupervised operating, although a substantial proportion (21 per cent) sometimes felt out of their depth when performing delegated emergency operations. Few had attended craft workshops or travelled to other centres, but of those who had, most considered both activities to be very useful. Photographic atlases and videos were not generally felt to be of great value by those who had used them. The majority of trainees did not believe that research activity had interfered excessively with their technical training.

Attitude of Health Personnel↗