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Biomedical subjects

J F Munro

Publications and source records attributed to J F Munro.

At least 73 records · Page 4Linked to original sources
PubMed1975

Abdominal pain in diabetic metabolic decompensation. Clinical significance.

Severe abdominal pain and tenderness occured in 46 of 211 episodes of severe diabetic metabolic decompensation. No association was found between abdominal pain and the degree of dehydration or the initial blood glucose level. In 17 instances, the abdominal pain could be attributed to the precipitating cause of the metabolic decompensation. The episodes of unexplained pain all occurred insulin-dependent patients less than 40 years of age; of these, only three had a plasma bicarbonate level greater than 10 mEq/liter, and in two patients, additional factors could account for the relative lack of ketoacidosis. Abdominal pain occurring in patients more than 40 years old, irrespective of the plasma bicarbonate level, and in patients of any age with a plasma bicarbonate level in excess of 10 mEq/liter, almost invariably indicates a specific underlying cause.

Abdomen↗
PubMed1974

Relation between pulmonary gas exchange and closing volume before and after substantial weight loss in obese subjects.

Relations between expiratory reserve volume (ERV), closing volume (CV) as a percentage of vital capacity (CV/VC%), and pulmonary gas exchange have been investigated in the sitting and supine postures in eight severely obese subjects before and after substantial weight loss. CV/VC% exceeded predicted values but did not change with posture or weight loss; the increase could have been owing to the smoking habits of the subjects. Arterial oxygen pressure (PaO(2)) was significantly less in the supine than in the sitting posture and improved after weight loss in six subjects. The reduction in PaO(2) was correlated with the extent to which dependent airways were closed within the range of tidal breathing, shown by increasing negativity of ERV-CV as a percentage of VC. A good correlation was also found between PaO(2) and ERV, an easier measurement for routine use. Improvement of pulmonary gas exchange occurred only in those patients who lost weight to within 30% in excess of ideal.

Adult↗
PubMed1974

Long-term follow-up of therapeutic starvation.

A total of 75 grossly obese patients were admitted to hospital for 80 episodes of prolonged starvation. Five took their own discharge within two weeks of admission and 12 defaulted from follow-up within 12 months of discharge. The others were all followed up for periods of 12 to 64 months. Altogether 39 episodes in 34 patients were classified as failures, eight as modified successes, and 16 as successes, though five of the latter patients subsequently defaulted. Success was associated with regular follow-up attendance but could not be otherwise predicted. A number of patients obtained tangible benefit from starvation despite a subsequent gain in weight.

Adolescent↗
PubMed1973

Euglycaemic diabetic ketoacidosis.

Of a series of 211 episodes of diabetic metabolic decompensation 37 had severe euglycaemic ketoacidosis (a blood sugar level of less than 300 mg/100 ml and a plasma bicarbonate of 10 mEq/1. or less). All were young insulin-dependent diabetics, only one being previously undiagnosed. Vomiting was a common factor, and in all carbohydrate reduction occurred with continued or increased daily insulin dose. Treatment comprised fluid and electrolyte replacement and large doses of insulin covered by adequate carbohydrate, many receiving 10% dextrose. Alkali was either withheld or given sparingly and the therapy was monitored by serial estimations of plasma bicarbonate. All the patients survived.

Adolescent↗