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Biomedical subjects

P Monro

Publications and source records attributed to P Monro.

18 recordsLinked to original sources
PubMed1994

The management of histologically unverified presumed cerebral gliomas with radiotherapy.

PURPOSE: To define the natural history, and prognostic factors of patients with histologically unverified presumed gliomas diagnosed on CT or MR imaging, and treated with external beam radiotherapy. METHODS AND MATERIALS: Retrospective review of 111 adults with histologically unverified presumed cerebral glioma treated with radiotherapy between 1974 and 1990. Using CT or MRI criteria alone 41 were presumed low grade, 63 high grade gliomas and 7 were unclassified. Survival results were compared to a cohort of 82 adults with histologically verified low grade gliomas treated over the same period with surgery and radiotherapy. RESULTS: The 5 year survival probability of the whole cohort was 31%. Age, performance status, and the degree of contrast enhancement were independent prognostic factors for survival. Patients with presumed low grade glioma had a 5 year survival of 41% compared to 52% for patients with verified low grade glioma. After correction for prognostic factors no significant difference was found in the survival between patients with verified and unverified low grade tumors. One of 15 cases with subsequent histology, obtained at autopsy or salvage surgery, had nonglial pathology. CONCLUSION: Patients diagnosed on the basis of clinical features and imaging as having presumed glioma have similar natural history and clinical behavior after treatment with radiotherapy to those with histologically confirmed gliomas. However, the results should not be taken as justification for avoiding biopsy. A proportion of patients may have nonglial pathology and new more effective treatment strategies for patients with glial tumors can only evolve on the basis of full diagnostic information including pathology.

Adolescent↗
PubMed1993

Osmotic production of sterile oral rehydration solutions--an economic, low-technology method.

A sterile oral rehydration solution can be produced by immersing in water a semi-permeable cellulose tube containing glucose and salts. Osmotically-driven ultrafiltration excludes all microbes and particulate matter even when the immersion water contains 45 x 10(6) cfu/ml of Pseudomonas aeruginosa, 25 x 10(7) cfu/ml of Staphylococcus aureus or 20 x 10(7) cfu/ml of Escherichia coli. Solutions of consistent composition can be obtained by having a standard amount of glucose-electrolytes in a cellulose tube of appropriate dimensions and immersing this in a fixed volume of water for a minimum period of time. The method is simple, inexpensive, low-technology and requires no external source of power. It has potential for producing sterile solutions for injections and intravenous use in situations with very limited and simple resources, in emergencies and during natural disasters. Further studies are now needed to determine whether the method can be adapted to provide the large quantities of oral rehydration fluid needed in field conditions.

Humans↗
PubMed1991

Bone weakness after the removal of plates and screws. Cortical atrophy or screw holes?

Bone weakness leading to refracture is a recognised complication of the removal of rigid fixation plates. We have used partially demineralised rabbit tibiae to simulate atrophic changes and to determine whether weakness is due to atrophy or to residual screw holes. Partial demineralisation and a screw hole each reduced maximum bending moment. However, energy absorbing capacity was little affected by demineralisation, but was reduced to 50% by a single drill hole. Residual screw holes are a considerably more important cause of bone weakness after plate removal than is cortical atrophy.

Animals↗
PubMed1989

Neoplastic meningitis in malignant melanoma: diagnosis with monoclonal antibodies.

Six patients with neoplastic melanomatous meningitis were studied. The diagnosis of this complication of malignant disease rests on the demonstration of malignant cells within the CSF. The addition of monoclonal antibody immunocytology to conventional techniques significantly improved the diagnostic sensitivity of CSF cytology, allowing for earlier and therefore more effective palliative treatment.

Adult↗
PubMed1989

Neurosurgery for cervical spondylosis.

The pathogenesis of radiculopathy and myelopathy secondary to cervical spondylosis is described, together with the clinical features of these conditions and the factors that influence their natural history. After discussing the differential diagnosis the medical management and the indications for surgery are considered. Details of the operative approaches are presented in association with the results of treatment.

Humans↗
PubMed1985

Mianserin in the prophylaxis of migraine: a double-blind study.

Evidence is reviewed indicating that instability in central nervous system handling of 5-hydroxytryptamine may be of primary importance in the pathogenesis of migraine, and that the observed diminution of platelet content and uptake of 5-hydroxytryptamine related to an attack may merely be a reflection of this. The rationale is discussed for selecting mianserin as a potentially effective migraine prophylactic based on: (i) its ability to restore to normal platelet 5-hydroxytryptamine uptake when this is decreased in depression; (ii) its effect on the central nervous system; and particularly (iii) its antiserotonergic activity. A double-blind control trial of mianserin versus placebo in the prophylaxis of migraine is described. There was a significant fall in both frequency and severity of migraine attacks when compared with baseline values in mianserin-treated patients but not in placebo-treated patients. There was no accompanying change on the Beck Depression Inventory. It is concluded that mianserin is an effective migraine prophylactic in some patients. There is no evidence indicating which pharmacological property of mianserin is responsible for this effect.

Adolescent↗
PubMed1984

Is leucocyte ascorbic acid an unreliable estimate of vitamin C deficiency?

Leucocyte ascorbic acid levels failed to identify six of seven elderly patients shown to be deficient on an oral vitamin C saturation test. Compared to those with a normal saturation test, patients judged deficient had lower levels for triceps skinfold thickness, mean arm muscle circumference and Quetelet's index; there was a significant association with the habit of eating alone, and with a dietary intake of less than 30 mg of ascorbic acid daily (the recommended daily allowance in the U.K.). No significant difference was found in the values for haemoglobin, serum albumin or potassium concentrations between the two groups, and no association shown between a deficient saturation test and smoking, season, sublingual varicosities or an abnormal bleeding time.

Aged↗
PubMed1970

Effect of treatment on renal function in severe osteomalacia due to Wilson's disease.

A patient with Wilson's disease presented at the age of 41 with a neurological defect and gross osteomalacia secondary to a defect of renal tubular reabsorption. He also showed the unusual features of a renal stone in the presence of the Fanconi syndrome and a relatively low alkaline phosphatase level, possibly due to the additional inherited defect of hypophosphatasia. During four years of treatment with penicillamine and calciferol clinical improvement was spectacular. Details of amino-acid clearances before and after treatment are given, and the results suggest that, as in the brain and the liver, the function of the distal renal tubules may be restored in Wilson's disease when copper is removed.

Adult↗