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S Munroe

Publications and source records attributed to S Munroe.

4 recordsLinked to original sources
PubMed2003

Human cytomegalovirus-associated periodontitis in renal transplant patients.

BACKGROUND: Human cytomegalovirus (HCMV) infection is associated with renal transplant failure. Periodontal pockets may be reservoirs for HCMV replication. OBJECTIVES: This study was done to determine active HCMV replication in saliva and gingival crevicular fluid of renal transplant patients affected by periodontitis. METHODS: HCMV pp67-mRNA amplification was analyzed in oral fluids of 38 transplant recipients at 6 months' posttransplantation. Patients received antiviral therapy until 3 months' posttransplantation. The HCMV-positive cell line VR-977 was the positive control, and oral fluids from healthy volunteers served as the negative control. Periodontitis was diagnosed by clinical examination. Serum HCMV IgG and IgM were analyzed to differentiate recent and latent infection. RESULTS: Prevalence of gingival overgrowth was 68.4%. HCMV gene transcripts were detected in the saliva of 21% and the gingival crevicular fluid of 18% of patients. All patients (100%) with HCMV pp67-mRNA detected in saliva demonstrated clinical manifestations of viral infection, as did 86% of patients with HCMV pp67-mRNA detected in the gingival crevicular fluid. Serum IgM was positive in 7.9% of patients and IgG in 65.8%; however, associations with active mRNA replication were not statistically significant. CONCLUSIONS: Renal transplant patients affected by periodontitis are at risk of viral replication within the periodontal tissues despite antiviral therapy. This study suggests that use of HCMV pp67-mRNA detection in saliva and gingival crevicular fluid provides markers of active viral infection, and evidence for a link between HCMV-associated periodontitis and renal transplant complications.

Adult↗
PubMed1999

An evaluation of resting energy expenditure in hospitalized, severely underweight patients.

A prospective trial was conducted with 14 hospitalized patients who were severely underweight with a mean weight of 40.9+/-5.1 kg and 70.7+/-7.8% of ideal body weight, to compare estimates of resting energy expenditure (REE) with measured values. The 9 women and 3 men, whose mean age was 66.5+/-13.9 y, underwent nutritional assessment and measurement of their REE by indirect calorimetry using the Sensormedics Deltatrac MBM100 indirect calorimeter. Their REE was also estimated by the Harris-Benedict formula (mean 1032+/-66 kcal/d) as well as a previously established empirical formula where REE = 25 x body weight in kg (mean 1023+/-129 kcal/d). Results by both estimates were significantly lower than the measured resting energy expenditure (MREE) in this group of patients (P<0.0001). The percentage difference between MREE and estimated REE by the Harris-Benedict formula was 18.4+/-9.4% and 20.9+/-7.5% by the empirical formula. The MREE exceeded the estimated REE in each individual. The correlation between MREE and body weight (r2 = 0.558, r = 0.005) was better than that between MREE and estimated REE by Harris-Benedict formula (r2 = 0.275, P = 0.08) suggesting that weight was the principal determinant rather than the other components (height, age, sex) of the Harris-Benedict formula. Our data shows that commonly employed formulae routinely underestimate the energy needs of severely underweight patients below 50 kg in body weight. The Harris-Benedict equation had limited predictive value for the individual, explaining approximately 25% of the variance in energy expenditure. Given the particular importance of matching energy intake to needs in this group of patients with limited reserves, many of whom are critically ill, we suggest an empirical equation using 30-32 kcal/kg be used to estimate the energy requirements of severely underweight patients when direct measurements are unavailable or clinically less imperative.

Adult↗
PubMed1992

Bed blocking in Edinburgh hospitals.

A point prevalence survey of in-patients in all acute hospitals within the city of Edinburgh in 1988 identified 224 elderly patients (65 and over) waiting for long stay care. This represents a 'bed blocking' rate of 19% across all specialties. The highest rate was found in Orthopaedic second line beds (approximately 33%) followed by Geriatric Assessment beds (approximately 30%); Acute General Medical Beds had approximately 13% of their beds blocked. Some 75% of the 224 patients were waiting for Geriatric long stay beds, 5% for Psychogeriatric, and a substantial proportion waiting for continuing care outwit the NHS (nearly 9% for Private Nursing Homes and 11% for residential accommodation). A repeat of this survey in 1990 revealed a small overall drop in bed blocking rate (18%) with moderate changes within the specialty groupings. However a substantial increase (from 20% to 32%) had occurred in those awaiting non-NHS accommodation, and a drop in those waiting for Geriatric Care (75% to 62%).

Aged↗