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Biomedical subjects

J F Munro

Publications and source records attributed to J F Munro.

At least 55 records · Page 3Linked to original sources
PubMed1981

Patient motivation and predicting outcome in a hospital obesity clinic.

One hundred and thirty-two women consecutively referred to a hospital obesity clinic were studied. Only 31 per cent attended for a year or more. The mean weight loss achieved by the 88 women who lost weight was 6.7 kg. The principal reason and degree of motivation for losing weight were not related to either the weight loss or the length of attendance. The initial anticipated rate of weight loss (AROWL) was of no predictive value, though this was influenced because all patients were given a 'realistic' AROWL at their first clinic visit. These results suggest that although specialist clinics may have a specific role to play, at present, obesity is a problem best dealth with on a community basis.

Adult↗
PubMed1980

TSH response to TRH in substantial obesity.

TSH response to TRH stimulation was studied in 40 non-obese control females and in 40 obese female subjects 40-148 per cent in excess of their ideal weight prior to receiving dietary advice. One patient was found to be hypothyroid and was excluded from further study. There was no significant difference between the basal serum TSH concentration in the subjects and controls. Obese subjects however had significantly greater serum TSH concentrations at 20 and 60 min following TRH stimulation. The implciations of these findings are at present unexplained.

Adult↗
PubMed1979

The significance of gross elevations of the erythrocyte sedimentation rate in a general medical unit.

One hundred consecutive patients with an ESR of 100 mm or more in the first hour admitted to a general medical unit were studied. Their mean age was 67 years and forty-seven were male. Three patients recovered without a satisfactory diagnosis. In thirty-three of the remainder a single diagnosis was considered responsible for the elevation of the ESR, and in the others multiple diagnoses were found. Infection was found in 60% of patients, malignancy in 28% (including 7% with myelomatosis), rheumatoid disease in 20% and renal disease in 11%. 34% of patients died within 6 months of entry into the study. In the absence of rheumatoid disease or a paraproteinaemia, elevation of the ESR in excess of 60 mm in the first hour at 1 month or longer was associated with a particularly poor prognosis. This study has shown the diagnostic implications of an ESR of 100 mm or more in the first hour and the prognostic significance of a persistent elevation of the ESR.

Adult↗
PubMed1979

Polymyalgia arteritica: a clinical review.

In a series of thirty-seven consecutive patients with polymyalgia arteritica, twenty-five had polymyalgia rheumatica and twelve had cranial arteritis. Some failed to respond promptly to low doses of prednisolone and it is recommended that the initial dose should be in the order of 40 mg daily. An ESR above 40 mm in the first hour was present in four patients 3 months after admission; three were found to have rheumatoid disease and one pulmonary tuberculosis. Symptomatic relapses occurred in fourteen patients on twenty-one occasions and all responded to an increase in the daily dose of maintenance prednisolone. Most occurred in the first year and were attributable to an excessively rapid reduction in steroid therapy. Relapses occurring in patients on a stable dose of prednisolone were commonly associated with the development of rheumatoid disease. In elderly patients who have relapsed, or who have had arteritic complications, life-long prednisolone therapy appears justifiable.

Aged↗
PubMed1978

Renal mobility in women attending a pyelonephritis clinic and in controls.

The range of vertical renal mobility was established in a group of 129 healthy female subjects and compared with the range of mobility observed in 236 female patients attending a pyelonephritis clinic. The mobility was significantly greater on the right side in both groups and both kidneys moved significantly more in the patient group than in the controls. Excessive mobility could not be directly related to bacteriologically confirmed infection, renal pain or IVP abnormality. Nephroptosis remains an enigma and excessive renal mobility must not be interpreted in isolation.

Adult↗
PubMed1978

Serum protein analysis and bone marrow cytology in patients with an extreme elevation of the erythrocyte sedimentation rate.

One hundred patients in whom an Erythrocyte Sedimentation Rate (ESR) in excess of 100 mm. in the first hour was found on 2 consecutive occasions were investigated. Serum protein electrophoresis was performed on 96 of these patients and bone marrow examination on 55 patients. Acute infection was the commonest diagnosis though the majority of patients had 2 or more separate conditions each contributing to the elevation of the ESR. Quantitive serum protein electrophoresis was abnormal in all but one patient and was of limited diagnostic value. A definite band in the globulin region was detected in 11 patients, 7 of whom were found to have myelomatosis. Bone marrow examination was useful only in patients with a discrete band in the globulin fraction or with a specific haematological abnormality. It is suggested, therefore, that bone marrow examination be confined to patients with such abnormalities irrespective of an elevation of their ESR.

Adult↗
PubMed1978

Fenfluramine, vitamin C and weight loss.

Forty-two female patients with refractory obesity completed a 20-week double-blind study during which they were given a diet designed to provide not more than 40 mg vitamin C and 1000 kcal (4.2 MJ) daily. Twenty-two of the patients took 600 mg of supplementary vitamin C daily and the remainder, a matched placebo. All were given their highest tolerated dose of fenfluramine up to a maximum of 160 mg daily. There was no significant difference in the mean weight loss of the two groups. This study fails to support the hypothesis that the anti-obesity effect of fenfluramine is influenced by the vitamin C intake.

Administration, Oral↗
PubMed1978

An evaluation of the efficacy and acceptability of 'Slender' in refractory obesity.

A formula diet 'Slender' was assessed in 55 patients with refractory obesity. During the initial 12 weeks of the study, the subjects were instructed to take a carbohydrate restricted diet designed to provide 1000 kcal (4.2 MJ) per day. They were then advised to replace up to four meals a day with a packet of Slender. Of the 42 subjects completing the study, 21 stopped taking Slender after six weeks and 21 completed 12 weeks. During the pre-Slender treatment, the mean weight gain was 1.7 kg. This contrasts with a mean weight loss during the first six weeks of treatment with Slender of 1.9 kg. Those continuing to take Slender for 12 weeks lost 3.7 kg and subjects who said that they had adhered strictly throughout the trial period had a mean loss of 4.6 kg. The overall results are relatively disappointing but are similar to that which can be achieved with other forms of therapy in comparable patients. If there is use for Slender, and other similar products, it may be the prevention of obesity rather than in the management of the morbidly obese.

Adolescent↗
PubMed1977

Plasma fenfluramine levels, weight loss, and side effects.

Fifty women with refractory obesity received fenfluramine for 20 weeks. Every two weeks details of weight change, drug dose, degree of anorexia, and any side effects were recorded and plasma was obtained for fenfluramine and norfenfluramine measurements. Of the 41 patients available for final analysis 26 achieved a maximum plateau dose of 160 mg/day. Plasma fenfluramine concentrations did not correlate with the degree of anorexia or with the incidence of side effects other than the severity of dream disturbance. There was a highly significant relation between weight loss and plasma fenfluramine and norfenfluramine concentrations and also between weight loss and the presence of sustained anorexia. Women who achieved mean plateau concentrations over 200 ng/ml lost a mean 8.8 kg while those with concentrations less than 100 ng/ml lost a mean of only 2.1 kg. When fenfluramine is prescribed in refractory obesity the dose should be increased stepwise until either satisfactory weight loss is achieved or troublesome side effects appear.

Adult↗
PubMed1977

Anticipated rate of weight loss during dieting.

Two hundred and thirty-five females anxious to lose weight were asked to state their anticipated rate of weight loss each week or each month after the first few weeks of dieting. They were divided into four groups of 50 subjects, one group enrolling in a slimming club for the first time, one group already attending the same slimming organisation and two groups on first attendance at one of two hospital obesity clinics. The remaining group comprised 35 subjects re-enrolling in a slimming club. Only 27 per cent of those interviewed on their first attendance had a realistic concept of the anticipated rate of weight loss (AROWL) while 60 per cent of those re-enrolling and 90 per cent of those currently attending a slimming club were realistic in their expectations. The younger subjects were significantly more obese and the least realistic concepts of the AROWL were held by those subjects most in excess of their ideal weight. This study highlights the frequency with which unrealistic concepts of the AROWL are held and suggests the need to reinforce realistic concepts of weight loss in the obese.

Adolescent↗