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Biomedical subjects

I R Gordon

Publications and source records attributed to I R Gordon.

17 recordsLinked to original sources

Suicide and related deaths in Victorian doctors.

A cohort of University of Melbourne medical graduates (1950-1959 graduates inclusive) was followed up until December 31, 1986. Vital status at the end of the study period was ascertained and, for those who had died, cause of death was determined. The cohort consisted of 1453 members (1279 men and 174 women). One hundred and twenty-six of the group had died (115 men and 11 women) and 68 (4.7%; 57 men and 11 women) were lost to follow-up. The major causes of death were cardiovascular disease and malignant neoplasms. The standardised mortality ratios (SMRs) for all-cause mortality were low (59 for the male doctors and 84 for the female doctors) indicating that male doctors experience a "force of mortality" 59% that of the general population and female doctors 84%. For the male doctors, the SMR for suicide was 113 (95% confidence interval [CI], 54-207) (10 of 115 deaths in male doctors) about double the SMR for mortality from all causes. For the female doctors, the SMR for suicide was 501 (95% CI, 103-1500) (3 of 11 deaths in female doctors). For deaths resulting from all accidents the SMR was low for the males (29) and higher for the females (126). The SMR for mental disorders for the male doctors was marginally raised (132). This study reveals some indication of a problem in doctors in regard to deaths by suicide, other violent deaths and mental disorders. A larger study involving a control group of equivalent social class is required to confirm the findings of this study.

Accidents

Keratan sulphate excretion in a patient with Kniest dysplasia.

The clinical and radiological features of a patient with Kniest dysplasia, a form of metatropic dwarfism, are described. The patient excreted glycosaminoglycans (mucopolysaccharides) in normal amounts during infancy but subsequently showed abnormal keratan sulphate excretion. The significance of these findings and the possibility that Kniest dysplasia represent another mucopolysaccharidosis are discussed.

Abnormalities, Multiple

Cystic fibrosis, atopy, and airways lability.

In a survey of cystic fibrosis (CF) in the Avon area, 48 children with CF from 40 families together with 71 of their parents were studied by spirometry, exercise tests, and pinch tests. A control group of 42 young adults was similarly tested; control data for children were taken from previously published work. The prevalence of atopy (any positive prick test) in children with CF was 48%. Sensitivity to grass pollens and house dust mite was no more common in these children (29%) than in a normal population (34%). Hypersensitivity to Aspergillus fumigatus was found in 35% of children with CF and was associated with severe lung disease. The parents had a normal pattern and prevalence of atopy. Exercise-induced airways obstruction was present in only 22% of children with CF; its association with severe lung disease rendered interpretation difficult. The parents had a normal response to exercise. Both hypersensitivity to A. fumigatus and exercise-induced airways lability had the features of acquired characteristics. There was nothing in the present study to support the hypothesis that the possession of a CF gene predisposed to atopy.

Adult

Clinical and biochemical studies in Engelmann's disease (progressive diaphyseal dysplasia).

The clinical and biochemical features of four adults with Engelmann's disease (Camurati-Engelmann disease; progressive diaphyseal dysplasia) are presented. One young patient, with a particularly severe form of the disease, is discussed in detail. Biochemical abnormalities were found in three of the patients. In two of them, one with localized hyperostosis and one with generalized bone disease, the only changes were an increase in the plasma alkaline phosphatase and urinary total hydroxyproline excretion. The most severely affected patients, who had had progressive and generalized bone disease from age two and a half years, also had persistent hypocalcaemia and hyperphosphataemia, a positive calcium balance, and a very low urine calcium excretion. It is suggested that some patients with Engelmann's disease may have a previously unrecognized metabolic disorder associated with increased retention of calcium and excessive bone formation. The possible role of abnormal phosphate metabolism in this increased formation of bone, and the relationship of Engelmann's disease to other hyperostoses, are discussed.

Adult

Urinary lithiasis in childhood in the Bristol clinical area.

A series of 59 consecutive cases of urinary calculi in childhood is presented, being acquired from one local area (Bristol). These children were treated from 1950 to 1973. The peak presentation was in the 2nd and 3rd year of life, with a secondary peak in the 10th year. Anatomical (39%), metabolic (8.5%) or primary infective abnormalities (29%) were demonstrable, but 22% had to be left in an unsatisfactory "idiopathic classification''. The overall recurrence rate of 7% was reduced to 3.5% when those patients with cystinuria were excluded. The local water supply areas have been studied and a tentative association is suggested between patients and their environment when they live in an area where the water is not only hard but also alkaline (pHgreater than 8).

Adolescent

Urinary lithiasis in childhood in the Bristol clinical area.

A series of 59 consecutive cases of urinary calculi in childhood is presented, being acquired from one local area (Bristol). These children were treated from 1950 to 1973. The peak presentation was in the 2nd and 3rd year of life, with a secondary peak in the 10th year. Anatomical (39%), metabolic (8.5%) or primary infective abnormalities (29%) were demonstrable, but 22% had to be left in an unsatisfactory "idiopathic classification". The overall recurrence rate of 7% was reduced to 3.5% when those patients with cystinuria were excluded. The local water supply areas have been studied and a tentative association is suggested between patients and their environment when they live in an area where the water is not only hard but also alkaline (pH greater than 8).

Adolescent

Hydronephrosis.

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Adolescent