Search PubMed⌕ Search

Biomedical subjects

J C Murdoch

Publications and source records attributed to J C Murdoch.

17 recordsLinked to original sources
PubMed1992

A comparative trial of lisinopril and nifedipine in mild to moderate hypertension in general practice.

AIMS: to compare lisinopril and nifedipine in the management of essential hypertension in 52 patients in general practice with respect to the obtaining of target diastolic blood pressure and freedom from side effects. METHOD: an open label, parallel randomised trial over an eight week period. RESULTS: lisinopril and nifedipine were found to effectively lower diastolic blood pressure with the latter having a significantly higher level of withdrawals and clinical side effects. CONCLUSION: lisinopril is equivalent to nifedipine in its hypertensive effect and has a better side effect profile.

Adult↗
PubMed1991

Communication of the diagnosis of Down's syndrome in New Zealand, 1972-88.

A postal questionnaire was sent to 117 mothers of Down's syndrome children born between 1972 and 1988 in New Zealand, and the response is compared to a similar study of 123 mothers in Scotland whose children were born between 1972 and 1981. Highly significant differences were found in the number of New Zealand children delivered by general practitioners and in the rate of breast feeding amongst New Zealand Down's syndrome children. Significant differences were also found in the later New Zealand cohort with respect to the mothers having seen a social worker, having been given literature and been given an appointment to see a paediatrician. In common with the Scottish study, only half of the mothers felt that their general practitioner or Plunket nurse had been helpful to them after the birth of their child. The implications of the results for the care of Down's syndrome children in New Zealand are discussed.

Attitude of Health Personnel↗
PubMed1991

Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome.

This study aimed to investigate the psychological characteristics of chronic fatigue syndrome (CFS: Holmes et al. 1988). A battery of psychometric instruments comprising the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Lazarus Ways of Coping (WoC) inventory, was administered to a sample of clinically-defined CFS sufferers (N = 58), to a comparison group of chronic pain (CP) patients (N = 81) and to a group of healthy controls matched for sex and age with the CFS sample (N = 104). Considerable overlap was found between CFS and CP patients at the level of both physical and psychological symptoms. This raises the possibility that CFS sufferers are a sub-population of CP patients. However, while there was some commonality between CFS and CP patients in terms of personality traits, particularly the MMPI 'neurotic triad' (hypochondriasis, depression and hysteria), CFS patients showed more deviant personality traits reflecting raised levels on the first MMPI factor, emotionality. Moreover, results were not consistent with the raised emotionality being a reaction to the illness, but rather were consistent with the hypothesis that emotionality is a predisposing factor for CFS. The majority of CFS patients fell within four personality types, each characterized by the two highest MMPI scale scores. One type (N = 20) reported a lack of psychological symptoms or emotional disturbance contrary to the overall trend for the CFS sample. This group conformed to the ICD-10 classification of neurasthenia.

Adaptation, Psychological↗
PubMed1990

Treatment of hypertension: the view from general practice.

All patients aged 35-64 years on a computerized age/sex register at Mornington Health Centre, Dunedin, were invited to meet with a Research Nurse for the assessment of their blood pressure. Results are presented from the 1,335 people attending (57% response). These show that 33 people (2%) had hitherto undiagnosed hypertension and that 157 (12%) had their hypertension diagnosed and treated. Evidence will also be presented of the level of control that indicates a marked improvement in published figures on the level of identification, treatment, and control in a community-based group.

Adult↗
PubMed1989

Is outcome for low risk obstetric patients influenced by parity and intervention?

Maternal and perinatal morbidity were examined to assess the influence of parity and intervention procedures among 1032 women considered low risk at commencement of labour. A diagnosis of fetal distress, failure to progress during labour, maternal problems after delivery and consultation with or transfer of the neonate to a paediatrician occurred more frequently amongst nulliparous women (p less than 0.001). Failure to progress in labour was found to be influenced by parity (primigravida), maternal age (less than 20 years) and also by the use of epidural anaesthetic for pain relief (p less than 0.001). Prevalence of abnormal delivery was found to be influenced by parity (primigravida), failure to progress in labour and diagnosis of fetal distress. The use of epidural anaesthesia for pain relief was also found to increase the rate of abnormal delivery (p less than 0.001). Statistically significant differences occurred between the groups of patients, with patients of private specialists having the highest rates for induction (34%), use of epidural for pain relief (40%) and abnormal delivery (46%).

Adult↗
PubMed1988

The myalgic encephalomyelitis syndrome.

The myalgic encephalomyelitis syndrome has been described over the past 40 years as a relapsing illness occurring mainly in young females, with the cardinal symptoms of muscle pain and exhaustion. This paper reviews recent studies on the syndrome in the United Kingdom, United States and New Zealand. The possible pathogenesis of the syndrome is discussed, as is the difficulty of managing such patients where no certain aetiology is present. It is suggested that the syndrome should be described as the myalgic exhaustion syndrome.

Encephalomyelitis↗
PubMed1979

Practical work in a behavioural sciences course.

This paper describes a recent change in the practical component of the Behavioural Sciences course at Dundee Medical School. Results obtained from an evaluation of the change appear to show that students' learning was enhanced by the new form of practical work.

Behavioral Sciences↗
PubMed1978

An objective in vitro study of ageing in the skin of patients with Down's syndrome.

The most sensitive mechanical index of issue ageing has previously been proved to be "limit strain". In a pilot study the skin from five patients with Down's Syndrome has shown no significant difference from the results found in normal individuals. It can therefore be concluded that there is no evidence for premature ageing in Down's Syndrome.

Adolescent↗
PubMed1978

Pituitary function in Down's syndrome.

Pituitary function studies have been carried out in eight male and eight female patients with Down's syndrome who were suspected of having hypothyroidism secondary to pituitary deficiency. In all cases, the response of Human Growth Hormone to hypoglycaemia was adequate and the response of Lutenising Hormone and Follicle Stimulating Hormone to the injection of Lutenising Hormone and Follicle Stimulating Hormone was not signfiicantly greater than that in age and sex-matched institutionalised controls. Therefore there is no evidence that the relative hypothyroidism in these patients is due to pituitary hypofunction, nor do the results provide evidence of pituitary deficiency in Down's syndrome generally.

Adult↗
PubMed1977

Down's syndrome: an atheroma-free model?

Postmortem examination of five institutionalised patients with Down's syndrome (DS) aged 40-66 years showed a complete absence of atheroma, while a similar number of mental defectives with DS were found to have mild or severe atheroma. Previous investigation of risk factors for atheroma in 70 patients with DS and 70 age-and sex-matched mental defectives living in the same institution showed significantly lower systolic and diastolic blood pressures in the DS group, with the exception of systolic pressure in men under 40. Fasting serum cholesterol and triglyceride concentrations were similar in the two groups, but triglyceride concentrations were significantly lower than in normal people without a history of vascular disease. These unexplained observations may be relevant in further studies of the pathogenesis of atheroma.

Adult↗
PubMed1977

Thyroid function in adults with Down's syndrome.

The thyroid status of 82 institutionalized adults with Down's syndrome has been assessed. Compared to age and sex matched control subjects, these patients had significantly lower mean total serum thyroxine (T4) and triiodothyronine (T3) concentrations (T4; 69.1+/-22.2 nmol/1; (mean+/-SD) vs. 100.1+/-19.1, P less than 0.001; T13; 1.61+/-0.47 nmol/1 vs. 1.76+/-0.34, P less than 0.025), lower free thyroxine index (FTI), (FTI; 66.1+/-22.4 vs. 95.1+/-20.2, P less than 0.001), and higher basal serum thyrotrophin (TSH) concentrations (TSH; 7.6+/-10.7 mU/1 vs. 3.8+/-1.5, P less than 0.001). These changes were not related to age or sex. Abnormalities in one or more test of thyroid function were demonstrated in at least 38 (46%) of the 82 patients. Two main patterns of abnormality were defined: 1) subnormal T4, FTI and elevated basal TSH levels (primary hypothyroidism) in 13 (16%). All seven of the 13 patients in whom TRH tests were performed showed the expected exaggerated TSH response, and seven out of the 13 patients (54%) had positive thyroid antibodies, 2) Subnormal T4, subnormal or low normal FTI, and basal TSH levels within the normal range in 18 (22%). The mean basal TSH concentration was, however, significantly higher than in patients with normal T4 and FTI levels, suggesting a minor degree of thyroid failure. Only two of the 18 patients (11%) had positive thyroid antibodies. Of the 17 patients in the group tested, 13 showed a normal TSH response to TRH, three an exagerrated response (all females), and one had an impaired response. Other patterns of abnormal thyroid function were observed occasionally: one female patient had biochemical T3 toxicosis; another had the biochemical pattern of subclinical hypothyroidism, four patients with normal basal T4, FTI and TSH levels showed an exaggerated TSH response to TRH and one patient had an impaired response. These data indicate that htyroid dysfunction, in particular hypothyroidism, is common in adults with Down's syndrome, though specific tests are usually required to make the diagnosis. The general reduction in thyroid function in Down's syndrome may be due to impaired development of the thyroid gland. However, frank chemical hypothyroidism may occur only when thyroiditis is superimposed on preexisting diminished thyroid reserve.

Adult↗