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Biomedical subjects

J C Murdoch

Publications and source records attributed to J C Murdoch.

At least 55 records · Page 3Linked to original sources
PubMed1984

Immediate post-natal management of the mothers of Down's syndrome and spina bifida children in Scotland 1971-1981.

A questionnaire completed by the mothers of 123 children with Down's syndrome and 109 children with Spina bifida born over the past 10 years in Scotland has shown that the majority of mothers were given either a poor outlook or no outlook at all for their children. Only a minority were referred to social workers while in hospital. The separation from their child shortly after birth is a significant factor in both groups of mothers particularly mothers of Spina bifida children, 61% of whom never saw their child during their stay in hospital. While 41% of Down's mothers received a visit from a parent of a Down's child only 16% of Spina bifida mothers were so visited. Two-thirds of those not offered such a visit would have welcomed one.

Adult↗
PubMed1984

Down's syndrome children and parental psychological upset.

A prospective morbidity study of the parents of Down's children and the parents of control children matched for age, sex, family size and social class failed to demonstrate any difference in the incidence of psychosis, psychoneurosis or self-poisoning referred to the general practitioner. It is suggested that the common assumption that Down's syndrome and parental anxiety are inevitably associated is questionable

Adult↗
PubMed1984

Comparison of the care of children with Down's syndrome with the care of matched controls.

A prospective study of the care of 134-children with Down's syndrome and 134 age- and sex-matched control children during 1981 has shown that the former group had significantly greater contact with the general practitioner, mostly owing to respiratory problems which were treated significantly more often with antibiotics. Referrals to specialist care were more common in the Down's children but the interface between general practice and paediatric care was not great. The study emphasizes the need for general practitioners to plan the care of Down's children and normal children with respect both to acute illness and the monitoring of chronic childhood illness.

Child↗
PubMed1983

Communication of the diagnosis of Down's syndrome and spina bifida in Scotland 1971-1981.

A questionnaire completed by the mothers of 123 children with Down's syndrome and 109 children with Spina bifida, born over the past 10 years in Scotland has noted a marked improvement in the time of telling mothers of the diagnosis of Down's syndrome, 88% being told within a week of the birth. Only just over half of the mothers felt that the person telling them made a good job of the task, and most were told without their husband being present. Although both parents knew nothing about the particular handicap, one third of the Down's mothers and over a half of the mothers of Spina bifida children were given no further opportunity to ask more about the child or their feelings. This poor opinion of mothers on the ability of health professionals to tell them of their handicapped children indicates a need to incorporate special teaching on such situations in medical and nursing training, and to agree simple protocols within newborn units, so that such tragedies may be avoided.

Adult↗
PubMed1983

Current opinion concerning the treatment of heart disease. Report of a postal survey among Tayside general practitioners.

Using a postal questionnaire method of investigation, the views of Tayside general practitioners were examined with respect to the management of three hypothetical patients with ischaemic heart disease. In the case of a man showing symptoms suggestive of infarction, hospital care was preferred by the majority of doctors. Of three categories of employment, the person in a manual occupation would be advised by most doctors to change his job after a second serious infarction. The advice given to patients was orientated towards the risk factors associated with ischaemic heart disease. Such advice was general rather than specific and emphasized restriction of activities rather than return to normal life. Commonly held social stereotypes appeared to affect the advice which practitioners said they would offer. The implications of these findings are discussed.

Coronary Disease↗
PubMed1982

A survey of Down's syndrome under general practitioner care in Scotland.

A survey of all general practitioners in Scotland has revealed details of 1,251 individuals with Down's syndrome being cared for by their family doctor; 1,150 were living at home.Eighty-two per cent of doctors responded to the questionnaire. High prevalence rates have been noted in the Western Isles and in Shetland. The survey confirms reports of a lowering of maternal and paternal age in Down's syndrome; 72 per cent of the mothers and 56 per cent of the fathers of Down's syndrome children born since 1971 were under 35 years at the time of birth. The survey also revealed an increase in the number of Down's people living with either one parent or relatives with increasing age. It is hoped that further research will be carried out into the problems facing Down's individuals and their families through the medium of general practice.

Adolescent↗
PubMed1982

Mitogen-stimulated lymphocyte growth and chronic uraemia.

Lymphocytes were isolated from venous blood by the Böyum method from 36 patients with chronic renal failure: the preparations were more frequently and more heavily contaminated with non-lymphoid cells than the equivalent preparations from normal controls. Volume spectroscopy measurements showed that, in the samples without gross contamination, lymphocytes from uraemic subjects react to mitogen stimulation with normal pre-S-phase cell-cycle kinetics. In other experiments, plasma from uraemic patients was shown to be more potent than serum in inhibiting the growth of mitogen-stimulated lymphocytes from normal subjects, both in the first G1-phase and in replicative growth. Thus humoral suppression appears to be more important than a cellular defect in explaining the depressed responses of uraemic blood to mitogen stimulation.

Cell Cycle↗
PubMed1981

Duplicate prescriptions: an aid to research and review.

We describe a method of studying patterns of prescribing and related morbidity in general practice. Prescribing data were automatically duplicated onto a ;no-carbon-required' prescription-pad. Additional information about diagnosis and indications for each drug, an indication of whether the drug was newly prescribed or a repeat, and a patient identification code were entered onto the bottom copy. A computer was used to process the data, which were gathered over a period of seven months.The method offers an efficient means of collecting data which can be applied by individuals or groups of doctors to improve patient care and help achieve rational prescribing.

Data Collection↗
PubMed1981

Prescribing in general practice and the provision of drug information.

Duplicate prescriptions were used to monitor patient prescribing and morbidity data for 20 Tayside general practitioners during a two-year study. Each participant took part in two periods of active monitoring separated by a three-month gap. Prescribing statistics collected during the first period of monitoring formed the basis of drug information which was circulated to participants shortly after the start of the second period. Some of this information was purely statistical; other information included comments as well as statistics. Subsequent monitoring assessed any changes in prescribing. The results indicate that drug information of this kind can influence general practitioner prescribing but that there were no differences in response to information which was purely statistical and information which included comments.

Drug Information Services↗
PubMed1980

The epidemiology of prescribing in an urban general practice.

The total prescribing in an urban general practice was recorded over a six-month period and classified according to the length of time that drugs were continued. The number of patients receiving any prescription rose with age, as did the total number of items per patient prescribed for; while the continued items rose with age, the number of items prescribed once only per patient remained constant in all age groups. The bulk of the total prescribing was for the elderly and this was mainly for continued items. The classification also shows that certain drug groups are liable to be continued whereas others are virtually always prescribed once only. The implications of these findings for self-audit of prescribing and the care of the elderly in general practice are discussed.

Adolescent↗
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↗