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Biomedical subjects

J R Robertson

Publications and source records attributed to J R Robertson.

At least 73 records · Page 4Linked to original sources
PubMed1986

Use of psychiatric drug treatment services by heroin users from general practice.

Centres for the treatment of drug abusers are often integrated with regional psychiatric hospitals and are the focus of the British response to opiate addiction. Little is known, however, about the use made of these services by drug users in the community or about the success of these services. This study examined the use made of one centre offering a detoxification service by a cohort of 183 heroin users from a large Scottish general practice. Over half of this cohort were referred to the psychiatric drug treatment service, but less than one third started treatment. The evidence did not indicate that patients who had extended contact with the psychiatric service showed prolonged abstinence, though methodological difficulties necessitate further prospective studies. This study raises important questions about the value and appropriateness of this type of service in the light of the pattern of voluntary remission and relapse displayed by heroin users and in the absence of adequate provision for drug abusers in the community.

Heroin↗
PubMed1986

Epidemic of AIDS related virus (HTLV-III/LAV) infection among intravenous drug abusers.

Stored blood samples from 164 intravenous drug abusers who attended a Scottish general practice were tested for HTLV-III/LAV (human T cell lymphotropic virus type III/lymphadenopathy associated virus) infection. Of those tested, 83 (51%) were seropositive, which is well above the prevalence reported elsewhere in Britain and Europe and approaches that observed in New York City. The timing of taking samples of negative sera and continued drug use suggest that as many as 85% of this population might now be infected. The infection became epidemic in late 1983 and early 1984, thereafter becoming endemic. The practice of sharing needles and syringes correlated with seropositivity, which, combined with the almost exclusive intravenous use of heroin and other behavioural patterns, may explain the high prevalence of HTLV-III/LAV infection in the area. Rapid and aggressive intervention is needed to control the spread of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Deaths of heroin users in a general practice population.

Recent evidence suggests that heroin users in the UK are 16 times more likely to die than otherwise expected, although causes of death are varied. The present investigation examines deaths of heroin users at a large Scottish general practice over a four-year period prior to 1 July 1985. A mortality rate of 9.72 per 1000 heroin-user patients per year was observed, roughly half that previously reported, although this difference did not prove to be statistically significant. A higher proportion of the observed deaths were attributed to heroin, and fewer to the misuse of other drugs, and it is speculated that this may reflect the practice's policy of not prescribing opiates to heroin users. Factors associated with heroin-user deaths are examined and areas identified where general practitioners may help to avert some of these deaths.

Adult↗
PubMed1985

Heroin users: notifications to the Home Office Addict's Index by general practitioners.

In a study of 113 heroin users who attended a Scottish general practice of 11 doctors information was gathered retrospectively regarding notification of these patients to the Home Office. The doctors were questioned about their practices for notification. Surprisingly few of the patients had been correctly notified and renotified where appropriate, and there was great variation in the doctors' notification practices, particularly with respect to defining addiction. General practitioners are now the largest source of notifications of controlled drug users, and the statistics issued by the Home Office must be interpreted in the light of their notification practices.

Adult↗
PubMed1985

Drug users in contact with general practice.

A group of heroin users who are in contact with a general practice in north west Edinburgh are described. The study group was younger and included more women than previous studies. These people used a large variety of drugs and mainly purchased them locally. Frequent and often prolonged abstinent periods occurred with no prescribed opiate treatment. The group had experienced a high rate of drug related medical disorders. All these points raise the possibility that opiate users who are known to general practitioners may be a distinctly different population from those who attend drug dependency clinics. The frequency of remission and the prevalence of polydrug use have profound implications for planning and evaluating an effective medical response.

Adolescent↗
PubMed1985

Heroin misuse and family medicine.

Drug users are a heterogeneous group in terms of social class and background, personality, and patterns of drug use. They are often stereotyped by both the public and the health services and this can lead to obstruction of a successful doctor-patient relationship. The real problem lies not so much in detoxification but in the prevention of relapses and the maintenance of the patient in a drug-free condition. There has recently been a shift in emphasis away from drug treatment centres and hospital based treatment towards community care and family medicine. The role of the family practitioner is largely unexplored yet, rather than inspiring research, the increased contact between general practitioners and drug users has caused concern. This review concentrates on two related areas of study important for family practitioners in the management of drug misuse: the role of drug misuse in family membership and in parenthood. Families have been shown to play a role in the aetiology of drug abuse, but more important is their role in the maintenance of an individual's drug dependence. The family doctor is in an ideal position to recruit the family into the drug user's treatment. Although far fewer 'addicts' come to serious harm than is commonly believed, the risks extend also to the children born of narcotic dependent mothers. Family doctors, obstetricians and paediatricians must be aware of the particular problems for mother and child.

Adolescent↗
PubMed1979

The clinical evaluation of obsessionality: a development of the Leyton Obsessional Inventory.

The Leyton Obessional Inventory gives both an indication of the range of obsessional symptoms present and the degree of resistance and interference associated with each symptom. A new method is described in which the covariation of resistance and interference is represented in the form of a matrix. The results, using this method, can give a unique picture of the quality of the patient's symptoms from the clinical standpoint and provide useful guidelines for treatment and follow up. Automatic data-provessing is offered for the convenience of clinicians and researchers wishing to utilize the test in this form.

Compulsive Behavior↗
PubMed1976

Laryngeal problems following infant esophageal surgery.

This paper focuses on vocal cord paralysis in children after operation for tracheoesophageal fistula and/or esophageal atresia. We reviewed the charts of 65 children who were operated upon for congenital esophageal atresia and/or tracheoesophageal fistula during a period from 1964 to 1974. Ten of these children manifested laryngeal symptoms. Five had laryngeal paralysis. Two were untreated. One was treated with cordectomy and stent. Two were treated successfully with the Thornell arytenoidectomy, one of these being done without a tracheotomy in place. Mention is made of a third case of bilateral vocal cord paralysis due to hydrocephalus treated successfully by the Thornell procedure. Follow-up laryngoscopy was done on 21 children without laryngeal symptoms whiich revealed two previously unsuspected vocal cord paralyses and one vocal cord paresis which cleared.

Child↗