Search PubMed⌕ Search

Biomedical subjects

L D Ritchie

Publications and source records attributed to L D Ritchie.

48 records · Page 3Linked to original sources

Orally administered MDMA causes a long-term depletion of serotonin in rat brain.

Recent studies suggest that 3,4-methylenedioxymethylamphetamine (MDMA), when administered subcutaneously, is toxic to central serotonergic neurons in rats. Because humans typically self-administer this drug orally, we compared this route to the s.c. route of administration. Orally administered MDMA produced a dose-related depletion of serotonin comparable to that produced by the s.c. route. These findings suggest that MDMA, when given orally, retains it neurotoxic activity and that humans using MDMA may be at risk for developing a persistent depletion of brain serotonin.

3,4-Methylenedioxyamphetamine↗

Prevention of cardiovascular disease in general practice: a proposed model.

A screening model based in general practice for the detection of subjects at risk of premature cardiovascular disease is described. Opportunistic screening is performed by a trained nurse who also gives initial advice on management. Immediate feedback to patients is possible since a rapid dry chemistry technique is used to measure blood cholesterol concentrations. The collation and analysis of data are achieved using a microcomputer. A central deidentified database is incorporated to allow epidemiological studies and intervention strategy evaluations to be made. Nineteen health centres have evaluated the model, and 40,000 subjects have been screened: 10% had diastolic blood pressures of over 95 mm Hg and 15% had a blood cholesterol concentration over 7 mmol/l (270 mg/100 ml) and 2% over 9 mmol/l (347 mg/100 ml). The initial data suggest that the model is acceptable to both health centre personnel and the general public and that the offer of screening is taken up by all elements of the target population.

Adult↗

Response of patients and doctors to the 1983 'pill scare'.

The immediate response of patients and doctors to the recent adverse publicity about the combined oral contraceptive ;Pill' were studied in two separate locations: a major family planning clinic and a large provincial health centre. Consultations arising from anxiety about the Pill were less than the general practitioners had anticipated but extra sessions were required at the family planning clinic to cope with the increased demand. Differences in the responses of doctors were observed both within and between the two locations. Doctors at the family planning clinic were more likely to change the brand of Pill, whereas doctors at the health centre were more likely to offer reassurance only. The respective roles of primary care teams and family planning clinics in the provision of a comprehensive contraception service to the community are discussed.

Attitude↗

Outpatient cardiac rehabilitation: are the potential benefits being realised?

OBJECTIVE: to give a comprehensive description of the practice of outpatient cardiac rehabilitation in Scotland. DESIGN: an identifying survey of 1,270 individuals in hospital, general practice and community sources nationally, followed by computer-assisted telephone interviews about programme characteristics with key personnel from identified cardiac rehabilitation schemes. OUTCOME MEASURES: patient provision, referral criteria and programme features. RESULTS: 65 programmes provided outpatient cardiac rehabilitation for 4,980 patients in one year, representing 17% of the 29,180 patients who survived admission to hospital with coronary heart disease. Cardiac rehabilitation practice varied widely: 53 (82%) programmes included exercise, although only 19 (29%) at the most beneficial level; 40 (62%) included relaxation training, although only three (5%) at a level shown to give benefit; 47 (72%) included education, although only 16 (25%) in a manner with reported benefits in randomised trials. CONCLUSIONS: outpatient cardiac rehabilitation was provided to a minority of patients with coronary heart disease. Programmes varied widely, and were often more limited than those reporting mortality and morbidity benefits in randomised trials. There is a substantial gap between current provision and practice of cardiac rehabilitation and that advocated in published guidelines.

Community Health Services↗