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Biomedical subjects

R M Murray

Publications and source records attributed to R M Murray.

At least 325 records · Page 18Linked to original sources
PubMed1983

Genetics of platelet MAO activity in discordant schizophrenic and normal twins.

Platelet monoamine oxidase (MAO) activity was compared in four age and sex-matched groups: monozygotic (MZ) twins discordant for schizophrenia, normal MZ twins, normal dizygotic (DZ) twins and unrelated individuals. Among the twin groups, schizophrenic and normal there was a remarkably consistent degree of genetic control amounting to 70-80 per cent of the variation in activity. The mean platelet MAO activity of the schizophrenic twins was significantly lower than that of controls, but not than that of their psychiatrically well, neuroleptic-free cotwins; indeed the correlation for the MZ twins discordant for schizophrenia was almost exactly the same as that for the normal MZs. Thus, lower platelet MAO activity in schizophrenia, where it is found, is genetically modulated and not the result of the illness or its treatment.

Adult↗
PubMed1983

Twin and adoption studies. How good is the evidence for a genetic role?

Research into the possibility that heredity may influence drinking habits is still in its infancy, and the conclusions that can be reached from a number of the available twin and adoption studies are limited by their methodological deficiencies. Nevertheless, the balance of evidence suggests a modest genetic effect on both normal drinking and alcoholism in men, though similar evidence for women is so far lacking. Further studies are required to assess the significance of the genetic contribution, to elucidate exactly what is inherited, and to examine the nature of gene-environment interactions.

Adoption↗
PubMed1983

Current genetic and biological approaches to alcoholism.

Three out of 4 adoption and 2 out of 3 twin studies imply a genetic contribution to alcoholism in males. A recent study of moderate drinking in male twins suggests that familial factors account for some two-thirds of the variance in alcohol consumption, and that the genetic component slightly outweighs the effects of the within family culture. There has been little support for the notion of a genetic entity which expresses itself as alcoholism in males and depressive illness in females, but among normal male twins anxiety and depression are genetically correlated with alcohol consumption. Increased liability to form acetaldehyde and the potentially additive tetrahydroisoquinolines could be one factor predisposing to alcoholism but human studies have been less convincing than their animal counterparts.

Alcohol Drinking↗
PubMed1982

Cerebral ventricular size in twins discordant for schizophrenia.

Comparison of the computerised tomographic scans of 11 pairs of healthy monozygotic (MZ) with those of 8 pairs of dizygotic (DZ) twins showed that ventricular size for seven pairs of MZ twins discordant for schizophrenia was not as high as in normal MZ twins. Furthermore, the schizophrenics had significantly larger ventricles than both control twins and their own co-twins, although there was a non-significant trend for their co-twins also to have larger ventricles than the controls. Some common environmental factor, possibly perinatal damage, may have led to the increase in ventricular size in the schizophrenia-discordant pairs, with schizophrenia developing in the more severely affected twin.

Adult↗
PubMed1982

Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism.

A comparison was made between the efficacy of eight laboratory tests and three rapid interviews in the detection of excessive drinking and alcoholism among 385 psychiatric patients. gamma-glutamyl transpeptidase, the best of the laboratory tests, detected only a third of those consuming more than 16 "drinks" per day or independently diagnosed as alcoholic. In contrast, the Brief MAST, the Cage, and the Reich interviews each identified nine out of ten alcoholics, and the Cage and Reich interviews detected 93% and 98% of excessive drinkers respectively. The three interviews, each of which takes less than 1 min to administer, have considerable potential for use in the routine screening of high-risk groups, such as hospital patients.

Adolescent↗
PubMed1982

Regional differences in obsessionality and obsessional neurosis.

The Leyton Obsessional Inventory was administered to 69 orthopaedic patients in Glasgow, and their responses were compared with those of 77 similar subjects in London and 73 in Cork. The responses of the Scots and the English did not differ, but both of these groups were significantly less obsessional than the Irish subjects, who were particularly likely to regard cleanliness and tidiness as virtues in themselves. Obsessionality was unrelated to age, sex, social class, family size and birth order, but higher Leyton scores were found among bachelors, and among women living in the country and without outside employment. It is suggested that the common factor among these 3 subgroups is emotional or geographic isolation, and that this may enhance any tendency to obsessional ruminations and routines. This could also account for the higher Leyton scores and greater incidence of obsessional neurosis in the Irish.

Compulsive Behavior↗
PubMed1982

Tolerance of the central nervous system to photon irradiation: endocrine complications.

Dose-response isoeffect equations have been determined for hypothalamic pituitary insufficiency following cranial irradiation. Of particular importance is the occurrence of complications at doses substantially less than those commonly used for the treatment of central nervous system tumors. Such complications may be severe and potentially life threatening. These complications occur when a small midline 'target' volume containing the pituitary gland, infundibulum and adjacent inferior hypothalamic structures is irradiated. Direct pituitary irradiation is unlikely to be a factor, at least in some cases. The possible role of incidental hypothalamic irradiation in the control of acromegaly and pituitary dependent Cushing's syndrome is discussed.

Brain↗
PubMed1982

Detecting excessive drinking among admissions to a general hospital.

A questionnaire combining items on alcohol consumption with the four CAGE questions was used by 27 housemen to detect abnormal drinking among 520 patients of all specialties admitted to a general hospital. 15.6--23.2% of patients were classified as abnormal drinkers with the largest proportions occurring among the emergency surgical, orthopaedic, psychiatric and medical patients. 95% of the abnormal drinkers were detected by the questions on consumption alone, while 22 of the 28 patients who were identified by both the consumption and CAGE questions had been admitted as a direct result of alcohol abuse. With the aid of simple questionnaire and some encouragement, junior medical staff can become quite adept at detecting abnormal drinkers in the course of their routine practice.

Alcoholism↗
PubMed1982

Aminoglutethimide in tamoxifen-resistant patients: The Melbourne Experience.

A group of 160 women with actively progressing metastatic breast cancer were treated with aminoglutethimide to induce medical adrenalectomy. The degree of adrenal suppression was monitored by measurement of dehydroepiandrosterone sulfate levels, and classification of response was carried out according to UICC criteria by two observers. Assessment of response is available for 136 patients, and of these 50 (36.7%) had an objective remission. In an additional 10 patients, the disease became static. Mean remission duration is 12.5 months (range, 4 to 30). Forty-one patients had previously remitted to tamoxifen and then relapsed, and of these 22 (53.6%) experienced another remission with aminoglutethimide. Fifty patients had failed to respond to tamoxifen, and of these 16 (32%) had a remission with aminoglutethimide. In the 20 patients who did not receive tamoxifen and in the 25 whose response to it could not be classified, the remission rates to aminoglutethimide were 25 and 28%, respectively. The high remission rate to medical adrenalectomy in patients who have previously responded to tamoxifen makes it the treatment of choice in tamoxifen-responsive patients.

Adrenal Glands↗
PubMed1981

Medical adrenalectomy with aminoglutethimide in the management of advanced breast cancer.

Sixty-five patients with actively progressing advanced breast cancer were treated with aminoglutethimide, a drug which inhibits adrenal steroid synthesis and decreases peripheral conversion of androgens to oestrogens. Of the 38 patients who have so far been classified, 13 (34%) have experienced objective regression of their disease, while in a further six patients (16%) the disease has become static. The median duration of the objective remission was in excess of 14 months, while in the group with static disease, the median duration of the static condition was longer than eight months. Side effects were either nonexistent or mild in the majority of cases, and the drug was well tolerated. Aminoglutethimide is an important new modality in the treatment of advanced breast cancer.

Adrenal Glands↗
PubMed1981

Medical adrenalectomy in patients with advanced breast cancer resistant to anti-oestrogen treatment.

Fifty-three women with actively progressing advanced breast cancer, who had all previously received tamoxifen, were treated with aminoglutethimide to induce medical adrenalectomy. Sixty-nine percent of the patients who had previously responded to tamoxifen subsequently responded to aminoglutethimide, while thirty-five percent of the nonresponders to tamoxifen subsequently responded to aminoglutethimide. The median duration of remission to aminoglutethimide was 12 months with a range from 4 to 22 + months. The drug was well tolerated and would appear to be the treatment of choice in tamoxifen responsive cases of advanced breast cancer.

Adrenalectomy↗
PubMed1981

The teaching of clinical skills at a postgraduate hospital.

The teaching of 'clinical skills' is generally held to be central to postgraduate training in psychiatry, but the term itself has so far escaped exact definition. In an effort to study some of the component clinical abilities, their inter-relationships, and the factors promoting their transmission, all junior psychiatrists at the Maudsley Hospital were surveyed for their views on the clinical training they had received. Three hundred and seventy three assessement on 43 units were made. Trainees perceived the academic instruction and advice on formulating cases which they had received as being quite unrelated to the quality of help with interview skills and instruction in practical management, but feedback from the consultant to the trainee on the latter's performance was necessary for a high standard of both academic and practical instruction. Encouragement to do research was transmitted independently of other clinical teaching. Over a 3-year period the standard of multi-disciplinary teamwork appeared to improve, but there was a decline in the standard of academic instruction and in encouragement to do research. These overall differences were due to changes in the teaching staff, rather than alterations in teaching methods. Surveys such as this may help to define the goals of postgraduate clinical training, and also monitor the extent to which an institution is achieving these goals.

Attitude of Health Personnel↗