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At least 19 recordsLinked to original sources
PubMed1989

Gynecologic surgery and surgical morbidity in mentally handicapped women.

A multidisciplinary clinic recognizing the reproductive health concerns of mentally handicapped women was organized in 1985. Thirty-three of the 300 women seen in the clinic required surgery. Thirty-seven operations, including 13 major abdominal and two major vaginal operations, were performed. Uterine leiomyoma and ovarian neoplasm were the most common gynecologic conditions requiring major surgery. No complications developed in women undergoing minor procedures; however, six patients undergoing major abdominal procedures developed significant postoperative complications. Because thorough and complete pelvic examinations are often difficult to accomplish in mentally handicapped women, these patients may have increased risk for the delayed diagnosis of gynecologic conditions that require major abdominal or vaginal surgery. Mentally handicapped women with significant physical handicaps are at increased risk of developing postoperative complications, and the postoperative stay may be prolonged.

Adult↗
PubMed1994

Dyskinesia in mentally handicapped women: relationship to level of handicap, age and neuroleptic exposure.

The prevalence of dyskinesia in a randomly selected set of 61 mentally handicapped women with a range of diagnoses, levels of IQ and exposure to neuroleptics was assessed using the Abnormal Involuntary Movements Scale (AIMS). Overall, 64% of patients had dyskinesia on the AIMS. There was no correlation with neuroleptic exposure, although 43% of patients had been significantly exposed. There was no correlation between the presence of dyskinesia and the original handicapping diagnosis, and there was no increase in dyskinesia as the patients age increased. There was a significant increase in dyskinesia as IQ fell. This study backs the contention that there is a close association between cognitive impairment and movement disorder.

Adult↗
PubMed1990

The effect of peroral lynestrenol on serum lipids and lipoproteins in therapeutic amenorrhea of mentally retarded women.

Serum concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), and triglyceride (TG) were measured and that of low density lipoprotein cholesterol (LDL-C) calculated in blood samples obtained from mentally handicapped women undergoing therapeutic amenorrhea (TA) induced by 5-10 mg of peroral lynestrenol, some receiving, some not receiving simultaneous anticonvulsant therapy (phenytoin, carbamazepine or barbiturate, alone or in combination). In addition, these analyses were carried out in women receiving only anti-convulsants and in controls (mentally handicapped women not receiving any of the above-mentioned medications). Significantly lower HDL-C, Apo A1, TG and cholesterol concentrations were measured in TA patients receiving lynestrenol only, than in those receiving anticonvulsants only, or in controls (p less than 0.001). With regard to HDL-C and Apo A1, patients receiving both lynestrenol and anticonvulsants were intermediate between lynestrenol only patients and controls, but the HDL-C/LDL-C and Apo A1/Apo B ratios were similar to those observed in lynestrenol only patients. Addition of 8 or 12 mg of estriol succinate to the lynestrenol regimen was virtually without an effect. However, halving of the lynestrenol dose resulted in a significant increase in HDL-C and in the HDL-C/LDL-C and Apo A1/Apo B ratios (p less than 0.001 or p less than 0.01), respectively. The lynestrenol dose was thus the most important determinant of lipoprotein pattern and should be kept as small as possible in order to reduce cardiovascular risk.

Adult↗
PubMed1992

Mental disorder, intellectual deficiency, and crime. Evidence from a birth cohort.

Studies of criminality among patients in psychiatric hospitals and of mental disorder among incarcerated offenders have suggested an association between the major mental disorders (schizophrenia and major affective disorders) and crime. However, these investigations are characterized by notable methodological weaknesses, and, consequently, this conclusion has remained tentative. Little is known about the criminality of intellectually handicapped people. The present study examined the relationship between crime and mental disorder and crime and intellectual deficiency in an unselected Swedish birth cohort followed up to age 30 years. It was found that men with major mental disorders were 2 1/2 times more likely than men with no disorder or handicap to be registered for a criminal offense and four times more likely to be registered for a violent offense. Women with major disorders were five times more likely than women with no disorder or handicap to be registered for an offense and 27 times more likely to be registered for a violent offense. These subjects committed many serious offenses throughout their lives. The criminal behavior in over half these cases appeared before the age of 18 years. Intellectually handicapped men were three times more likely to offend than men with no disorder or handicap and five times more likely to commit a violent offense. Intellectually handicapped women were almost four times more likely to offend than women with no disorder or handicap and 25 times more likely to commit a violent offense.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Outpatient sedation: an essential addition to gynecologic care for persons with mental retardation.

Routine gynecologic care for persons with mental retardation may be difficult to provide, especially to those women who do not allow a pelvic examination to be performed. Of 275 women referred to a multidisciplinary clinic addressing the reproductive health concerns of mentally retarded women, 61 patients (22%) did not allow a gynecologic examination to be performed. The administration of ketamine alone, midazolam alone, or a combination of midazolam and ketamine allowed for the successful performance of a gynecologic examination in 81% of previously uncooperative women. No adverse effects of the medications were noted. We conclude that sedation of difficult-to-examine, mentally handicapped women can be safely performed in the outpatient setting, thus avoiding the need for general anesthesia and its inherent risks.

Ambulatory Care↗
PubMed1989

Teaching mentally handicapped adults how to use a cafeteria.

This study taught three moderately to severely mentally handicapped women skills to enable them to make use of cafeterias. While some work has been carried out in this area (e.g. Marholin et al., 1979; Van den Pol et al., 1981; Desai, 1983), it has not established whether hospital-based individuals with this level of handicap and no previous experience of cafeterias can be taught how to use them. A role-playing procedure was used during training with in vivo assessments being carried out before and after training. An in vivo generalization assessment was also conducted. Training was found to be successful with the skills taught transferring to the real life situation and subjects' improved performance, in the majority of the skill areas, generalizing to a 'new' cafeteria which had a completely different system of use.

Adult↗
PubMed1992

The therapeutic sterilisation of the mentally handicapped. Experience with the Abortion and Sterilisation Act of 1975.

The Abortion and Sterilisation Act of 1975 gives legal sanction for the sterilisation of persons with a mental handicap, and by 1989, 1,817 such persons had been sterilised in South Africa. In this paper, we review our experience in investigating all 291 persons who were referred to the Pregnancy Advisory Service of Groote Schuur Hospital for this purpose. Referrals included 37 white, 233 coloured and 21 black patients. One hundred and eight (37.1%) were severely retarded, 104 (35.7%) were moderately retarded, 70 (24%) were mildly retarded and 9 (3.2%) were not testable. None could give informed consent and the applications for sterilisation came from burdened families of whom one-third were already caring for illegitimate children born to these mentally handicapped women. Of the 291 applications, 231 (79%) were recommended for sterilisation. The main issues involved in making a decision to sterilise mentally retarded individuals are the valid assessment of the degree of retardation, the availability of alternative means of fertility control, and the complex ethical factors that have to be considered with regard to the sterilisation of persons with a mental handicap.

Adolescent↗
PubMed1991

Iron status in a group of long-stay mentally handicapped menstruating women: some dietary considerations.

As part of a longitudinal study aimed at assessing the dietary intakes and nutritional status of a group of long-stay mentally handicapped subjects, 15 women of menstruating age were considered for a substudy to assess the influence of intake levels of dietary iron, energy, tea, coffee and vitamin C on their iron status. The assessment comprised a week-long weighed dietary survey and the measurement of a number of haematological indices that included serum ferritin concentration. Information on duration of menses was also collected and included in the assessment. Two-fifths of the subjects assessed had a serum ferritin concentration less than 12 micrograms/l indicating iron deficiency, including one who was considered anaemic as suggested by a haemoglobin level less than 12 g/dl. Duration of menses showed a negative significant correlation with serum ferritin concentration. The mean iron intake in the group was 9.5 +/- 1.5 mg/day. Energy intakes were low and positively correlated with iron intake. Although serum ferritin showed no correlation with iron intake, it showed significant negative correlations with the daily and meal-time intakes of tea and a significant positive correlation with the meal-time intakes of vitamin C. The six iron-depleted subjects were assessed as a separate group (Group I) in comparison with the other nine subjects who had a serum ferritin concentration greater than 12 micrograms/l. The results of this assessment showed that, while there were no significant differences in duration of menses or the mean daily intakes of iron and energy between the two groups. Group I subjects had significantly higher daily and meal-time intakes of tea and significantly lower meal-time intakes of vitamin C compared to Group II subjects. The study provides some evidence suggestive of an association between the iron deficiency states observed and tea intake in adversely affecting iron status, particularly in the absence of adequate meal-time intakes of vitamin C. The findings from the study also suggest that long-stay mentally handicapped women of menstruating age, in addition to their handicap and dependency states which may often predispose them to a low dietary intake, are at particular risk of iron deficiency.

Adult↗
PubMedDate not supplied

[Drug evaluation in healthy volunteers. Legislative and ethical aspects].

Studies in healthy volunteers have been legalized since December 20th 1988 in France. The healthy volunteer is employed for a variety of studies in phases I and IV of drug development. This type of research can equally be called nontherapeutic in nature. Every experiment involving healthy volunteers should be approved by the Ethics Committee. Using volunteers within the department, company or other organisation, while offering advantages for the investigator should be prohibited as freedom of concept might not be safeguarded. As well, financial incentives may over-persuade individuals, including students, who have low incomes and promote the "professional volunteer". To avoid this problem, French law planned a national register. The potential benefits of such a disposition are still unknown. Having been given appropriate information concerning the drug trial, his obligations and rights, the healthy volunteer gives his written consent. Specific recommendations for nontherapeutic assessments of drug effects are given concerning prisoners, the mentally handicapped, women with a risk of frequency, children. Ethical considerations concerning research on a healthy population must go beyond the law recently promulgated in France.

Drug Evaluation↗
PubMed1991

[Waldheim--the difficult task of investigation].

This is a report on a mental hospital--or, rather, a department of a mental hospital--called "Waldheim", (literal meaning: "hostal, or home in the woods") which is a section of the mental hospital at Hochweitzschen in Saxony in the former German Democratic Republic (GDR). Public opinion had been aroused some time ago by an article published in the German weekly "Stern" in which it was stated that psychotic patients were being subjected to leukotomy or stereotactic surgery, and that castration by x-ray treatment was being performed in mentally handicapped women, in that hospital. The article prompted the then Ministery of Health of the GDR to constitute an "expert committee" to investigate into the matter. The magazine's allegations were partly confirmed by the committee. The GDR parliament then constituted a "special parliamentary commission" for another inquiry. Again several allegations were confirmed. It was stated that the events and actions in that hospital had been unsatisfactorily assessed and digested. The authors undertake to make the procedures followed by the medical and nursing staff, accessible to a wider public and to render them more lucid. Important structural characteristics of the patterns that developed there, were the governmentally prescribed segregation of severely diseased persons to "treat" them far away from their residential community, the absence of a critical general public, and the amalgamation of supervisory institutions with those that require to be supervised.(ABSTRACT TRUNCATED AT 250 WORDS)

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

Socio-psychological study of the prostitutes.

Only 8 percent of the prostitutes were literate. Income per night varied from Rs 10 to Rs 30 for 72% of the prostitutes. Whereas only one third of the married women were happy with the profession, 95.92% of Devdasis liked the profession. Illiteracy, domestic unhappiness, deception, destitution, poor socio-ecomic status of parents, and religious custom of Devdasi were the important contributory factors for landing innocent girls or socially handicapped women into prostitution.

Adolescent↗
PubMed1990

[Sterilization of the mentally handicapped according to section 1905 of the German Civil Code in relation to developing a patient management regulation].

Discussions on the sterilization of the mentally handicapped are still overshadowed to a great extent by the dire consequences of National Socialist policies which were only poorly concealed in the legislation of the period. These laws have meanwhile been rescinded but that has not eradicated the phenomenon itself. In fact, in recent years about 1,000 mentally handicapped persons have been sterilized--without their consent and without any firm legal basis for such action--shortly before reaching the age of 18. In most cases, the parents and the physicians involved joined forces in taking the matter into their own hands. Against this background there is a clear need for legislative action. Virtual agreement has been reached on this between the political groupings represented in the Bundestag and the organizations working for the welfare of the handicapped. Nonetheless, the recently submitted draft of a new bill is for the most part unacceptable. It is an improvement of earlier drafts in asmuchas the attempt to establish a close and often inappropriate link with Sect.218 a of the Penal Code (concerning abortion) has at least partly been given up. But the fact remains that handicapped women are still subjected to greater burdens than their male counterparts. Under the planned amendment to Sect.1905 Para. 1 (4) of the Civil Code, the act itself will define the requirements for a sterilization to be carried out "for medical reasons" (i.e. if life or health of the expectant mother are in jeopardy). Sect.1905 of the Civil Code contains no specific regulations as to when a sterilization is permissible "for eugenic reasons," but the fact remains that it can still be quite easily carried out under the general grounds. Pursuant to Sect.218a of the Penal Code an abortion can be exempt from punishment under special circumstances (i.e. on "social grounds") if the mother is at the time in a desperate situation which cannot be rectified in any other way. It certainly reflects very poorly on us if we do not succeed in giving the handicapped the help and support they need in their life situations which are so completely different from ours.

Child↗
PubMed1984

Hereditary multiple exostoses. Report of a family.

In a family with hereditary multiple exostoses (diaphyseal aclasis), six generations are known to have been affected. Thirty-three of 85 family members have had the disorder. This condition affects the long bones, pelvis, scapulae, and ribs, and the exostoses continue to enlarge until epiphyseal fusion occurs. Associated deformities, including short stature and malformations of the wrist and ankle, were found in 72%. Fifty percent of affected individuals were moderately or severely handicapped; women and men were affected with equal severity. Exostoses were usually noted by two years and always by five years of age. Hereditary multiple exostoses is inherited as an autosomal dominant condition and is inherited as an autosomal dominant condition and in this familial study the gene showed 93% penetrance. Only one individual appeared clinically normal but nevertheless transmitted the gene to offspring. Red cell antigens, enzymes, and serum enzymes were studied, but none were positive for linkage to the gene for this disease. The frequency of sarcomatous change varies between 3% and 25% in reports in the literature, but no cases occurred in six generations of this family.

Adolescent↗