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Biomedical subjects

B Kirman

Publications and source records attributed to B Kirman.

14 recordsLinked to original sources

Down's syndrome.

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Chromosome Aberrations↗

Drug therapy in mental handicap.

Definitions of mental handicap are imprecise in practice, and a wide spectrum of patients are provided for under this heading. There can be no question of specific treatment for 'mental handicap' as such. Many situations arising in institutions for the mentally handicapped derive from the nature of the institution and the regime. Drugs may be used 'faute de mieux' when environmental manipulation would be more appropriate. There is much over-prescribing, and the choice of drugs is not always logical; monitoring of dose is seldom employed. A major source of behaviour disturbance in the mentally handicapped is lack of suitable occupation. Apart from a few specific indications, use of sedatives and tranquillizers for the mentally handicapped should be seen as a holding device, to enable a different system of management to be adopted or to disrupt an undesirable behaviour pattern.

Boredom↗

Mental handicap.

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Adult↗

Genetic prognosis in severe mental handicap.

698 children below age sixteen years with severe mental handicap (below IQ50) who were admitted to hospital between 1956 and 1959 were surveyed for genetic prognosis. They were divided into 23.7% ascribed primarily to environmental factors, 50.9% unclassified aetiologically, 16.2% of Down's syndrome, 5.3% other genetic syndromes and 3.9% with congenital hydrocephalus. The incidence of a similar degree of mental retardation among the sibs of 660 whose families were traced, was 1.1% in the "environmental" group; 4.7% for the unclassified; 1.7% for Down's syndrome, 11.5% for other genetic syndromes and 4.3% for hydrocephalus with spina bifida. There were no affected sibs of the uncomplicated cases of congenital hydrocephalus. This survey underlines the fact that a high proportion of cases of mental handicap remain without aetiological diagnosis. It emphasises the value of such a diagnosis for genetic counselling. Advice given depends on the circumstances of the particular case which requires a detailed social history and sympathetic rapport by members of the team as well as appropriate clinical expertise (Kirman, 1971, 1972). When families with similarly affected new relative or previous severely mentally handicapped sibs are set aside, the recurrent risk for unclassified cases is reduced to three per cent.

Adolescent↗