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Biomedical subjects

D N MacKay

Publications and source records attributed to D N MacKay.

At least 19 recordsLinked to original sources
PubMed1996

Treatment of acute bronchitis in adults without underlying lung disease.

OBJECTIVE: To determine whether antibiotic and bronchodilator treatment of acute bronchitis in patients without lung disease is efficacious. DESIGN: A MEDLINE search of the literature from 1966 to 1995 was done, using "Bronchitis" as the key word. Papers addressing acute bronchitis in adults were used as well as several citations emphasizing pediatric infections. A manual search of papers addressing the microorganisms causing acute bronchitis was also done. Data were extracted manually from relevant publications. SETTING: All published reports were reviewed. Papers dealing with exacerbations of chronic bronchitis were excluded in this review. RESULTS: Although acute bronchitis has multiple causes, the large majority of cases are of viral etiology. Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis are the only bacteria identified as contributing to the cause of acute bronchitis in otherwise healthy adults. Nine double-blind, placebo-controlled trials were reviewed. Four studies showed no advantage for doxycycline and one study showed no advantage for erythromycin. One study using erythromycin and one study using trimethoprim and sulfamethoxazole showed that these antibiotics were slightly better than placebo. Two other studies showed an impressive superiority for liquid or inhaled albuterol when compared with erythromycin. CONCLUSIONS: Most studies showed no significant difference between drug and placebo, and the two studies that did showed only small clinical differences. Albuterol had an impressive advantage over erythromycin. Antibiotics should not be used in the treatment of acute bronchitis in healthy persons unless convincing evidence of a bacterial infection is present.

Acute Disease↗
PubMed1991

The prevalence of severe mental handicap in Northern Ireland.

There are four administrative areas (Health and Social Services Boards) in Northern Ireland. Two prevalence surveys, carried out several years apart, show that there is a significant geographical gradient in the rates of severe mental handicap (IQ less than 50). The rates in the 20-29-year-old groups in the Eastern and Northern Boards range between 4.07 and 4.82 per thousand; comparable rates in the Southern and Western Boards range between 5.17 and 6.37. A similar gradient was discernible in the distribution of Down's syndrome.

Adolescent↗
PubMed1987

Measles (rubeola) infection in a hospital setting.

Although acquisition of measles infection in medical facilities is well documented, hospital outbreaks have been rare. During a recent community measles epidemic, one patient and four employees of the Mary Hitchcock Memorial Hospital developed the disease. Two of the employees were born before 1956, the year recommended by the Centers for Disease Control as an appropriate cutoff year for routine measles vaccination. Screening of 456 hospital employees for measles immunity demonstrated a 5% incidence of susceptibility in 135 individuals born between 1950 and 1956. This experience demonstrates the significant potential for the spread of a community measles outbreak into the hospital setting. Because of the high transmissibility of this disease and its potentially serious consequences in hospitalized patients, we suggest that all hospital employees born after 1950 who have significant patient contact should have documented immunity against measles.

Adolescent↗
PubMed1987

Application of decision analysis to drug selection for formulary addition.

Decision analysis (DA) is a quantitative method for making decisions, incorporating both probabilistic data and value judgments, and clinical and economic outcomes. The P & T Committee at the Mary Hitchcock Memorial Hospital used this technique to aid in selection of a third-generation cephalosporin for formulary addition. Cost-specific data from this hospital, together with clinical data derived from the medical literature, and a panel of infectious disease specialists were used to compare costs associated with antibiotic regimens of three infections. Results show that ceftizoxime is the least costly treatment for hospital-acquired pneumonia and sepsis of unknown origin, whereas metronidazole plus gentamicin is the least costly regimen for intra-abdominal infections. This demonstrates that drugs with higher acquisition costs can, in some cases, be less expensive than drugs with lower acquisition costs when the total cost of drug therapy is considered.

Cephalosporins↗
PubMed1983

Fine motor performance in subjects of subnormal, normal and superior intelligence. II. Reaction time and warning interval duration.

Twenty-four groups of subjects of widely ranging chronological ages (CA: 6-21 years), mental ages (MA: 5-17 years) and IQs (30-130) took part in three reaction time (RT) tasks. These differed only in terms of pre-response complexity, the main differentiating factors being the knowledge of which of four light reaction signals (RSs) would be illuminated (the results of the RS effects have been described by Bankhead & MacKay, 1982) and direction of eye gaze during irregular presentation of three warning intervals (WIs: 1, 3 and 5 s). In the first task ('simple' RT) the subject had to respond to a single light at which he/she looked directly during the WI; in the second ('simple-fixed' RT) the subject fixated a point midway between a horizontal array of four RSs, and had to respond to each one in turn in a series of trial blocks, the subject always being aware of which RS was about to appear; in the third ('complex' RT) the subject had to fixate this same point, and respond to which ever RS came on. (In this last condition, probability of onset varied between RSs, and subjects could try to anticipate which RS was likely to appear in any given trial.) Results showed that: i The 24 groups could be economically considered as representing four different clusters in terms of performance, the best of which involved subjects of relatively high CA and MA, the worst of which comprised severely subnormal subjects (Bankhead & MacKay, 1982). ii While subjects in each of the three most superior clusters tended to show relatively long RTs after the 1-s WIs, the RTs of the poorest cluster were longest after the 5-s WIs. These results were discussed both in terms of task requirement and of attentional deficits among certain of the subjects.

Adolescent↗
PubMed1978

Mental subnormality in Northern Ireland.

A prevalence survey of mental subnormality in Northern Ireland was carried out on lines similar to an earlier investigation by MacKay (1971). In a general population of one and a half million there were 6,854 ascertained subnormal individuals. The male : female ratio was 1. 14 :1. Approximately one in three subnormal people was under residential care. The prevalence of severe subnormality (IQ less than 50) in the 15-19 year old group was 4.81. The findings do not support the "steady rate" theory of severe subnormality.

Adolescent↗