Biomedical subjects
Publications and source records attributed to R M Walters.
A case of trisomy 12p mosaicism originating de novo in a 21-year-old profoundly mentally handicapped female who presented with severe behaviour problems is described. The 12p syndrome has been confirmed by clinical, cytogenetic and biochemical studies. The findings are compared with those of other cases with trisomy 12p arising de novo.
Four patients with IQs below 50 displayed suicidal behaviour. This refutes the notion that the severely mentally handicapped are unable to form such an intention.
The medication prescribed for 269 mentally handicapped hospital residents aged 60 years and over on 1 January 1987, including five with Down's syndrome, and for 31 residents aged 50 years or over with Down's syndrome was analysed.Fifty of the 269 elderly residents were receiving no medication but the mean number of prescriptions for the remaining 219 was four. Of the total sample of 269 residents, 32% were taking drugs for psychiatric and psychological disorders; 11% regular antiepileptic drugs; 62% long-term drugs for other problems (diuretics and laxatives were the most common); 29% had long-term prescriptions for topical preparations, enemata or suppositories; 23% were on shortterm prescriptions for other problems; and 17% had short-term prescriptions for topical preparations, enemata or suppositories. For the 31 Down's syndrome residents the commonest prescriptions were for skin preparations.Particular care is needed in making a diagnosis and monitoring the effects of treatment on mentally handicapped patients because a complete history and full cooperation on examination may not be forthcoming. These findings have implications for primary health care teams who will be responsible for the mentally handicapped when hospitals close and the residents live in the community.
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One hospital's nursing staff used a structured process to challenge the purpose and function of the patient classification system. The result was internal development of a more effective system with significant cost savings.