Search PubMed⌕ Search

Biomedical subjects

C G Keith

Publications and source records attributed to C G Keith.

At least 37 records · Page 2Linked to original sources
PubMed1987

Extremely-low-birthweight infants: neurological, psychological, growth and health status beyond five years of age.

Of 60 consecutive survivors of birth weight 500-999 g, who were born in one tertiary perinatal centre from 1977 to 1980, 59 infants were assessed by a multidisciplinary team at two years of age (corrected for prematurity) and 58 children were evaluated when aged at least five years. At the latter examination, 9% of the 58 children who were assessed were severely disabled; 17% had a mild or moderate disability; and 74% had no important disability. For the 53 children who were tested, the means for the three scales of the Wechsler Preschool and Primary Scales of Intelligence were just above the test mean. The psychologist noted behavioural problems during her assessment in 50% of children, and 29% of mothers reported behavioural problems which could interfere with schooling. At the age of five years and over, five (9%) children had cerebral palsy and one child was deaf. Twenty-two (38%) children had a visual impairment, although only one child was blind; the detection of retinopathy of prematurity in the nursery was an important risk factor. Health problems with readmissions to hospital and suboptimal growth were present in many children at two years of age and frequently these problems persisted to five years of age. Although only four (7%) children were too disabled to attend a normal school, apprehension exists that many of the other children may later encounter educational difficulties. At the two-years' assessment, ascertainment of cerebral palsy had not been complete or entirely accurate and the Mental Developmental Index of the Bayley Scale tended to underestimate the later psychological performance.

Cerebral Palsy↗
PubMed1987

Oculomotor nerve palsy in childhood.

Oculomotor nerve palsy was found in 28 children. Trauma was the cause in seven, infection in six, while tumour, poison and migraine were each responsible for one case. Twelve cases were cryptogenic: eight of these were present at birth (but three were probably due to birth trauma), and four cases appeared in infancy, but with no cause found even on full neuroradiological investigation. Among these 12 cases the pupil was large in only three, normal in four and small in five. Cyclic spasms were not seen in this series. Among the five congenital cases associated abnormalities including spina bifida, Goldenhar's syndrome and developmental delay were found in four. Acquired palsy does not seem to have a sinister significance.

Amblyopia↗
PubMed1985

Retinoblastoma and retinoma occurring in a child with a translocation and deletion of the long arm of chromosome 13.

A young girl who had an active retinoblastoma in the left eye, and a retinoma or spontaneously regressed retinoblastoma in the right eye, was found to have a complex translocation-deletion involving chromosomes 13 and 10. Karyotypic analysis suggested that three simultaneous breaks had led to the interchange of centric and telomeric regions of chromosome 10 and 13, with loss of an interstitial acentric fragment from 13, which included subband 13q14.2. The child is intellectually retarded, and has the characteristic midface appearance associated with 13q-deletion syndrome. It is believed that this is the first report of a case of retinoblastoma and retinoma occurring in association with 13q-deletion syndrome.

Child, Preschool↗
PubMed1985

Handicaps and health problems in 2 year old children of birth weight 500 to 1500 g.

Fifty-nine infants of birthweight 500 to 999 g born in 1977 to 1980 and 132 infants of birthweight 1000 to 1500 g born in 1977 to 1978 were reviewed at two years corrected age. For the whole cohort, cerebral palsy was found in 12.6%, bilateral deafness in 1%, blindness in 1% and severe developmental delay in 12%. There was no significant difference in these disabilities between the groups of larger and smaller infants; 37.7% of the cohort was readmitted to hospital on at least one occasion, 35.6% of children had wheezing episodes and/or lower respiratory tract infections which together accounted for 51% of hospitalizations. The infants of birthweight 500 to 999 g tended to require more frequent and prolonged hospitalizations. Dolicocephalic head shape, chest deformities, iatrogenic sequelae from intensive care, poor growth and cicatricial retrolental fibroplasia were significantly more frequent in children of birthweight 500 to 999 g. Parents reported that 39% of their children had 'colic', 31.6% had sleep disturbance and 25% had multiple behavioural problems. Low frustration tolerance, inability to wait, hypo- or hyperactivity and an inappropriate relationship with the mother as measured by the psychologist all occurred significantly more frequently in children of birthweight of less than 1000 g. This report confirms the belief that a comprehensive follow-up is required for very low birthweight (VLBW) children because significant health problems continue after primary hospitalization.

Cerebral Palsy↗
PubMed1984

Retinopathy of prematurity in extremely low birthweight infants.

From 1977 to 1982, 108 infants weighing less than 1000 g at birth were examined in a nursery for premature babies for evidence of retinopathy of prematurity (ROP). Of these 108 infants, 88 were subjected to follow-up examinations for periods of 10 months to six years. ROP had been observed in 53% (47/88) of these children; it had been severe in 31% (27/88). Subsequently, 19% (17/88) of these children developed retrolental fibroplasia (RLF); all of these had had severe ROP, except one, in whom it is presumed to have been missed. The RLF was severe in only one eye of one child. Each of these infants had received only 25 mg of vitamin E by mouth. The writers consider that the case for the administration of large doses of vitamin E in the prevention of RLF is still not proven and conclude that, if vitamin E does have a protective effect, then a dose of 25 mg is sufficient.

Humans↗
PubMed1984

Bardet-Biedl syndrome.

The Bardet-Biedl syndrome is characterized by five main features: obesity, polydactyly, pigmentary retinopathy, mental deficiency and hypogonadism; recently a sixth feature, renal disease, has been described. It was formerly known as the Laurence-Moon-Biedl syndrome, but Laurence and Moon described a different entity in which the main feature was paraplegia. Fourteen cases have been seen: all had pigmentary retinopathy which, in most cases, was severe and tended to affect central vision early in life. All had subnormal intelligence, twelve were obese, ten had polydactyly, eight hypogonadism, and two had renal disease. The condition was thought to be rare, but this may have been due to the failure to diagnose incomplete or partial cases. It is suggested that the prevalence is 1:160 000 of the population.

Child↗
PubMed1984

Vitreous fluorophotometry in children with type I diabetes mellitus.

A clinical, biochemical and ocular study was carried out on 17 children with type I diabetes mellitus. Eight had no clinical or angiographic evidence of retinopathy (Stage 0), seven had stage 1, one had stage 2 background retinopathy (Malone's classification) and one had intraretinal microvascular abnormalities. The vitreous fluorescein concentration 3 to 5 mm in front of the macula in those without retinopathy varied from low to abnormally high, while the concentrations in those with retinopathy were above normal. There was no correlation between haemoglobin A1 estimations taken at the time of the study and the vitreous fluorophotometry readings. This variation in fluorophotometry values obtained in diabetics with stage 0 disease differs from the findings in previous reports and may be of prognostic value in determining those patients at risk of developing retinopathy, and may be an indication for improving diabetic control.

Adolescent↗
PubMed1983

Ocular morbidity in infants of very low birth weight.

In the years 1977-8,258 infants weighing less than 1500 g were born at, or transferred to, the Royal Women's Hospital, Melbourne; 177 (68.5%) survived, and 111 of these attended for an ophthalmic examination. Significant ocular lesions were found in 37 (33%): 21 (19%) children had squint, 19 (17%) had a significant refractive error, 11 (10%) had cicatricial retrolental fibroplasia (RLF), and 3 (2.7%) had very poor vision due to optic atrophy associated with cerebral palsy. No children were blind owing to RLF, indicating that the recent increase in survival rate of infants of very low birth weight has not been accompanied by an increase in the prevalence of severe RLF. In those children with neither cerebral palsy nor RLF the prevalence of squint was 11% and of refractive errors 13%. Myopia was found mainly in children who had shown RLF changes in the neonatal period. It is recommended that infants of very low birth weight continue to be screened in the premature nursery for RLF, and also at the age of 2, for the detection of refractive errors and squint.

Australia↗
PubMed1983

The significance of ocular morbidity in very-low-birthweight infants to the Australian health service.

The survival rate of very-low-birthweight (VLBW) infants has greatly increased due to the introduction of intensive-care methods to neonatal nurseries. It was feared that this would also cause an increase in the amount of ocular morbidity associated with prematurity. In order to estimate this, 111 very-low-birthweight infants (birthweights less than or equal to 1500 g) were reviewed at two years of age. They comprised 63% of the total number of long-term surviving babies born at, or transferred in the neonatal period to, the Royal Women's Hospital, Melbourne, in 1977 and 1978. In 33% a significant ocular problem was detected; 19% had strabismus, 17% had a significant refractive error, 10% had cicatricial retrolental fibroplasia (RLF), and 2.7% were blind, due to optic atrophy associated with cerebral palsy. Other studies have shown that 7% of VLBW infants develop severe (Stage III) RLF, and 18% of these (1.26% of VLBW infants) will be socially or totally blind. In order to estimate the significance of VLBW infants to the ophthalmic health services, and to the organisations for the care of the visually handicapped, these figures can be extrapolated. Based on 1980 figures, it would be expected that approximately 1105 VLBW infants would survive annually, and nine would become blind from RLF, while 110 would have been affected by RLF. Thirty-three children would be blind from optic atrophy associated with cerebral palsy, 210 would have strabismus, and at least 187 would have a significant refractive error. VLBW infants will contribute significantly to the number of children requiring ocular care, and because of the high incidence of ocular abnormalities, it is recommended that routine screening of all VLBW infants be carried out at one year and two years of age.

Australia↗
PubMed1983

The effect of minimal occlusion therapy on binocular visual functions in amblyopia.

The binocular visual functions of amblyopic children were studied during treatment involving brief weekly periods of occlusion of the unaffected eye while the child performed demanding visuomotor tasks against either a background of rotating gratings or a stationary uniform gray stimulus. The gains in stereoacuity were quite significant and in most cases more obvious than the rather small gains in letter visual acuity. On initial presentation only 21 of the 60 patients showed evidence of stereopsis and of these only seven possessed a stereoacuity of 100 secs or better. Following six treatment sessions the number of patients that demonstrated stereopsis increased to 36 of whom 17 possessed reasonably good stereoacuity (100 secs or better). However, there was no difference in the degree of improvement exhibited by those patients that viewed rotating grating patterns during treatment and others from the control group that viewed the uniform gray stimulus. Thus, there was no evidence that any of the visual gains were enhanced or promoted by active visual stimulation of the amblyopic eye with rotating gratings during the brief periods of occlusion of the unaffected eye. Finally, a comparison of the scores of the children on various stereo-tests suggest that tests comprised of small figure elements that are present in high density may be best for screening purposes. On the other hand, for quantifying the stereoacuity of children known to possess abnormal binocular vision it may be more appropriate to employ tests that use large figure elements that provide strong fusion cues.

Adolescent↗
PubMed1983

Contrast thresholds for sine gratings of children with amblyopia.

Contrast threshold functions were measured on 26 amblyopic children before and after minimal occlusion therapy. On initial presentation the relative contrast sensitivity deficit the amblyopic eye was in every case much less than that predicted from the deficit in visual acuity for letters. In fact, in seven of the children the contrast sensitivity functions for the amblyopic and fellow nonamblyopic eye were indistinguishable despite the expression of substantial amblyopia on letter charts. Only four children exhibited a substantial contrast sensitive loss in the amblyopic eye with a cut-off spatial frequency below 30 cycles/degree. The majority of children who showed deficits in contrast sensitivity did so only at medium and high spatial frequencies. On the basis of these findings it appears that measurements of contrast thresholds for single sinusoidal gratings do not probe fully the deficits of spatial resolution in amblyopia. Finally, among the few children who exhibited a sizeable initial deficit, only two showed obvious improvement in contrast sensitivity in response to minimal occlusion therapy.

Adolescent↗
PubMed1982

Visual outcome and effect of treatment in stage III developing retrolental fibroplasia.

Forty-five babies were seen with retrolental fibroplasia (RLF) stage III or more, that is, with a large vasoformative ridge protruding into the vitreous cavity. Thirty-four attended for follow-up, but subsequently 6 died. Of the remainder 12 had satisfactory vision, 3 unilateral and 8 bilateral high myopia, 3 were totally blind, and 2 were partially blind. It was found that stage III RLF could be subdivided according to its severity. Early stage III had a good prognosis, with 11 out of 18 achieving satisfactory vision, but only one out of 16 in RLF stage IIIa or more. Cryothermy was applied to 9 babies in the latter group, but it did not seem to influence the final outcome.

Birth Weight↗
PubMed1982

Changing outcome over 13 years of very low birthweight infants.

The survival prospects for infants of birthweight less than or equal to 1500 g born in recent years have improved. Evidence for a corresponding decrease in long-term morbidity of survivors is conflicting but recent reports from some centers indicate that high morbidity rates are occurring. Until additional satisfactory reports are available on the outcome of very low birthweight (VLBW) infants born after 1975, preferably from a community or region, uncertainty will continue. The outcome of three cohorts of VLBW infants, born in the Royal Women's Hospital, Melbourne between 1966 and 1978 is reported; more than 90% of each cohort were fully assessed, aged 2-8 years. There were 169 long-term survivors from the first cohort (1966-1970 births) and 72 from the second cohort (1973-74 births); survival rates were 37.1% and 37.3% respectively; however, for the 1977-78 births, there were 161 survivors, a significant increase to 68.3%. In the first cohort, 32.7% had one or more visual defects and 3.9% were blind but visual morbidity decreased progressively in cohorts 2 and 3; 3% of the second cohort and 1.2% of the third cohort were blind. There was a trend for a decrease in severe sensorineural deafness. Cerebral palsy increased progressively, respectively 2.6%, 4.5% and 11.9% in the first, second and third cohorts. There was a significant increase in the mean Mental Developmental Index of the Bayley Scales at the age of 2 years from 75.38 for the 64 children born in 1966-70 compared with 90.96 for 150 children in the 1977-78 cohort. Although there had been an increase in upper social class families in the more recent cohort, improvement in test scores was still highly significant when higher social classes (1-3 Congalton Scale) were excluded. However, there was no significant improvement in the 6 year psychological test scores of the first and second cohorts. There was a steady increase in occurrence of cerebral palsy. Significance associations in the 1977-78 cohort were found with only 2 perinatal variables (use of theophylline and necrotizing entercolitis). Furthermore, 17 (89.5%) of children had a five-minute Apgar score greater than 5 and 14 (73.7%) did not require ventilatory support: Prevention of cerebral palsy by selective treatment in the delivery room or nursery was not feasible for prediction of this condition was not possible from perinatal risk factors.

Australia↗