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Biomedical subjects

E Alberman

Publications and source records attributed to E Alberman.

At least 73 records · Page 4Linked to original sources

Socio-economic and ethnic factors in stillbirth and neonatal mortality in the NE Thames Regional Health Authority (NETRHA) 1983.

All stillbirths and neonatal deaths occurring in the North East Thames region were studied in 1983. This report describes the socio-economic and ethnic differences in that cohort. The stillbirth and neonatal mortality rates of babies born to fathers of social class V (16.8 per 1000 total births) was almost double that of social class I fathers (8.6 per 1000 total births). The most marked social class gradient was seen in the macerated stillbirth groups. Of particular concern was the extremely high stillbirth and neonatal mortality rate for women born in the Indian subcontinent. This was most evident in Pakistani women who had a stillbirth plus neonatal mortality rate of 17.3 per 1000 total births, almost twice that of the women born in the UK (9.0 per 1000 total births). Again, as with social class, macerated stillbirths appeared to contribute disproportionately to the excess mortality. Mortality rates were aggregated into four birthweight specific groups. Asian women had higher mortality rates in the higher birthweight groups, whereas in the lower birthweight group their babies did slightly better. This study indicated that the special needs for working class and ethnic minority mothers within NE Thames were not being met, and the Regional Health Authority was strongly recommended to review services to these groups.

Adult↗

Cerebral palsy: why we must plan for survival.

The survival of children in the South East Thames region, born between 1970 and 1979 and diagnosed as having some form of cerebral palsy was investigated. Of the 732 children studied, 651 (90%) are still alive, and hence cerebral palsy must be regarded as a condition with which people live rather than a condition of which they die. Survival varies considerably among the different diagnostic groups: those suffering from spasic quadriplegia, dyskinetic and 'mixed' cerebral palsy are most severely affected. Our evidence suggests that, though immobility and severe mental subnormality are the strongest predictors of mortality in children with cerebral palsy, the majority of even the most severely affected patients survive to adulthood. It is therefore appropriate to plan for their survival by funding and evaluating programmes to maximise health, independence, and quality of life.

Adolescent↗

Clinical features and associations of 560 cases of motor neuron disease.

In 560 cases of motor neuron disease, studied retrospectively from their case notes in three teaching centres, the age at onset ranged from 13 to 87 years (mean 56 years), and the mean duration of illness until death was 2.6 years. In the subgroup of the disease presenting with progressive bulbar palsy presenting after age 59 years, there was a previously unrecognised excess of females sufficient to equalize the sex ratio of incidence of the disease in this age group. No potentially causative clinical associations emerged; no relation was noted between occupational exposure to leather products, trauma or surgical procedures and the disease. There was a trend for patients with motor neuron disease to give a history of abstention from alcohol.

Adult↗

Screening infants for hearing loss.

A computerised child health register was used to study the coverage, referral rate, and false positive rate of the eight month hearing distraction test in a cohort of 1990 births to residents of one district during an eight month period. Coverage by the age of 9 months was under 60% and varied with ethnic group and immunisation record. The true problem rate among those referred was 48%. None of the three children in the cohort who had a sensorineural hearing loss was picked up by screening, although it did identify children with conductive loss. The findings question the value of the distraction test as currently used, and underline the usefulness of computerisation, even if limited to child registration, in the evaluation of screening tests.

Adolescent↗

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. I: Methods of data collection and analysis.

This paper describes the collection and analysis of data by a group of international collaborators (International Collaborative Effort on Perinatal and Infant Mortality) interested in comparative studies on birthweight distributions and reproductive outcome. This is the first of a series of reports on the results of these studies. It gives an account of the countries or states involved, and the collection and characteristics of the data. The countries and states included sixteen of the United States, plus England and Wales, Denmark, Bavaria and North Rhine-Westphalia from the Federal Republic of Germany, Israel, Japan, Norway, Scotland, and Sweden. The data comprised birthweight distributions in 500-gram groups for all births and for singletons separately, for livebirths, stillbirths, first week deaths and, where available, late neonatal and infant deaths, from 1970 up to 1985.

Birth Weight↗

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. II: Comparisons between birthweight distributions of births in member countries from 1970 to 1984.

Member states of the International and Collaborative Effort (ICE) are the United States of America, England and Wales, Denmark, Bavaria and North Rhine-Westphalia of the Federal Republic of Germany, Israel, Japan, Norway, Scotland and Sweden. The group has collected, analysed and compared distributions of birthweight for member countries, where available from 1970 onwards, for singleton and all livebirths, stillbirths, early and late neonatal and postneonatal deaths. The present paper is an account of the differences in birthweight distributions, and trends over time seen between and within countries, for livebirths and stillbirths. The major findings are the relative robustness over time of the parameters which characterize the distribution of birthweight within countries, and the marked and consistent differences between these distributions in different countries.

Birth Weight↗

Comparison of sporadic and familial disease amongst 580 cases of motor neuron disease.

A review of 580 hospital case notes of patients with motor neuron disease (MND) revealed 20 families in which more than one case had been reported. For 27 of the cases in these families full medical records were available, and a history of a further 37 affected family members were obtained. The cases in these 20 families are termed familial and the remainder sporadic. Parent to child transmission occurred in 16 of the 20 families of the familial cases, suggesting autosomal dominant inheritance. In three families there was involvement of siblings only, and in one family two cousins were affected. The sex ratio for the documented familial case records seen was 0.8:1 (M/F = 12:15), for the total (documented and historical) it was 1.06:1 (33:31), but in sporadic cases it was 1.6:1 (341:212) and more frequent occurrence of sensory features at presentation was reported in the familial cases (15% in the familial cases and 5% in the sporadic cases). However, none of these differences reached statistical significance. Familial cases also differed from sporadic cases in having a younger age of onset (a mean of 52 years in the familial cases compared with 56 years in the sporadic) and in the shorter median reported duration of illness (1.1 year in the familial cases; 2.6 years in the sporadic). However, in only one fifth of sporadic cases was the age at onset and death known, although this was known for 22 of the 27 familial cases, so that the data on survival and age of onset are too incomplete to test formally.

Age Factors↗

Multiple births.

Explore the source record for details and available documents.

Family↗

Estimate of prevalence of mild mental retardation: methodological aspects.

This paper sets out from an epidemiological point of view problems of measuring the prevalence of mild mental retardation. These include the problems always met in prevalence studies, of the validity of the classification, the completeness of ascertainment and the estimation of the size and characteristics of the denominator population. They also include difficulties peculiar to the condition of mild mental retardation, including the choice of method of classification whether by IQ testing or administratively; the heterogeneous nature of the individuals so characterised; and the confounding effects of social and biological factors and the changes in the implications for the affected individual of the condition, depending on age, sex and environment. It is concluded that normally measurements of prevalence can only be carried out on school age children and that these will change with age, and that we probably know very little about prevalence or implications of mild mental retardation at other ages.

Adult↗

Differential diagnosis of motoneurone disease from other neurological conditions.

Analysis of 422 patients with clinical diagnoses of motoneurone disease (MND), multiple sclerosis, cervical spondylosis with myelopathy, or stroke, from two referral centres, suggested a simple four-step algorithm for diagnosing MND. The algorithm provided a 98% sensitivity (true positive diagnosis) and 86% specificity, and therefore gives a baseline for diagnostic criteria suitable for use in clinical research of MND.

Algorithms↗

Post-marketing surveillance of oral contraceptives.

Problems arise in the post-market surveillance of the possible long-term effects of oral contraceptives. These drugs are taken by very large numbers of people, in various doses, types and duration. One aspect is considered in this paper, the effects on pregnancy of these drugs taken before conception. Retrospective case trial studies are described together with longitudinal studies on women from their first exposure to a specific oral contraceptive. The difficulties of this approach, the causes of bias, the effect of social habits, and the discontinuity of usage are debated.

Contraceptives, Oral↗