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Biomedical subjects

K B Nelson

Publications and source records attributed to K B Nelson.

At least 91 records · Page 5Linked to original sources
PubMed1979

Neonatal signs as predictors of cerebral palsy.

Signs of neonatal neurologic dysfunction, recorded in approximately 40,000 infants, were evaluated prospectively for their ability to predict later motor handicap. Tenfold to 33-fold increases in risk of cerebral palsy (CP) were observed in surviving children with any one of the following characteristics: birth weight less than 2,000 gm, head circumference more than 3 SD above or below the mean, five minute Apgar score of 3 or less, diminished activity or diminished cry lasting for more than one day, thermal instability, need for gavage feeding, hypotonia or hypertonia, single or multiple apneic episodes, or hematocrit less than 40%. Of worse portent, with relative risks exceeding 50, were neonatal seizures or Apgar scores of 3 or less at ten minutes or later. These characteristics were also markers of considerable risk of early death. For 0.5% of surviving infants, an overall impression of abnormality of brain function during the nursery period was recorded by the attending physician; there was a 99-fold increase in CP among these children.

Apgar Score↗
PubMed1978

Febrile seizures and later intellectual performance.

The relationship of febrile seizures to later intellectual and academic performance was examined in a sibling-control study. Amont 431 sibling pairs tested at the age of 7 years, the mean full scale IQ on the Vechsler Intelligence Scales for Children was not different for children who had febrile seizures as compared with siblings who were seizure-free. Neither recurrent seizures nor those lasting 30 minutes or longer were associated with IQ deficit. Poor academic achievement, defined as Wide Range Achievement Test performance more than one grade level below school placement in children with IQs of 90 or above, was equally frequent in index cases and control patients. Febrile seizures were not associated with a decrement in IQ or early academic performance, as judged by comparison of affected children with their siblings.

Achievement↗
PubMed1977

Perinatal risk factors in children with serious motor and mental handicaps.

Fifty children with marked neurological abnormality manifested by moderate or severe motor disability and severe mental retardation were compared with a large control population with respect to prospectively ascertained perinatal characteristics. None of 60 prenatal factors distinguished the affected group from controls. In labor and delivery, lowest fetal heart rate in the second stage of labor, arrested progress of labor, and use of midforceps discriminated between the two groups. Neonatal characteristics of children who were later severely handicapped differed from controls, particularly with respect to difficulty in initiating and maintaining respiration, intracranial hemorrhage, neonatal seizures, low birth weight and small head circumference, lowest hemoglobin or hematocrit, and overall neurological status. Multivariate analysis, including factors from all epochs, indicated that intracranial hemorrhage and neonatal seizures were the strongest independent discriminators between the neurologically impaired children and controls.

Asphyxia Neonatorum↗
PubMed1976

Predictors of epilepsy in children who have experienced febrile seizures.

We examined the frequency of development of afebrile seizures in 1706 children who had experienced at least one febrile seizure and were followed to the age of seven years. Epilepsy developed by seven years of age in 20 per 1000 (2 per cent), and another 10 per 1000 had at least one afebrile seizure that did not meet our definition of epilepsy. In children whose neurologic or developmental status was suspect or abnormal before any seizure and whose first seizure was complex (longer than 15 minutes, multiple or focal) epilepsy developed at a rate 18 times higher than in children with no febrile seizures (92 vs. 5 per 1000; P less than 0.001). In the largest group with febrile seizures, those previously normal with noncomplex first febrile seizures, epilepsy developed in 11 per 1000; this rate, although moderate, was greater than that for children with no febrile seizures (P = 0.027). Prior neurologic and developmental status and characteristics of the first febrile seizure are important predictors of epilepsy after febrile seizures.

Age Factors↗
PubMed1968

Cerebral hypotonia.

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Brain Damage, Chronic↗
PubMedDate not supplied

Problems with definitions and classifications of newborn encephalopathy.

Encephalopathy in the newborn has been classified in a manner suggesting that the etiology is known, such as hypoxic-ischemic and post-asphyxial encephalopathy. In the absence of evidence that most cases of newborn encephalopathy reflect these phenomena, we prefer the simple, descriptive terms, neonatal or newborn encephalopathy. Qualitative and quantitative grading schemes are described in this review and some of their potentially correctable limitations are discussed. The ideal grading scheme continues to be an unattained goal.

Asphyxia Neonatorum↗
PubMedDate not supplied

Does phenobarbital used for febrile seizures cause sleep disturbances?

The effect of phenobarbital on total sleep time, night awakenings, and lengthy awakenings was examined as part of a randomized trial of children with febrile seizures; information about sleep patterns was gathered by parental observation. Children were between ages 8-36 months at enrollment and were examined subsequently for 2 1/2 years. Night awakenings were not more common in children assigned to phenobarbital except for those who were poor sleepers at the beginning of the study. Total sleep time was no different in children assigned to phenobarbital than in those assigned to placebo. It is concluded that sleep problems reported in most young children with febrile seizures treated with phenobarbital did not exceed those reported in children treated with placebo, but a subset of predisposed children did experience an increase in night awakenings.

Child, Preschool↗
PubMedDate not supplied

Risk factors for febrile seizures in the People's Republic of China: a case control study.

A case control study was conducted to investigate the association of family history of febrile seizures (FS) and history of maternal, pregnancy and delivery, and postnatal factors with FS. Information was gathered by door-to-door survey in six major cities in the People's Republic of China. Factors present before the date of onset of FS were assessed in 182 subjects and in an equal number of controls matched for age, sex, and geographic area. The odds ratio for risk of FS in children with a family history of FS in a first-degree relative was 10.0 (confidence interval 2.7-58.6), confirming other observations that familial factors are an important predisposing characteristic for FS. Maternal acute respiratory infection during the first trimester of pregnancy was slightly more frequent in children with FS (odds ratio, 1.9 confidence interval 1.0-3.9). None of the other examined pregnancy or delivery factors was associated with an increased risk, suggesting that birth history is not an important factor predisposing to FS.

Adolescent↗