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At least 811 records · Page 45Linked to original sources
PubMed1999

'Health assessment' at school entry: performance of a system based on school nurse interviews.

OBJECTIVES: To describe the performance of a school entry 'health assessment' based on school nurse interviews. BACKGROUND: Universal medical examination at school entry has largely been replaced by a 'health assessment' led by the school nurse, based on screening tests, a health interview, eliciting parental and professional concern and past history. As a result children with possible problems are selected for school medicals, reviewed in school or referred to a range of health professionals and other agencies. SETTING: Inner city south-east London. SUBJECTS: Children born between 1/3/89 and 31/8/89 who were on the class lists of 21 randomly selected primary schools. DATA COLLECTION: A form for each subject was distributed to the school nurse and completed as children were invited for screening, school health interviews and medical examinations. MAIN OUTCOME MEASURES: Proportion of subjects attending, patterns and proportions of reviews and referrals. RESULTS: 426 children were eligible for inclusion and 419 (98%) forms were returned. 232 children were seen for a health interview and a further 50 were screened for vision, hearing and growth problems only. 124 had no contact with the school nurse or doctor. Following health interview or screening, 180 children were reviewed and/or discussed with other health professionals. 71 external referrals were made. CONCLUSION: Adequate coverage at school entry is difficult to obtain. The objectives of school entry health assessment and the relationship between selection criteria and health needs require clarification.

Child↗
PubMed2005

Severe retinopathy of prematurity: longitudinal observation of disease and screening implications.

PURPOSE: To test the effectiveness of our Canadian retinopathy of prematurity (ROP) screening guidelines as applied to high-risk premature infants. STUDY DESIGN: Retrospective longitudinal cohort study. SUBJECTS: A total of 969 infants were examined longitudinally between 1991 and 2000 and 46 of these infants screened were treated for severe ROP. METHODS: Data from weekly ROP screening examination results were collected from a geographical area and analysed. RESULTS: The average incidence of severe ROP requiring treatment in the population of premature infants eligible for screening was 48.3 per 1000. In all, 46 infants were treated in this cohort. The mean gestational age (GA) was 25.5 weeks of age and the mean birth weight was 750 g. The mean chronological age (CA) and postmenstrual age (PMA) at the time of first screening was 36 days and 30.7 weeks, respectively. The first identification of any ROP in this group was at a mean CA 60 days and PMA of 34.1 weeks. The mean CA and PMA of the first observation of stage 3 were 74 days and 36.3 weeks. The mean CA and PMA at the time of treatment were 86 days and 37.7 week. CONCLUSIONS: Our observations and analysis indicate the following ROP screening recommendations: infants of 28 weeks of GA or less, infants with a GA between 28 weeks and 30 weeks should have a single 'spot examination' at approximately 37 weeks of PMA (or prior to discharge from hospital) to include possible outliers; infants born with a birth weight of 1250 g or less; initial screening examination should be at 31 weeks of PMA or 4 weeks of CA, whichever is later; in the presence of any active ROP, the infant should be followed every 1-2 weeks; and stage 3 should be followed at least every 7 days.

Age Factors↗
PubMed1996

Systemic effects of screening for retinopathy of prematurity.

AIMS: To detect systemic complications of screening for retinopathy of prematurity (ROP), paying particular attention to the physical examination. METHODS: Oxygen saturation, pulse rate, and blood pressure were monitored before, during, and after 110 ROP screening examinations. RESULTS: Following topical mydriatics diastolic blood pressure was elevated by a mean of 6 (SD 7.2) mm Hg. Immediately after the examination there was a further rise in both systolic and diastolic pressure of 4.3 (14.5) mm Hg and 3.3 (11.6) mm Hg, respectively. Oxygen saturation and pulse rate remained stable during the control period and administration of eyedrops. Saturation fell by a median of 3% (95% confidence interval plus or minus 1.2%) after the examination while there was rise in pulse rate of 7 (SD 23.1) beats per minute. This change in pulse rate was not observed in infants on concurrent methylxanthine therapy. No infant had clinically significant changes at the end of the study. CONCLUSION: The initial changes in blood pressure may represent side effects of topical mydriatics but the later changes following the physical examination may be an additional response to the stress of ROP screening.

Anesthetics, Local↗
PubMed2000

Refractive errors and strabismus in premature Asian infants with and without retinopathy of prematurity.

AIM: In Caucasian populations, premature infants with retinopathy of prematurity (ROP) have been reported to have higher risks of developing refractive errors and strabimus. The purpose of this study is to evaluate the rate of these complications in Asian premature infants with and without ROP. METHODS: A retrospective case review of all premature infants referred to the Singapore National Eye Centre for ophthalmology screening. These included all neonates born earlier than 34 weeks gestational age and less than 1500 grams in birth weight. Standardized ophthalmology examinations including cycloplegic refraction and fundus examination at regular intervals were performed to determine the presence of ROP, refractive errors, squints and other ocular abnormalities until the patients were 3 years old. RESULTS: During 1991 to 1993, a total of 113 neonates were reviewed. Of these, 16 (14.2%) developed ROP. The risk of ROP was higher with lower birth weights and earlier gestational ages. At 1-year follow-up, the rate of myopia was 33.3% in babies with ROP compared to 3.7% in babies with no ROP (p < 0.001). The higher rates of myopia in babies with ROP remained with longer follow-up (33.3% and 25% in ROP group versus 3.4% and 3.8% in no ROP group, at 2 and 3 years respectively). There was no difference in rates of astigmatism or hyperopia throughout the 3 years. At 1 year follow-up, the rate of strabismus was 20% in the ROP group compared to 4.9% in the no ROP group (p = 0.07). However, this difference in rates of strabismus was not significant at 2 and 3 years of follow-up. CONCLUSION: Premature babies with ROP had higher rates of myopia and strabismus than those without ROP. Long-term follow-up of these babies is important for early detection and treatment of these ocular problems.

Asian People↗
PubMedDate not supplied

Retinopathy of prematurity: A refresher for obstetricians.

Advances in neonatal care improved the survival of many preterm infants, but also increased the incidence of retinopathy of prematurity (ROP). Numerous risk factors have been associated with the development of ROP, the most important of which are: low birth weight, early gestational age at delivery, and duration of oxygen therapy. Screening premature infants is a critical factor for any prevention and treatment protocol. The Retinopathy of Prematurity Subcommittee of the American Academy of Ophthalmology (AAO) and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) have developed guidelines that assist practicing physicians in managing children with ROP. A portion of these guidelines is particularly applicable to practicing obstetricians who, along with the pediatricians, are often the primary physicians for the affected families. The aim of this paper is to present a comprehensive overview of the epidemiology, etiology, manifestations, prevention, and management of ROP. In the last section, the authors present guidelines for practicing obstetricians that incorporate the most recent recommendations of ophthalmic and pediatric thought leaders.

Child↗