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Biomedical subjects

J L Nanson

Publications and source records attributed to J L Nanson.

11 recordsLinked to original sources

Bone age and growth in fetal alcohol syndrome.

We have found delayed mean bone age in 63 children with fetal alcohol syndrome (FAS). The mean bone age Z-score for boys (n = 31) was -2.12 SDs and for girls (n = 32) was -1.62 SDs. This might suggest that they have potential for catch-up growth. However, experience with children with intrauterine growth retardation suggests that this will not be the case and that FAS children will be of reduced height at maturity. Further support for this assumption was gained from a sample of 26 patients who were followed until at least the age of 14 years for females and 16 years for males. There was no significant change in height Z-scores from early childhood to early adulthood, the mean score being -2.16 SDs and -2.11 SDs at mean ages of 4.83 years and 18.69 years, respectively. On the other hand, there were significant changes in weight and head circumference. The mean weight Z-score changed from -2.10 SDs to -1.14 SDs (p < 0.001). The head circumference mean Z-score in 16 patients was -3.13 SDs at a mean age of 2.79 years and -2.63 SDs at a mean age of 17.37 years (p = 0.013). Short stature can continue to be used as a diagnostic criterion for FAS beyond childhood.

Adolescent↗

Physician awareness of fetal alcohol syndrome: a survey of pediatricians and general practitioners.

OBJECTIVE: To determine the knowledge, clinical experience and perceived needs for resource materials of Saskatchewan physicians in regard to fetal alcohol syndrome (FAS) and alcohol-related birth defects. DESIGN: Mailed survey. SETTING: Saskatchewan. PARTICIPANTS: All 48 pediatricians and half (394) of the family physicians (FPs) and general practitioners (GPs) practising in Saskatchewan received a questionnaire. The numbers of physicians who completed it were 24 and 249 respectively. RESULTS: The pediatricians were more likely than the other physicians to be aware of FAS and to have diagnosed at least one case of FAS. Among the FPs and GPs, the year of graduation from medical school was a significant factor in their knowledge of FAS and their diagnostic practices. Those who graduated before 1974, the year FAS was first described in the medical literature, were less likely than the more recent graduates to be aware of FAS and to ask their patients about alcohol use during pregnancy but were more likely to feel comfortable discussing alcohol-related issues in families. All of the groups reported a need for more information about FAS and for resources on alcohol-related issues in general. CONCLUSIONS: Saskatchewan physicians are aware of FAS but have expressed a need for more information about FAS, particularly for parents, as well as physician training materials and information about where to refer patients with FAS and parents with alcohol-related problems.

Adult↗

Autism in fetal alcohol syndrome: a report of six cases.

This paper reports on six children who all fulfill the criteria for fetal alcohol syndrome and have a history of maternal alcohol abuse during pregnancy, and who also fulfill the criteria for diagnosis of autism. Their behavior and natural history is compared with eight contrast FAS children, of similar ages and functional levels, who were free of autistic behaviors. The autistic FAS children were all moderately or severely retarded. Autistic behavior has not been commonly associated with prenatal alcohol exposure. Clinicians need to be aware of this potential dual diagnosis so that appropriate educational and treatment resources can be employed.

Adolescent↗

Attention deficits in children exposed to alcohol prenatally.

Twenty children with fetal alcohol syndrome or fetal alcohol effect (FAS/FAE) were compared with 20 attention deficit disorder (ADD) children and 20 normal controls on three experimental tasks designed to isolate four different components of attention. Parents completed three questionnaires regarding their child's activity level and overall functioning, and the children completed a short form of an IQ test. The children in each group ranged from 5 to 12 years. Results indicate that although the children with FAS/FAE are significantly more impaired intellectually, their attentional deficits and behavioral problems are similar to those of children with ADD. These findings imply that the treatments known to facilitate learning in children with ADD may also benefit children with FAS/FAE.

Adolescent↗

Hyperkinesis and maternal smoking.

Mothers of methylphenidate-sensitive hyperkinetic children reported smoking two to three times as many cigarettes as the mothers of dyslexic and normal controls; the reported cigarette consumptions of the fathers showed no significant differences. These findings are consistent with the hypothesis that smoking during pregnancy is an important cause of the hyperkinetic syndrome.

Adolescent↗

Neuropsychological evaluation of preschoolers with fetal alcohol syndrome.

Children with Fetal Alcohol Syndrome (FAS) manifest a variety of central nervous system deficits which may include mental retardation, perceptual, linguistic and fine motor deficits, as well as behaviour problems. The neuropsychological performance of to preschool-aged children with FAS was compared to age, sex, and race-matched controls. Profile analysis revealed significant deficits in the FAS group on measures of intelligence and linguistic abilities. Comparison of group profiles revealed that the FAS group displayed impaired visual-motor integration in the presence of average visual-perceptual matching. The FAS children were also reported to exhibit a greater frequency of behaviour problems compared to controls. Although the FAS group were significantly growth delayed, the often reported association between cognitive abilities and skeletal growth was not evident. These results indicate that preschoolers with FAS display a distinct pattern of impairments, and understanding of this unique ability profile is important for the development of support and intervention programs for these patients and their families.

Body Height↗

A health promotion perspective on the House of Commons' report "Foetal Alcohol Syndrome: a Preventable Tragedy".

The Ottawa Charter for Health Promotion is used as a conceptual framework to examine the recommendations concerning prevention in the House of Commons' Report "Foetal Alcohol Syndrome: A Preventable Tragedy." Fetal alcohol syndrome cannot be separated from the complex social, physical and economic environments affecting alcohol consumption. For substantial progress to be made in preventing this significant cause of mental handicap, it will be necessary to consider a wide range of preventive actions, beyond public education and mandatory warning labels on alcoholic beverages. A health promotion framework offers a comprehensive, intersectoral approach to this problem.

Alcoholism↗

Foetal alcohol syndrome in Saskatchewan: unchanged incidence in a 20-year period.

Despite major initiatives in public and professional education about foetal alcohol syndrome (FAS) in Saskatchewan in the last 20 years, its incidence rate has not fallen. The rate was 0.515 per 1,000 live births in 1973-1977 and 0.589 in 1988-1992. Two hundred and seven (207) cases were ascertained, the majority being patients of the Alvin Buckwold Child Development Program in Saskatoon. These individuals were severely handicapped: 72% had at least one malformation, the mean intelligence quotient was 67.8 (range 35-106) and 45.9% had a behaviour problem. Only 25.6% still lived with their biological parents when last seen, and only 27 of 108 cases were in a regular class at school without additional support being necessary. New approaches are needed to reduce the incidence of FAS. Emphasis should be placed on individual case-finding, counselling for high-risk women, and community development programs. We are currently attempting this through a provincial coordinating committee.

Adolescent↗

Hospital utilization of Saskatchewan people with fetal alcohol syndrome.

We describe the hospital utilization of 194 Saskatchewan persons with Fetal Alcohol Syndrome (88% Aboriginal), born between 1973-92. Complete provincial hospitalization data were obtained for 128 patients; partial data for 29 patients. Proportionately more persons missing data were adopted, not living with biological family members or were deceased. The hospital separation rates for the children with FAS, pooled from 1987-91, compared to the 1989-90 Saskatchewan rates were significantly higher (95% level of confidence) for males and females < 1 year, 1-4 years and 5-14 years of age. Relative to Saskatchewan Registered Indians, significantly higher hospitalization rate ratios were observed for males with FAS in all age groups and for females only age 5-14 years. Rate ratios for younger females may not have achieved significance because of missing data. Higher hospitalization rates in children with FAS may not be explained solely by factors associated with ethnicity.

Adolescent↗