PubMed Health⌕ Search

Biomedical subjects

Joseph M Dooley

Publications and source records attributed to Joseph M Dooley.

14 recordsLinked to original sources
PubMed2006

Descriptive epidemiology of concussion.

To describe the epidemiology of reported concussion derived from a large, nationally representative health survey, the microdata files of the Canadian National Population Health Survey (1996-1997) were analyzed. Respondents reported whether they had "any injuries that were serious enough to limit their normal activities" in the preceding 12 months and the nature of the most serious injury. A total of 99.8% of 81,804 eligible respondents, representing 28,606,100 Canadians, reported their injury experience within the preceding year, with 89 reporting a concussion. The annual prevalence of Canadians reporting a concussion as their most serious injury was 110 per 100,000 population (95% confidence interval: 80, 140). Those reporting concussion were more likely to be younger (P < 0.001) and male (P = 0.02). Males were significantly overrepresented in the 16-34 year-old group (P = 0.004). More than 54% of all concussions were sport-related (95% confidence interval: 39%, 67%), occurring at a place for recreation or sport, with sport having a role in >85% of concussions in the 16-34 year-old group. This study presents annual prevalence estimates of reported concussion, derived from a sizeable, nationally representative population survey.

Adolescent↗
PubMed2006

Activity levels among adolescents with migraine.

Data was analyzed from the nationally representative Canadian Community Health Survey. A total of 17,549 adolescents reported whether they had "migraine headaches" (response rate 99.9%) and in what exercise activities they participated. Those with migraine reported more daily activity than migraine-free peers when corrected for age and sex. They were as likely to play contact sports but were more involved in other noncompetitive activities, such as walking (P<0.001), gardening and yard work (P=0.008), jogging and running (P=0.002), and fishing (P=0.03). Canadian adolescents with migraine are therefore overall more active than their peers without migraine.

Adolescent↗
PubMed2006

Headaches in the pediatric population.

Headaches are an extremely common complaint encountered in the pediatric population. The headache history establishes the diagnosis in the vast majority and most importantly identifies features suggesting a secondary cause. The headache history outlined will aid in headache classification and screen for ominous causes. A comprehensive headache examination is aimed at excluding secondary causes. Headaches resulting from serious organic causes are virtually always associated with neurologic signs at the time of presentation. Investigations are not routinely required for pediatric headache, but neuroimaging should be strongly considered in children with an abnormal neurologic examination or history worrisome for intracranial pathology. The management approach for children with primary headaches should focus on reassurance and education. Developing an individualized therapeutic strategy requires knowledge of the child's headache-related disability and impact on quality of life. Treatment should begin with a nonpharmacologic approach, which influences lifelong prevention and management of headaches. Pharmacologic interventions target both acute symptomatic treatment and prophylactic medications. Preventative treatment may be beneficial when headaches result in significant disability and impaired quality of life. The limited available evidence for prophylactic treatment options is reviewed. Research into pediatric headache prevention and management remains a priority given the potential lifelong morbidity associated with headache.

Headache↗
PubMed2006

Tic disorders in childhood.

Despite our familiarity with tic disorders, their management remains challenging. The difficulty seldom relates to the diagnosis, which is usually based on the history, but rather in dealing with the impact of the tics and multiple comorbidities. The child and family must be educated and must be taught how to facilitate a positive attitude among others who come in contact with the patient. Knowledge and acceptance of the tics by other family members, peers, teachers, and coaches often become central to the child's well-being. Although many children can be managed without pharmacotherapy, medications are often central to achieving success. The goals of therapy and the appropriate choice of medication must be individualized. We are frequently challenged not only by the wide array of medication choices available but also by the decision of which symptom to treat first. The tics, despite being flamboyant, are often viewed by the child and family as less disabling than co-occurring conditions, such as attention-deficit hyperactivity disorder, obsessive-compulsiveness, or rage. Even when tics are the major issue, patients must define their goals for therapy. It is unreasonable to expect a complete resolution of tics and safety usually rules in favor of better tolerated but potentially less efficacious therapies. Developing strategies to minimize the lifelong impact of the multiple components of Tourette syndrome is an essential aspect of the care of these patients.

Adolescent↗
PubMed2006

Relation of pregnancy and neonatal factors to subsequent development of childhood epilepsy: a population-based cohort study.

OBJECTIVE: We examined the effect of pregnancy and neonatal factors on the subsequent development of childhood epilepsy in a population-based cohort study. PATIENTS AND METHODS: Children born between January 1986 and December 2000 in Nova Scotia, Canada were followed up to December 2001. Data on pregnancy and neonatal events and on diagnoses of childhood epilepsy were obtained through record linkage of 2 population-based databases: the Nova Scotia Atlee Perinatal Database and the Canadian Epilepsy Database and Registry. Factors analyzed included events during the prenatal, labor and delivery, and neonatal time periods. Cox proportional hazards regression models were used to estimate relative risks and 95% confidence intervals. RESULTS: There were 648 new cases of epilepsy diagnosed among 124,207 live births, for an overall rate of 63 per 100,000 person-years. Incidence rates were highest among children <1 year of age. In adjusted analyses, factors significantly associated with an increased risk of epilepsy included eclampsia, neonatal seizures, central nervous system (CNS) anomalies, placental abruption, major non-CNS anomalies, neonatal metabolic disorders, neonatal CNS diseases, previous low birth weight infant, infection in pregnancy, small for gestational age, unmarried, and not breastfeeding infant at the time of discharge from hospital. CONCLUSIONS: Our study supports the concept that prenatal factors contribute to the occurrence of subsequent childhood epilepsy.

Breast Feeding↗
PubMed2005

Self-reported headache frequency in Canadian adolescents: validation and follow-up.

OBJECTIVE: To validate our previous estimates of the prevalence of frequent headache and associated factors in a new sample of 12- to 13-year-old adolescent Canadians, and to explore if estimates of the prevalence of frequent headache and associated factors remain stable within the original cohort after a two-year interval. METHODS: We analyzed the self-administered questionnaire microdata files of the National Longitudinal Survey of Children and Youth (NLSCY: 1998-1999). 1694 respondents representing 724,400 youth aged 12 to 13 years were used to validate the prevalence in our initial estimates. From the initial cohort, 1764 respondents representing 819,600 youth, now aged 14 to 15 years, were used to examine whether frequent headache prevalence or associated factors had changed in the intervening two years. RESULTS: Among the analyzed individuals, 26.3% of 12- to 13-year olds and 31.2% of 14- to 15-year olds reported frequent headaches of "about once a week" or more often (P= .001). Our previous study of the NLSCY: 1996-1997 found a prevalence of 26.6% in 12- to 13-year olds. We previously identified 22 risk factors, of which 15 were replicated and one proxy was available within this iteration of the survey. For the 12- to 13-year olds, 14/16 were associated (P < .01, chi-square) with frequent headaches. For the initial cohort, now 14- to 15-year olds, 15/16 risk factors remained associated (P < .01, chi-square) with an increased risk of headaches. CONCLUSIONS: Our estimates of frequent headache prevalence are reliable and consistent in two large nationally representative cohorts of 12- to 13-year olds. In the first of these groups there was an increase in prevalence over 2 years as adolescence progresses. Our identified risk factors for frequent headaches have been validated within another cohort and are maintained as the cohort ages.

Adolescent↗
PubMed2004

Depression in parents of children with Duchenne muscular dystrophy.

This study examined depression, self-esteem, and mastery in the family caretakers of a group of males with Duchenne muscular dystrophy in comparison to a control group. A questionnaire based on the National Population Health Survey from Statistics Canada, a survey to collect information on the health of the Canadian population and related sociodemographic information, was conducted by telephone with 42 parents. The results were compared with the national data from the National Population Health Survey (1994 and 1999), matched for province of residence, number of children in the household, age, and marital status of the respondents. Parents of children with Duchenne muscular dystrophy had a higher probability of going through a major depressive episode and had significantly lower self-esteem and mastery scores than the national control group. None of the variables investigated (age, intelligence quotient, and ambulatory status of child or sex, age, and marital status of parent) could predict the depressive episode, with two exceptions. Parents without a partner had lower scores on the mastery scale, and parents of males older than 13 years of age were more likely to experience distress that interfered with life. It is incumbent on those caring for patients with Duchenne muscular dystrophy to counsel families regarding their potential to suffer a major depressive episode and to advise on appropriate therapy.

Adaptation, Psychological↗
PubMed2004

Brainstem calcification in Möbius syndrome.

Möbius syndrome is characterized by congenital facial diplegia, and may be associated with limb or orofacial malformations. A number of mechanisms have been proposed to explain the pathogenesis, including prenatal ischemia. We identified seven children with Möbius syndrome over the 10-year interval 1992-2001, all of whom manifested incomplete bilateral facial palsy. Associated limb and orofacial anomalies were observed in six cases. Computed tomographic scans were available in six children, and five of them manifested brainstem calcification which was most prominent in the floor of the fourth ventricle. The calcification was detected as early as 7 days of age and did not change with time, suggesting a static condition of prenatal onset. These observations support the hypothesis that the pathology in Möbius syndrome is secondary to prenatal brain ischemia.

Brain Stem↗
PubMed2004

Which characteristics of children with a febrile seizure are associated with subsequent physician visits?

OBJECTIVE: To reanalyze an existing data set to determine which children with an initial febrile seizure have excessive subsequent physician visits. METHODS: Individual data from a regional cohort of 75 children with a first febrile seizure and 150 febrile and 150 afebrile control subjects were linked to a comprehensive physician services database. The impact of study variables on subsequent physician utilization over the following 6 years was modeled using analysis of variance. RESULTS: Children with a known family history of febrile seizures at the time of study entry had 24% fewer physician visits. Control children with a known family history of afebrile seizures had 7% fewer visits than those with negative family histories. Children with an initial febrile seizure had 45% more physician visits when they knew of a relative with afebrile seizures than those with negative family histories. CONCLUSIONS: Knowing the family history of seizures is probably a marker of reduced physician utilization. At the time of an initial febrile seizure, knowing the family history of afebrile seizures defines a group of patients with excessive subsequent physician visits.

Analysis of Variance↗
PubMed2003

The utility of the physical examination and investigations in the pediatricneurology consultation.

For most consultations the diagnosis is established by a thorough clinical history. We prospectively assessed the impact of each component of the pediatric neurologic consultation in 500 consecutive referrals to a tertiary care pediatric neurology clinic. Diagnosis and management decisions were declared for each patient by the consultant after each stage of the consultation process (1: receipt of consultation letter, 2: history, 3: physical examination and 4: receipt of investigation results). We found that the physical examination and investigations influenced management decisions for less than 6%. Specifically the examination was never influential for children with headaches, Tourette syndrome, developmental delay or attention-deficit-hyperactivity disorder (ADHD). Investigations never influenced management for those with Tourette syndrome, ADHD, or cerebral palsy. Therefore for the majority of children the critical component of the pediatric neurology consultation is a detailed clinical history.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Fever-induced dystonia.

The etiology of dystonia in children is often elusive. We report two children with fever-induced dystonia, an association which has not been previously reported. Both children had episodes of lower extremity dystonia with inversion of the feet and dorsiflexion of the great toes. Events began at 2 years of age, were preceded by febrile illness, and lasted for up to 24 hours. In both children, one of the parents had a history of similar but milder symptoms in childhood. Between spells the children were neurologically normal. Multiple investigations, including metabolic and imaging studies, were normal and therapies were ineffective. As the children aged the dystonic events occurred less frequently. This dystonic syndrome is a previously unrecognized benign episodic movement disorder of childhood.

Child↗