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Biomedical subjects

K Lennox

Publications and source records attributed to K Lennox.

12 recordsLinked to original sources
PubMed1995

Developmental care: making your NICU a gentler place.

Over the years, the nursing care provided at Women's College Hospital in Toronto has broadened to become increasingly holistic. Our neonatal intensive care unit (NICU) has kept pace. Seven years ago we introduced the philosophy of developmental care in the NICU, and it has continued to evolve ever since. This framework of care not only makes us more effective in meeting the neurodevelopmental needs of preterm infants, it also leads to enhanced relationships between parents and their babies.

Child Development↗
PubMed1993

Extreme immaturity: outcome of 568 pregnancies of 23-26 weeks' gestation.

OBJECTIVE: To provide guidelines to the perinatologist regarding extremely premature infants based on the experience of the University of Toronto Newborn Service (two high-risk perinatal units and one outborn neonatal intensive care unit), with a catchment area of 60,000 deliveries annually. METHODS: The study included all births or admissions in the Newborn Service from January 1, 1982 to June 30, 1987 with gestational age determined by the best obstetric estimate of gestational age, ranging from 23-26 completed weeks. The obstetric records were reviewed and the surviving infants followed prospectively for a minimum of 2 years after delivery. RESULTS: Analysis of the neonatal and 2-year follow-up data on 568 infants born between 23-26 weeks' gestation revealed a 39% mortality rate, which increased with decreasing gestation. The highest mortality rates occurred following complicated pregnancies, including fetal growth restriction. Intact survival increased with increasing gestational age, from 11% at 23 weeks to 50% at 26 weeks. There was a marked improvement in both mortality and morbidity by 25 completed weeks. CONCLUSIONS: The results suggest that an aggressive approach before 24 completed weeks' gestation is not warranted. From a total of 60,000 live births per year, only one child born at 23 weeks' gestation and three at 24 weeks were free of major handicap at 2 years.

Birth Weight↗
PubMed1988

Two-year follow-up of infants enrolled in a randomized trial of surfactant replacement therapy for prevention of neonatal respiratory distress syndrome.

A randomized clinical trial of the use of bovine surfactant for the prevention of neonatal respiratory distress syndrome was completed at our Institution in 1984 (Pediatrics 1985;76:145-153). All infants entering the trial were enrolled in our follow-up clinic and seen at regular intervals for assessment of growth and development, neurologic and sensory status, and incidence of respiratory disease and allergic conditions. Infants have now been followed-up for at least 2 years. Of those infants for whom follow-up is complete, two of 32 (6.3%) surfactant-treated infants died, five (15.6%) had major neuro-developmental handicaps, and five had minor neurodevelopmental handicaps. In the control group, eight of 33 (24%) infants died, whereas only two (6.1%) survived with major neurodevelopmental handicaps, and four (12.1%) were left with minor handicaps. Except for an increased neonatal death rate in the control group, other differences were not statistically significant. The groups were also comparable in terms of the incidence of late respiratory or allergic disease as assessed by history. Treatment with bovine surfactant at birth of premature infants at high risk for respiratory distress syndrome appears to be safe and of short-term benefit, although no decrease in neurodevelopmental handicap at 2 years' follow-up can be demonstrated.

Clinical Trials as Topic↗
PubMed1988

Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period.

The follow-up records of 605 infants with birth weights of less than 1,500 g, with data available for 2 years after birth, were examined for evidence of abnormal pulmonary signs or symptoms. A total of 119 infants were identified and the neonatal oxygen requirements of these infants were compared with those of 486 infants who had normal pulmonary function. A requirement for oxygen at 28 days of life had a positive predictive value for abnormal pulmonary findings at the time of follow-up of only 38%, whereas 31% of those with normal pulmonary findings at the time of follow-up were still receiving oxygen at this age. The need for oxygen at 28 days was a good predictor of abnormal findings in infants of greater than or equal to 30 weeks' gestational age at birth but became increasingly less useful as gestational age decreased. It was found that, irrespective of gestational age at birth, the requirement for additional oxygen at 36 weeks' corrected postnatal gestational age was a better predictor of abnormal outcome, increasing the positive predictive value to 63%. The prediction of a normal outcome remained 90% for infants not receiving oxygen at this corrected gestational age.

Female↗
PubMed1978

Evaluation of intellectual, linguistic, and achievement variables in normal, emotionally disturbed, and learning disabled children.

This study addresses itself to developing an abbreviated test battery to assess children presenting learning difficulties in the classroom. Factor analyses of the WISC, ITPA and PIAT revealed that 85% of the total variance of these tests can be accounted for by an abbreviated battery utilizing 12 subtests from the 26 in the total from all three tests. Evidence is presented that the discrepancy between academic achievement and academic aptitude is not as great as expected, in children with apparent underachievement, when careful, reliable measures are used.

Achievement↗
PubMed1977

A matched-subject comparison of underachievers with normals on intellectual, behavioral, and emotional variables.

Children labeled as underachievers are compared to a matched group functioning normally within the classroom. Factor analyses of the data from several tests reveal that the "normal" children not only have achieved higher academic performance but also have better learning aptitude. The inference may be made that many "underachievers" actually have a low general aptitude when carefully measured.

Achievement↗
PubMed1976

Differences between patients with temporal lobe seizures and those with other forms of epileptic attacks.

Seventy-eight patients with temporal lobe type seizures were precisely matched for age, sex, and Wechsler I.Q. levels with patients suffering from other seizure types. Statistically significant differences were established between the groups in regard to treatment response, etiologies, and behavioral variables. Further analysis of the data showed that the behavioral problems of the temporal lobe patients were present only in that group that suffered from more than one seizure type. That temporal lobe epilepsy group having only one seizure type differed from the controls with one seizure type in regard to etiological factors; they actually showed better performance on certain subscales of the WAIS, as well as better employment records. The clinical impression of the temporal lobe epilepsy patient usually presenting more difficulties than other patients with epilepsy results from the fact that the temporal lobe patients have, in the overwhelming majority of instances, more than one seizure type.

Adolescent↗
PubMed1976

Comparison of psychiatric inpatient male and female adolescent drug abusers.

Drug-abusing male and female adolescent psychiatric inpatients were compared on a variety of etiological, environmental, and social variables. Results indicated that the frequency, duration, and pattern of abuse did not differ significantly for males and females. Factor analyses, however, revealed that for females, drug abuse and pathology in general were associated with family related variables; for males, patient abuse and patient pathology emerged as factors orthogonal to family drug abuse and family pathology. These findings indicate that female pathology is more reactive to the family situation and hence they raise the hypothesis that when the female separates from the family her pathology will decrease more than the pathology of the male who separates.

Achievement↗