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Biomedical subjects

L Rosenbloom

Publications and source records attributed to L Rosenbloom.

At least 19 recordsLinked to original sources
PubMed1992

Rehabilitation and outcome after severe head injury.

After severe head injury, many children continue to experience major cognitive and behavioural problems and consequent educational difficulties, even after good physical recovery. Forty three children referred to the regional multidisciplinary head injury rehabilitation team are described. The clinical outcome at a median interval of 13 months after injury showed that 18 (42%) had persistent neurological impairment and 15 (35%) had an identified need for special educational support. Thirty seven children were further assessed for psychiatric morbidity, cognitive impairment, and classroom performance. Rutter behavioural questionnaires were sent to parents and teachers of head injured index cases and classmate controls matched for age and sex. Index parents scored their children significantly worse in both 'health' and 'habits' and more cases than controls had scores suggesting a psychiatric disorder. Teachers scored index cases significantly worse for five of the traits questioned, but discriminated cases from controls less decisively than parents. Index cases were significantly disadvantaged on teachers' assessments of classroom skills and performance. A need for improved support and training of staff who teach head injured children was identified.

Adolescent↗
PubMed1991

Wrongful birth.

In the U.K. there has been a considerable increase in medical negligence litigation. Children born with congenital abnormalities cannot sue for having been allowed to be born but their parents can claim for the costs of their care if they can prove that appropriate care would have led to a termination of pregnancy. Six children who are the subject of such proceedings are described and the alleged faults that led to their neural tube defects not being recognised are detailed. General recommendations for a consistent antenatal approach to the diagnosis and management of neural tube defects are suggested.

Female↗
PubMed1990

Birthweight specific trends in cerebral palsy.

A register of infants with cerebral palsy born to mothers resident in the Mersey region from 1967-84 has been maintained using various sources of information. A total of 1056 patients are registered of whom 331 (31%) have hemiplegia or mixed hemiplegia, 236 (22%) have diplegias or mixed diplegia, and 369 (35%) have quadriplegia or mixed quadriplegia. The remainder have dyskinetic or dystonic forms except for seven, who are unclassified. There has been no significant change in the prevalence of cerebral palsy among infants of normal birth weight (greater than 2500 g). Among low birthweight infants (less than or equal to 2500 g) there has been a significant increase in prevalence of all the main clinical types. This increase started later among the very low birthweight infants (less than or equal to 1500 g) than among those weighing 1501-2500 g. These changes in prevalence could be the result of either improved survival of prenatally impaired infants because of improvements in medical care, or a reflection of failure to maintain optimal conditions at or around the time of birth.

Birth Weight↗
PubMed1988

Cerebral palsy in low-birthweight infants. I. Spastic hemiplegia: associations with intrapartum stress.

Children with and without spastic hemiplegia were identified among a representative sample of 1048 low-birthweight survivors by clinical assessment after three years of age. The hypothesis that hemiplegia was predetermined at birth was tested by estimating the probability of hemiplegia for each infant by logistic regression analysis, using data from hospital records on conditions known at the time of birth. 16 of 42 children with cerebral palsy had spastic hemiplegia. Allowing for the lower birthweights of hemiplegic children, increased prevalence was associated with previous reproductive loss, breech vaginal delivery, later birth-order, prolonged second stage of delivery, emergency caesarean section, and low Apgar scores. These variables identified correctly most children as having a higher or lower estimated probability of hemiplegia. Hemiplegia was also associated with prolonged respiratory disease and intraventricular haemorrhage. In this population it is likely that intrapartum events were closely related to the pathogenesis of hemiplegia; their effects may have been mediated by postnatal events.

Cerebral Palsy↗
PubMed1988

Cerebral palsy in low-birthweight infants. II. Spastic diplegia: associations with fetal immaturity.

Twenty children with spastic diplegia were identified by clinical assessment among a representative cohort of 1048 survivors with a birthweight of 2000g or less. Data from hospital case-records were used to investigate which perinatal conditions might differentiate infants with diplegia from other low-birthweight survivors. Even allowing for a strong association with lower gestational age, diplegic children were more likely to have suffered respiratory disease, necrotising enterocolitis and fits in the neonatal period, than children without cerebral palsy. Among preterm infants, diplegia differed from hemiplegia mainly in a lack of significant association with recorded maternal characteristics and markers of intrapartum stress. Important determinants of diplegia were not identified, but the results suggest that infants born both immature and relatively immature for their gestational age have the highest risk of diplegia. Factors that influence the rate of fetal development may be implicated in the aetiology of diplegia in both preterm and fullterm infants.

Cerebral Palsy↗
PubMed1988

Cerebral palsy: a 1987 perspective.

Changing views on reaching a diagnosis, methods of assessment, and management are apparent for neurological disorders in general, and cerebral palsy in particular. A personal approach to the problems associated with the evaluation and care of children and young people with cerebral palsy is outlined, with particular emphasis on the contributions form, and optimal use of, the multidisciplinary assessment team.

Adolescent↗
PubMed1987

Non-convulsive status epilepticus.

Status epilepticus can complicate any type of seizure activity. A group of 13 children with non-convulsive status has been studied. Five presented with chronic fluctuating neurological features, while eight had intermittent episodes of their atypical status, although each of these lasted for several days. The clinical features, treatment, and outcome for these groups of children are described. Most of the children in both groups are mentally retarded after regressing at the time of their status epilepticus. The recognition and aggressive treatment of atypical status is important in reducing the risk of subsequent mental handicap.

Anticonvulsants↗
PubMed1987

Effects of birth weight, gestational age, and maternal obstetric history on birth prevalence of cerebral palsy.

A register of children with cerebral palsy born to mothers resident in the Mersey region from 1966 to 1977 was compiled from health service records. Frequency distributions and prevalences of birth weight and gestational age differed for those with hemiplegia, diplegia, and quadriplegia. In particular, the children with diplegia showed a bimodal frequency distribution. Children of normal birth weight with diplegia had a higher prevalence of severe mental retardation than those of low birth weight. These differences may be due to survival bias and may not be of aetiological importance. Furthermore, the mothers of diplegic infants had a significantly higher proportion of spontaneous abortions, stillbirths, and low birthweight infants in their obstetric history. This suggests that prenatal factors predominate in the aetiology of diplegia.

Abortion, Spontaneous↗
PubMed1986

Disintegrative psychosis of childhood: teenage follow-up.

Nine patients with disintegrative psychosis of childhood were reviewed after follow-up periods of 11 to 16 years. Eight of the nine had a uniform picture of early normal development for two years or more, followed by subacute regression over a period of a few months, to become functionally severely retarded with autistic behavioural features and overactivity. Neurological investigations were consistently negative. The clinical course has remained largely static for these patients, but two have developed epilepsy. They are likely to remain severely handicapped, but not to deteriorate. It is possible that this remarkably homogeneous clinical picture is the result of unidentified encephalopathic processes occurring during early childhood.

Adolescent↗
PubMed1986

Familial cerebral palsy associated with normal intelligence.

We describe two families affected by a recessively transmitted familial cerebral palsy with onset in infancy. Two sisters in the first family have a severe spastic diplegia. The older sister also has mild mental retardation and hypothyroidism whilst the younger sister is of normal intelligence. Two brothers in the second family have a spastic quadriparesis, fifth finger camptodactyly and normal intelligence.

Adolescent↗