A. Dudley

The University of Texas Health Science Center at Houston

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M. Tuddenham

Barnet Enfield and Haringey Mental Health Trust

Viviana Ellis

The University of Texas Health Science Center at Houston

Hector Mendez‐Figueroa

The University of Texas Health Science Center at Houston

Andrew Sommerlad

University College London

Zachary B. Jenner

University of California Davis Medical Center

Han-Yang Chen

The University of Texas Health Science Center at Houston

Suneet Chauhan

The University of Texas Health Science Center at Houston

Dina Gazizova

Central and North West London NHS Foundation Trust

Cooperative Institutions

The University of Texas Health Science Center at Houston

Brown University

The University of Texas MD Anderson Cancer Center

American Congress of Obstetricians and Gynecologists

Barnet Enfield and Haringey Mental Health Trust

The University of Texas Medical Branch at Galveston

Galveston College

Memorial Hermann

S.P.E.C.I.E.S.

Anna Needs Neuroblastoma Answers

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2286 – The difficulty of diagnosing dementia in patients with intellectual disability: experience from a UK memory clinic

European Psychiatry (2013)

Andrew Sommerlad A. Dudley

The prevalence rate of dementia in older adults with intellectual disability (ID) is comparable with that of the general population and is significantly higher in people with Down Syndrome (DS). It is recommended that diagnosis should be made following history, physical and mental state examination, cognitive assessment, blood tests and, ideally, neuroimaging. However, experience suggests that dementia may be underdiagnosed in this patient group thereby restricting access to appropriate management. We aimed to elucidate the barriers to a timely diagnosis of dementia in the ID population attending a specialised ID memory clinic in London, UK. We conducted a service review of the Clinic, retrospectively reviewing the records of all patients seen in 2011 to assess attendance and diagnosis rate, co-morbid physical and mental illness and the completion of neuroimaging and blood tests. 32 patients were seen at least once during 2011 in the memory clinic, of whom 11 (34%) received a diagnosis of dementia. 22 (69%) of those seen had DS and 18 (56%) were male. 12 (38%) patients have thyroid dysfunction and 8 (25%) have epilepsy. 23 patients had completed a DLD in the past year and 14 (44%) had completed more than one DLD. 12 (38%) patients had a previous brain scan and 27 (84%) patients had had blood tests in the previous year. Comorbid physical illnesses, consistent attendance at appointments, access to psychological assessment and willingness to undergo neuroimaging and phlebotomy are significant barriers to diagnosis of dementia in patients with ID.

Memory clinic

Attendance

10.1016/s0924-9338(13)77145-1

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Morbidity Associated with Fetal Macrosomia among Women with Diabetes Mellitus

American Journal of Perinatology (2017)

A. Dudley Hector Mendez‐Figueroa Viviana Ellis Han-Yang Chen Suneet Chauhan

This article aims to compare the composite maternal and neonatal morbidities (CMM and CNM, respectively) between macrosomic (≥4,000 g) and nonmacrosomic (<4,000 g) newborns among women with diabetes mellitus (DM). Maternal demographic and peripartum outcome data (N = 1,260) were collected from a retrospective cohort. CMM included chorioamnionitis/endometritis, wound infection, shoulder dystocia, eclampsia, pulmonary edema, admission for hypoglycemia, 3rd/4th degree perineal laceration, and death. CNM included 5-minute Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score of <4, neonatal intensive care unit (NICU) admission, respiratory distress syndrome, mechanical ventilation, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis stage II/III, hypoglycemia, hypocalcemia, bronchopulmonary dysplasia, sepsis, seizures, hyperbilirubinemia, and death. Multivariable Poisson regression models with robust error variance were used to calculate adjusted relative risk (aRR) and 95% confidence interval (CI). The study population consisted of 967 subjects, including 854 (88.3%) nonmacrosomic and 113 (11.7%) macrosomic infants. After adjustment, the risk of CMM was higher among macrosomic deliveries (aRR = 4.08, 95% CI = 2.45-6.80). The risk of CNM was also higher among macrosomic deliveries (aRR = 1.77, 95% CI = 1.39-2.24). Macrosomia was associated with an increased risk in NICU admission, hypoglycemia, and hyperbilirubinemia. Among DM deliveries, macrosomia was associated with a fourfold higher risk of CMM and almost twofold higher risk of CNM.

Chorioamnionitis

Necrotizing Enterocolitis

Shoulder dystocia

10.1055/s-0037-1608811

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Downs syndrome, dementia and epilepsy

European Psychiatry (2008)

Dina Gazizova A. Dudley M. Tuddenham

10.1016/j.eurpsy.2008.01.297

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