Summary and conclusionsBy the age of 11 years 1043 children (6-7%) in an unselected national sample had a history of seizures or other episodes of loss of consciousness; 322 (20 8/1000) had a history offebrile convulsions without other epileptic problems. A clear-cut diagnosis of non-febrile epilepsy was established in 64 children (41/1000) by the age of 11 on the basis of confirmatory information supplied by family doctors and paediatricians. A further 39 (2-6/1000) were reported as having epilepsy but did not fulfil the -study criteria. The progress of 59 of the 64 children with established epilepsy was reviewed again when they were aged 16. Of the 37 educated in normal schools eight (22%) had one or more seizures in their 16th year compared with 13 out of 22 (59%) -who received special education.A possible cause for epilepsy was found in 17 of the 64 (27%) children, but for the majority there was no obvious reason.

Three hundred and three children with febrile convulsions were identified in a national birth cohort of 13 135 children followed up from birth to the age of 5 years. Breech delivery (p <0 05) was the only significantly associated prenatal or perinatal factor. There were no associations with socioeconomic factors.Excluding the 13 known to be neurologically abnormal before their first febrile convulsion, children who had had a febrile convulsion did not differ at age 5 from their peers who had not had febrile convulsions in their behaviour, height, head circumference, or performance in simple intellectual tests. IntroductionAlthough febrile convulsions are relatively common, considerable confusion remains about whether the seizures in themselves have a deleterious effect on the subsequent development of the child. Theoretically, at least, a convulsion can result in cerebral anoxia with the death of brain cells and consequent loss of intellectual and motor ability.In 1942 Thom published the results of a community based study of children who had had "infantile convulsions."' He reported that 120o of these children were mentally defective (Intelligence Quotient (IQ) <75) and a further 13°o retarded (IQ 75-90), concluding that "infantile convulsions do tend to increase materially the risk of epilepsy and mental deficiency in later life." The study may be criticised: the children were part of a selected group; their neurological state before the convulsions was not taken into account and the infantile convulsions were of mixed aetiology and type. These criticisms apply to many subsequent follow up studies of children who have had febrile

These results demonstrate the efficacy of the abbreviated MEDS score, the MEW score and NPT venous lactate levels in predicting 28-day mortality in ED patients with sepsis. The abbreviated MEDS score was found to be the best performing risk assessment model which, with prospective validation, may aid early clinical decision-making in ED patients with sepsis and might affect the outcome from sepsis.

The prevalence of diabetes mellitus among the cohort of children in the Child Health and Education Study studied at age 10 was

Patients commonly express bother with the symptom of frequent urination. The relationship between actual voiding frequency and this symptom is undocumented. We reviewed records of 200 women who had completed 24-hour frequency-volume charts, and had indicated their degree of bother with urinary frequency utilizing the short form of the Urogenital Distress Inventory. The degree of bother was correlated with daytime and nighttime voiding frequency, maximum functional capacity, mean voided volume, and demographic variables. Among 200 women, 180 (90%) indicated at least a minor degree of bother with urinary frequency. A voiding frequency of eight or more times in 24 hours was reported by 166 (83%) of women. Among the 34 women voiding fewer than eight times/24 hours, 26 (76%) reported bother with urinary frequency. There was large variation in the degree of bother reported at a given voiding frequency. Postmenopausal women without hormone replacement therapy (HRT) recorded more nighttime voids than those on HRT. Among postmenopausal women without HRT, mean voided volume and maximum functional capacity were inversely related to patient age. Our study suggests that the currently utilized cutoff value of eight daily voids to define urinary frequency, may not be helpful in the management of women in this country. A racially diverse study of the voiding habits of asymptomatic North American women is mandated.