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Biomedical subjects

D L Sutton

Publications and source records attributed to D L Sutton.

7 recordsLinked to original sources

Patterns of hospitalisation in a paediatric diabetes clinic in Sydney.

The hospital notes of all children with diabetes admitted to the Children's Hospital (both newly diagnosed and subsequent admissions) for the period 1985-1987 were examined. The information collected included basic demographic data, number of bed-days per admission, and reasons for admission. The direct cost of a bed-day and an admission for diabetes in this hospital were calculated. The median duration of an admission at diagnosis was 12 days, and of a subsequent admission 7 days. The proportion of total admissions to the Children's Hospital in 1987 which were due to diabetes (post diagnosis) was eight times the prevalence of IDDM in the 0-14-year population. In 1987, 5.5% of the diabetic patients (excluding new cases) aged 0-19 years and registered with this Diabetes Unit were admitted to hospital. Most of these admissions were for poor control, and were thus potentially preventable. The age group most at risk for admission due to ketoacidosis was the 10-14-year group. The cost of a diabetic bed-day was $Aust 295, average cost of an admission at diagnosis $Aust 3660, and of a post-diagnosis admission $Aust 2680. Thus, even in this young age group there is considerable morbidity due to diabetes, most of which can probably be prevented.

Adolescent

Incidence and prevalence of insulin-dependent diabetes mellitus in the zero- to 19-years' age-group in Sydney.

A population-based register of cases of insulin-dependent diabetes mellitus in the zero- to 19-years' age-group was established in the Southern Metropolitan Health Region of Sydney. The aims of the register were to provide accurate incidence and prevalence data for comparison with those of studies from elsewhere in the world and to evaluate diabetes services, morbidity and compliance with self-care regimens. This article presents the incidence and prevalence data. In the Southern Metropolitan Health Region, the annual incidence of insulin-dependent diabetes mellitus per 100,000 population who were aged zero to 19 years, rose from 10.3 cases in 1984 to 14.8 cases in 1987, and in the zero- to 14-years' age-group, it rose from 13.6 cases per 100,000 population in 1984 to 19.4 cases per 100,000 population in 1987; the increases were not statistically significant. The prevalence in the zero- to 19-years' age-group was 0.80 cases per 1000 population, and in the zero- to 14-years' age-group, it was 0.74 cases per 1000 population on February 1, 1986. Age-specific incidence rates were calculated for the years 1984-1987. Incidence peaks occurred at the ages of six years, 10 years and 12-13 years.

Adolescent

Nifedipine in the treatment of myotonia in myotonic dystrophy.

Abnormal calcium transport may be implicated in the membrane defect in myotonic dystrophy. A single blind crossover trial of placebo (t.i.d.), nifedipine 10 mg (t.i.d.) and nifedipine 20 mg (t.i.d.), was performed in 10 patients with myotonic dystrophy. The severity of myotonia was assessed by measuring finger extension time after maximum voluntary finger flexion. A significant improvement in myotonia, after nifedipine, was recorded by this technique and supported by a subjective improvement in 50% of patients and clinical improvement of greater than 20% in five patients. Initial grip strength and muscle fatiguability measured by grip strength ergometry were not significantly altered.

Clinical Trials as Topic

Giardiasis with protein-losing enteropathy.

Generalized edema and ascites were the main presenting features of giardiasis in a 3-year-old boy. Hypoalbuminemia, jejunal villous atrophy, Giardia lamblia in the duodenal aspirate, and abnormal gastrointestinal protein loss were present before therapy with metronidazole. Eradication of parasites resulted in complete clinical, histological, and biochemical remission. Giardiasis must now be included in the etiology of protein-losing enteropathy.

Child, Preschool

Diagnostic value of vestibular function tests: an analysis of 200 consecutive cases.

The contribution that vestibular function tests can make in achieving a topographic and etiologic diagnosis is being increasingly questioned. A greater reliance is therefore being placed on audiometeric tests including auditory brain stem tests. Our experience with vestibular testing has been most favorable, using photoelectric nystagmography and the Torok monothermal differential caloric test. This analysis of 200 consecutive cases shows that patients with normal vestibular function can be differentiated with certainty from those with organic disorders. In the latter group the site of lesion could be confirmed with greater than 90% accuracy. The reasons why vestibular tests in general are non-productive are discussed.

Allied Health Personnel

Cerebral abscess in the under 6 month age group.

Cerebral abscess is rare in children under 6 months of age but is associated with high mortality and morbidity. We report the 12 cases admitted to this hospital in the past 20 years and review the published reports on cerebral abscess in infancy and childhood. Although mortality associated with cerebral abscess in infancy has improved, morbidity is still high. We recommend that all infants aged under 6 months presenting with bacterial meningitis have a computed tomogram or ultrasound examination to exclude cerebral abscess and hydrocephalus.

Bacterial Infections