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Biomedical subjects

G Sterky

Publications and source records attributed to G Sterky.

At least 37 records · Page 2Linked to original sources
PubMed1985

Utilization of emergency care by pre-school children in Stockholm suburbs.

The number of emergency visits (i.e. visits on the same day as the first contact for the problem in question was taken) by a defined population of pre-school children in Stockholm was studied during three months in 1977 and 1982. The aim was to describe the pattern of utilization of care. In 1982 we wanted to study whether instructions to integrate preventive and curative care at Child Health Centres (CHCs) had altered this pattern. All visits to nurses and physicians providing emergency care for children were recorded. The total number of visits was 33 per 1 000 children per week in 1977, and 39 (age-adjusted) in 1982. The increase was attributed to visits to the Child Health Centres. Thirteen and 28% of all the visits, respectively, were paid to the CHC nurses. Considering visits to a physician, there was only a slight increase from 1977 to 1982. In 1977 20% of the visits to a physician occurred within the primary health care organization. In 1982 the figure was 41%. A 29% decrease was recorded for the emergency services at the hospitals, from 1977 to 1982. Our findings show that the nurses at the Child Health Centres are a very important but little recognized resource for the care of sick children. At the CHCs the services are usually established in a way that follows the principles agreed on for the primary health care. It would seem suitable to use these resources also for curative care.

Child↗
PubMed1984

Health problems and care in young families--an evaluation of survey procedures.

This report compares the value of a diary, and telephone interviews covering either the previous 24 hours or the previous week as methods of collecting data from young families on perceived health problems and the measures taken to deal with them. The population of 310 families was randomly divided into three groups. The study design allowed the evaluation of both qualitative and quantitative aspects of the different methods. For each individual a health problem was perceived every four days and care for health problems was reported every six days. The frequency of participation was highest in the 24-hour recall group. In the diary group a weekly telephone call elicited a higher compliance than a weekly letter of reminder. In spite of a higher reporting of symptoms in the diaries the relative number of measures taken was greater in the two recall groups. When comparing the information obtained by one-week recalls with that of 24-hour recalls it was found that the risk of forgetting a perceived symptom or measure taken was low but the risk of overreporting symptom days may increase with time. The distribution of symptoms in eight main categories was equal as reported by the different methods. The cost for the investigator per individual day covered was more expensive when using the 24-hour recall method compared to the diary method.

Acute Disease↗
PubMed1982

The incidence of diabetes mellitus in Swedish children 0-14 years of age. A prospective study 1977-1980.

This is a prospective study of the incidence of insulin-dependent diabetes mellitus (IDDM) in children 0-14 years of age, including all newly diagnosed cases in the whole of Sweden from July 1, 1977 until June 30, 1980. All 45 Swedish departments of paediatrics participated. During the three-year-period studied, 1108 Swedish children, 0-14 years of age had their onset of diabetes. That means around 369 new diabetics yearly in the age groups studied. The mean yearly incidences in the years 1977-80 were 22.6, 22.8 and 22.6 per 100000 children, respectively. Mean prevalence on June 30, 1980 and 1.48 per 1000 children 0-14 years with a wide range of 0.71-2.65. The age distribution at onset showed a gradual increase and peak incidences at 11 years of age for the girls and 4 and 13 years of age for the boys. There was a consistently higher incidence for boys in the younger age groups during the three-year-period studied. Peak incidences of new cases were reached in January, March and July through October for the age groups 5-9 and 10-14 years of age. No such seasonal variation was seen for children 0-4 years of age. The cumulative incidence of IDDM at 14 years of age was 3.2 per 1000 for the boys and 2.9 per 1000 for the girls. The degree of ascertainment in this study was 93.4%.

Adolescent↗
PubMed1981

Personality changes and social adjustment during the first three years of diabetes in children.

Two groups of 64 diabetic and 30 carefully selected and matched non-diabetic control children 4-17 years old were studied with regard to psychological and social adaptation. Four sets of psycho-social methods were used: (a) psychiatric assessment of the mental state, (b) evaluation of the social situation, (c) measurement of the intellectual capacity, and (d) a Rorschach test. A base-line study was done within 5 months after the onset of diabetes and a follow-up 3 years later with the same methods. The mental state was assessed with regard to 18 variables, and the Rorschach test utilized 12 variables. There were no significance differences as to mental state between diabetics and non-diabetics neither at base-line nor at follow-up. Within each group, however, the diabetics showed an increase with regard to symptoms of aggression while the non-diabetics showed a decrease in such symptoms. Diabetics with high or low glucosuria levels did not differ in this respect. When summarizing mental deviations from average in the two groups the diabetics showed more deviations both at base-line and at follow-up, and a tendency towards higher degrees of mental activity, emotional ability and social contact. In the Rorschach test the diabetics showed a higher level of anxiety concerning their own health than the non-diabetics, but there was a decrease in this variable over the 3-year period. However, in an attempt to summarize the degree of mental disturbance, as estimated in the Rorschach test, no significant differences were found between diabetics and non-diabetics. Nor were any significant differences found between the groups with regard to social problems or intellectual capacity. It is concluded that the few abnormal patterns of raction that were observed may well be explained by the traumatic experience of the onset of a serious chronic disorder such as diabetes, and that a relatively strict care given to diabetic children does not seem to disturb their own or their parents' coping ability or psycho-social adjustment. The strictness might even have a supportive effect.

Adaptation, Psychological↗
PubMed1979

Quality of care: a tracer diagnosis study of acute otitis media, comparing a district paediatric service with paediatric and otolaryngology emergency departments.

Acute otitis media was used as a tracer condition for comparing patient care as regards patient satisfaction, compliance and medical outcome in a district paediatric office, an otolaryngological and a paediatric hospital emergency department. The initial work-up of the 216 patients studied at the three units was in good agreement with predefined standards. However, while the district paediatrician arranged a follow-up for all patients, the hospitals did so only in 10--30% of the visits. Parent satisfaction was significantly higher at the district office when the time spent waiting and the time the patient was with the doctor were kept constant. Urinary penicillin was not detected in 1/17 of district paediatric and in 6/19 of otological patients. Compliance with follow-up was also much higher at the district paediatrician. Medical outcome did not differ between the units. The majority of the parents expressed preference for the type of care given in a neighbourhood service. It is suggested that the criteria for adequate treatment of acute otitis media adapted for emergency departments may be revised in case easy access is provided to a medical centre offering continuity of care and proper follow-up. Studies of the quality of care have so far not managed to demonstrate a definite and positive relationship between the process of care, patient satisfaction and final medical results.

Adult↗
PubMed1978

HLA phenotypes and diabetic retinopathy.

The incidence of HLA antigens B8, BW15, DW3 and DW4 was found to be significantly increased in 99 patients with growth onset, insulin-dependent diabetes of more than 15 years duration. Different degrees of retinopathy were seen in 75% of the patients. No significant correlation between the presence of specific HLA alleles and the stage of retinopathy was found. We have discussed the possibility that all patients who develop diabetes have identical disease-predisposing genes, irrespective of their HLA alleles. If this was the case, the HLA phenotype would not determine the risk of developing diabetic retinopathy.

Adult↗
PubMed1978

Observations on intrauterine growth in urban Ethiopia.

A total of 3144 deliveries comprising a wide range of socio-economic groups in Addis Abeba were investigated. A positive correlation was found between family income and birth weight, with a difference of nearly 500 g between the extremes of socio-economic classes. A seasonal variation in mean birth weight was also observed. The mean length of gestation was 7.4 days shorter, and the anthropometric measures at birth were significantly lower in the Ethiopian infants as compared with the Swedish norm. The median weight and length development in relation to gestational age in the Ethiopian newborns was similar to the Swedish standard up to approximately 34--35 weeks of gestation. After that time there was very little further intrauterine growth in Ethiopian infants. The possible reasons for the observed pattern of growth are discussed.

Birth Weight↗
PubMed1978

The incidence of diabetes mellitus in Swedish children 1970--1975.

We report a retrospective study of diabetic children, 0--14 years of age, from seven Swedish departments of paediatrics. There were 359 new cases in the years 1970--1975. Notification suggested that there was a mean yearly incidence of 19.6 cases per 100 000 with a year to year variation of 10.0--26.4 per 100 000. Consequently about 330 new cases of childhood diabetes would be expected in Sweden every year. Incidence varied considerably between different geographical areas. The age distribution was bimodal with a main peak at about 12 years and another peak at about 7 years. There was some evidence for clustering of new cases in January and the autumn. The mean prevalence of childhood diabetes in the seven districts was 1.3 per 1 000.

Adolescent↗
PubMed1976

Dietary effects in the early recovery phase of kwashiorkor. Plasma levels of triglycerides, FFA, D-beta-hydroxybutyrate, glycerol, postheparin lipoprotein lipase (LPL), glucose and insulin.

The fatty liver often found in untreated kwashiorkor has been associated with highly variable concentration of circulating lipids. The effect on lipid metabolism of two isocaloric diets--one synthetic monomolecular (Vivonex) and one standard (Casilan)--which both initiated satisfactory clinical improvement was studied in 21 Ethiopian children with kwashiorkor during the first weeks of rehabilitation. Before treatment mean fasting values of all biochemical parameters were within normal ranges except for moderately elevated triglycerides--an unexpected finding-and low insulin. Individual values varied greatly; triglyceride between 0.39 and 3.49 mmol/1. FFA correlated both to glycerol, D-beta-hydroxybutyrate and triglyceride values. During treatment insulin, glucose and glycerol remained essentially unchanged and were similar in both dietary groups. In the Vivonex group only there was an initial marked, parallel fall of FFA and D-beta-hydroxybutyrate suggesting greater availability of carbohydrate and enhanced glucose utilization. This pattern of response seemed to occur without comparable inhibition of lipolysis. Triglycerides--like serum albumin--increased faster in the Casilan group. The highest mean triglyceride value was reached by day 8 in the Casilan group and by day 15 in the Vivonex group. Ten minutes following heparin injection triglycerides declined, FFA and glycerol increased indicating release of in vivo active lipase. LPL activity assayed in vitro was similar and unaffected by 2 weeks of dietary treatment in both groups. LPL activity was inversely correlated to triglycerides providing--beside the type of diet--another possible explanation for the wide variations seen in circulatory triglycerides.

Blood Glucose↗