Continued rising trend of childhood Type 1 diabetes mellitus in Devon and Cornwall, England.
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Biomedical subjects
Publications and source records attributed to E Sanderson.
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AIMS: To determine the incidence of Type 1 diabetes mellitus (DM) in children aged 0-15 years in the far south-west of England between 1975 and 1996. METHODS: Patient information was collected to set up the Cornwall and Plymouth Children's Diabetes Register (CPCDR) through two main data sources; hospitals and the general practitioners in all surgeries in the study region. All children under 16 years living within Cornwall and the Isles of Scilly, and the former Plymouth Health Authorities and diagnosed as having Type 1 DM during the study period were included. The case ascertainment was estimated by a capture-recapture method. Trends and differences in incidence of sex, age, time period and district of diagnosis were analysed by Poisson regression analysis. Roger's method was used to estimate the seasonal variations. RESULTS: A total of 522 subjects aged between 0 and 15 years were identified from 01/01/1975 to 31/12/1996, giving an overall crude incidence of 14.9/ 100 000 population/year. The case ascertainment was 94.4% (95% confidence interval (CI) 91.4- 97.6%) for the whole register. Poisson regression analysis showed that a significant increase of incidence (2.49% per year) was observed throughout the 22-year study period, which was mainly a result of the significant increase in the 0-4 year age-group (6.29% per year). The incidence significantly differed among the 22-years (P = 0.007), the three age groups (0-4, 5-9 and 10-14 years, P<0.001) and different sexes (P=0.049). The significant seasonal variations were detected with peak incidence appearing in autumn and winter. CONCLUSIONS: The first validated childhood-onset diabetes register has been set up in the far south-west of England. The incidence of childhood Type 1 DM in this region has increased significantly over the past two decades, especially in children under 5 years.
A study to assess health visitors' perceptions of pregnant women most likely to breastfeed revealed that many did not recognise the significance of all factors identified in previous research as indicating a negative attitude. CHRISTOPHER DRACUP and ELIZABETH SANDERSON discuss the application of these factors in identifying mothers for breastfeeding promotion.
Nicotine is increasingly recognized to promote transmitter release in the brain by a direct action on presynaptic terminals. Pharmacological evidence indicates that this action is mediated by nicotinic receptors. From their sensitivity to mecamylamine, neosurugatoxin and neuronal bungarotoxin these presynaptic receptors can be distinguished from alpha-bungarotoxin-sensitive muscle-type nicotinic receptors, and can be correlated with [3H] nicotine binding sites in the brain. The release of many transmitters in different brain regions is susceptible to stimulation by nicotine, but this effect is not ubiquitous. However, lesioning and subcellular fractionation studies suggest that the majority of brain nicotine receptors are located presynaptically, so that a direct influence of nicotine on transmitter release assumes considerable importance. Although the sensitivity of presynaptic receptors is such that they are likely to be partially activated by doses of nicotine obtained by smoking, the desensitization-induced up-regulation of nicotinic binding sites that follows chronic nicotine treatment raises questions about their functional status during tobacco usage. Chronic administration of the agonist (+)anatoxin-a also up-regulated [3H] nicotine binding sites, and led to increased nicotine-evoked transmitter release in vitro. This could have implications for the involvement of these receptors during withdrawal.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
A 30-year retrospective review of 544,354 Seattle area hospital admissions yielded 25 patients who underwent surgical therapy for the relief of intractable idiopathic constipation. All patients were refractory to conventional medical treatment consisting of the daily use of laxatives, cathartics, emollients or enemas. Long-term follow-up was available for 13 of the 25 patients. All 13 patients had clinical improvement as a result of the operation. This confirms results reported by other authors. Subtotal colectomy and left hemicolectomy are the procedures generally favored.
This paper highlights the need for support for new mothers and explains how health visitors researched the need for, and set up, a postnatal support group.