PubMed Health⌕ Search

Biomedical subjects

J M Court

Publications and source records attributed to J M Court.

At least 19 recordsLinked to original sources
PubMed1991

Factors predicting residual beta-cell function in the first year after diagnosis of childhood type 1 diabetes.

Twenty-five children aged 2-14 years (mean age 8.39 +/- 0.78 years) were studied prospectively during the first year after the diagnosis of type 1 diabetes. Of their clinical and metabolic features at diagnosis, only age showed a significant independent relationship with endogenous C-peptide production during the first year. Age was correlated with higher values for basal and stimulated plasma C-peptide at 7-14 days after diagnosis, at 6 months and at 12 months. At diagnosis, age was also associated with a higher value for HbA1c and a lower prevalence of insulin antibodies. C-peptide production peaked at 3 months and thereafter declined. Mean HbA1c and insulin requirement were both minimal at 6 months. At diagnosis, there were significant inverse relationships between basal C-peptide production and both insulin dose and HbA1c and between stimulated C-peptide production and HbA1c. Basal and stimulated C-peptide production were inversely related to insulin dose at 6 and 12 months. Stimulated C-peptide was higher at 12 months in children retaining islet cell antibodies. These findings confirm the importance of age as a predictor of residual beta-cell function in type 1 diabetes and indicate that older children present clinically following a slower course of beta cell destruction.

Adolescent↗
PubMed1991

Outpatient-based transition services for youth.

There is a paucity of information on the process of transition from pediatric to adult services for young people with chronic disease/disability. Adolescents and young adults have differing needs from children and older adults, and ideally transition services should take these needs into account. Diabetes provides a useful model to examine the process of transition and to seek views of young people. A study of 70 young adults with diabetes is reported. It is suggested that the ideal time for a transfer from a pediatric to an adult service is between 17 and 20 years, but this will vary considerably depending on developmental needs. Specialist physicians remain the most important professionals in the view of the young diabetics, who valued the physician as one to whom they can relate and get to know well by seeing regularly. The role of educational programs and help with psychosocial problems at this age are discussed in the light of conflicting evidence in the literature.

Adolescent↗
PubMed1989

Double-blind controlled trial of azathioprine in children with newly diagnosed type I diabetes.

A double-blind controlled trial of azathioprine (2 mg.kg-1.day-1) was conducted with 49 patients aged 2-20 yr (mean 10.8 yr) who had newly diagnosed type I (insulin-dependent) diabetes. Patients were randomly assigned to receive either azathioprine (n = 24) or placebo (n = 25) for 12 mo, beginning within the 20-day period after diagnosis. Baseline clinical and metabolic characteristics did not differ between the two groups. No patient experienced complete remission, defined as restoration of normal carbohydrate tolerance without other treatment. Partial remission, defined as good metabolic control (hemoglobin A1c less than or equal to 7.9%, preprandial blood glucose less than or equal to 8 mM with an insulin dose of less than 0.5 U.kg-1.day-1), occurred in 10 placebo (40%) and 7 azathioprine (29%) patients at 6 mo and in 4 placebo (16%) and 4 azathioprine (17%) patients at 12 mo (differences not significant). Fasting plasma C-peptide was significantly greater in the azathioprine-treated group at 3 and 6 mo, but this difference was not sustained. C-peptide responses to a standard meal and the frequency of islet cell and insulin antibodies did not differ between the two groups over the 12-mo period. Azathioprine caused no significant side effects. We conclude that in the dosage used, and despite early effects on endogenous insulin secretion, azathioprine alone does not influence the remission phase in children with newly diagnosed type I diabetes.

Azathioprine↗
PubMed1989

Health literature for parents of children with cerebral palsy.

This study examined the use of and need for written educational material by the parents of 41 children with cerebral palsy, aged between five and 63 months. After their initial counselling, the majority felt that they needed written information. The parents of 31 children attempted to find suitable books or pamphlets, but in 13 cases they failed to do so or found the material unsatisfactory. A significant association was found between reading material which the parents found satisfactory and their knowledge about the basic features of cerebral palsy.

Books↗
PubMed1987

Objective assessment of limb movement in children with cerebral palsy.

A preliminary report of a method for assessing the quality of movement in children with cerebral palsy, using an accelerometer, is presented. Able-bodied and disabled children performed a simple task, and there were marked differences between the two groups. Whilst the technique requires further development, it is hoped that accelerometry may eventually provide an objective tool to enable rigorous testing of various therapeutic procedures in cerebral palsy.

Acceleration↗
PubMed1979

Age, sex, and season of onset of juvenile diabetes in different geographic areas.

Age, sex, and estimated time of onset of insulin-dependent diabetes were determined for children in Pittsburgh (N = 673), Gainesville (N = 976), Galveston (n = 741), and Melbourne (N = 851). The US cities had a decrease in new cases during the summer and peak incidence in January through April. In Melbourne, monthly trends were reversed: there were more cases during May through August. In US cities, but not in Melbourne, children less than 6 years old showed a greater variation by season than children 6 years old and older. Observations of the same fall and winter onset (in different calendar months) of insulin-dependent diabetes in Australia and the United States, and exaggeration of seasonal differences in young US children, suggest that onset of insulin-dependent diabetes is associated with seasonally varying viral diseases. Mumps and rubella infections do not seem to be responsible for much of the seasonal variation. Seasonal peaks of mumps and rubella are later than those observed for insulin-dependent diabetes, and immunization with live mumps and rubella viruses has not been associated with changes in incidence of insulin-dependent diabetes. An increase in disease incidence in boys over girls below age 6 years and in girls over boys at ages 6 through 11 years was consistently observed but not explained.

Adolescent↗
PubMed1978

Lipogenesis in developing human adipose tissue.

De novo lipid synthesis can be demonstrated in human fetal subcutaneous tissue cells which are in the initial stages of liquid accumulation. Lipogenic capacity measured as ability to incorporate acetate into neutral lipid was shown to increase with gestational age. This lipogenic capacity was accompanied by an increased activity of acetyl co-enzyme A carboxylase. Insulin, which is known to activate this enzyme in mature adipose tissue, increased neutral lipid synthesis in fetal subcutaneous tissue. When tissue insulin levels were determined, insulin was found from 16 wk gestation. At this time triglyceride content of the tissue was also increasing. Thus de novo fatty acid synthesis is a means by which the developing adipose cell initiates lipid accumulation.

Acetates↗
PubMed1978

Identification of small cells in fetal and infant adipose tissue.

In developing adipose tissue, cells of size less than 25 micron may make a major contribution to adipose tissue cell populations. This study reports the separation, identification, and sizing of infant and foetal adipose tissue small cells. Subcutaneous adipose tissue was taken from the anterior abdominal wall of children aged 2 months and 22 months. Subcutaneous tissue was also obtained from a paraumbilical site in 4 fetuses of gestational age 16 weeks. Tissue samples were fixed in buffered osmium tetroxide solution containing collidine. Aliquots of cell preparations suspended in saline on microscope slides were viewed and separated using a dissecting microscope. A diameter distribution of particle size was obtained using at least 200 cells for each preparation. There was a substantial number of cells that were smaller than 20 micron. Their modal cell size was remarkably constant in fetuses and in 2-month-old and 22-month-old infants. Ultrastructural studies show that the tissue is composed of a relatively uniform population of cells within sparsely collagenous connective tissue. Although some of the cells show no intracytoplasmic aggregates of lipid material, others show variable amounts of lipid material which can occupy a very large part of the cell volume.

Adipose Tissue↗
PubMed1978

The growth and development of fat cells in infancy.

Studies on the development of adipose tissue in infancy would seem essential to test the hypothesis that adult fat stores relate to the numbers of fat cells developed during early childhood. Thirty infants aged from 1-28 months and 13 fetuses of approximately 11-16 weeks of gestation obtained at therapeutic abortion and two preterm infants of 28 weeks of gestation were studied. The cells of both fetal and infant adipose tissue were separated from connective tissue and fixed by treatment with osmium tetroxide in buffered collidine using a method modified from Hirsch and Gallian (J. Lipid Res.,9:100(1968) for estimation of cell size and number. In fetal and early infancy there are two populations of cells in adipose tissue. Small cells found in tissue before birth and the first months of postnatal life do not contain fat. The larger cells, which are fat containing, represent maturing fat cells. They are cells which include fat cells recognized by previous workers but up to 24.6% were found to be less than 25 micron in diameter. Small cells in the early stages of fat accumulation may make an important contribution to the cell population of fat mass. It is apparent that increasing fat accumulation in the first 6-12 months of life, as demonstrated by increased skinfold thickness measurements, is associated with increasing fat cell size and that this association bears a linear relationship.

Adipose Tissue↗