The incidence of Type 1 (insulin-dependent) diabetes mellitus was prospectively evaluated in Catalonia, Spain in patients up to 30 years of age during the period 1987-1990. The population at risk (0-29 years) consisted of 2,690,394 inhabitants (total population of Catalonia 5,978,638). All the cases were independently identified from four sources: endocrinologists, sales of blood glucose monitors and insulin pen injectors, diabetes societies and diabetic summer camps. The degree of ascertainment was 90.1%. The overall observed incidence rate was 10.7 per 100,000 per year, being 11.5 per 100,000 per year in the 0-14 age group. The incidence in males (12.0 per 100,000 per year) was higher than in females (9.3 per 100,000 per year), with a male/female ratio of 1.36/l. The sex differences were only present in cases over 14 years of age. Age specific incidence rates per 100,000 per year were 4.4 (confidence interval 95%: 3.2-5.7) in the age group 0-4, 9.9 (8.5-11.4) in 5-9, 17.5 (15.7-19.4) in 10-14, 11.4 (9.9-13.0) in 15-19, 11.3 (9.7-13.0) in 20-24 and 8.5 (7.2-9.9) in 25-29. There was a seasonal onset pattern, with the highest incidence in winter (December-February). We conclude that the incidence of Type 1 diabetes observed in Catalonia during the period 1987-1990 is higher than that recently reported in other Mediterranean countries. This study offers the first standardized data on Type 1 diabetes incidence in Catalonia, including cases up to 30 years, and contributes to the knowledge of the epidemiology of diabetes in South Europe.

No abstract

No abstract

ONE of the major public health problems in the United States and all the Western nations is the tremendous increase in the incidence of gonorrhea.l. ' Though notoriously underreported by practicing physicians, resulting in a significant bias in available statistics, the rates clearly show that gonorrhea, always endemic, has now reached epidemic propenicillin and other antibiotics.3Here are some of the reasons why gonorrhea continues to flourish: a very brief incubation period, the frequent asymptomatic nature of the infection in females, lack of natural or acquired immunity, increased use of contraceptive pills and intrauterine devices, public apathy, changing moral standards, and the increasing resistance of the gonococcus to penicillin and other antibiotics.3 a Though all age groups are being affected by this resurgence of gonorrhea, it is primarily a disease of the young. It assumes significant frequency at puberty, becomes most prevalent in the age group 20 to 24, and then declines to age 50 and older at which time the rates are similar to those in the 14 and younger groUp.4In 1970, of the reported cases in the United States, 33 per cent were less than 20 years of age., Gonococcal infections in infants and young children have gone up parallel to the increase in young adults. We here describe the clinical, epidemiologic and microbiologic findings in 15 children with proved gonococcal infections seen in 18 months at the Children's Memorial Hospital, University of Oklahoma Health Sciences Center. These children ranged in age from newborns to 13 years. Clinical ExpressionsSeven of the fifteen children were newborn infants with gonococcal conjunctivitis. They were born at the University Hospital and exhibited conjunctival inflammation within 48 hours after delivery. According to the hospital records, all had received prophylaxis with 1 per cent silver nitrate solution immediately after birth. Two of the mothers had a history of gonorrhea. All were deemed asymptomatic and supposedly free of infection at the time of delivery.Another child with gonococcal conjunctivitis was a two-year-old girl, the sister of one of the newborns treated two months earlier for conjunctivitis. She had been in close daily contact with the infant while the latter was ill. Two boys, ages 21 and 4! years respectively, presented with signs and symptoms of urethritis. The first boy had a one-week history of hesitancy, enuresis, and pain on urinalion. A urinlysis done three days prior to admission revealed microscopic hematuria, pyuria, and proteinuria, but culture of the urine was negative. On admission, he had slight induration of the mid-shaft of the penis and a grayish penile discharge. This discharge showed many pus cells with a moderate number of gram-negative diplococci and culture subsequently yielded Neisseria gonorrheae. He responded satisfactorily to a course of penicillin-G. The source of his infection could not be ascertained.The second boy with urethritis was 41 years old. He gave a two-week history of a purulent penile discharge...

No abstract