ABSTRACT
We have examined the feasibility of a telemedicine-enabled screening service for children and adolescents with diabetes in Queensland. There are approximately 1400 young people with diabetes in Queensland and only about two-thirds of them are screened in accordance with international guidelines. A regional retinal screening service was established using a nonmydriatic digital retinal camera. Seven centres volunteered to participate in the study. During a five-month pilot trial, 83 of the young people with diabetes who attend these centres underwent digital retinal screening (3.7%). Retinal images were sent via email to a paediatric ophthalmologist for review and results were returned via email. A copy of each participant's results was forwarded by mail to the referring diabetes doctor and the participant and family. The majority of the image files (96%) were rated as excellent or good. Only one participant was identified as having an abnormal result. Participants and their families expressed satisfaction with the digital retinal screening process.
Subject(s)
Diabetes Mellitus, Type 1 , Diabetic Retinopathy/diagnosis , Telemedicine/organization & administration , Adolescent , Child , Feasibility Studies , Female , Health Services Research , Humans , Male , Mass Screening/organization & administration , Patient Satisfaction , QueenslandABSTRACT
A 14 week old female infant who presented with a mesoblastic nephroma was found to be hypercalcaemic. This was corrected prior to removal of the tumour and serum calcium concentrations remained within the normal range postoperatively. Hypercalcaemia is a life threatening complication of mesoblastic nephromas and should be investigated in all cases.
Subject(s)
Hypercalcemia/etiology , Kidney Neoplasms/complications , Wilms Tumor/complications , Calcitonin/therapeutic use , Calcium/blood , Female , Humans , Hypercalcemia/blood , Hypercalcemia/drug therapy , Infant , Kidney Neoplasms/blood , Kidney Neoplasms/therapy , Nephrectomy , Vincristine/therapeutic use , Wilms Tumor/blood , Wilms Tumor/therapyABSTRACT
The incidence of nephrocalcinosis in very low birthweight (less than 1500 g) premature infants was assessed by ultrasound scan and analysis of urine. Three of 36 infants had nephrocalcinosis. All had been receiving long term frusemide for bronchopulmonary dysplasia with simultaneous fluid restriction. Urinary investigations showed no consistent findings in babies with nephrocalcinosis.