Newly diagnosed diabetes: a study of parental satisfaction.

A national survey of 509 parents of children with newly diagnosed diabetes elicited a 92% response rate, showing that 96% of children were admitted to hospital, 42% staying in hospital longer than one week and 41% received an intravenous infusion. More than 90% of parents expressed satisfaction with the information given at diagnosis, the preparation they received before discharge home, and the outpatient follow up services. Home visits from a diabetes nurse specialist (DNS) were received by 73% of families and 44% reported that the DNS was the most supportive person in the first year after diagnosis. Readmission during the first 12 months after diagnosis was required by 23% of children, more often in the youngest age group. Poor liaison with schools and the lack of diabetes knowledge in teachers were the sources of greatest dissatisfaction. Children under the care of paediatricians with no specialist interest in diabetes were significantly more likely to be kept in hospital longer at diagnosis and parents were less satisfied with outpatient care and school liaison. The study supports previous recommendations that diabetes nurse specialists are a priority resource in providing support services and that every district should have a paediatrician with a special interest in diabetes and a designated children's diabetic clinic.

Bromodeoxyuridine uptake in the assessment of hyperthermic therapy for intraocular tumor.

Assessment of uveal melanoma response after many nonenucleation therapies is difficult with current modalities, since tumor regression is usually delayed. The goal of most treatments, including ionizing radiation or radiation and adjunct hyperthermia, is to destroy the reproductive capacity of the tumor. Cell cycling analysis with bromodeoxyuridine, a thymidine analogue only incorporated during DNA synthesis, was a useful indication of tumor control after hyperthermia was used to treat a Greene intraocular melanoma model. Cell cycling decreased from a mean of 16% before therapy to less than 1% in all the successfully treated tumors. Cell cycling changes preceded histologic evidence of cell death. In contrast, tumors that grew after insufficient treatment had increased cell cycling to a mean of 25%. Cell cycling studies with bromodeoxyuridine represent a sensitive gauge of the reproductive integrity of the tumor.

An assessment of the comparative advantages of paediatric activities using routine hospital records.

Comparison is made of the advantages, in terms of benefit to patients and salary costs, of employing a consultant paediatrician and non-specialist physicians in clinical work, management activities, research, and education. Comparisons are based on data derived by a simple method from inpatient records of 10 125 children aged 0-5 years admitted over a 23-month period to Mbale Hospital, Uganda. Benefits to inpatients were assessed from the quarterly death and failure rates and the proportion of failures occurring within 24 h of admission to hospital. The relative costs of the various items of medical work were based on the salary costs that they incurred. The advantages of one activity compared with another are demonstrated, and the results clearly indicate that greater benefit at lower cost was obtained by the use of physicians in management and supervisory work than by employing them in the routine care of inpatients.