Using web technology to support population-based diabetes care.

Background: Managed clinical networks have been used to coordinate chronic disease management across geographical regions in the United Kingdom. Our objective was to review how clinical networks and multidisciplinary team-working can be supported by Web-based information technology while clinical requirements continually change.

Methods: A Web-based population information system was developed and implemented in November 2000.

Supporting trainees in difficulty: a new approach for Scotland.

National Health Service (NHS) Education for Scotland (NES) works with NHS and University employers, through the four Postgraduate Deaneries to provide education and training for medical trainees from graduation to completion of specialist and general practice training. Most trainees make good progress through the relevant curriculum supported by a managed system of supervision with regular appraisal and feedback. Similarly most trainees demonstrate their progression to Certificate of Completion of Training through the assessment process that is defined in each specialty curriculum.

Unexplained high thyroid stimulating hormone: a "BIG" problem.

Macro-hormones and macro-enzymes are high molecular weight conjugates of hormones or enzymes, respectively, often with immunoglobulins. These are referred to as macromolecular complexes, and may cause artefactually elevated biochemical tests results. Macro enzymes of the most commonly measured serum enzymes have been identified and are recognised as a source of elevated measurements that may cause diagnostic confusion; macro-creatine kinase and macro-amylase are the two better known macro-enzymes in clinical practice.

The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease.

Objective: To determine whether aspirin and antioxidant therapy, combined or alone, are more effective than placebo in reducing the development of cardiovascular events in patients with diabetes mellitus and asymptomatic peripheral arterial disease.

Design: Multicentre, randomised, double blind, 2x2 factorial, placebo controlled trial.

Setting: 16 hospital centres in Scotland, supported by 188 primary care groups.

Stratification of foot ulcer risk in patients with diabetes: a population-based study.

This trial assessed whether a simple clinical tool can be used to stratify patients with diabetes, according to risk of developing foot ulceration. This was a prospective, observational follow-up study of 3526 patients with diabetes (91% type 2 diabetes) attending for routine diabetes care. Mean age was 64.