Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long-term follow-up.

Type 2 diabetes is associated with raised risk of several cancers, but for type 1 diabetes risk data are fewer and inconsistent We assembled a cohort of 23 473 UK patients with insulin-treated diabetes diagnosed at ages <30, almost all of whom will have had type 1 diabetes, and for comparison 5058 diagnosed at ages 30 to 49, of whom we estimate two-thirds will have had type 2, and followed them for an average of 30 years for cancer incidence and mortality compared with general population rates. Patients aged <30 at diabetes diagnosis had significantly raised risks only for ovarian (standardised incidence ratio = 1.58; 95% confidence interval 1.

My cheek puff sign: Bell's palsy, Charles Bell and Dr Robert Knox.

Bell's palsy fully recovers in the great majority of cases. What may not be sufficiently appreciated is how distressing it can be. This Perspective recounts a personal experience; describes an unrecorded puzzling physical sign; and details the interest the experience generated in Charles Bell and in the infamous Robert Knox, whose paths crossed.

If case reports be the food of knowledge, write on: our Cases of the Quarter.

The value of publishing case reports has long been debated and the arguments are summarised. Last year, to encourage trainees, the Royal College of Physicians of Edinburgh's Senior Fellows Club inaugurated an annual prize for the best case report or case series published in the Journal of the Royal College of Physicians of Edinburgh by a doctor in training. Some of the highlights of last year's entries are reviewed, commented on and developed.

Contextual factors affecting hint utility.

Background: Interactive learning environments often provide help strategies to facilitate learning. Hints, for example, help students recall relevant concepts, identify mistakes, and make inferences. However, several studies have shown cases of ineffective help use.

Mortality from cerebrovascular disease in a cohort of 23 000 patients with insulin-treated diabetes.

Background And Purpose: Disease of the cardiovascular system is the main cause of long-term complications and mortality in patients with type I (insulin-dependent) and type II (non-insulin-dependent) diabetes. Cerebrovascular mortality rates have been shown to be raised in patients with type II diabetes but have not previously been reported by age and sex in patients with type I diabetes.

Methods: A cohort of 23 751 patients with insulin-treated diabetes, diagnosed under the age of 30 years from throughout the United Kingdom, was identified during 1972 to 1993 and followed up for mortality until the end of December 2000.