The measurement of patients' satisfaction is increasingly becoming legal and ethical duty of healthcare providers worldwide. Till now, there were no validated, widely available Polish scales to assess patients' satisfaction with nursing care. The aim of this study was to assess the experiences and satisfaction with nursing care of patients hospitalized in surgical and nonsurgical wards in Poland using Polish version of the Newcastle Satisfaction with Nursing Scale. This is a multicentre, cross-sectional, descriptive study. Eight hospitals were qualified to participate in a convenience manner. The correlations between variables were analysed using the Mann-Whitney or the Kruskal-Wallis tests. In the case of a significant correlation, the Dunn's test was used to conduct multiple comparisons for the group of variables. A significance of α = 0.05 was assumed for the tests. A total 918 patients participated in the study, and 787 (85.72%) questionnaires were correctly filled out. The average result on the 'experience' scale was 73.22 (Me 73.07) and on the 'satisfaction' scale, 74.98 (Me 76.31). Education levels did not affect the experiences of nursing care levels p = 0.2204 and satisfaction with nursing care p = 0.1075. Patient age had a statistically significant impact on the results of the 'experiences of nursing care' scale p = 0.0005 and the 'satisfaction with nursing' scale p = 0.0194. The experiences of nursing care (p = 0.0002) and patients satisfaction (p = 0.0000) were significantly higher in surgical wards than in nonsurgical wards. The experiences of nursing care were significantly lower in the university hospital than in provincial hospitals (p = 0.0374) and district hospitals (p = 0.0183). A comparison of patient satisfaction with nursing in various hospitals shows that patients were most satisfied in district hospitals (average 78.10, Me 82.89), followed by provincial hospitals (average 72.11, Me 76.31) and the university hospital (average 70.64, Me 71.05).

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Serum angiotensin-converting enzyme (ACE) was measured in 150 insulin-dependent diabetes mellitus (IDDM) patients and 72 healthy subjects by radioassay, using [3H]-hippuryl-glycyl-glycine as a substrate. Mean (SD) serum ACE activity in diabetic patients was 120 +/- 33 nmol ml-1 min-1 (range 46-215) and was significantly increased by 56% compared to control values (77 +/- 23 nmol ml-1 min-1, range 46-125, P < 0.001). ACE activity > 125 nmol ml-1 min-1 was observed in 60 of 150 IDDM patients. 96 IDDM patients were normoalbuminuric (< 22 mg 24 h-1) and 49 patients were micro- or macroalbuminuric (range 22-6010 mg 24 h-1). Micro- and macroalbuminuric IDDM patients were found to have significantly greater ACE activity values than normoalbuminuric patients (128 +/- 36 vs. 115 +/- 30 nmol ml-1 min-1, P = 0.025). Metabolically well-controlled IDDM patients (glycosylated haemoglobin < or = 8%) had lower ACE activity values than the patients with glycosylated haemoglobin greater than 8% (109 +/- 20 vs. 127 +/- 32 nmol ml-1 min-1, P < 0.02). A significant correlation between degree of metabolic control and ACE activity was found (r = 0.435, P < 0.001) so that an increase in one glycosylated quartile unit is accompanied by an increase in ACE activity of 10.5 nmol ml-1 min-1. Thus ACE activity in the serum of IDDM patients was increased by 56% in 40% of the patients. It was increased in IDDM patients without complications and in patients with retinopathy or nephropathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus in its early stages, is associated with kidney enlargement and increased glomerular filtration rate in humans and in rats. The present study was designed to clarify the direct effect of diabetes on serum and tissue angiotensin converting enzyme (ACE) activity in streptozotocin-induced diabetic rats. Serum ACE activity, as determined using a radiometric assay, was significantly increased in the diabetic rats (n = 15) 14 days after induction of diabetes (670 +/- 31 vs. 506 +/- 14 nmol ml-1 min-1). Lung ACE activity, but not renal, was significantly elevated at 7 and 14 days by 29 and 46%, respectively. Plasma renin activity in the diabetic rats was decreased at 7 and 14 days by 41 and 78%, respectively. Incubations of lung slices in the presence of glucose at different concentrations did not affect in-vitro release of the enzyme. Administration of insulin (8 units kg-1) to diabetic rats (n = 6) on the 4th day for 11 days reduced ACE activity to values below control. Thus, serum and lung ACE activity is increased in the diabetic rat and reduced upon insulin treatment.

Serum uric acid has been described as being increased in the prediabetic stage of diabetes mellitus and as being decreased in overt diabetes. In this study we compared the serum uric acid levels of patients with insulin-dependent diabetes mellitus (IDDM) to those of controls matched for sex, age and ethnic origin. Also the correlation between serum uric acid levels and the fractional excretion of uric acid in IDDM patients was investigated, as well as the correlation between glycosuria and the fractional excretion of uric acid. The mean serum uric acid was lower in IDDM patients than in normal controls (4.0 ± 1.3 vs. 4.3 ± 1.3 mg/ 100 ml; p < 0.03), mainly due to significantly lower levels in male and Ashkenazi IDDM patients, as compared to their respective controls. The fractional excretion of uric acid was found to be elevated in IDDM patients: 13.0 ± 8.6% (mean ± SD). A significant negative correlation was found between serum uric acid levels and the fractional excretion of uric acid in IDDM patients (p < 0.001), although not when the males were examined separately. We found no correlation between the fractional excretion of uric acid and the degree of glycosuria in IDDM patients. In addition, the prevalence of hypouricemia (serum uric acid < 2.5 mg%) was the same in IDDM patients and controls.