Serum ferritin was measured in 50 patients at diagnosis of diabetes mellitus (DM) and in 20 patients with established DM and poor metabolic control. Twenty-two patients had hyperferritinemia at diagnosis. Four patients had a recognised cause for their hyperferritinemia. In the remaining 18 patients ferritin levels decreased from a mean of 506 +/- 3.6 (SE) ug/l at diagnosis to 254 +/- 29.2 ug/l seven months later (p < 0.001). Metabolic control improved significantly over the same time. All 20 patients with established DM and poor metabolic control had normal ferritin levels. When compared with the newly diagnosed hyperferritinemic patients no difference was found in levels of glycosylated haemoglobin, but ferritin values differed significantly between the two groups (p < 0.001). These results indicate that transient hyperferritinemia is a feature of newly diagnosed DM but not of established DM with poor control. If used to screen diabetic patients for haemochromatosis, serum ferritin should be measured in established DM rather than at diagnosis.

BackgroundIn May 2018, the Irish Constitution was changed following a referendum allowing termination of pregnancy by abortion. It is envisaged that the majority of terminations will be by medical abortion and will take place in general practice before 12 weeks gestation.AimTo elicit attitudes and level of preparedness of Irish GPs to provide medical abortion services.Design & settingCross-sectional study of 222 GPs who were associated with the University of Limerick Graduate Entry Medical School (GEMS) and GP training programme.MethodAn anonymous online questionnaire was distributed via email. Reminders were sent 2 and 4 weeks later.ResultsThe response rate was 57.2% (n = 127/222). Of the responders, 105 (82.7%) had no training in this area, with only 4 (3.1%) indicating that they had sufficient training. Nearly all responders (n = 119, 93.7%) were willing to share abortion information with patients. Just under half of responders (n = 61, 48.0%) would be willing to prescribe abortion pills, with 47 (37.0%) unwilling to do so. Only 53 (41.7%) responders believed that provision of abortion services should be part of general practice, with 52 (40.9%) saying that it should not. As to whether doctors should be entitled to a conscientious objection but should also be obliged to refer the patient, 92 (72.4%) responders agreed. Over two-thirds of responders (n = 89, 70.1%) felt that necessary patient support services are not currently available.ConclusionThere is a lack of training and a considerable level of unwillingness to participate in this process among Irish GPs. There is also a perceived lack of patient support services for women experiencing unwanted pregnancy. It is incumbent upon state and professional bodies to address these issues.

The outcome of very low birth weight (VLBW) infants < 1500 g including those weighing < 1000 g has greatly improved in the last decade. As Caesarean section becomes a safer and more acceptable method of childbirth, it is increasingly performed at earlier stages of gestation. Evidence that Caesarean delivery is effective in reducing intrapartum complications is hard to obtain. We have therefore reviewed our experience in the survival of VLBW infants over a 3 ye3r period.161 infants weighing less than 1500 g were delivered at the obstetric unit and cared for at the Regional Neonatal Intensive Care Unit in Leeds between January 1983 and; December 1985. The hospital survival rate was 63% in 49 infants who weighed 1001-1500 g and 84% in 112 who weighed 1001-1500 g. The survival rate after Caesarean birth was higher than that after vaginal delivtry in the 1001-1500 g group. It is too early to say whether there is a significant difference in the outcome between Caesarean and vaginal births as this requires follow up of these infants at 1 year, 2 years and 5 years.

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