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Abstract: Diabetes is one of the most common chronic diseases in our society. While insulin treatment for diabetes type I could delay and reduce the incidence of diabetic complications, it is associated with an increased risk of severe hypoglycemia. To restore physiologic insulin metabolism, transplantation of insulin producing cells (Pancreatic Beta cells) represent the sole available therapy. It could be done either through pancreas or islet of Langerhans transplantation. In this paper, we review actual knowledge regarding these two types of transplantations. [Copyright &y& Elsevier]

The relationship between volume and surgical outcome seems logical, but needs to be demonstrated in the real world. A qualitative systematic review has been conducted to verify this hypothesis. Five systematic reviews and hundred original papers have been retreived and analysed. Most of the studies were retrospective and used administrative data instead of medical charts. Moreover few studies involved a good case mix adjustment when comparing surgical units or individual surgeons. These methodological flaws do not allow any evidence based conclusions. Even though a positive relationship is suggested for surgical units, the relationship between volume and outcome was however less obvious for an individual surgeon. There is some evidence that the relationship varied greatly according to the specialty or the procedure evaluated. A new approach based on predictive scores comparing expected versus observed outcomes is mandatory and seems to be the best way to assess objectively the relationship between surgical volume and outcomes. [ABSTRACT FROM AUTHOR]