Between 1976 and 1984, 136 patients with portal hypertension due to extrahepatic obstruction were operated on. Twenty two patients had emergency and 114 elective operations. The operative mortality was 90/o and 1%, respectively. Altogether 117 patients (86%) were followed up for from two to 10 years: 17 rebled, none developed encephalopathy or sepsis after splenectomy, and 90% and 75% were alive at five and 10years

Polycystic ovary syndrome (PCOS) is a diagnosis made in women between late adolescence and the menopause. Patients may present with menstrual irregularity, features of hyperandrogenism (hirsuitism, acne) or infertility. Diagnosis of PCOS is made on clinical features, abnormal biochemistry adjunct and/or ultrasound ovaries. PCOS is also associated with insulin resistance with consequent hyperinsulinaemia, hyperlipidaemia and obesity. Efforts to reduce insulin resistance and hyperinsulinaemia such as weight reduction and insulin sensitisers have been beneficial and form an important management strategy for some aspects of the syndrome. Other measures include treatment directed at specific clinical features, such as hirsuitism, menstrual irregularities and infertility. Due to the present evidence suggesting a link with insulin resistance and increased cardiovascular risk, patient education and attention to diabetes and cardiovascular risk factors need to be addressed. Copyright © 2005 John Wiley & Sons, Ltd.

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