SUMMARY Adrenocortical function was studied in 52 newborn infants who had been divided into three groups: preterm well, preterm ill, and term ill. Basal plasma 17-hydroxyprogesterone concentrations were significantly increased in both groups of preterm infants. There was no significant difference in basal plasma cortisol concentrations, although they were highest in preterm ill infants. All infants responded to adrenocorticotrophic hormone (ACTH) stimulation (36 rig/kg intramuscularly) with a two to threefold increase in the concentration of both steroids. The peak plasma 17-hydroxyprogesterone response was significantly higher in preterm ill infants. A subgroup of five infants, who were highly stressed but had undetectable basal plasma cortisol concentrations, also showed an appropriate response to ACTH. The results provide useful reference data to assess adrenal function in the infant of a mother given glucocorticoids during pregnancy. There is also a change from the pattern of fetal adrenal steroidogenesis soon after birth, which may be affected by exogenous ACTH stimulation. Roughly 10% of stressed newborns failed to synthesise cortisol basally; temporary glucocorticoid replacement for such infants may be appropriate.Plasma concentrations of 17-hydroxyprogesterone are markedly raised in untreated infants with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

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More than half of the patients with symptoms of colorectal cancer are found to have extracolonic pathologies by CTC analysis. However, the proportion of patients found to have extracolonic malignancies after 1 year of CTC examination is not significantly greater than after barium enema or colonoscopy examinations. International Standard Randomised Controlled Trials no: 95152621.isrctn.com.

A new established pilot husky voice clinic with agreed referral protocols for patients at risk of developing laryngeal malignancy was audited. Thirty-four patients were seen, 41.2 per cent having abnormal findings on flexible nasendoscopy, 29.4 per cent requiring rigid endoscopy, 38.1 per cent were discharged after the initial visit. One case of early laryngeal cancer was picked up during this period from this group of patients. The data for the remaining population in Portsmouth was examined, and a further eight cases of laryngeal cancer were diagnosed in keeping with national incidences. A rapid access clinic with agreed protocols that referring practitioners adhered to, was useful for diagnosing laryngeal cancer and should meet the requirements of the government's 14-day rule.

Background: Females combat sport athletes are likely to partake in rapid weight reduction strategies prior to competitions. Objective: The purpose of this study was to investigate the relationship between weight cutting habits of female combat sport athletes and the risk of developing the female athlete triad. Methods: 102 female combat sport athletes (amateur=40; professional=62; 28.8±4.5y), competing in boxing (n=30), kickboxing (n=12), and mixed martial arts (n=60), completed two questionnaires. An adapted version of the Rapid Weight Loss Questionnaire (RWLQ) was used to determine the severity of athletes’ weight cutting behaviors, and the Low Energy Availability in Females Questionnaire (LEAF-Q) was used to determine female athlete triad risk. Data was analyzed to determine correlations between LEAF-Q and RWLQ scores along with weight cutting behaviors. Scores were also compared between competition level and combat sports. Results: The results of this study showed that 38% of female combat sport athletes were at risk of developing the female athlete triad. Significant correlation between RWLQ and LEAF-Q scores (p=0.013; r=0.244, r2=0.060) were noted. A significant difference (p=0.006) between the RWLQ scores of amateurs and professionals was also noted, with professionals engaging in more severe weight cutting behavior. Mixed martial artists reported the highest RWLQ and LEAF-Q scores, which were significantly greater than boxers. No other correlations between LEAF-Q and weight cutting behaviors were noted. Conclusion: Despite a small effect size (r²=0.060), the findings of this study demonstrate that more severe weight cutting behaviors may increase the female athlete triad risk among female combat sport athletes.