Can mid-regional pro-adrenomedullin (MR-proADM) increase the prognostic accuracy of NEWS in predicting deterioration in patients admitted to hospital with mild to moderately severe illness? A prospective single-centre observational study.

Objective: To assess the value added to the National Early Warning Score (NEWS) by mid-regional pro-adrenomedullin (MR-proADM) blood level in predicting deterioration in mild to moderately ill people.

Design: Prospective observational study.

Setting: The Medical Admissions Suite of the Royal Victoria Infirmary, Newcastle.

An unusual cause of adrenal insufficiency and bilateral adrenal masses.

Unlabelled: Primary adrenal insufficiency secondary to syphilis is extremely rare, with only five cases being reported in the literature. We report a case of adrenal insufficiency as a manifestation of infection (tertiary syphilis). A 69-year-old, previously fit and well Caucasian male was found to have adrenal insufficiency after being admitted with weight loss, anorexia and postural dizziness resulting in a fall.

Elevated serum fibroblast growth factor 21 levels correlate with immune recovery but not mitochondrial dysfunction in HIV infection.

Background: Anti-retroviral treated HIV-infected patients are at risk of mitochondrial toxicity, but non-invasive markers are lacking. Serum FGF-21 (fibroblast growth factor 21) levels correlate strongly with muscle biopsy findings in inherited mitochondrial disorders. We therefore aimed to determine whether serum FGF-21 levels correlate with muscle mitochondrial dysfunction in HIV-infected patients.