Detecting patients with Cushing's syndrome: The importance of initial test selection.

Background And Objectives: The recommended initial tests for suspected Cushing's syndrome are late-night salivary cortisol (LNSC), 24-hour urinary free cortisol (UFC) and the 1 mg overnight dexamethasone suppression test (ONDST). These tests have higher sensitivity and specificity than serum cortisol. The aim of this study was to determine the relative frequency of these requested tests in primary care.

Approach to the diagnosis of secondary hypertension in adults.

Presentations that should raise suspicion of secondary hypertension include early-onset, severe or resistant hypertension. A suggestive family history or clinical clues can point to a specific secondary cause. The most common causes and associations are renal disease, primary aldosteronism and obstructive sleep apnoea.

Where in the world? Latitude, longitude and season contribute to the complex co-ordinates determining cortisol levels.

Objective: Cortisol is a critical stress hormone with circadian rhythms synchronized by light. There are seasonal differences in expression of pro-inflammatory genes and in some diseases moderated by glucocorticoids. As light changes with season and with latitude and longitude, we assessed changes in population cortisol associated with these parameters.

Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle.

Objective: To quantify intraindividual variability of antimüllerian hormone (AMH) as analytical and biological coefficients of variation and assess the effects of variation on clinical classification.

Design: Retrospective cohort study.

Setting: Not applicable.

Nostrils of healthy volunteers are independent with regard to Staphylococcus aureus carriage.

The right and left nares of healthy adults (n = 251) were swabbed separately to determine carriage of Staphylococcus aureus in each nostril. Carriers were significantly more likely to carry S. aureus in one nostril than in both.

GC/MS identification of toxic pyrrolizidine alkaloids in traditional remedies given to two sets of twins.

Neo- and perinatal mortality is high in most of Africa. Twins are at particular risk of perinatal mortality. The contribution of traditional remedies is seldom addressed.