The role of cumulative growth hormone exposure in determining mortality and morbidity in acromegaly: a single centre study.

Purpose: Acromegaly has traditionally been associated with significant mortality and cardiovascular morbidity. The aim of this study was to assess the overall mortality and improvement in mortality and morbidity in acromegaly and correlate these with cumulative growth hormone exposure.

Methods: All patients treated for acromegaly at our centre until 2012 were analysed in this retrospective observational study.

Using support workers to release time for qualified midwives in maternity care.

Maternity services must meet the demands of an increasingly diverse and rapidly growing population. Recent policy changes mean midwives are taking on roles formerly performed by doctors, leaving maternity support workers to undertake many traditional midwifery tasks. This article discusses how MSWs can facilitate choice by helping midwives deliver a flexible, personalised service to childbearing women and how the MSW role has developed.

A nurse-led clinic in chronic and allergic contact dermatitis.

It has generally been acknowledged that the incidence and prevalence of contact dermatitis has increased in recent years. It can develop at any stage of a person's life span (rare before puberty), and in many different circumstances and occupations. The demand on consultant dermatologists for contact dermatitis services has resulted in the depletion of some essential components to the investigation process, and patient outcomes have been affected.

In vitro and in vivo gene transfer with poly(amino acid) vesicles.

Non-viral gene delivery systems utilise either amine lipids or polyamines and although non-viral gene delivery systems are said to have a superior safety profile to viruses, the polyamines such as poly(L-lysine) are toxic when used without derivatisation and usually require specific receptor mediated uptake and/or endosomolytic agents to be effective. However, the conversion of poly(L-lysine) and poly(L-ornithine) polyamino acids into amphiphilic vesicle forming polymers reduces the toxicity of the polyamino acids and enables the resulting polyamino acid vesicles to deliver genes both in vitro and in vivo in the absence of receptor specific ligands and endosomolytic agents. The incorporation of a distearoylphosphatidylethanolamine poly(ethylene glycol)-galactosamine conjugate (with the galactosamine unit at the distal end of the poly(ethylene glycol) moiety) into the polyamino acid formulations improved in vitro gene transfer in the case of the amphiphilic poly(L-ornithine) (POP) although no in vivo targeting was detected with the galactosamine formulations.