These preliminary data suggest that patient-reported indicators of a pulmonary exacerbation may not be the same for all adults with CF. Whether different indicators are associated with specific demographic or clinical variables remains to be evaluated.

Child-reported indicators of a pulmonary exacerbation tend to map onto those reported by adults. These results provide the rationale for the development of a single scale for school age children and adults that could be sensitive to progressive stages of CF disease.

Management of columnar lined oesophagus (CLO; Barrett s oesophagus) is controversial. We prospectively audited surveillance practices in Scotland and prospectively assessed the impact of introducing local guidelines for Barrett s surveillance in Edinburgh. Most respondents were gastroenterologists. The majority take random, not four quadrant, biopsies from the CLO. In Edinburgh during 2000, 80 patients underwent surveillance. The guideline protocol was not followed in 30 (37.5%) patients. Follow up of patients without dysplasia generally conformed to the guidelines. Follow up of patients with low grade dysplasia was highly variable while management of those with high grade dysplasia followed the guidelines. Overall we found a wide variability in the management and surveillance of CLO. Early experience suggests that implementation of guidelines is helpful but there is still variation in practice.

Medical Research Society y I 7 IDENTIFICATION OF HUMAN MONOCLONAL ANTDODIES UWOLVED IN TEE NATURAL PRoTECllVE IMMUNE RESPONSE TO MALARIA RICBARDJENNINGS~0 . 0 5 ) . Growth in infancy was correlated more strongly with baseline bone mass than with bone loss. We conclude that bone loss at the femoral neck continues into the NATIONAL INSlTllJTE FOR MEDICAL RESEARCH. LONDON NW7 1 M P folnprnvn d a n a IS one of the most unpomt hvman psfhogens. causmg bmMn one and three million dcsmt a ycy worldwde As yet then IS no eRktlve vaccme Cmldaable muty is rlucvced by adulthood popk livlng m cndanlc arc.0. but the scar& fM a Vaccme has been bmpm-d by II lack of mdcntsndmg as to how Uus tmmundy IS m&ated Maoy studm, mcl!Xhg