The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) is a subphenotype of the polycystic ovary syndrome. It is one of the most common causes of menstrual problems, hyperandrogenic symptoms, and insulin resistance among young women. Review of clinical data in an outpatient adolescent clinic showed that of the 1,002 young women (ages 10-21 years) attending the clinic over a 2-year period, 50 (5%) were diagnosed with HAIR-AN syndrome. Mean age of the patients was 15.5, initial mean weight at diagnosis was 94.5 kg, and the mean BMI was 33.33 kg/m 2 . Patients were treated with a weight-stabilization and -reduction program, oral contraceptive pills, and in most cases metformin. Of the patients, 80% were compliant with the follow-up and treatment regimen, 60% maintained or reduced their weight, 95% had regular menstrual cycles, and in most patients, the acne and/or hirsutism were the same or better than at the start of treatment. We conclude that HAIR-AN syndrome is a common disease in young women and multifaceted, aggressive treatment appears to be effective in reducing the severity of symptoms and preventing further consequences.

Summary: The efficiency of communication between junior hospital doctors and 77 general surgical patients was assessed by using standardized questionnaires before and after the doctor/patient interview on both the patient and the house doctor. Patients were better informed about their illness than their surgery, and doctors wrongly estimated patients' knowledge in 41% of cases. Self-reported preoperative anxiety of patients was low and was estimated wrongly by house doctors in 58% of cases. In 52% of cases house doctors were considered by patients to be the most important source of information, but patients had little comprehension of the seniority of other doctors. Although 60% of patients were satisfied with the communication, the majority complained of lack of information concerning convalescence, postoperative pain and routine ward procedures. IntroductionDespite major advancements in medical knowledge and technology, difficulties of communication remain a serious problem. Research into communication in medicine suggests that the failure to resolve these difficulties can be partly attributed to doctors (Pellegrino 1976, Francis et al. 1969, Reinhard 1974. The medical profession appears to be content with its ability to communicate with patients and seems unaware of existing problems.Numerous studies have highlighted the benefits for doctors and patients which can be attained by improving communication (Reading 1979, Schmitt & Wooldridge 1973, Langer et al. 1975. In surgery, it has been suggested that effective communication can reduce postoperative complications and analgesic requirements, thus effecting earlier discharge. This study was undertaken to evaluate communication in a surgical setting and to assess the satisfaction of doctors and patients with the present level of communication.

Aims: For the general dental practitioner (GDP) coronectomy may be a treatment option that is discussed with a patient prior to referral to a specialist in primary or secondary care for management of problematic mandibular third molars. The purpose of this study was to examine the variance between coronectomy prescription between GDPs compared to specialist clinicians when assessing cases for coronectomy using plain view radiographs. Methods: An online survey was completed by 50 GDPs across the UK. This survey had also been completed by 25 specialist oral and maxillofacial or oral surgery clinicians of varying levels of experience from six different units across the UK and the Republic of Ireland. Results: Results were compared and, whilst agreement between GDPs was higher in coronectomies prescribed, there was a significantly larger number of coronectomies prescribed in the GDP group. Conclusions: The increased number of coronectomies prescribed by the GDP group compared to the specialist group could reflect a lack of experience in the regular assessment of mandibular third molars or a clinician being more aware of the litigious climate of dentistry when based in primary dental care.

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