Objective-To assess the effect of high dose inhaled corticosteroids on skin.Design-Cross sectional study of patients receiving treatment for chest diseases.Setting-Outpatient chest clinic in a teaching hospital.Patients-68 Patients divided into four groups of similar age-namely, 15 receiving long term oral prednisolone, 21 receiving high dose inhaled corticosteroids, 15 receiving low dose inhaled corticosteroids, and 17 controls.Main outcome measures-Skin thickness at three sites measured by A scan ultrasound and clinical assessment of purpura.

No abstract

We present a review of the Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa) guideline, which provides paediatricians with a framework for managing Anorexia Nervosa in the inpatient setting.

This is a unique regional audit of anal cancer. Improvements need to be made in documentation particularly of staging, treatment, pathology reporting and outcome. This study concurs that Human Papilloma Virus appears to predispose to Squamous anal cancer. Radiological staging needs to be standardized according to best clinical practice. As recommended by NICE all patients should be referred to a multidisciplinary anal cancer team, which can provide individual treatment plans. Increased specialization could mean specialist regional MDTs for anal cancer.