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This study summaries the current management of scoliosis in patients with Duchenne Muscular Dystrophy. A literature review of Medline was performed and the collected articles critically appraised. This literature is discussed to give an overview of the current management of scoliosis within Duchenne Muscular Dystrophy. Importantly, improvements in respiratory care, the use of steroids and improving surgical techniques have allowed patients to maintain quality of life and improved life expectancy in this patient group., Competing Interests: The authors have no conflicts of interest to declare.

Objective: Several methods of treating babies with Pierre Robin sequence have been described since the condition itself was first documented in 1923. The main aim of treatment has been to relieve upper airway obstruction. Treatment methods used range from positioning of the baby to invasive surgery. The aim of this article was to describe the assessment, treatment, and monitoring methods used for babies referred with Pierre Robin sequence (PRS)., Setting/patients: From December 1995 to May 2000, 22 consecutive patients were admitted to Birmingham Children's Hospital with PRS. Their airway and nutritional status were assessed and continuously monitored., Interventions: Treatment concentrated on the relief of airway obstruction with a nasopharyngeal airway (NPA) and nutritional support of the babies until they grew out of their respiratory and feeding difficulties., Main Outcome Measures: Outcome measures were oxygen saturation, growth of the babies, and the need for surgery., Results: All babies were managed successfully with an NPA and nutritional support. No baby required surgery, and the majority showed good weight gain., Conclusion: Relieving airway obstruction by NPA is an effective and safe treatment for babies with PRS until they have grown out of their respiratory and feeding difficulties. It avoids the need for surgery and can be used on neonatal wards using the monitoring described.

We observed that a female patient with a poorly differentiated adenocarcinoma of the stomach undergoing gastrectomy was markedly resistant to the action of the neuromuscular blocking drug atracurium. There was no evidence of tumour metastasis and her liver function tests were normal. Electrophoresis of plasma proteins revealed a marked increase in alpha 1 globulin. Alpha 1 acid glycoprotein is an acute phase reactant that is increased in patients with cancer and is present in the alpha 1 globulin electrophoresis pattern. It is likely that the mechanism for the resistance to neuromuscular block in the patient was an increase in drug binding to alpha 1 acid glycoprotein.

Somatostatin has been shown to be effective in the management of the dumping syndrome and there have been reports of the effective use of long acting somatostatin analogue in the management of this condition. However, there have been few reports of the prolonged use of a somatostatin analogue in the late dumping syndrome. We describe a patient in whom this management provided good long term symptomatic relief which was confirmed biochemically.