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In this report, we describe the diagnosis, investigation and management of a patient presenting with refractory status epilepticus secondary to a previously unrecognised urea cycle defect, ornithine transcarbamylase deficiency, causing a hyperammonaemic encephalopathy. While metabolic disorders will be readily considered in a paediatric population presenting with difficult seizures, it is unusual for such cases to present in adulthood, and maintaining a broad differential in patients with status epilepticus is important. Early recognition and initiation of treatment are vital. Furthermore, the patient had been diagnosed with schizophrenia over a decade previously and more recently started on sodium valproate, a medication known to contribute to hyperammonaemia. This case also emphasises the importance of exclusion of underlying organic disease prior to diagnosis of psychiatric conditions., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Adiponectin, an adipokine secreted from adipose tissue (AT), exerts beneficial pleiotropic effects on obesity-related metabolic diseases. We have analyzed the adiponectin gene (ACDC) and its expression in two genetically different breeds of pigs, lean type, large white (LW) and fat type, Casertana (CE). DNA, RNA, and protein extracts from 10 LW and 10 CE pigs were analyzed by sequence analysis, enzyme-linked immunosorbent assay (ELISA), fast protein liquid chromatography, and northern and western blotting. Sequence analysis revealed an identity of 100% between the ACDC gene from the two breeds, but the expression of the adiponectin protein was higher in LW than in CE pigs. We identified sexual dimorphism of adiponectin in both breeds, namely a balanced distribution of the low isoforms ( approximately 50 kDa), whereas the middle isoforms ( approximately 75-150 kDa) were increased in sows. In conclusion, in this study, we demonstrate that adiponectin is produced and secreted differently in the two breeds of pig, namely adiponectin is more abundant in LW than in CE. Moreover, the visceral AT of LW expresses more adiponectin than the subcutaneous AT. This relationship is absent in CE. These observations provided the first evidence that adiponectin expression is correlated with the "fat" phenotype in pig.