FutureMS cohort profile: a Scottish multicentre inception cohort study of relapsing-remitting multiple sclerosis.

Purpose: Multiple sclerosis (MS) is an immune-mediated, neuroinflammatory disease of the central nervous system and in industrialised countries is the most common cause of progressive neurological disability in working age persons. While treatable, there is substantial interindividual heterogeneity in disease activity and response to treatment. Currently, the ability to predict at diagnosis who will have a benign, intermediate or aggressive disease course is very limited.

'Scan-negative' cauda equina syndrome: Evidence of functional disorder from a prospective case series.

In the first prospective comparison of 'scan-negative' (n=11) and 'scan-positive' (n=7) patients with cauda equina syndrome (CES) we found that Hoover's sign of functional leg weakness but not routine clinical features differentiated the two groups (p<0.02). This offers a new direction of study in this area, although magnetic resonance imaging is still required for all patients with possible CES.

Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial.

Objective: To evaluate the effectiveness of a peer led parenting intervention delivered to socially disadvantaged families.

Design: Randomised controlled trial.

Setting: Schools and children's centres in a socially deprived borough of inner London.

Innovations in Practice: Empowering Parents, Empowering Communities: A pilot evaluation of a peer-led parenting programme.

Background:   Efficacious parenting interventions are under-utilised in mainstream services. Empowering Parents, Empowering Communities (EPEC) aims to increase community access to effective parenting support through a peer-led manualised intervention.

Method:   Training outcomes, clinical effectiveness and acceptability of EPEC were evaluated using a pre-post cohort design.

A reminder of the classical biochemical sequelae of adult gastric outlet obstruction.

The commonest cause of gastric outlet obstruction (GOO) is pyloric stenosis secondary to peptic ulcer disease or gastric carcinoma. Patients with GOO have unique metabolic sequelae, namely hypochloraemic, hypokalaemic metabolic alkalosis with paradoxical aciduria and hypocalcaemia. A case of a patient presenting as GOO is discussed.

Colonic injury following percutaneous endoscopic-guided gastrostomy insertion.

Percutaneous endoscopic gastrostomy (PEG) is a common practice usually offered to patients who are unable to tolerate or swallow oral feed and require long-term nutrition. We present a case of early pneumoperitoneum after a PEG placement due to colonic perforation. The patient was severely malnourished and had a medical history of brain injury, cerebrovascular accident cerebrovascular accident (CVA) and bilateral below knee amputations from a bomb blast 13 years ago.