Relaxin agonists under preclinical and early clinical investigation for the treatment of heart failure.

Introduction: Acute failure is a critical condition, encompassed by the sudden or progressive onset of symptoms or signs of congestion. The treatment strategies available are mainly supportive and do not improve mortality or long-term outcomes. Therefore, there is a need for alternative novel treatment strategies.

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study.

Background: Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery.

Methods: This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014.

Participation restriction and assistance needs in people with spinal cord injuries of more than 40 year duration.

Study Design: Prospective observational.

Objectives: Examine changes in participation restriction and assistance needs in a sample of people with long-standing spinal cord injuries (SCIs).

Setting: Two British spinal centres.

Long-term bladder and bowel management after spinal cord injury: a 20-year longitudinal study.

Study Design: Prospective observational.

Aim: The aim of this study was to analyse changes in bladder and bowel management methods in persons with long-standing spinal cord injury (SCI).

Setting: Two spinal centres in UK.

Comparison of statistical methods for calculating life expectancy after spinal cord injury.

Study Design: Retrospective observational.

Objectives: To compare results of several different methods for calculating life expectancy in the same sample of people with spinal cord injury (SCI), and critically assess their advantages and disadvantages.

Setting: Two spinal centres in Great Britain.

Causes of death after traumatic spinal cord injury-a 70-year British study.

Design: Retrospective and prospective observational.

Objective: Analyse causes of death after traumatic spinal cord injury (tSCI) in persons surviving the first year post injury, and establish any trend over time.

Setting: Two spinal centres in Great Britain.

Long-term survival after traumatic spinal cord injury: a 70-year British study.

Study Design: Retrospective and prospective observational.

Objectives: Analyse long-term survival after traumatic spinal cord injury (SCI) in Great Britain over the 70-year study period, identify mortality risk factors and estimate current life expectancy.

Setting: Two spinal centres in Great Britain.

Development of a Rheumatology-specific Patient Concerns Inventory and Its Use in the Rheumatology Outpatient Clinic Setting.

Objective: Successful management of rheumatic conditions involves increasing complexity of care. Delivering this in a holistic way is a growing challenge. The aim of our study was to develop a Patient Concerns Inventory (PCI) and assess it in the rheumatology clinic setting.

Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction.

The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients including complex anatomic urinary tract reconstructive procedures tailored to the unique needs of each individual with variable outcomes. We performed a literature review evaluating the long-term outcomes of these reconstructive procedures.

Duplicated inferior vena cava with associated ilio-femoral deep vein thrombosis.

We present the case of a fit and well 20-year-old gentleman who presented to our emergency department with unilateral lower limb pain and swelling. Subsequent imaging revealed a left ilio-femoral deep vein thrombosis, with associated duplication of his inferior vena cava. He was treated conservatively with a heparin infusion, warfarin and compression therapy prior to being discharged following a short inpatient stay.

Splenic flexure volvulus.

We present the case of a woman in her 50s presenting with acute abdominal pain and absolute constipation. Subsequent investigations revealed large bowel obstruction which was shown on computed tomography scan to be secondary to a rare volvulus of the splenic flexure of her colon. The patient was taken for an urgent laparotomy with resection of 45 cm of large bowel and formation of a primary anastomosis.

Management of peritoneal carcinomatosis secondary to metastatic cancer of unknown primary in men.

Peritoneal seeding of cancer cells leading to peritoneal carcinomatosis (PC) is an ominous finding that has primarily been described in women with underlying ovarian malignancy. It is also a common development in patients with gastrointestinal malignancy and may sometimes occur in the absence of a known, identified primary malignancy. Peritoneal carcinomatosis resulting from a cancer of unknown primary (CUP) is a rare and ill-defined entity, and as a result, there is no clear guidance on the most effective management strategy for this group of patients.

A rare presentation of sarcoidosis, back pain and spondylolisthesis.

A 48-year old man presented with back pain that was resistant to treatment. An MR scan showed spondylolisthesis at L4-5 and narrowing of the exit foraminae. He had a posterior fusion which did not relieve his symptoms.

Techniques used for assessing the sense of smell.

Assessment of the sense of smell is a challenging clinical investigation. Although a wide range of tests are available, many are modifications of tests designed more than 20 years ago. This article describes the smell tests that are available, and consider smell assessment after nasal surgery.

Bedside assessment of sympathetic skin response after spinal cord injury: a brief report comparing inspiratory gasp and visual stimulus.

Study Design: A case control study in five controls, and 20 tetraplegic and paraplegic patients, complete and incomplete.

Objective: The aim was to assess the feasibility of a simple test for sympathetic system preservation after spinal cord damage in a pain-free manner and which could be undertaken worldwide without specialist equipment or manpower.

Settings: Patients were attending the Southport Regional Spinal Injuries Centre, England, either as outpatients or as in-patients during rehabilitation.

Respiratory alkalosis and associated electrolytes in long-term ventilator dependent persons with tetraplegia.

Study Design: A pilot case control study of the acid-base and electrolyte status in 30 long-term ventilator-dependent (LTVD) and 30 self ventilating persons with tetraplegia.

Objectives: To assess the extent of respiratory alkalosis and screen for associated hypokalaemia, hypomagnesaemia and/or hypophosphataemia.

Setting: Medically stable persons with tetraplegia under the long-term care of the Southport Spinal Injuries Centre, England.