Exploring patient and staff member views on a 'consent for contact' system for sexual health research: A mixed methods study.

Background: Recruitment in sexual health research is challenging. This study explores the potential of a Consent for Contact system (C4C) - generic consent for research contact - to improve participant recruitment and engagement in sexual health research. Our objectives were to understand patient and staff understanding of research, their views on a separate C4C system, and their preferences for its acceptability in a sexual health clinic setting.

Value and Limitations of Urethrotech Catheterisation Device to Manage Difficult Urethral Catheterisation in Male Spinal Cord Injury Patients.

Methods: We used a Urethrotech catheterisation device in 57 male patients with spinal cord injury, in whom urethral catheterisation was unsuccessful or previous catheterisation was difficult.

Results: Urethrotech catheter could be inserted in 51 patients. No patient developed urinary tract infection.

Delay in diagnosis of urethral perforation due to catheterisation in a person with cervical spinal cord injury. Importance of (1) imaging studies done promptly for detection and documentation of urethral trauma, (2) Urethrotech catheterisation device to minimise urethral trauma and achieve successful catheterisation: A case report.

Introduction And Importance: Spinal cord injury patients are at risk for urethral trauma during catheterisation. We report a patient in whom urethral perforation due to catheterisation was not recognised for ∼ four days.

Case Presentation: Following a routine catheter change by community nurses in a male person with tetraplegia, the catheter drained only a small amount of urine.

Enteral Nutrition Versus Parenteral Nutrition on Outcomes in Acute Pancreatitis: Insights From the Nationwide Inpatient Sample.

Introduction: Despite considerable research on the comparison of enteral and parenteral nutrition in patients with acute pancreatitis, there is an ongoing debate about the optimal timing of nutrition initiation, invasiveness of interventions, impact on outcomes, and patient tolerance. Given the gap that still exists in the literature, we investigated the relationship between the mode of nutrition and critical outcomes such as mortality rates, inpatient complications, length of hospitalization, and discharge disposition, using comprehensive national-level data. In addition, we investigated the impact of early enteral nutrition on outcomes in acute pancreatitis.

Milk of calcium in renal calyces, renal pelvis, and ureter in a person with tetraplegia.

Milk of calcium is a colloidal suspension of precipitated calcium salts which lies in a dependent manner and imaging reveals a horizontal upper edge. We report a 44-year-old male person with tetraplegia, who had been staying in bed for prolonged periods due to ischial and trochanteric pressure sores. Ultrasound scan of the kidneys revealed numerous variable-sized stones in the left kidney.

Acute unilateral isolated ptosis as a complication of sinusitis in a post-COVID-19 patient.

A fit and well young man presented to our emergency department in the UK. On examination, he had an isolated left-sided ptosis; he had a 3-day history of frontal headache which was worse on head movement. He lacked any clinical signs of cranial, orbital, or preseptal infection, and his eye movements were normal.

Acute Severe Heart Failure in Paediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2: A Case Report.

A 17-year-old boy presented during the COVID-19 pandemic in late 2021 with intractable fevers and hemodynamic instability with early gastrointestinal disturbances, resembling features of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. Our patient required intensive unit care for persistently worsening signs of cardiac failure; initial admission echocardiography demonstrated severe left ventricular dysfunction with an estimated ejection fraction of 27%. Treatment with intravenous IgG and corticosteroids showed a rapid improvement in symptoms, but further specialist cardiological input was required for heart failure in the coronary care unit.

Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra.

We used a safety-valve (Trans-Urethral Catheterisation Safety Valve, Class Medical, Limerick, Ireland) to prevent urethral trauma due to inflation of the anchoring balloon in the urethra during catheterisation of male spinal cord injury patients in a spinal unit. The safety-valve is attached to the balloon channel of a Foley catheter. If the balloon is inflated when it is in the urethra, the pressure valve is activated.

A systematic review and meta-analysis of the use of methylene blue to improve the lymph node harvest in rectal cancer surgery.

Background: Methylene blue staining of the resected specimen has been described as an alternative to the conventional palpation and visual inspection method to improve lymph node harvest. This meta-analysis evaluates the usefulness of this technique in surgery for rectal cancer, particularly after neoadjuvant therapy.

Methods: Randomized controlled trials (RCTs) comparing lymph node harvest in methylene blue-stained rectal specimens to those of unstained specimens were identified from the Medline, Embase, and Cochrane databases.

Value of serial ultrasound imaging in conservative management of epididymo-cutaneous fistula in a person with cervical spinal cord injury.

Epididymo-cutaneous fistula was seen in a person with cervical spinal cord injury and neuropathic bladder. This patient developed left epididymitis; then he formed an abscess superficial to the tail of the epididymis, which burst open to the skin discharging pus; subsequently, this progressed to epididymo-cutaneous fistula. A few drops of urine would leak through the fistula.

Large amounts of debris in the neuropathic bladder in persons with spinal cord injury; value of ultrasound scan in detection and management of vesical debris.

Persons with spinal cord injury are at risk for developing debris in the neuropathic bladder. Ultrasound scan of the urinary bladder helps to (1) detect debris, (2) differentiate debris from other bladder lesions, (3) alert the spinal cord physician to review bladder management, and (4) monitor the effect of various treatment regime to clear the debris. We present 4 cases to illustrate the sonographic appearances of debris in the neuropathic bladder and how treatment plans tailored to the needs of the individual patient helped to clear the debris.

A meta-analysis of low Hartmann's procedure versus abdominoperineal resection for non-restorative treatment of rectal cancer.

Background: Non-restorative surgery for rectal cancer is indicated in patients with comorbidities, advanced disease and poor continence. The aim of this meta-analysis was to compare the postoperative morbidity of Hartmann's procedure (HP) with that of extrasphincteric and intersphincteric abdominoperineal resection (APR) in the treatment of rectal cancer.

Methods: The Medline, Embase and Cochrane databases were searched for publications comparing postoperative morbidity of HP and APR.

An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs.

Backgrounds & Aims: Primary biliary cholangitis (PBC) is a chronic liver disease in which autoimmune destruction of the small intrahepatic bile ducts eventually leads to cirrhosis. Many patients have inadequate response to licensed medications, motivating the search for novel therapies. Previous genome-wide association studies (GWAS) and meta-analyses (GWMA) of PBC have identified numerous risk loci for this condition, providing insight into its aetiology.

X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

Background & Aims: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease.

Methods: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals).

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

Generalised muscle weakness after bladder wall injection of Abobotulinum Toxin A: experience of a woman with tetraplegia who required increased caregiver support: importance of doctor-patient communication: duty of candour for spinal cord physician and responsibilities of a patient.

Introduction: Generalised muscle weakness can occur after bladder wall injection of Abobotulinum toxin and the patient may require additional caregiver support.

Case Presentation: A woman with C-8 AIS A tetraplegia received bladder wall injection of Abobotulinum toxin A 1000 units for detrusor over-activity. After 2.

Persistent urine leakage around a suprapubic catheter: the experience of a person with chronic tetraplegia.

Introduction: Persistent urine leakage after suprapubic cystostomy in tetraplegic subjects occurs due to shrinkage of the urinary bladder and bladder spasms. The patient's social life is adversely affected as clothes become wet, smelly, and require frequent changing, thus increasing the workload of carers.

Case Presentation: A 48-year-old male sustained C-4 complete (AIS:A) tetraplegia while swimming in 2007.

Fatal cerebral hemorrhage in a tetraplegic patient due to autonomic dysreflexia triggered by delay in emptying urinary bladder after unsuccessful intermittent catheterization by carer: lessons learned.

Introduction: Over-distension of urinary bladder in a high spinal cord injury patient is a triggering factor for autonomic dysreflexia. Removing triggering factors is vital to prevent autonomic dysreflexia.

Case Presentation: A 36-year-old tetraplegic patient, who was managed by intermittent catheterizations performed by caregivers, developed recurrent autonomic dysreflexia during a week due to: 1) carers not performing intermittent catheterizations every night; 2) infrequent catheterizations during the day, leading to distension of urinary bladder.

Fatal collapse due to autonomic dysreflexia during manual self-evacuation of bowel in a tetraplegic patient living alone: lessons to learn.

Background: To identify areas for improvement, the National Health Service in England mandates the review of case reports of patients who have died, which should be translated into improved care for other patients.

Case Report: A 49-year-old Caucasian man sustained C-7 tetraplegia in a motorcycle accident in 1992. In 2009, he developed seizures and collapsed in the lavatory on a number of occasions during manual self-evacuation of his bowel.

Severe, Protracted Spasm of Urinary Bladder and Autonomic Dysreflexia Caused by Changing the Suprapubic Catheter in a Cervical Spinal Cord Injury Patient: Treatment by a Bolus Dose and Increased Total Daily Dose of Intrathecal Baclofen.

Background: Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported.

Case Report: A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump.

Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient: lessons we learn.

Introduction: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case.

Case Report: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications.