Clin Med
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The kisspeptins are a group of recently discovered peptide hormones (collectively termed kisspeptin), which play a pivotal role in reproduction. Research investigating the actions of kisspeptin is helping to elucidate the regulatory mechanisms which govern fertility and may lead to the development of novel treatments for some reproductive disorders.
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People with spinal cord injury (SCI) suffer from the complications of paralysis in addition to the diseases of the general population. Spinal injury centres in the UK are tasked primarily with looking after newly injured patients and patients with established SCI must often turn to their local hospitals and general physicians for inpatient medical care. This paper outlines investigation and management of some of the common conditions which the physician on the general ward might expect to come across in patients with SCI and also how best to maintain the general health of the SCI patient in hospital.
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The decision to admit a frail older patient is rarely made by a geriatrician and often falls to staff in the emergency department (ED), who may not have the training to balance the risks, benefits and alternatives. We based a consultant geriatrician in the ED with the primary aim of facilitating admission prevention for older patients and this was achieved for 64% (543/848) of patients. ⋯ The overall 7-day ED re-attendance rate was 10.1%, but only 3.4% of patients were admitted with the same problem, indicating true admission prevention rather than admission delay. In conclusion, the placement of a consultant geriatrician in the ED is effective in facilitating admission prevention for older patients.