Involving patients in research broadens a researcher’s field of influence and may generate novel ideas. Preclinical research is integral to the progression of innovative healthcare. These are not patient-facing disciplines and implementing meaningful public and patient involvement (PPI) can be a challenge. A discussion forum and thematic analysis identified key challenges of implementing public and patient involvement for preclinical researchers. In response we developed a “PPI Ready” planning canvas. For contemporaneous evaluation of public and patient involvement, a psychometric questionnaire and an open source tool for its evaluation were developed. The questionnaire measures information, procedural and quality assessment. Combined with the open source evaluation tool, researchers are notified if public and patient involvement is unsatisfactory in any of these areas. The tool is easy to use and adapts a psychometric test into a format familiar to preclinical scientists. Designed to be used iteratively across a research project, it provides a simple reporting grade to document satisfaction trend over the research lifecycle.

One thousand three hundred and eighty-two patients with rheumatoid arthritis requiring second-line therapy at 108 centres were entered into an open 6-months prospective tolerability study of enteric-coated sulphasalazine 2 g/day (Salazopyrin EN-tabs). Clinical and laboratory variables were measured, any adverse reactions and the reasons for withdrawal of medication were recorded. The outcome of therapy was known in 87.5% of patients entered of whom 65% continued with sulphasalazine beyond the 6-month study period. 3.2% withdrew for reasons unrelated to treatment, 5% for lack of effect and 26.8% due to an adverse event; gastrointestinal/central nervous 66.6%, rash 15.4%, haematological 5.1%, hepatic 4.7% and miscellaneous 8.1%. 1.2% of patients experienced potentially serious reactions: anaphylactic, haematological and hepatic. The majority of adverse events occurred early and were reversible upon cessation of medication. No clear relationship between withdrawal due to an adverse event attributed to sulphasalazine and the nature of the concomitant non-steroidal anti-inflammatory drug was identified.

SUMMARY Barium enema reductions were attempted in 65 (90%) of 72 intussusceptions, of which 51 (79%) were successful. This represents a success rate of 70% overall. The average hospital stay was 31/2 days. There was no mortality and, apart from a recurrence rate of 10%, no morbidity. It is suggested that barium enema reduction should be the treatment of choice provided that there is an emergency service of a paediatric radiologist and the patient is adequately resuscitated, the only absolute contraindication being evidence of pneumatosis intestinalis or peritonitis. Those patients who presented with shock, rectal bleeding, duration of symptoms longer than 48 hours, and pronounced degree of bowel obstruction had a higher rate of unsuccessful reduction. However, only the last two were significant. Further, provided that the clinical condition remains satisfactory and the reduction has been achieved to the caecum, a repeat barium enema after some hours may be successful in achieving reflux of contrast into the ileum, confirming complete reduction.Recently, there has been a trend towards the use of barium enema reduction in the treatment of intussusception. This paper reviews and analyses all those patients treated with barium enema reduction at our hospital and looks into the factors that are in favour for or against its use. Patients and methodsAll patients with intussusception admitted into the hospital from June 1977 to December 1983 inclusive were studied. There were 66 patients with 72 cases of intussusception (six recurrences). The ResultsAfter adequate resuscitation with half strength dextrose-saline or plasma, or both, barium enema reduction was attempted in 65 cases (90% of the total). Diazepam and hyoscine butylbromide in the appropriate dosage were given for sedation and bowel relaxation, respectively (diazepam 250-300 iig/kg by slow intravenous injection, hyoscine butylbromide 400 [tg/kg by slow intravenous injection).In the other seven cases, barium enema was not attempted (three because of previous recurrence, three because of very gross bowel obstruction, and one because of the choice of the attending surgeon). Forty nine cases out of the 65 attempts were successfully reduced, and two more cases that were thought to be incompletely reduced were found to be completely reduced at laparotomy. The barium enema therefore completely reduced the intussusception in 51 of the 65 attempts, a success rate of 79%. There were five recurrences, and two were in one patient. The interval between the reintussusception varied between one month and eight months with an average of about three months. The recurrence rate was 10% (5 out of 51).Twenty five cases were subjected to operation (14 after failed hydrostatic reduction, two after pre-75 on 12 May 2018 by guest. Protected by copyright.

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