The modified sandwich-vacuum pack technique of temporary abdominal wall closure is easy and rapid, cost effective and provides an effective means of containing abdominal wall contents.

The role of the central renin‐angiotensin system in the pathogenesis of hypertension in spontaneously hypertensive rats (SHR) was examined following acute and chronic intracerebroventricular (i.c.v.) infusions of angiotensin1 (AT1) receptor antagonists. Groups of SHR were chronically instrumented for acute i.c.v. administration of the AT1 receptor antagonists, losartan and CV‐11974, on mean arterial blood pressure (MAP) and heart rate (HR). Other groups of SHR also had mini‐osmotic pumps implanted for chronic i.c.v. infusion of CV‐11974. Initially both young (15–18 weeks, n = 8) and old (25–29 weeks, n = 9) SHR received acute i.c.v. injections of losartan (10 μg) while a third group of young SHR received CV‐11974 (1 μg, n = 6). In all three groups of SHR, MAP and HR did not change up to 24 h after antagonist injection. However, changes in MAP and HR in response to i.c.v. angiotensin II (AII, 100 ng) were abolished 15 min after administration of the AT1 receptor antagonists. These responses had returned to control levels after 3 h in both groups given losartan but were still significantly depressed at 24 h in the CV‐11974‐treated group. By contrast, responses to i.v. AII (25 ng) before and 1 h after administration of AT1 receptor antagonists were not significantly different.4 For chronic studies, four groups of SHR received chronic i.c.v. infusion of either vehicle (n = 9) or CV‐11974 (1, 5 and 100 μg kg−1 day−1) (n = 4, 7 and 8 respectively) for 4 days. Baseline cardiovascular parameters were monitored daily together with changes in MAP and HR in response to both i.c.v. and i.v. AII (100 ng and 50 ng respectively) and i.v. phenylephrine (3 μg). Responses to i.c.v. carbachol (5 μg) were also recorded on day 4 while barorefiex function was assessed between days 1–3. In SHR treated chronically with i.c.v. vehicle or CV‐11974, at 1 or 5 μg kg−1 day−1, resting MAP and HR did not vary over the four day infusion period. However, SHR treated with 100 μg kg−1 day−1 CV‐11974 had significantly lower MAP compared to vehicle‐treated SHR. While there was some variation in resting HR, there were no differences between the drug‐treated and vehicle‐treated groups. Pressor responses following i.c.v. AII administration were slightly, but significantly, inhibited on days 3 and 4 in the low dose CV‐11974‐treated (1 μg kg−1 day−1) SHR. However, these responses were abolished on all 4 days in the 5 and 100 μg kg−1 day−1 CV‐11974‐treated groups. By contrast, changes in MAP and HR following i.v. AII injection did not vary over the 4 day infusion between SHR treated with the 2 lowest doses of CV‐11974 and the vehicle‐treated group. However, in the high dose CV‐11974‐treated SHR (100 μg kg−1 day−1), the cardiovascular effects of AII were abolished. In addition, phenylephrine (i.v.) and carbachol (i.c.v.) induced changes in MAP and HR were not significantly different in all four treatment groups. Similarly, baroreflex function was unaffected by i.c.v. infusion of 100 μg kg−1 day−1 CV‐11974, except for a significant fall in BP50 which paral...

HighlightsRetroperitoneal pelvic desmoid tumours are rare with limited publications.A rare case of a retroperitoneal pelvic desmoid tumour is discussed.Excision was challenging requiring the sacrifice of some of the iliac vessels.No other case reports document a surgical excision requiring this.To date our patient suffers minimal morbidity and has had no recurrences.

Women carrying germline mutations in BRCA1 or BRCA2 have significantly increased lifetime risks of breast and tubo-ovarian cancer. To manage the breast cancer risk women may elect to have breast screening by MRI/mammogram from age 30, to take risk-reducing medication, or to have a prophylactic bilateral mastectomy. To manage the tubo-ovarian cancer risk, the only effective strategy is to have a bilateral salpingo-oophorectomy, recommended by age 40 (BRCA1) or 'around' age 40 (BRCA2). Early studies suggested that uptake of these cancer risk-reducing strategies was low. More recent studies have revealed higher rates of uptake, however it is unclear whether uptake is genuinely improving or whether the higher uptake rates reflect changes in the populations studied. In this study we surveyed 193 BRCA1/2 mutation carriers in the state of Tasmania to determine the uptake of cancer risk-reducing strategies and what factors might influence women's decisions in relation to both gynaecological and breast surgery. We observed that uptake of risk management strategies varied depending on the strength of the recommendation in the national guidelines. Uptake rates were > 90% for strategies which are strongly recommended, such as breast screening by MRI/mammogram and bilateral salpingo-oophorectomy, and were unaffected by demographic factors such as socio-economic disadvantage and educational achievement. Uptake rates were much lower for strategies which are presented in the guidelines as options for consideration and where patient choice and shared decision making are encouraged, such as prophylactic mastectomy (29%) and chemoprevention (1%) and in the case of prophylactic mastectomy, were influenced by both socio-economic advantage and educational achievement.