Reconstructive trends following mastectomies in Scotland: A comparison with England.

Introduction: In England there has been a substantial increase in the use of immediate implant-based reconstruction, accounting for over half of all immediate reconstructions (IR). Less than one third of patients in England undergo autologous reconstruction IR. Our aim was to examine IR trends in Scotland.

A review of likelihood ratios in forensic science based on a critique of Stiffelman "No longer the Gold standard: Probabilistic genotyping is changing the nature of DNA evidence in criminal trials".

Stiffelman [1] gives a broad critique of the application of likelihood ratios (LRs) in forensic science, in particular their use in probabilistic genotyping (PG) software. These are discussed in this review. LRs do not infringe on the ultimate issue.

Interpreting Evidence of Torture.

The Istanbul Protocol provides a scheme for giving evidence of signs of torture. This scheme does not conform with the principles of logical inference, revolving as it does round the concept of 'consistency'. The shortcomings of the Protocol are explained using the evidence given in the recent case of KV(Sri Lanka) and the logical approach to such evidence explained.

Pilomatrixoma: A Comprehensive Review of the Literature.

Introduction: Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a superficial benign skin tumor that arises from hair follicle matrix cells. Although pilomatrixomas are well-recognized lesions, clinically they are frequently misdiagnosed as other skin conditions. By reviewing all the literature over the past 10 years, the aims of this article are to analyze the cause, clinical presentation, management, and outcome of pilomatrixoma among children and adults to gain a more complete understanding of this lesion in today's clinical context.

A response to "Likelihood ratio as weight of evidence: A closer look" by Lund and Iyer.

Recently, Lund and Iyer (L&I) raised an argument regarding the use of likelihood ratios in court. In our view, their argument is based on a lack of understanding of the paradigm. L&I argue that the decision maker should not accept the expert's likelihood ratio without further consideration.

Management of Incompletely Excised Skin Tumors: Our Experience.

Background: Current British Association of Dermatologists guidelines recommend that Mohs micrographic surgery should be considered for incompletely excised basal cell carcinomas and squamous cell carcinomas. Units that perform Mohs surgery are limited. In Teesside, the skin cancer multidisciplinary team discusses all incompletely excised skin tumors, considers all treatment options, provides recommendations, and initiates the agreed management plan.

Pilomatrix carcinoma: 12-year experience and review of the literature.

Pilomatrix carcinoma is a rare, locally aggressive tumor with a tendency to recur. Distant metastases have been reported, with pulmonary lesions being the most frequent manifestation. Similar to pilomatrixoma, pilomatrix carcinoma typically presents as a nontender, firm dermal swelling and is found most commonly in the head and neck region.

A comment on the PCAST report: Skip the "match"/"non-match" stage.

This letter comments on the report "Forensic science in criminal courts: Ensuring scientific validity of feature-comparison methods" recently released by the President's Council of Advisors on Science and Technology (PCAST). The report advocates a procedure for evaluation of forensic evidence that is a two-stage procedure in which the first stage is "match"/"non-match" and the second stage is empirical assessment of sensitivity (correct acceptance) and false alarm (false acceptance) rates. Almost always, quantitative data from feature-comparison methods are continuously-valued and have within-source variability.

Girdlestone procedure for avascular necrosis of the hip in an intravenous drug user.

The Girdlestone procedure is an excision arthroplasty of the hip. Rarely used nowadays, it was required in a young patient following discovery of avascular necrosis of the femoral head as a result of septic emboli from infective endocarditis in an intravenous drug user. This procedure was deemed necessary based on poor cardiac function and anaesthetic risk.

'Step-port' laparoscopic cystgastrostomy for the management of organized solid predominant post-acute fluid collections after severe acute pancreatitis.

Background: Post-acute pancreatic collections (PAPCs) may require intervention when persistent, large or symptomatic. An open cystgastrostomy is an effective treatment option particularly for larger, solid predominant collections. A laparoscopic cystgastrostomy (LCG) as initially described, could be technically challenging.

The World Health Organization's 'Surgical Safety Checklist': should evidence-based initiatives be enforced in hospital policy?

Objectives: To assess the awareness and voluntary usage of the World Health Organization's Surgical Safety Checklist (WHO SSC), just prior to its mandatory implementation.

Design: Questionnaire-based, prospective, telephone survey.

Setting: Patients are exposed to systematic risks and principles of surgical safety are inconsistently applied even in sophisticated settings.

A simple solution to a complex position in cleft surgery.

Correct positioning of the surgeon and patient in palate surgery is a problem often faced by the craniofacial surgeon. To achieve the best result, it is essential that the surgeon has direct visualization and sufficient access to the field. We describe a simple solution to this complex problem, which has been used by Dr.

Endotracheal tube fixation methods for optimal stability: a comparison of adhesive tape, suture, and tape-suture fixation.

Accidental extubation of an intubated patient is a serious consideration in the surgical patient. Adequate fixation in the intubated patient is essential to prevent potentially life-threatening complications. Several methods of endotracheal tube fixation have been described in the literature.