Produce a positive strategy for whistleblowing.

A day in the life of UK healthcare can make sad reading. Complaints made to the ombudsman over care funding have doubled in 5 years. Plans to encourage people to save to meet their own social care costs in old age are being discussed.

Increased catabolism and decreased unsaturation of ganglioside in patients with inflammatory bowel disease.

Aim: To investigate whether accelerated catabolism of ganglioside and decreased ganglioside content contribute to the etiology of pro-inflammatory intestinal disease.

Methods: Intestinal mucosa from terminal ileum or colon was obtained from patients with ulcerative colitis or inflammatory Crohn's disease (n = 11) undergoing bowel resection and compared to control samples of normal intestine from patients with benign colon polyps (n = 6) and colorectal cancer (n = 12) in this observational case-control study. Gangliosides and phospholipids of intestinal mucosa were characterized by class and ceramide or fatty acid composition using liquid chromatography triple-quad mass spectrometry.

Trade unions have long since dropped divisive attitudes.

The letter by Bríd Hehir from the Do Good Charity (September 26) will no doubt stir up a lot of reaction by her provocative views on trade union values. Well Ms Hehir, if you think there is too much 'chaff' in the NHS that needs chucking out then please bring your 'do good' skills to the table.

Health-related quality of life in pediatric ulcerative colitis patients on conventional medical treatment compared to those after restorative proctocolectomy.

Purpose: Health-related quality of life (HRQL) is not well studied in proctocolectomy patients with pediatric onset of ulcerative colitis (UC). We aimed to (1) compare the HRQL of proctocolectomy patients with those treated with conventional therapy and (2) determine factors that influence HRQL in UC patients < 18 years.

Methods: Chart review was done on patients diagnosed with pediatric onset of UC (<18) at the Stollery Children's Hospital.

Criticism of nurses by nurses is unwelcome and unjustified.

Your letters page ( February 15 ) gave startlingly contrasting opinions on the Confessions of a Nurse series on More 4 - from inspirational to disreputable. I see it as refreshing.

Let's unite in valuing the contribution we all make.

I have just read Aldo Picek's envious rant about NHS staff pensions ( letters August 17 ). He writes: 'NHS nurses do not know how privileged they are.'

Colocolic intussusception in a preterm infant with intestinal malrotation.

The association of intussusception and intestinal malrotation is referred to as Waugh syndrome. A prospective study among 49 children with intussusception found a 40% incidence of malrotation. We describe the rare occurrence of colocolic intussusception in a neonate with malrotated intestine.

A mobile Meckel!

A technetium-99m pertechnetate Meckel scan is the standard diagnostic test to diagnose Meckel diverticulum. Although a negative scan does not exclude Meckel diverticulum, it should be kept in mind that the diagnosis can be missed on the basis of a single negative scan. Another important point is the typical position of this anatomical abnormality in the scan.

Esophageal mucoceles causing airway obstruction as a complication of esophageal diversion: two rare pediatric cases and a review of the literature.

An esophageal mucocele causing airway obstruction is an exceptionally rare complication of esophageal diversion in children. In this instance, they are fluid-filled dilatations of the esophageal remnant following bipolar exclusion of the thoracic esophagus. Only six pediatric cases have been reported previously in the literature.

A case of successful ablation of a gastrophrenic fistula with n-Butyl-2-Cyanocrylate.

A 79-year-old woman with a fistula between a subphrenic abscess and the fundus of the stomach was successfully treated with n-Butyl-2-Cyanoacrylate. Conservative management had failed. Clinical presentation, treatment progress and imaging findings by computed tomography scan, ultrasound, gastroscopy and fluoroscopy are presented, along with a brief review of the relevant literature.

Autonomous thyroid nodule in an adolescent 10 years after total body irradiation for bone marrow transplant.

A male patient with B-cell lymphoma was treated with chemotherapy and allogeneic bone marrow transplant, including preparatory total body irradiation. Ten years later, at age 15 years, the patient developed an autonomous thyroid nodule and an incidental papillary microcarcinoma. This is the first report of an autonomous thyroid nodule after total body irradiation for bone marrow transplant.

Fetus-in-fetu: confirmation of prenatal diagnosis with MRI.

Fetus-in-fetu is a rare form of monozygotic diamniotic twin pregnancy in which one fetus is enclosed within its twin (Khadaroo et al., 2000). This case report highlights the use of prenatal MRI to confirm prenatal diagnosis of an intra-abdominal FIF to aid obstetricians, neonatologists, and pediatric general surgeons in perinatal and surgical management.

Association between surgical margins and long-term outcome in advanced hepatoblastoma.

Background: Many patients with hepatoblastoma present with unresectable disease. Neoadjuvant therapy has improved resectability rates to as high as 70% to 90%. Despite this improvement, many patients will be left with tumors that are of borderline resectability.