Recruitment to oral and maxillofacial Surgical (OMFS) specialty training was centralised in 2010. The 'flexibility' for OMFS to respond to specialty specific recruitment issues is reducing and many Specialty Trainees' (ST) posts are left unfilled. The National Institute for Health and Care Research (NIHR) appointment process designed to address the problem of recruiting and appointing academic surgeons with local selection with national benchmarking has worked.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
April 2024
When dual degree OMFS training was mandated in the UK in 1995, OMFS specialists were required to be registered with both the General Dental Council (GDC) and General Medical Council (GMC). In 2005 this legal requirement for dual registration with both regulators was removed. During 2021 the authors surveyed UK OMFS specialists and trainees asking them why they chose to remain on or leave the Dental Register to give context to the changing numbers of OMFS specialists and trainees holding Dental Registration between 2014 and 2023.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
October 2022
Background: Heterogeneity in oral potentially malignant disorder (OPMD) poses a problem for accurate prognosis that impacts on treatment strategy and patient outcome. A holistic assessment based on gene expression signatures from both the tumour cells and their microenvironment is necessary to provide a more precise prognostic assessment than just tumour cell signatures alone.
Methods: We reformulated our previously established multigene qPCR test, quantitative Malignancy Index Diagnostic System (qMIDS) with new genes involved in matrix/stroma and immune modulation of the tumour microenvironment.
Br J Oral Maxillofac Surg
January 2022
Mean retirement age for UK doctors is 59.6 years, giving the average OMFS consultant approximately 20 years of practice. Current pension tax regulations, new consultant posts typically restricted to a maximum of 10 sessions (40 hours), increasing proportions of consultants working less than full time (LTFT), all combined with the backlog of elective care created by COVID-19 will create a significant gap between workforce capacity and clinical demand.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
December 2020
Whilst there have been great improvements in the management of elite and professional athletes with the formalisation of the clinical specialty of Sports and Exercise medicine, the management of facial injuries has perhaps lagged in this group. Professional athletic careers can be put in jeopardy due to unnecessarily long absences from training and competition after facial injuries. Professional and elite sports athletes can benefit from different approaches to the management of their facial injuries to reduce time away from competing but maximise their safety.
View Article and Find Full Text PDFMetastasis of oral squamous cell carcinoma (OSCC) to the cervical lymph nodes has a significant impact on prognosis. Accurate staging of the neck is important in order to deliver appropriate treatment for locoregional control of the disease and for prognosis. The management of the neck in early, low volume disease (clinically T/T oral cavity tumours) has long been debated.
View Article and Find Full Text PDFHousehold isolation measures to reduce coronavirus transmission during the COVID-19 pandemic have resulted in increased risk of domestic violence and abuse (DVA). DVA physical injury most frequently involves the face. Dentists, dental care professionals, oral surgeons and oral and maxillofacial surgeons all have a critical part to play in identifying patients experiencing DVA, who present with dental and facial injury, and in making referrals to specialist agencies.
View Article and Find Full Text PDFBackground: Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours.
Methods: We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery.
The history of nursing education has often been portrayed as the subordination of nursing to medicine. Yet, as scholars are increasingly acknowledging, the professional boundaries between medicine and nursing were fluid in the nineteenth and early twentieth centuries, when both scientific knowledge and systems of nurse training were in flux. Through its focus on the role of medical practitioners in educating nurses in wound sepsis at four British hospitals between 1870 and 1920, this article attempts to further unite histories of medicine and nursing.
View Article and Find Full Text PDFBackground: Exosomes are extracellular vesicles released by almost all cell types, including cancer cells, into bodily fluids such as saliva, plasma, breast milk, semen, urine, cerebrospinal fluid, amniotic fluid, synovial fluid and sputum. Their key function being intercellular communication with both neighbouring as well as distant cells. Cancer exosomes have been shown to regulate organ-specific metastasis.
View Article and Find Full Text PDFSupport Care Cancer
September 2018
Purpose: Head and neck cancer (HNC) diagnosis and treatment are distressing and have immediate detrimental impacts on functioning and quality of life (QoL). Nevertheless, little is known about long-term psychosocial effects. The aim of this study was to determine the prevalence and correlates of clinical post-traumatic stress disorder (PTSD) and subclinical post-traumatic stress symptoms (PTSS) in HNC patients surviving more than 2 years since treatment and in their partners.
View Article and Find Full Text PDFFacial injuries are widely assumed to lead to stigma and significant psychosocial burden. Experimental studies of face perception support this idea, but there is very little empirical evidence to guide treatment. This study sought to address the gap.
View Article and Find Full Text PDFBackground: People who experience physical trauma face a range of psychosocial outcomes. These may be overlooked by busy clinicians. While some risk factors are understood, understanding of the psychological effects of violent injury remains limited, particularly in UK settings.
View Article and Find Full Text PDFThe CD44 family of molecules exists as a wide range of isoforms ubiquitously expressed on the surface of mammalian cells. The variation in patterns of CD44 expression on cancer cells has been widely studied in relation to their behaviour, and further interest has recently arisen in CD44 as a marker of the subfraction tumour cells acting as cancer stem cells in several types of tumours. This review focuses on the patterns of CD44 expression on the stem cell fraction of oral squamous cell carcinoma and on the relationship of detectably different patterns of CD44 expression to the behaviour of tumours.
View Article and Find Full Text PDFThere is increasing evidence that patients treated for trauma or cancer of the head and neck may go on to experience psychological distress. We aimed to measure the impact of this on their quality of life (QoL) and to explore their willingness to be referred for psychological support. A total of 96 patients with facial injuries and 124 with cancer of the head and neck completed a self-reported questionnaire to identify psychological distress (Hospital Anxiety and Depression Scale (HADS) and the Acute Stress Disorder (ASD) Scale), quality of life (WHOQoL-BREF), satisfaction with treatment, and willingness to accept psychological support.
View Article and Find Full Text PDFBackground: Epigenetic reprogramming of the methylome has been implicated in all stages of cancer evolution. It is now well accepted that cancer cells exploit epigenetic reprogramming, a mechanism that regulates stem/progenitor cell renewal and differentiation, to promote cancer initiation and progression. The oncogene FOXM1 has been implicated in all major forms of human cancer.
View Article and Find Full Text PDFBackground: There is now substantial evidence that only a subpopulation of cells in solid cancers is able to sustain tumour growth and to re-initiate new tumours. Various cancers and cancer-derived cell lines, including head and neck squamous cell carcinomas (HNSCC), have a subpopulation of cancer stem cells (CSCs), marked by high levels of expression of the CD44 adhesion molecule. However, it has been unclear whether, in addition to acting as a marker, CD44 has functions that directly influence stem cell properties.
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