Working at the interface: lessons from a joined-up approach between oral medicine and paediatric dentistry.

Oral mucosal and other head and neck conditions in children have a variety of presentations. The joint oral medicine and paediatric (JOMP) dental clinic is a specialised unit within a London teaching hospital, developed to manage a wide range of oral conditions with an absolute commitment to a child-centred care approach. The authors present eight cases from the JOMP clinic experience at Guy's and St Thomas' NHS Foundation trust, over a nine-year period.

Cultural Beliefs Regarding Breast Reconstruction in a Minority Group.

Background: The diagnosis and treatment of breast cancer can significantly affect a woman's health and well-being. Several studies have identified factors contributing to disparities in breast reconstruction among ethnic groups, but few have examined the experience of Hispanic women.

Methods: Hispanic women who had undergone breast reconstruction were interviewed in retrospective focus groups.

An Award of Damages for Commercial Surrogacy Overseas?

This article examines the United Kingdom Supreme Court decision in Whittington Hospital NHS Trust v XX [2020] UKSC 14. The case centred on whether damages could be awarded for the cost of a commercial surrogacy arrangement in California, following clinical negligence by the hospital that left the plaintiff unable to carry her own children. After examination of this case, the article outlines and compares the United Kingdom and Australian surrogacy laws.

Predictors of Opioid Consumption in Immediate, Implant-Based Breast Reconstruction.

Background: Current rates of opioid prescribing have deleterious consequences on both patient and societal levels. This study aims to evaluate responsible opioid prescribing and predictors of opioid consumption in immediate implant-based breast reconstruction.

Methods: Patients undergoing consultation for immediate, implant-based breast reconstruction were enrolled in a prospective, cohort survey study.

Perception of pain and influences on opioid use in implant-based breast reconstruction patients.

Although there has been a recent focus on decreasing opioid prescribing through alternative pain medication protocols, the patient's perception of pain related to breast reconstructive surgeries has not been well described. We sought to evaluate patient perception of pain control as it influences opioid use. We hypothesize that modifiable factors may influence patterns in pain perception and postoperative opioid use.

Opioid Consumption Following Breast Surgery Decreases with a Brief Educational Intervention: A Randomized, Controlled Trial.

Background: Current rates of opioid prescribing and consumption in the United States have resulted in deleterious consequences for both patients and society. There has been a focus on opioid consumption and overprescribing, but the utility of patient education in reducing opioid consumption has only recently been explored. This randomized trial aimed to evaluate the effectiveness of a brief patient educational intervention in reducing pain and opioid consumption in patients undergoing mastectomy and breast reconstruction.

Optimisation of umbu juice spray drying, and physicochemical, microbiological and sensory evaluation of atomised powder.

Optimum conditions of umbu juice spray drying were selected using inlet air temperature (), feed flow rate () and 10-DE maltodextrin concentration () as independent variables, and water activity, moisture content, hygroscopicity and phenolic compounds retention as responses. Powders water activity was determined with a water activity metre, moisture content and hygroscopicity gravimetrically, total phenolics spectrophotometrically, apparent and absolute density, porosity and solubility by standard methods, particle size by laser diffraction, and morphology by Scanning Electron Microscopy. Nectars sensory analysis was based on acceptance, purchase intention and multiple comparison preference tests.

Plastic Surgery for Women.

Plastic surgery is a broad field, including maxillofacial surgery, reconstruction after injuries, hand surgery, and skin flaps and grafts, but the most common procedures for women are liposuction and body contouring, breast surgery, and facial cosmetic procedures. Techniques of face and brow lifts, blepharoplasty, and rhinoplasty are discussed as well as botulinum toxin and filler injections, and laser and pulsed light techniques that may delay or eliminate the need for surgery. Comparison of the surgeries for breast reconstruction, reduction, augmentation, and mastopexy is discussed.

Oral health-related quality of life following dental treatment under general anaesthesia for early childhood caries - a UK-based study.

Objective: To assess parental reports of changes in oral health-related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction-only (Exo) treatment approaches on this.

Methods: Data were collected using the proxy reported components of the Child Oral Health-Related Quality of Life (COHRQoL ) questionnaire: the Parent-Caregivers Perceptions questionnaire (P-CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department.

Case Report: Beware the Silver Nitrate Stick--A Risk Factor for Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ).

Topical silver nitrate may be used in oral and maxillofacial clinical settings owing to its astringent, caustic and disinfectant properties. Uses of the toughened silver nitrate pencil stick include haemostasis at bleeding points and for the management of aphthous ulcers, hypergranulation tissue, warts and verrucas. We present an interesting case of apparent silver nitrate-induced, bisphosphonate-related osteonecrosis of the hard palate following mucosal lesion biopsy in a multiple myeloma patient receiving zoledronic acid intravenous infusions.

Regulating preimplantation genetic diagnosis in Australia: Disability and parental choice.

Preimplantation genetic diagnosis (PGD) is the process by which an early in vitro embryo is screened for a genetic condition. As the name suggests, the procedure is undertaken prior to the embryo being implanted into a woman and therefore affected embryos can be discarded. This article argues that the objections previously put forward opposing the use of PGD to select against disability are flawed.

Unilateral parotid mass as an unusual presentation of lupus erythematosus profundus.

Unilateral parotid swelling or mass in the lupus erythematosus profundus person is a rare or under reported clinical scenario in existing literature. This is a case of a 49-year-old man with such presentation for whom medical management of the underlying condition led to the resolution of the swelling. Lupus erythematosus profundus must be considered as a differential diagnosis of unexplained parotid swelling to prevent incorrect diagnosis, unnecessary surgical intervention (eg, parotidectomy) and the morbidity that comes with it (eg, facial nerve weakness, Frey's syndrome etc).

The regulation of preimplantation genetic diagnosis: is there anything the United Kingdom can learn from the Australian experience?

The United Kingdom fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), is set to be abolished and its functions transferred to the Care Quality Commission. Together with the Human Fertilisation and Embryology Act 1990 (UK), the HFEA has played a central role in the regulation of preimplantation genetic diagnosis (PGD) and human leukocyte antigen tissue typing (HLA typing). Australia, on the other hand, does not have a national regulatory body for assisted reproductive technologies, which are instead regulated by a series of national guidelines, State legislation and State regulators.

Program spending to increase adherence: South African cervical cancer screening.

Background: Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW) home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa.

Methodology/principal Findings: We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program.

Nonoperative management of epidural hematomas and subdural hematomas: is it safe in lesions measuring one centimeter or less?

Background: Management of a patient with a closed head injury is based on neurologic status and computerized tomography scan results. We hypothesized that those patients with an epidural hematoma (EDH) or subdural hematoma (SDH) <1 cm in thickness could safely be treated nonoperatively.

Methods: We retrospectively reviewed charts of 204 consecutive patients with either an EDH or SDH.

Posttraumatic mandibular deformities.

In covering the Emergency Department, the Plastic Surgeon can be faced with the mandibular fracture patient. Although the timely repair of the fracture usually leads to normal function and appearance, occasionally the surgeon is faced with the untoward sequelae of the mandible fracture. Post-traumatic mandibular deformities include non-union, malunion, malocclusion, TMJ dysfuction, and facial asymmetry.

Impact of utilizing p16INK4A immunohistochemistry on estimated performance of three cervical cancer screening tests.

The histopathological diagnosis of cervical intraepithelial neoplasia grade 2,3 (CIN 2,3) is subjective and prone to variability. In our study, we analyzed the impact of utilizing a biomarker (p16(INK4A)) together with histopathology to refine the "gold standard" utilized for evaluating the performance of 3 different cervical cancer screening tests: cervical cytology, human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Cervical biopsies from 2 South African cervical cancer screening studies originally diagnosed by a single pathologist were reevaluated by a second pathologist and a consensus pathology diagnosis obtained.

Distinguishing the temporal association between women's intravaginal practices and risk of human immunodeficiency virus infection: a prospective study of South African women.

Cross-sectional studies have suggested that intravaginal practices, such as douching or "dry sex," may increase women's susceptibility to infection with human immunodeficiency virus (HIV). The authors examined the temporal nature of this association in a cohort of South African women. At enrollment (2001-2002), 4,089 women were tested for HIV infection.

The costs of reducing loss to follow-up in South African cervical cancer screening.

Background: This study was designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting.

Methods: Women were enrolled in this Cape Town, South Africa-based screening study between 2000 and 2003, and all had scheduled follow-up visits in 2003. Community health worker (CHW) time, vehicle use, maintenance, and depreciation were estimated from weekly logs and cost accounting systems.

Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial.

Context: Non-cytology-based screen-and-treat approaches for cervical cancer prevention have been developed for low-resource settings, but few have directly addressed efficacy.

Objective: To determine the safety and efficacy of 2 screen-and-treat approaches for cervical cancer prevention that were designed to be more resource-appropriate than conventional cytology-based screening programs.

Design, Setting, And Patients: Randomized clinical trial of 6555 nonpregnant women, aged 35 to 65 years, recruited through community outreach and conducted between June 2000 and December 2002 at ambulatory women's health clinics in Khayelitsha, South Africa.

Bacterial vaginosis and susceptibility to HIV infection in South African women: a nested case-control study.

Background: Bacterial vaginosis (BV) may increase women's susceptibility to HIV infection, but there are few prospective data.

Methods: During follow-up for up to 36 months, 86 new HIV seroconverters (case patients) were identified among 5110 women enrolled in a cervical cancer screening trial. Nonseroconverting control subjects (n=324) were frequency matched to case patients by age and duration of follow-up.

Direct comparison of liquid-based and conventional cytology in a South African screening trial.

Our study directly compares the performance of liquid-based (LBC) and conventional cytology for detecting high-grade cervical intraepithelial neoplasia and cancer (CIN 2+) in high-risk, previously unscreened women. As part of a larger randomized clinical trial assessing the efficacy and safety of a "screen and treat" program for cervical cancer prevention, 5,652 South African women, aged 35 to 65 years, were screened using either ThinPrep or conventional Papanicolaou cytology. The cytology method used (i.

Intravaginal practices, HIV and other sexually transmitted diseases among South African women.

Background And Objectives: Intravaginal practices, including wiping, douching, or inserting substances into the vagina, have been hypothesized to increase women's risk of HIV infection. However, data on the prevalence of these practices, and associations with HIV and other sexually transmitted diseases (STD), are limited.

Study Design: We interviewed 2,897 women participating in a gynecologic screening study in Cape Town, South Africa, about their intravaginal practices.