Virtual panendoscopy--a new tool to help evaluating oral cancer.

Virtual panendoscopy (VP) is a new, non-invasive diagnostic technique available to assess luminal structures. It involves the use of the data obtained from scanning of patients using multidetector CT scanners. The data is manipulated using a software programme to generate 3D models with fly through capability to examine various anatomical tubes.

Nonunion of an isolated cuboid fracture: a case report.

Nonunion of an isolated undisplaced cuboid fracture is unusual. We report a case of symptomatic nonunion of an isolated cuboid fracture after nonoperative treatment. Fracture union was achieved with surgery, and the patient returned to full activities.

StayFuse for proximal interphalangeal joint fusion.

Background: Proximal interphalangeal (PIP) joint fusion is a commonly performed procedure for lesser-toe deformities. There are various techniques described to accomplish it. We report the results of PIP joint fusion carried out with an intramedullary fusion device in 150 consecutive toes.

A prospective study of early removal of the urethral catheter after colorectal surgery in patients having epidural analgesia as part of the Enhanced Recovery After Surgery programme.

Aim: Early removal of the urethral catheters is part of the enhanced postoperative recovery programme (ERAS). The effect of epidural anaesthesia on urinary retention was investigated in patients after colorectal resection.

Method: A prospective cohort study of all patients having colorectal surgery within an ERAS programme that included insertion of an epidural catheter over the last 5 years.

Anterior cruciate ligament rupture and osteoarthritis progression.

Anterior Cruciate Ligament (ACL) rupture is a common sporting injury that frequently affects young, athletic patients. Apart from the functional problems of instability, patients with ACL deficient knees also develop osteoarthritis. Although this is frequently cited as an indication for ACL reconstruction, the relationship between ACL rupture, reconstruction and the instigation and progression of articular cartilage degenerative change is controversial.

Critical sequences of phenomena in the progression of atherosclerotic lesions, with reference to the role of microvessels.

Atherosclerosis affects the inner layers of human arteries, and causes major problems by blocking, directly or indirectly, the flow of blood. This paper concerns the growth of atherosclerotic lesions (atherogenesis), in particular potential factors that may allow a form of 'positive feedback' that drives the development of lesions, and considers the role of microvessels. The lesions of atherosclerosis have previously been compared to, or thought of as, sites of inflammation, and involve the accumulation of cells, including large lipid-containing macrophages, and extracellular elements.

An atypical case of purple glove syndrome: an avoidable adverse event.

A 73-year-old man presented in status epilepticus. He had a long history of epilepsy for which he was treated with regular phenytoin and phenobarbitone. On admission, his phenytoin level was found to be subtherapeutic and was treated with rectal diazepam and intravenous lorazepam.

Hypergammaglobulinemia, normal serum albumin and hypercalcaemia: a case of systemic sarcoidosis with initial diagnostic confusion.

A 53-year-old Afro-Caribbean woman presented to casualty with a constellation of symptoms pointing to a diagnosis of hypercalcaemia. This was confirmed on laboratory investigation. Findings of a raised serum protein (108 g/l) and normal albumin (35 g/l), lead to an initial working diagnosis of multiple myeloma.

Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

Background: Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma.

Methods: Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study.

Understanding and recollection of the risks associated with cesarean delivery during the consent process.

Objective: To investigate women's recall of information provided during the consent process for cesarean delivery, specifically the associated risks, 24 hours after the procedure.

Methods: A prospective questionnaire-based study was conducted at the Barnet and Chase Farm Hospitals NHS Trust between May 2009 and August 2010. Women who had undergone a cesarean delivery (planned or emergency) completed a self-administered questionnaire 24 hours after delivery.

An unusual case of incomplete Kawasaki disease in an adolescent returning from holiday in Montana.

Here we present an unusual case of incomplete Kawasaki disease in a 15-year-old boy returning from a holiday with his family in Montana. His symptoms were initial diarrhoea and lethargy, with fever, rash, conjunctivitis, and arthralgia developing during the course of his illness. His condition worsened while he was at his local hospital, and he was transferred to the regional tertiary paediatric hospital.

Review article: Plica syndrome of the knee.

Plica syndrome is a pathological condition secondary to inflammation. Plicae around the knee are common and generally asymptomatic. They often are misdiagnosed.

Case report. A novel approach to the management of a ruptured Type II endoleak following endovascular repair of an internal iliac artery aneurysm.

Endovascular repair of isolated iliac artery aneurysms is an established safe and effective management option. Type II endoleak is a potential complication, but rarely results in significant morbidity or mortality. We report a case of a patient who presented with a ruptured internal iliac artery aneurysm secondary to a Type II endoleak.

Radially expanding laparoscopic trocar ports significantly reduce postoperative pain in all age groups.

Background: Trocar entry points have been identified as a significant source of pain after laparoscopic surgery. This is particularly true of the larger 12-mm ports that require deep fascial closure to avoid port-site herniation. We investigated whether using radially expanding trocars not requiring fascial closure compared to conventional cutting trocars for the 12-mm port in transabdominal preperitoneal (TAPP) hernia repairs had any effect on postoperative analgesic requirements and return to work or normal activity.

Measurement and implications of postural changes in blood pressure.

Postural changes in blood pressure are a commonly elicited vital sign. It is important that the measurements are reproducible in order to be clinically meaningful. This article makes recommendations about how and what to document as part of the technique of recording, on the basis of the literature.

An unusual cause of intractable heel pain.

We report a case of severe heel pain that did not respond to noninvasive measures. Magnetic resonance imaging scans revealed a soft tissue mass that after complete surgical excision was found to be an epidermal cyst. The patient experienced full resolution of the symptoms after excision of the epidermal cyst.

Is community-acquired pneumonia an independent risk factor for cardiovascular disease?

Community-acquired pneumonia (CAP) is the most frequent infectious cause of death in western countries. The high mortality rate in CAP is commonly related to comorbid conditions such as cardiovascular disease. Clinical studies in both primary and secondary care settings have identified an increase in short- and long-term risk of cardiovascular events and death from vascular events following acute respiratory infections.