The Surgical Art Face©: Developing a Bespoke Multimodal Face Model for Reconstructive Surgical Education.

Surgical and educational challenges exist in relation to the teaching of facial reconstructive surgery due to the complexities of the facial landscape and training models available. This chapter will describe the development and implementation of alternative modes of teaching facial reconstructive techniques in a multi-disciplinary setting, pioneered by Surgical Art ( www.surgical-art.

Complex paediatric fracture dislocation of the elbow - A rare case report.

Traumatic elbow dislocation with concomitant fractures of the lateral condyle and the medial epicondyle in the paediatric population is an extremely rare injury. We are reporting a case of a locked fracture-dislocation of the elbow in an 11-year-old girl. The dislocation was treated by open reduction and the lateral condyle was surgically fixed.

Surgical Risk and Pathological Results of Emergency Resection in the Treatment of Acutely Obstructing Colorectal Cancers: A Retrospective Cohort Study.

Purpose: The treatment of acutely obstructing colorectal cancers is still a matter of debate. The prevailing opinion is that an immediate resection should be performed whenever possible. This study sought to determine whether immediate resection is safe and oncologically valid.

Final year dental students' perception and practice of professionalism and ethical attitude in ten Sudanese dental schools: A cross-sectional survey.

Introduction: Professionalism and ethics are essential components of all dental schools. Therefore, this study aimed to assess the level of professionalism among Sudanese undergraduate dental students.

Materials And Methods: This descriptive cross-sectional study was conducted among 307 students in the final year undergraduate Dental Surgery Bachelor program with 155 public and 152 private university students.

Vitamin D level and its determinants among Sudanese Women: Does it matter in a sunshine African Country?

Background: Vitamin D deficiency is a worldwide concern. The aim of the current study was to determine the vitamin D level and its contributing factors in Sudanese women.

Methods: In this cross-sectional study, 251 Sudanese women attending Family Health Centers in Khartoum, Sudan were interviewed.

Paediatric virology and human papillomaviruses: An update.

Almost 10 years ago, in October, 2008, the scientist who reported for the first time the association between human papillomaviruses (HPV) and cervical cancer, was awarded with the Nobel prize. In the years that followed, Professor Harald zur Hausen actively supported the value of the HPV vaccination in the prevention of different types of cancer and highlighted the necessity of its introduction in both girls and boys. However, to date, in the majority of countries, HPV vaccination among male adolescents has not been implemented into the national vaccination schemes, while in several countries, including Greece, the participation rate to HPV vaccination among female adolescents still remains low.

A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak.

This year marks the 100th anniversary of the 1918 Spanish flu outbreak on the Greek Aegean Sea island of Skyros, which devastated its population in less than 30 days. According to Constantinos Faltaits's annals published in 1919, the influenza attack on the island of Skyros commenced acutely 'like a thunderbolt' on the 27th of October, 1918 and was exceptionally severe and fatal. At that time, the viral cause of the influenza had not been detected, while the total number of victims of the Spanish flu outbreak has been estimated to have surpassed 50 million, worldwide.

The impact of complications on a programme of enhanced recovery in colorectal surgery.

Background: The advantages of Enhanced Recovery (ER) programmes are well known, in terms of improved overall experience of the patients, which associates with low morbidity and reduced length of stay. As a result, the pattern of morbidity is changing and some patients may develop complications after discharge. Aim of this work was to evaluate the impact of morbidity and related outcomes such as unplanned readmission and reoperation rate on an ER programme in colorectal surgery.

Disseminated herpes simplex virus: a case of eczema herpeticum causing viral encephalitis.

Eczema herpeticum is a dermatological emergency causing a mortality of up to 10% if untreated. It frequently presents in a localised form and rarely disseminates via haematogenous spread with pulmonary, hepatic, ocular and neurological manifestations. Although it commonly appears on a background of atopic dermatitis, many other dermatological conditions have been described preceding this disease.

Emergency treatment of complicated colorectal cancer.

Aim: To find evidence to suggest the best approach in patients admitted as an emergency for complicated colorectal cancer.

Methods: The medical records of 131 patients admitted as an emergency with an obstructing, perforated, or bleeding colorectal cancer to Noble's Hospital, Isle of Man, and the Umberto I University Hospital, Rome, were retrospectively evaluated. Patients were divided in 3 groups on the basis of the emergency treatment they received, namely 1) immediate resection, 2) damage control procedure and elective or semielective resection, and 3) no radical treatment.

Paediatric Virology: A rapidly increasing educational challenge.

The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood.

Day-case laparoscopic cholecystectomy: analysis of the factors allowing early discharge.

Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed.

Gastroesophageal reflux disease. Are we acting in the best interest of our patients?

Oesophageal adenocarcinoma is strictly related to gastroesophageal reflux and cylindrical metaplasia of the epithelium of the distal esophagus (Barrett's esophagus) due to chronic inflammation. Worldwide incidence of oesophageal adenocarcinoma is rising despite the availability of precise international guidelines for the treatment of gastroesophageal reflux disease and the increasing use of proton-pump inhibitors (PPIs). While PPIs can control GERD symptoms in a significant amount of cases, still a large number of patients progress to Barrett's esophagus and adenocarcinoma.

Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool.

Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage.

Early Discharge After Colorectal Resection: The Positive Impact of an Enhanced Recovery Program on a Rural Colorectal Surgery Service.

Background: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital.

The "Left Ureteral Triangle" as an Anatomic Landmark for the Identification of the Left Ureter in Laparoscopic Distal Colectomies.

Ureteral injury is one of the possible complications of distal colectomies. It may be caused by misidentification of the anatomic landmarks during the left lateral dissection, due to factor pertaining to the patient, the disease, and the surgeon. The only way to reduce the risk of this avoidable complication is the perfect knowledge and identification of the anatomy of the left ureter.

Multifocal Nodular Fatty Infiltration of the Liver: A Case Report of a Challenging Diagnostic Problem.

Background: Fatty infiltration of the liver usually has a diffuse pattern, but in very rare cases it presents as multiple focal lesions of the liver, mimicking metastases. A correct diagnosis is crucial to address prognosis and eventual treatment.

Case Report: We present the case of a completely fit and asymptomatic patient referred for multiple bilateral liver metastases of unknown origin.

Improving the documentation of nasogastric tube insertion and adherence to local enteral nutrition guidelines.

Fine bore nasogastric (NG) tubes are often required for patients who have insufficient nutrition to meet their daily requirements, as well as for feeding or medications when there are difficulties with swallowing. "Death or severe harm as a result of a naso […] gastric tubes being misplaced in the respiratory tract" is one of the Department of Health's list of "never events". Noble's Hospital, Isle of Man, has local guidelines based on the National Patient Safety Agency's 2005 guidelines and 2011 update, regarding the initial insertion and confirmation of placement of NG tubes.

Colorectal surgery in a rural setting.

Colorectal surgery is increasingly being concentrated in high-volume tertiary centers, whereas it has been demonstrated that it can be performed safely and effectively even in low-volume hospitals. We analyzed data of patients who underwent major colorectal surgery in 1 year in a "rural" hospital, located on a small island, where a dynamic colorectal multidisciplinary team (MDT) and an enhanced recovery programme have been implemented. Primary endpoints were rate of laparoscopic resections, morbidity, mortality and number of lymph nodes retrieved and examined.

What is the future of biomedical research?

Randomized controlled trials require hard work and financial commitment, whereas meta-analyses and systematic reviews can be relatively easy to perform and often get published in high impact journals. Many researchers might decide to devote themselves to the latter approach, resulting in a negative impact on clinical research. We have reviewed the number of indexed meta-analyses and systematic reviews on PubMed and compared it with the number of randomized controlled trials over the same period.