Oncoplastic breast surgery in Europe.

Oncoplastic breast surgery (OPS) has become an integral part of breast cancer surgery for both breast conservation and mastectomies. In recent years, the emphasis on early detection and the advances in systemic and locoregional therapy has improved prognosis leading to an increased focus on survivorship and quality of life issues including patients' short and long-term aesthetic appearance as a key part of the surgical management. There is a significant variation across Europe in the type of specialist performing breast cancer surgery and the provision of OPS as such.

From whole blood to component therapy: the economic, supply/demand need for implementation of component therapy in sub-Saharan Africa.

Blood may be transfused as whole blood or as one of its components. Because patients seldom require all of the components of whole blood, it makes sense to transfuse only that portion needed by the patient for a specific condition or disease. This treatment, known as "blood component therapy", allows several patients to benefit from one unit of donated whole blood.

Rh isoimmunization in Sub-Saharan Africa indicates need for universal access to anti-RhD immunoglobulin and effective management of D-negative pregnancies.

Transplacental or fetomaternal hemorrhage (FMH) may occur during pregnancy or at delivery and lead to immunization to the D antigen if the mother is Rh-negative and the baby is Rh-positive. This can result in hemolytic disease of the fetus and newborn (HDFN) in subsequent D-positive pregnancies. The aim of this study is to highlight the challenges associated with the effective management and prevention of Rh alloimmunization among Rh-negative women in Sub-Saharan Africa.

Impact of a Bereavement and Donation Service incorporating mandatory 'required referral' on organ donation rates: a model for the implementation of the Organ Donation Taskforce's recommendations.

In 2008 the Organ Donation Taskforce published its recommendations for increasing organ donation in the UK by 50% over 5 years. Bolton NHS Trust has addressed the problem of low rates of organ donation by amalgamating Bereavement and Donation Services and introducing a trigger to refer automatically all potential organ donors to the regional transplant donor co-ordinators. We audited the ability of the new service to deliver the aims and recommendations of the Organ Donation Taskforce.

'Picture Quiz Answers: A severe rash.

This patient was diagnosed as having Stevens-Johnson Syndrome. The most likely cause was the sulfasalazine, which had been started recently. This drug was stopped.

A severe rash.

A fifty-one-year-old man with history of treated hypertension and seronegative rheumatoid arthritis presented to hospital with a three day history of a rash affecting the whole body and general malaise. He had been commenced on sulfasalazine 2 weeks ago to control his rheumatoid arthritis, which the patient had discontinued taking three days prior to admission. On examination, he was comfortable with a temperature of 39°C and a widespread erythematous maculopapular rash.

Entonox analgesia for prostatic biopsy.

We performed a prospective randomised double-blind study to evaluate the efficacy of Entonox (nitrous oxide) as an analgesic for trans-rectal ultrasound (TRUS) and prostate biopsy. A total of 50 patients breathed either Entonox or air during sextant prostatic biopsies all of which were performed by the same surgeon. The degree of pain experienced was recorded on a 100 mm visual analogue pain scale.

The value of animal models in the development of new drugs for the treatment of the sepsis syndrome.

The sepsis syndrome has proved to be one of the most difficult clinical situations to replicate in animal models. The outcome of sepsis in patients depends not only on the pathogens, sizes of bacterial challenge and adequacy of treatment, but also on age, host defence mechanisms and individual response to septic shock and multiple organ failure. Novel immunomodulatory agents may control endotoxaemia or bacteraemia in animal models but they have not proved effective in septic patients.