Patient satisfaction following nipple-areolar complex reconstruction and tattooing.

Background: Nipple-areolar complex (NAC) reconstruction and tattooing complete and compliment reconstruction of the breast mound. Patient satisfaction with NAC reconstruction and tattoo, independent from breast mound reconstruction is evaluated in this study.

Methods: Patients who underwent nipple tattooing between January 2001 and June 2008 were sent a postal questionnaire retrospectively.

Ileocolic Intussusception - A rare cause of acute intestinal obstruction in adults; Case report and literature review.

Colonic Intussusception although common in children, is a rare cause of acute intestinal obstruction in adults. The etiology, clinical presentation and management of this condition is different in adults as compared to children. Pre-operative diagnosis is usually difficult due to the non specific and intermittent nature of the symptoms.

Severe facial edema at high altitude.

We present a complication associated with high altitude of unusual severity. Pronounced facial edema developed in a 27-year-old woman during a trek to Kilimanjaro, Tanzania. The development of facial edema has previously been documented in visitors unaccustomed to high altitude.

A matrix metalloproteinase inhibitor to treat unresectable cholangiocarcinoma.

Matrix metalloproteinases (MMPs) are implicated in tumour invasion and metastasis. We report the first use of an MMP inhibitor to treat unresectable cholangiocarcinoma. Four men with stage IV cholangiocarcinoma received oral Marimastat (10 mg bd) indefinitely following relief of obstructive jaundice.

Analysis of the initial 100 scans from the first CT scanner deployed by the British armed forces in a land environment.

Aims: To examine usage of the first CT scanner installed in a UK field hospital, BMH Shaibah, over a 13 month period.

Methods: All request forms and reports for the first 100 studies were analysed retrospectively.

Results: An average of 7.

The effectiveness of scoring and bipolar diathermy on ear cartilage behavior: ex vivo study.

A common unsatisfactory long-term outcome of otoplasty is undercorrection and residual deformity. Aggressive scoring with a scalpel blade can cause unattractive and painful ridging, especially in older patients with stiffer cartilage. We developed an ex vivo pig ear model to compare the effectiveness of bipolar diathermy with blade scoring for cartilage warping.

Examining bowel preparation before flexible sigmoidoscopy.

Aim: To investigate bowel preparation for a flexible sigmoidoscopy, particularly the procedure for the administration of a phosphate enema and patient expectation to 'wait as long as they can' before the urge to rush to the toilet.

Method: A survey approach was used with a questionnaire recording the time to toilet after the enema and level of bowel clearance.

Results: Over half of participants (24 of 40) chose to use the toilet immediately.

Winning the war on terror: psychology as a strategic framework.

International relations is fundamentally about people. Psychology provides a wide range of tools to understand the rise of Islamic fundamentalist terrorism and offers part of the framework for its resolution. Western societies need to avoid being consumed with fear, revenge or anger which might lead to polarisation and perpetuate the cycle of violence.

A reflective evaluation of patient handover practices.

This article is a personal reflection of the patient handover process. It explores approaches to handover, issues of time management, documentation and phenomenology. A handover sheet was developed with the assistance of a nursing team to maximise communication during handover.

A comparison of serial halving and the rule of nines as a pre-hospital assessment tool in burns.

Following endorsement of serial halving by the Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh this study aimed to determine whether the technique was comparable to the rule of nines in making initial assessments of body surface area burned. Ten 'casualties' were made up to represent burn victims (range 6-61%). An external panel of six consultants and one specialist registrar in plastic surgery were invited to assess the simulated casualties.

Radiology.

The speciality of Radiology is little over 100 years old yet the expansion and diversity within the speciality is accelerating. This paper reviews the recent technological developments by modality, their impact on medical imaging and touches on some research techniques which may find their way into mainstream imaging.

Analysis of 47 road traffic accident admissions to BMH Shaibah.

Objective: To analyse road traffic accident (RTA) admissions to British Military Hospital (BMH) Shaibah with respect to seatbelt usage, position in vehicle, age, type of injury and mechanism of injury.

Method: Retrospective analysis of discharge summaries and hospital notes of all service personnel admitted to BMH Shaibah due to RTA, from August 2003 to January 2004. Results During the study there were 315 reported RTA, 3 fatalities, and 47 inpatient admissions.

Oral retinoids for the prevention of skin cancers in solid organ transplant recipients: a systematic review of randomized controlled trials.

Background: The increased incidence of skin cancers after solid organ transplantation is well recognized. Skin cancers developing in transplant recipients are more aggressive in behaviour. Therapeutic options to reduce and/or delay the development of cutaneous neoplasms are therefore of interest.

Association between anatomical features and anterior knee pain in a "fit" service population.

Anterior knee pain and overuse sports type injuries have been associated with anatomical factors. Specific diagnosis in knee pain is difficult, most service patients are grouped together as "Patello-Femoral Stress Syndrome". Knee pain incidence within the service population is unknown, but thought to be greater than those presenting to General Practitioners.

End-to-side venous anastomoses....a patency test.

A hitherto unpublished means of testing the patency across an end-to-side venous anastomosis is described. It relies on the elasticity of the venous walls to produce ballooning when the appropriate segments of the veins are occluded and blood is flowing unimpeded across the end-to-side anastomosis. It is foolproof, easy to perform and has no ambiguity in its interpretation.

Surveys on the use of cardiac markers in the UK.

Background: Troponin measurements are now central to the diagnosis of acute coronary syndromes and for the stratification of the severity of cardiac disease. Some laboratories have quickly adopted the new testing strategies, which include troponin measurement for the diagnosis of acute myocardial infarction, while others are still developing appropriate protocols for cardiac testing that they can support financially. However, it is not known how widespread is the adoption of these new strategies across the UK.

A guide to sending e-mail telemedicine referrals.

This article describes simple e-mail protocols that have proven their effectiveness in the telemedicine links established by the Swinfen Charitable Trust. They are presented here as a guide for the benefit of those doctors who may be considering setting up their own telemedicine links.