The ophthalmic blade perfectly made to create an oral antral communication blockade; a technical note.

Oral antral fistulas are commonly referred to the Oral and Maxillofacial department for surgical management. Though conventional methods of repair are well established, we present a technical note highlighting the novel use of an ophthalmic blade in raising palatal mucoperiosteal flaps. We have experienced much success with this instrument and believe it represents a very useful and complimentary addition to the oral and maxillofacial surgeon's kit.

Review of outcomes of 500 consecutive cases of non-melanoma skin cancer of the head and neck managed in an oral and maxillofacial surgical unit in a District General Hospital.

We provide a non-melanoma skin cancer (NMSC) service for skin cancers of the head and neck in the south-west of England. We hypothesised that certain anatomical sites such as the nose and eyelid would have a higher incidence of close or involved margins than others, and that the choice of repair might influence the excised margins. We therefore retrospectively analysed the data of 500 consecutive NMSC that were operated on in the oral and maxillofacial surgery unit of Taunton and Somerset NHS Trust. The database reports were crosschecked against the Trust's own pathology reporting system to ensure that they were accurate. Data collected included clinical and personal details of patients, anatomical sites, type of reconstruction, histopathological diagnosis, excision margins, and complications. Of the 500 patients reviewed 362 (72%) were basal cell carcinomas (BCC) and 138 (28%) squamous cell carcinomas (SCC). The outcomes of 243 patients treated by primary closure, 134 treated by reconstruction with local flaps, and 123 treated by skin grafts, were reviewed with particular attention paid to the anatomical site and excision margins. There was an overall incomplete excision rate of 10.8% (n=54) and 29 patients developed complications (5.8%). We confirmed that rates of close or incomplete margins are more likely in certain anatomical sites such as the nose, forehead, and ear. The rate of involved margins was unaffected by choice of surgical technique.

Genome-wide prediction models that incorporate de novo GWAS are a powerful new tool for tropical rice improvement.

To address the multiple challenges to food security posed by global climate change, population growth and rising incomes, plant breeders are developing new crop varieties that can enhance both agricultural productivity and environmental sustainability. Current breeding practices, however, are unable to keep pace with demand. Genomic selection (GS) is a new technique that helps accelerate the rate of genetic gain in breeding by using whole-genome data to predict the breeding value of offspring. Here, we describe a new GS model that combines RR-BLUP with markers fit as fixed effects selected from the results of a genome-wide-association study (GWAS) on the RR-BLUP training data. We term this model GS + de novo GWAS. In a breeding population of tropical rice, GS + de novo GWAS outperformed six other models for a variety of traits and in multiple environments. On the basis of these results, we propose an extended, two-part breeding design that can be used to efficiently integrate novel variation into elite breeding populations, thus expanding genetic diversity and enhancing the potential for sustainable productivity gains.

Saturday night burns: an increasing problem?

In Italy the economic crisis has caused changes in behavior in daily as well as leisure activities. For instance, night clubs have changed both their scenography and what they can offer. From simply providing a place to dance, they can now offer more complex scenography with spectacular fireworks and lit cocktails. While this can be amazing for all of us it can also be another cause of burn injuries. We conducted a retrospective study of all burns patients admitted to the Accident and Emergency Department at CTO Hospital in Turin from 2009 to 2013, after a night clubbing. A total of five patients were identified with an average age of 20 years old: four were burned by flaming cocktails and one was burned by a firework. Two received outpatient treatment, while orotracheal intubation and admission were needed for three, and two required surgical debridement and resurfacing with split skin graft. All patients had permanent sequelae caused by pathologic scarring and/or dyschromia. Our findings show that the risk of burn injuries is higher at weekends, mainly in summer, if all correct safety procedures are not followed. Meanwhile it is important to highlight that the promotion of inappropriate behavior at night clubs during firework displays and the passing of flaming cocktails should be avoided.

En Italie la crise économique a entraîné des changements dans le comportement de tous les jours ainsi que des activités de loisirs. Par exemple, les boîtes de nuit ont changé à la fois leur scénographie et ce qu'ils peuvent offrir. D'abord ils fournissaient simplement un endroit pour danser, mais ils peuvent désormais offrir une scénographie plus complexe avec des feux d'artifice spectaculaires et des cocktails éclairés. Même si cela peut être amusant pour nous tous, il peut aussi être une autre cause de brûlures. Nous avons mené une étude rétrospective de tous les patients brûlés admis à l'hôpital CTO de Turin de 2009 à 2013, après une nuit dans une boîte. Les patients identifiés étaient cinq jeunes avec un âge moyen de 20 ans: quatre ont été brûlés par des cocktails enflammés et un a été brûlé par un feu d'artifice. Deux ont reçu un traitement ambulatoire, trois ont reçu l'intubation orotrachéale et l'admission de prévention, et deux ont reçu un débridement chirurgical et avec les greffes de peau. Tous les patients avaient des séquelles permanentes causées par la cicatrisation et / ou dyschromie pathologique. Nos résultats montrent que le risque de brûlure est plus élevé le week-end, surtout en été, si toutes les procédures de sécurité appropriées ne sont pas suivies. Il est important de souligner que la promotion d'un comportement inapproprié dans les boîtes de nuit pendant les feux d'artifice et le passage de cocktails flambés doit être évitée.

The use of abbreviations in surgical note keeping.

Abbreviations are used to improve the speed of note keeping and to simplify patient notes. However studies have shown that they can reduce clarity, increase mistakes and cause confusion in management plans. Our review highlights the misuse of abbreviations in surgical note keeping.