The incidence of non-melanoma skin cancer in the UK and the Republic of Ireland: a systematic review.

BACKGROUND: Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) remain the most prevalent malignancies, contributing a higher workload to cancer registries than all cancers combined. The nature of skin cancers in addition to current coding methods employed by registries give a skewed representation of the workload. OBJECTIVES: A comprehensive search examining the incidence of BCC and/or cSCC at a regional or national level in the UK and Ireland was devised. Standardisation methods were grouped to permit comparison, and a bias assessment tool was employed. MATERIALS & METHODS: Sixteen UK and Republic of Ireland epidemiological studies on BCC/cSCC over a 48-year period were compiled, examining incidence, trends and emerging risk factors. RESULTS: Incidence of BCC within the UK is increasing annually by up to 4%, with rates in Wales increasing by up to 6.6% and 1.6% annually for BCC and cSCC, respectively. Inverse relationships are noted between BCC/cSCC and social deprivation. Although the elderly remain the most at risk, the 30-49 age group have illustrated growth rates of approximately 4%. CONCLUSION: This review outlines increasing incidence in the UK with higher rates noted in Wales, the Southeast, West and Central regions. Incidence rates are higher amongst the least socially deprived and an increasing incidence amongst younger age groups was found, however further trend analysis is required. A more comprehensive data collection method within registries is necessary to ensure accurate representation and fluid comparison. Service planning and public awareness campaigns must be implemented to prevent overwhelming future services.

Analysis and physicochemical properties of cellulose nanowhiskers from Pennisetum purpureum via different acid hydrolysis reaction time.

Cellulose nanowhisker (NWC) was extracted by hydrolysing Pennisetum purpureum (PP) fibres with acid and alkali. They were subjected to different periods of acid hydrolysis; 30, 45, and 60 min. NWC morphology and physicochemical properties were characterised by transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), particle size analyser, Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and thermogravimetric analysis. NWC3, which underwent the longest hydrolysis time, showed the smallest width and length, under TEM. All samples presented a needle-like shape under TEM and AFM; uneven lengths and irregular shapes under FESEM; and a broad range of distribution, with the particle size analyser. All samples exhibited a good crystallinity index (CrI)-72.0 to 74.6%. The highest CrI% corresponded to 60 min of acid hydrolysis. Thermogravimetric analysis showed thermal stability between 310.72 °C and 336.28 °C. Thus, cellulose nanowhisker from PP fibres, have high potential as bio-nanocomposites.

Fasciotomy for chronic exertional compartment syndrome of the leg: clinical outcome in a large retrospective cohort.

BACKGROUND: Chronic exertional compartment syndrome (CECS) is an overuse disorder typically affecting an athletic population. CECS is a diagnosis based on history and intracompartmental pressure (ICP) testing. CECS patients can be treated surgically by fasciotomy; however, research on the relationship between ICP and patient symptoms and also between ICP and patient-reported outcome post-fasciotomy is limited. This study aims to (1) assess functional outcome and patient satisfaction post-fasciotomy and (2) identify any potential correlation between ICP and reported levels of pain. METHODS: 138 CECS patients who had ICP measurements and subsequently underwent fasciotomy were identified from our regional service for exercise-induced lower limb extremity pain between January 2000 and March 2017. Clinical outcomes were recorded at the time of ICP testing and in the post-operative follow-up clinic. Pain was reported using a verbal rating scale (VRS) ('low', 'moderate' or 'high') or as a visual analogue score (VAS) 0-10 (0 = least painful, 10 = most painful). Spearman's ranked correlation test was used to calculate correlation between ICP and reported pain. RESULTS: A total of 138 patients were eligible for inclusion in this study (mean age 29.7 ± 9.7 years, 110 M, 28 F) of which 109 patients (VRS n = 61, VAS n = 48) reported pain level at pre- and post-operative stages. Mean pre-operative VAS score was 8.52 ± 0.71, and decreased to 0.77 ± 0.69 post-operatively. An insignificant positive correlation (r = 0.046, two-tailed p = 0.76) was found between VAS pain and ICP. A significant moderate positive correlation (r = 0.497, two-tailed p = 0.01) was found between VRS pain and ICP. CONCLUSION: Fasciotomy significantly reduces pain and increases activity levels in CECS patients. ICP was found to positively correlate with patient-reported pain.

In vitro degradation of a 3D porous Pennisetum purpureum/PLA biocomposite scaffold.

The in vitro degradation and mechanical properties of a 3D porous Pennisetum purpureum (PP)/polylactic acid (PLA)-based scaffold were investigated. In this study, composite scaffolds with PP to PLA ratios of 0%, 10%, 20%, and 30% were immersed in a PBS solution at 37°C for 40 days. Compression tests were conducted to evaluate the compressive strength and modulus of the scaffolds, according to ASTM F451-95. The compression strength of the scaffolds was found to increase from 1.94 to 9.32MPa, while the compressive modulus increased from 1.73 to 5.25MPa as the fillers' content increased from 0wt% to 30wt%. Moreover, field emission scanning electron microscopy (FESEM) and X-ray diffraction were employed to observe and analyse the microstructure and fibre-matrix interface. Interestingly, the degradation rate was reduced for the PLA/PP20 scaffold, though insignificantly, this could be attributed to the improved mechanical properties and stronger fibre-matrix interface. Microstructure changes after degradation were observed using FESEM. The FESEM results indicated that a strong fibre-matrix interface was formed in the PLA/PP20 scaffold, which reflected the addition of P. purpureum into PLA decreasing the degradation rate compared to in pure PLA scaffolds. The results suggest that the P. purpureum/PLA scaffold degradation rate can be altered and controlled to meet requirements imposed by a given tissue engineering application.

Mechanical, thermal and morphological characterisation of 3D porous Pennisetum purpureum/PLA biocomposites scaffold.

The mechanical, thermal, and morphological properties of a 3D porous Pennisetum purpureum (PP)/polylactic acid (PLA) based scaffold were investigated. In this study, a scaffold containing P. purpureum and PLA was produced using the solvent casting and particulate leaching method. P. purpureum fibre, also locally known as Napier grass, is composed of 46% cellulose, 34% hemicellulose, and 20% lignin. PLA composites with various P. purpureum contents (10%, 20%, and 30%) were prepared and subsequently characterised. The morphologies, structures and thermal behaviours of the prepared composite scaffolds were characterised using field-emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA). The morphology was studied using FESEM; the scaffold possessed 70-200µm-sized pores with a high level of interconnectivity. The moisture content and mechanical properties of the developed porous scaffolds were further characterised. The P. purpureum/PLA scaffold had a greater porosity factor (99%) and compression modulus (5.25MPa) than those of the pure PLA scaffold (1.73MPa). From the results, it can be concluded that the properties of the highly porous P. purpureum/PLA scaffold developed in this study can be controlled and optimised. This can be used to facilitate the construction of implantable tissue-engineered cartilage.

Two sibs with anophthalmia and pulmonary hypoplasia (the Matthew-Wood syndrome).

We describe two sibs with pulmonary hypoplasia and anophthalmia; one also had a number of other malformations. Only one other broadly similar case could be found in the literature, and it was an isolated occurrence. The condition is named the Matthew-Wood syndrome.

Long-term prognosis of displaced Colles' fracture: a 10-year prospective review.

In all, 85 per cent of Colles' fractures are clinically satisfactory after 10 years. Clinical results improve little after 3 months. Displaced intraarticular fracture, wrist deformity and algodystrophy are associated with an unsatisfactory outcome.

Assessment of a contact-plate sampling technique and subsequent quantitative bacterial studies in atopic dermatitis.

The aerobic bacterial flora of 20 patients with atopic dermatitis and 19 control subjects was extensively sampled using the Williamson and Kligman scrub technique and a contact-plate method (cysteine lactose electrolyte deficient media). Comparison of the two quantitative techniques showed that the contact plate is a reliable and convenient alternative to the scrub technique for the quantification of Staphylococcus aureus, micrococci and coagulase negative staphylococci. Quantification of bacterial flora using both techniques showed high rates of colonization by S. aureus on both involved and clinically normal skin of patients with atopic dermatitis. A linear increase in S. aureus counts with increasing severity of dermatitis was found. In contrast, diphtheroids showed a trend of decreasing isolation rates and counts as the severity of the dermatitis increased. Isolation rates and absolute counts for micrococci/coagulase negative cocci were unaffected by the severity of the dermatitis.

The fixation and prognosis of trochanteric fractures. A randomized prospective controlled trial.

A randomized prospective controlled trial of 155 patients with trochanteric fractures compared the AO dynamic hip screw and the Jewett nail plate. The dynamic hip screw showed significantly less evidence of mechanical failure and a lower incidence of reoperation. The implant had no effect on mortality or success of rehabilitation. Mortality was significantly associated with social dependence before fracture and the hospital attended. Capacity to return home and walk again were associated with mobility before fracture and age. While the fate of the majority of patients appeared to be determined by their state before fracture, hospital differences appear to offer the greatest potential for influencing the outcome of this condition.

Oedeme bleu: a reappraisal.

The case-histories of four patients with self-induced lymphoedema show a distinctive organic syndrome, but the underlying mental mechanisms in these patients show no common thread other than an apparent wish to draw attention to an untreatable condition. A policy of non-intervention may reduce or limit the eventual disability.