K.F.B. Payne

A Review Of Current Clinical Photography Guidelines In Relation To Smartphone Publishing Of Medical Images

The rise in popularity of smartphones has seen a surge in the number of smartphone-specific software applications (apps) available. Among these apps, many are medical and healthcare related, of benefit to both the general public and healthcare staff. With this improved technology comes the ability to display full-colour images and videos, for which medical images could be utilised. We reviewed current clinical photography guidelines in relation to the publishing of medical images in smartphone apps. Of the 5 relevant guidelines, none discussed hand-held electronic media or smartphone app publishing. This creates confusion for clinicians as to how to interpret current guidelines for this purpose. Medical illustrators, clinicians and NHS Trusts need to be aware of the changes in technology and the ethical considerations of allowing medical images to be published within smartphones. We discuss the issues surrounding consent and provide practical tips for obtaining informed consent from patients to publish medical images in smartphone apps.

Using The iBook In Medical Education And Healthcare Settings - The iBook As A Reusable Learning Object; A Report Of The Author's Experience Using iBooks Author Software

The recently launched iBooks 2 from Apple has created a new genre of ‘interactive multimedia eBook’. This article aims to dscribe the benefit of the iBook in a medical education and healthcare setting. We discuss the attributes of an iBook as compared with the requirements of the conventional web-based Reusable Learning Object. The structure and user interface within an iBook is highlighted, and the iBook-creating software iBooks Author is discussed in detail. A report of personal experience developing and distributing an iBook for junior trainees in oral and maxillofacial surgery is provided, with discussion of the limitations of this approach and the need for further evidence-based studies.

The role of diffusion-weighted magnetic resonance imaging in the diagnosis, lymph node staging and assessment of treatment response of head and neck cancer

Standard magnetic resonance imaging (MRI) and computed tomography continue to be the imaging modalities of choice in staging and reviewing patients with head and neck cancer. Diffusion-weighted MRI (DW-MRI) is an advanced imaging modality that records the molecular diffusion of protons and thus provides an opportunity to further assess tissue character. Interest in DW-MRI of the head and neck continues to grow, especially its application to the assessment and treatment of head and neck cancer. We highlight the potential role of DW-MRI in the delineation, characterization, and lymph node staging of head and neck tumours. Furthermore, we discuss the ability of DW-MRI to provide a real opportunity to differentiate post-treatment tumour recurrence from chemoradiotherapy-induced local tissue changes. The future impact of these findings upon the clinical practice of the head and neck surgeon is discussed.

A review of TMJ-related papers published in the British Journal of Oral and Maxillofacial Surgery in 2011 and 2012

This review summarises the articles relating to the temporomandibular joint (TMJ) that were published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) between January 2011 and December 2012. In total 24 papers were published. Of these, 16 (67%) were full-length articles, which included prospective, retrospective, and laboratory-based studies as well as reviews. The remaining 8 papers were short communications, technical notes, and letters to the editor, which report on, amongst other things, unusual cases, rare complications, and novel surgical techniques.

Minimally invasive treatment of oral ranulae: adaption to an old technique

Oral ranulas are cysts in the floor of the mouth that result from the extravasation of mucous. Historically there has been little consensus on the ideal first-line treatment, but currently, definitive treatment involves excision of the sublingual gland, which can injure the lingual nerve and submandibular duct. Minimally invasive surgical alternatives such as marsupialisation have been proposed, but so far have been associated with a high rate of recurrence. The aim of this pilot study was to evaluate the success of a simple, modified suture technique for the treatment of oral ranulas that can be done in the outpatient department. We retrospectively analysed outcomes after the technique was used as a first-line treatment in 15 consecutive patients between 2011 and 2013. Although 2 attempts were needed in 4 patients, complete resolution of the ranula was seen in 13. Other than the need for a second attempt, and recurrent failure in 2 cases, there were no complications. This minimally invasive and quick procedure is a suitable first-line alternative to other less successful or higher risk options.

Medical students’ understanding of oral and maxillofacial surgery: an Irish perspective

Oral and Maxillofacial Surgery (OMFS) remains an enigmatic specialty in Irish medicine and many students are unaware of its scope and the unique career pathway involved. We completed a multicentre cross-sectional study to identify their ability to identify the requirements for entry to specialty training year 3 (ST3) in OMFS, to assess their awareness of OMFS surgeons, and their general awareness of, and exposure to, the specialty. Data were collected through an electronic questionnaire. Participants were asked to select the most suitable surgical specialty to treat a number of common conditions in the head and neck, and to choose the requirements they deemed essential for specialist training. Knowledge was measured by the number of correct responses. A total of 443 medical students participated (University College Cork (UCC) n=328, 74%; Royal College of Surgeons in Ireland (RCSI) n=113, 26%). A total of 318/374 (85%) had had no previous experience of OMFS, 38/374 (10%) had had theoretical teaching only, and 18/374 (5%) had had clinical experience. A total of 212/329 (64%) wished for greater exposure as a student, but only 34/329 (9%) would consider a career in the specialty. The median (IQR) number of correct responses for OMFS procedures was 3.0/10 (2.0), with women, direct entrants, and RCSI students scoring highest. Only 11/367 (3%) could identify the minimum entry requirements for a post of specialist registrar. This study has identified a potential gap in the undergraduate curriculum. Although medical students are rarely taught about OMFS, they show an interest in learning more.

A review of oral surgery-related papers published in the British Journal of Oral and Maxillofacial Surgery during 2011 and 2012

This paper is a synopsis of all articles relating to oral surgery that were published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) between January 2011 and December 2012. Of the 57 published, 40 (70%) were full-length articles that predominantly focused on implantology, dentoalveolar surgery, and bisphosphonate osteonecrosis of the jaws (BONJs). In addition, a number of short communications, technical notes, and letters to the editor described rare cases, unusual complications, and novel surgical techniques.

Why worry about bisphosphonate-related osteonecrosis of the jaw? A guide to diagnosis, initial management, and referral of patients

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a chronic condition of the oral cavity resulting in mucosal ulceration and exposure of underlying necrotic bone, and the ensuing secondary complications. As a relatively newly recognised condition, the epidemiology of BRONJ is poorly described. In a 2012 position statement by the UK Faculty of General Dental Practice, an estimated incidence of 10 patients per year per million population was stated.1 This would indeed classify it as a rare condition, with a GP expecting to see only a handful of cases in their career. However, with increased numbers of patients on bisphosphonate (BP) therapy, all GPs should be aware of the risk factors for BRONJ and the pre-assessment advice they give to patients commencing BP therapy. BPs inhibit the action of osteoclast cells, decreasing bone turnover and increasing bone density.2 The mechanism by which BPs cause osteonecrosis is not proven but is probably due to a combination of decreased bone remodelling, poor wound healing, and an antiangiogenic effect leading to ischaemic changes and subsequent necrosis in response to a local traumatic insult.2 The main indications for the use of BPs are for the treatment of post-menopausal osteoporosis, steroid-induced osteoporosis, Paget’s disease, and the complications of metastatic bone lesions and multiple myeloma, namely, hypercalcaemia and bony pain. It is outside the scope of this article to discuss BP …

Launch of British Association of Oral and Maxillofacial Surgeons book: Important oral and maxillofacial presentations for the primary care clinician-educating and promoting our specialty to general practitioners across the UK

t e are delighted to inform colleagues about a new book unded by theBAOMS,which is to be launched at theGeneral ractitioners’ Conference, Harrogate, in October 2016. After unprecedented collaboration and support from the oyal College of General Practitioners, a book entitled mportant oral and maxillofacial presentations for the priary care clinician’ (Fig. 1) is about to be distributed free of harge to each of the 9500 general practices in the UK. An lectronic version is also being sent to all 50,000 GPs. Two opies of wall posters to complement it will also be delivered o each practice, and these group together all the algorithms ontained in the book to help to manage oral and maxilloacial conditions. The project has been funded by the 2016 AOMS Presidents’ Fund. We should not underestimate the fact that oral and maxllofacial conditions that present to general practice can be hallenging to identify and manage, given the relatively limted training provided in this area when compared with that iven to other specialties, and the huge number of medical onditions that GPs are expected to know about. The aim of his unique book, therefore, is to present both the common nd less common conditions in logical, themed chapters, and lso to try to demystify our specialty and illustrate the many ervices that we can provide. There are eight chapters, starting with examination of the ral cavity, followed by oral ulceration, patches and lumps of he oral mucosa, lumps on the face, restricted movement of he jaw, facial pain, and lumps in the neck. The book contains oxes headed “ask, look, and sinister features” in each chapter Fig. 2), with subsequent algorithms that are designed to help