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A Dermatology walk‐in clinic available to all hospital staff (HS) was commenced to treat skin problems related to personal protective equipment (PPE) during the COVID‐19 pandemic. An observational case series was conducted in a single district general hospital within Wales (United Kingdom) to record the dermatological diagnoses. Our participant sample comprised of clinical and non‐clinical staff working in COVID‐19 and non‐COVID‐19 areas of the hospital. Over the data collection period (6 weeks), a total of 72 patients attended the clinic of whom 62 were female and 10 were male (mean age = 43yrs). Data comprised of demographic data, current occupation (shown in Table 1), duration of symptoms, past medical history, regular medication and treatment interventions. An analysis of the clinical diagnoses seen are reported in Table 2.

Objectives The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. Methods Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. Results Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. Clinical Significance Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.

Cerebral cavernous malformations (CCM) are collections of enlarged capillaries with irregular structure, located in the brain or spinal cord, that can be life-threatening. We describe a neurologically asymptomatic 15-year-old boy who presented with cutaneous venous malformations (CVM) that developed in adolescence. Owing to his family history of CCM, genetic testing was obtained and confirmed a new mutation in the CCM3 (PDCD10) gene. Brain imaging showed multiple CCM. Although currently asymptomatic, he will continue to be monitored annually by neurology to assess for symptoms of intracranial hemorrhage (ICH) that would warrant investigation with MRI.

Background Cow’s milk allergy (CMA) is the commonest food allergy in UK children with many misleading presentations. In 2011, the National Institute for Health and Care Excellence (NICE) provided primary care guidelines on food allergy. In Northern Ireland (NI), a regional expert group was convened in 2012 to develop a CMA-focused guidance document, later published as Milk Allergy in Primary care (MAP) guideline, along with other infant feeding issues. MAP was designed for shortcomings of national and international guidelines in the initial clinical recognition and management of mild to moderate non-IgE-mediated disease in primary care.

Pilomatrixomas are relatively common childhood tumors that usually occur in the head and neck region. The clinical diagnosis of these lesions may be difficult, especially if the examining physician is unfamiliar with them. Excision is usually recommended, as a foreign body reaction due to calcification of the lesion may occur and cause a vigorous inflammatory response with risk of scarring. A retrospective study was carried out by examining the preoperative ultrasound scans of 28 suspected pilomatrixomas in 25 children. The findings on sonography were correlated with the histologic results in 19 cases (18 pilomatrixomas and one ruptured epidermoid cyst). In the majority of patients, sonography either correctly supported or excluded the clinical diagnosis of pilomatrixoma and contributed to appropriate preoperative assessment and subsequent management of the lesion. We therefore found sonography of suspected pilomatrixomas in children to be a useful and noninvasive procedure, offering a significant improvement in the accurate diagnosis of these lesions.

Background: There is now general agreement that a comprehensive psychiatric service can operate with the minimum use of in-patient facilities. Consequently, the emphasis in most European countries is on reducing the number of inpatient beds and expanding the range of community care facilities, including day hospital services, available to mentally ill patients. Decision-making with respect to placement is now even more important given the changes currently taking place on the supply side. Method: The study examines the factors that influence placement decision-making between inpatient care and day hospital care in one Health Board in Ireland. Placement was examined over a 9 month period for all patients presenting for treatment in one particular area with a population of 39 000 people. Patients were not randomized between the two settings due to ethical concerns about the randomization process. The issue of placement is analysed using a logit estimation procedure. Results: The results suggest that two variables have a significant affect on placement for the population under review: whether the patient is accompanied at the time of admission and the domicile of the patient. Conclusions: Greater flexibility with respect to the opening hours of day hospital facilities, linked to improved transport facilities, together with further analysis on the process of admission to hospital, particularly the dynamics of the interaction between providers, patients, and accompanying persons, may improve placement decision-making for mentally ill patients. Copyright © 1999 John Wiley & Sons, Ltd.

To date, standard gamble, time trade-off, visual analogue and, more recently, willingness to pay, have been most commonly employed in health economics to assess utilities from various health care interventions. This article considers the use of conjoint analysis as an alternative technique to assess utilities. The technique is applied to assess women's preferences for the management of miscarriage. The paper addresses methodological issues in the application of the technique to health care and demonstrates its use in estimating willingness to pay and utilities. It is concluded that conjoint analysis is potentially a very useful tool and that future research should investigate more thoroughly the potential application of the technique in health economics.

Objectives To estimate and compare the costs of surgical and medical treatment of miscarriage to the National Health Service. Design A patient-centred, partially randomised trial. Setting A teaching hospital in Scotland. Participants Four hundred and thirty-seven women with a proven first trimester miscarriage. Main outcome measures The cost per patient of surgical and medical management of miscarriage plus the extra cost per patient of introducing medical management of miscarriage under three different scenarios are calculated. Results The average cost of surgical treatment was £397 compared with £347 for medical treatment. Sensitivity analysis showed that the extra cost of introducing the medical management of miscarriage ranged from a cost saving of £71 per patient to an additional cost of £47 per patient. Conclusions Our analysis showed that it may be possible to generate cost savings by introducing medical methods in the management of early miscarriage. However, the savings assume that costs associated with theatre use can be fully realised.

This is a commentary of Cochrane review, published in this issue of EBCH, first published as: Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S. Sublingual immunotherapy for treating allergic conjunctivitis. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD007685. DOI: 10.1002/14651858.CD007685.pub2. Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration

The fundamental premiss of Gods, Ghosts and Men in Melanesia (Lawrence and Meggitt 1965) was that the epistemology of people of the Seaboard of Papua New Guinea was more dominated by religion than was that of the Highlanders. Among the latter, the Chimbu have commonly been portrayed as supreme pragmatists. However, they believe in a complex and variegated spirit-world, described in some detail in this paper.