British Journal of Oral and Maxillofacial Surgery

Editorial Board

2012-04-01

Meeting the psychological needs of patients with facial disfigurement

Eileen Bradbury — 2011-03-28

Abstract: Those with congenital or acquired disfigurement are faced with the challenges of social reactions and their own psychological responses to looking different. There is no simple linear relation between the degree of disfigurement and the degree of experienced distress. Factors that influence an individual's ability to cope include the social meaning of the disfigurement, life history, social and family support, and developmental stage. Decision-making about surgery, including that for those seeking aesthetic surgery, should take account of these complex factors to understand the patient's needs, ensure informed consent, and avoid unnecessary or ill-timed surgery. All those working with patients with disfigurement should have an understanding of their psychosocial needs, and there should be access to an identified member of staff such as a clinical nurse specialist with counselling skills, and a recognised referral route to a psychologist or liaison psychiatrist.

The contemporary management of chyle leak following cervical thoracic duct damage

P.A. Brennan, J.N. Blythe, M.K. Herd, A. Habib, R. Anand — 2011-03-07

Abstract: The considerable anatomical variation of the thin walled cervical thoracic duct predisposes it to inadvertent damage during neck dissection. If this is not recognised at the time of surgery, a chyle leak can result in potentially serious complications as well as delaying the patient's discharge from hospital. This article summarises the basic anatomy of the terminal thoracic duct in the neck and discusses the pathophysiology of a chyle leak. We present the latest ideas for managing this problem when it is identified at the time of surgery, and review the diagnosis and contemporary management options available for dealing with this difficult problem when it is found to occur post-operatively.

Head and neck cancer patients’ perspective of carer burden

E. Precious, S. Haran, D. Lowe, S.N. Rogers — 2011-06-06

Abstract: There is a growing appreciation of the important role that carers have in supporting patients following treatment for head and neck cancer. We asked patients about the role fulfilled by their carer(s) and the support they give, and for their thoughts on the burden this placed on the carers. We did a cross-sectional survey of 751 patients with head and neck cancer who were alive and disease-free using two questionnaires: one combined study-specific questions about carers with questions from Khafif et al., and the other was the University of Washington Quality of Life questionnaire version 4 (UW-QoL). There were 386 replies. Nearly half (46%, 162/354) had carers who were mainly family members. Patients identified their main roles as providing emotional support (75%), taking them to healthcare appointments (67%), cleaning the home (62%), and shopping for food (59%). Around a third felt that their care was a considerable burden, and a similar proportion felt that it was very hard for their carers. Patients over 65 years of age were the most likely to need a considerable amount of care and support, and those with low socio-emotional UW-QoL composite scores were most likely to need a considerable amount of care and support, to regard the burden on their carers as considerable, and to think that it was very hard for their carers to take care of them. The study emphasises the necessity to take account of the needs of carers. More research is required on the patient–carer relationship and how best to support it.

Internet use among head and neck cancer survivors in the North West of England

Simon N. Rogers, Aleksandra Rozek, Narges Aleyaasin, Prakash Promod, Derek Lowe — 2011-05-19

Abstract: In general, use of the internet by patients in their healthcare is increasing. However, its use specifically among those with head and neck cancer in the UK has not been reported. The aims of this study were to report access to the internet by survivors of head and neck cancer, to indicate where it fits within their information sources, how they have used it, and how they might use it in future. A question on its use has been included in annual surveys of patients since 2006. Patient-reported access to the internet increased from 32% in 2006 to 54% in 2010. There were considerable differences in access by age; currently (2010) 83% of those under 55 years, and 40% of those aged 65–84 years. Binary logistic regression modelling involving age at survey (p<0.001), age leaving education (p<0.001), and sex (p=0.01), gave all three as independent predictors of access. In the 2010 survey 49% (234/473) never used the internet, 10% (49/473) used it rarely, 15% (70/473) used it occasionally, and 25% (120/473) used it often. The main reasons for its use for head and neck cancer were to find information, learn about treatment, side effects, and medication, and obtain advice from members of multidisciplinary teams. The findings of this study show that the internet has an important role for patients in providing information and support about their cancer, although other sources are still very important. Data from the study will help inform those promoting e-health about the type of resource that is wanted by patients.

Analysis of the impact of deprivation on urgent suspected head and neck cancer referrals in the Mersey region between January 2004 to December 2006

Paul Brocklehurst, Raheela Rafiq, Derek Lowe, Simon Rogers — 2011-06-02

Abstract: Serious delay in patients presenting with head and neck cancer is associated with poor outcomes. We aimed to examine the influence of deprivation on professional delay in the Mersey region from 2004 to 2006. The study sample comprised 6681 patients who were referred between January 2004 and December 2006. The dataset was dominated by the largest hospital (H1), which received 48% of all cases. Median referral overall was 12 days (IQR 8–15 days), and 74% of patients were referred in 14 days or less. Professional delay (percentage 14 days or less) was associated with hospital (from 58% H1 to 97% H5), year of referral (from 64% in 2004 to 80% in 2006), age (from 69% under 55 years to 80% over 75 years), and deprivation (Index of Multiple Deprivation 2000 from 67% most deprived (IMD 1) to 85% least deprived (IMD 5)). Hospital location was associated with these factors and the results imply that by far, the most important variable in predicting professional delay was the hospital that received the referral. Trends over time in age, and to a lesser extent, for deprivation were noted in H1, but were largely absent across other hospitals. Some of them needed to make substantial improvements to meet the two-week referral pathway and it would be interesting to compare these results with current practice. This study highlights the importance of maintaining the standards of the current policy on two-week referrals for suspected head and neck malignancy.

A double-blind, placebo-controlled, randomised trial of active manuka honey and standard oral care for radiation-induced oral mucositis

2011-06-03

Abstract: Our aim was to investigate the effect of active manuka honey on radiation-induced mucositis. A total of 131 patients diagnosed with head and neck cancer who were having radiotherapy to the oral cavity or oropharyngeal area were recruited into the study, and were randomly allocated to take either manuka honey or placebo (golden syrup) 20ml 4 times daily for 6 weeks. Mucositis was assessed according to the Radiation Therapy Oncology Group (RTOG) scale at baseline, weekly during radiotherapy, and twice weekly thereafter until the mucositis resolved. The patient's weight was recorded at the same time as the mucositis was assessed. Throat swabs to identify bacterial or fungal infections were taken at baseline, and during and after radiotherapy. There was no significant difference between honey and golden syrup in their effects on mucositis. Active manuka honey did not improve mucositis, but both the honey and the syrup seemed to be associated with a reduction in bacterial infections. Compliance was a problem after the onset of mucositis, which may have affected the findings.

Safety of a regimen for thromboprophylaxis in head and neck cancer microvascular reconstructive surgery: non-concurrent cohort study

T.K. Blackburn, K.R. Java, D. Lowe, J.S. Brown, S.N. Rogers — 2011-07-15

Abstract: We aimed to assess bleeding complications after increasing the thromboprophylactic dose of dalteparin from 2500 to 5000 units 12h preoperatively in line with guidance on risk stratification and appropriate pharmacological thromboprophylaxis. We evaluated two groups of patients for confounding factors and bleeding, a prospective consecutive high dose group (n=29), and a retrospective low dose group (n=30) who had had ablative and microvascular reconstructive surgery for oral or oropharyngeal cancer. The bleeding index over 5 days (range 40–60) was used as an objective measure of perioperative bleeding. The null hypothesis was that there was no difference in the bleeding index between the two groups. We found no significant difference in the mean bleeding index between the two groups (p=0.56) (mean (SD) bleeding index in the high dose group 45.3 (26.1), and 48.7 (18.1) in the low dose group). The 95% confidence interval (CI) was −1.51 lower to 0.83 higher in the high dose group. Five patients (2 (7%) in the high dose, and 3 (10%) in the low dose group) were returned to theatre with bleeding complications. There was a trend to a higher failure rate of free flaps in the high dose group (4 (13%) complete, and 1 partial failure compared with 1 (3%) complete and 1 partial failure in the low dose group). There were no symptomatic thromboembolic events in either group. An increased dose of dalteparin did not seem to increase conventional surgical bleeding complications, which was consistent with the null hypothesis at evidence level 2b, but a larger sample is needed to explore its impact on venous thromboembolic events and on the failure of microvascular free flaps.

A review of facial protective equipment use in sport and the impact on injury incidence

2011-02-04

Abstract: Sporting activities have an inherent risk of facial injury from traumatic impacts from fellow competitors, projectiles, and collisions with posts or the ground. This retrospective review systematically describes the interplay between the type of sport (including the level at which specific sports are played), the sex of the players and their musculoskeletal characteristics, the technology behind the materials used, the protective devices commonly used, the anatomical site, and the regularity of incidence of fractures. We describe how variations in sporting activities induce different orofacial fracture patterns, and critically consider the methods used to test protective headgear against more contemporary techniques. Facial injuries can have a profound psychological effect on those injured, can take a long time to heal, and have been known to end promising careers. Use of properly fitted protective head or facial equipment could reduce the number of facial fractures commonly seen in sports. We recommend that individual sports should have full risk assessments, and that mandatory standards should be agreed about protective devices that would be appropriate.

Early dental implant failure: risk factors

Zaid H. Baqain, Wael Yousef Moqbel, Faleh A. Sawair — 2011-05-25

Abstract: The objective of this prospective study was to estimate the incidence of early loss of dental implants and the potential risk factors. The predictive variables were classified as being patient, implant, anatomical, or operation-specific. The outcome variable was early failure of the implant. The significance of differences was assessed using bivariate analyses, and then a multivariate logistic regression model to identify independent predictors for early loss of implants. A total of 169 patients, 116 women and 53 men, mean age 47 (range 16–80) years, had 399 implants inserted. Fifteen implants were lost in 14 patients (8%). The early loss of dental implants was significantly associated with width of keratinised gingiva (p=0.008), the use polyglactin sutures (p=0.048), and the use of narrow implants (p=0.035). Multivariate logistic regression analysis established the significance of narrow keratinised gingiva (OR=4.7, p=0.005) and the use of polyglactin sutures (OR=3.8, p=0.042), which we conclude are probably the strongest predictors of early failure of implants.

The effect of low-intensity pulsed ultrasound on the osseointegration of titanium dental implants

Qing Liu, Xin Liu, Baolin Liu, Kaijin Hu, Xiaodong Zhou, Yuxiang Ding — 2011-04-04

Abstract: Our aim was to record the effect of low-intensity pulsed ultrasound (LIPUS) on the osseointegration of endosseous dental implants in 10 New Zealand rabbits. One titanium implant with screw was inserted into the metaphyseal region of each femur and tibia in the knee joints of each rabbit, making a total of 40 implants. The area of one lateral knee joint, including implants, was irradiated with LIPUS for 10min twice a day for 21 days. The other side acted as control, having been given “sham” irradiation. Two rabbits were killed at each of 0, 2, 4, 6, and 8 weeks after irradiation. A micro-computed tomogram (μCT), histological examination, and implant pull-out test were used to judge the reactions of the bone to the titanium implant. Histological and μCT examinations showed that osseointegration of the implants on the LIPUS-treated side happened earlier and more effectively than on the control side. The mechanical test showed that the maximal axial pull-out strength of the implants on the LIPUS-treated side was greater than that on the control side. We conclude that LIPUS has the potential to accelerate the osseointegration of dental implants.

Investigation of perfusion in osseous vessels in close vicinity to piezo-electric bone cutting

C. von See, N.-C. Gellrich, M. Rücker, H. Kokemüller, H. Kober, E. Stöver — 2011-05-19

Abstract: Cutting bones by piezosurgery leads to failure of perfusion at the site of the osteotomy, the cause of which cannot be identified immediately. Among other things the formation of vascular thrombi by the transmission of oscillations from the piezoelectric unit to the bone may be responsible. We used three output levels of oscillation that were predefined by the system. The outer cortical bone of the calvaria of rats (n=24) was removed horizontally and the intraosseous vessels exposed at the surface of the osteotomy. The blood flow was then examined repeatedly using intravital fluorescence microscopy. To calculate the transmission of oscillations to the bone, the spatial oscillation frequency of each calvarium and the contact pressure during removal of bone in vitro (n=18) were also examined. After removal of the bone there was constant blood flow at all three levels of oscillation output. In no case did an individual vessel seem to be occluded. The excitation oscillation of the bone was established at 2000Hz in all spatial directions, irrespective of the predefined oscillation output. The application of piezosurgery does not cause the formation of vascular thrombi in the bone. This probably results from the oscillation damping properties of bone.

The effect of sutureless wound closure on postoperative pain and swelling after impacted mandibular third molar surgery

Hamid Mahmood Hashemi, Majid Beshkar, Reihaneh Aghajani — 2011-06-02

Abstract: Our aim was to assess the influence of sutureless and multiple-suture closure of wounds on postoperative complications after extraction of bilateral, impacted, mandibular third molars in 30 patients in a split mouth study. After the teeth had been removed, on one side the flap was replaced but with no suture to hold it in place (study side), and on the other side the wound was closed primarily with three sutures (control side). Recorded complications included pain, swelling, bleeding, and formation of periodontal pockets. The results showed that patients had significantly less postoperative pain and swelling when no sutures were used (p=0.005). There were no signs of excessive bleeding or oozing postoperatively on either side. Six months postoperatively there was no significant difference in the depth of the periodontal pocket around the second molar.

Relation between a first branchial cleft anomaly and the facial nerve

Yu-Xing Guo, Chuan-Bin Guo — 2011-04-25

Abstract: Relations between first branchial cleft anomalies and the facial nerve vary. We reviewed 41 patients’ medical records and pathological sections to clarify the relation, and found that those on the right side in young patients, which were Work type II and situated low down, were likely to be deep to the facial nerve.

Design and manufacture of customised protective facial sports splints

M.A. Kittur, L.A. Dovgalski, P.L. Evans, S.J. Key — 2011-06-20

Fractures to the bones of the facial skeleton are common injuries sustained in contact sports. For professionals, the prolonged recovery from such a bony injury may have both financial and psychological consequences. Facial splints, masks, or shields have previously been reported as adjuncts that provide protection to the bony prominences of the face and may allow a more speedy return to the field of play. We describe a simplified procedure for the fabrication of these splints.

Malignant change in a massive pleomorphic adenoma resembling the presentation of advanced inflammatory breast cancer

Leonie Seager, Serryth Colbert, Anne V. Spedding, Peter A. Brennan — 2012-04-01

Abstract: Massive tumours of the parotid are uncommon as due to their site, they are usually removed at an earlier stage. We present a bizarre case of a carcinoma ex-pleomorphic adenoma which mimicked an advanced breast cancer, complete with a ‘nipple-like’ extension and peau d’orange changes in the overlying skin as a result of a dense dermal inflammatory response. A procedure akin to a mastectomy with facial nerve preservation was carried out for removal. To our knowledge, peau d’orange has not been reported before in parotid tumours.

Use of two-piece polyetheretherketone (PEEK) implants in orbitozygomatic reconstruction

M.L. Goodson, D. Farr, D. Keith, R.J. Banks — 2011-06-23

Polyetheretherketone (PEEK) is a semicrystalline polyaromatic linear polymer that exhibits an excellent combination of strength, stiffness, durability, and environmental resistance. It is derived from the polyaryletherketone family of linear aromatic polymers.

Postoperative management of arthroplasty by using unique splints in almost edentulous patient

Wataru Kakuguchi, Hiro-o Yamaguchi, Nobuo Inoue, Yasunori Totsuka — 2011-05-12

Management of ankylosis of the temporomandibular joint (TMJ) is difficult. Arthroplasty without interpositional grafts requires a gap of 10–20mm to prevent reankylosis, and often results in deviation of the mouth after shortening of the ramus and contraction of postoperative scars. Various interposition grafts, reconstruction, and distraction osteogenesis have been used, but maintenance of space is the key to a successful arthroplasty. Interposition with a temporalis muscle flap and a Matthews device arthroplasty (MDA) has given good results. The flap prevents ankylosis but does not completely maintain a vertical gap. Though the Matthews device ensures the gap, it requires 2 operations. We think that treatment of ankylosis of the TMJ should ensure an ideal occlusion and requires sequential physiotherapy. Postoperatively it is particularly important to restore mandibular function and prevent reankylosis.

Intraoperative red cell salvage in head and neck surgery

M.A. Nusrath, C.J. Edge, A. Ahmed-Nusrath — 2011-06-27

We describe the use of intraoperative cell salvage for surgical excision of a nasopharyngeal angiofibroma. A 13-year-old boy (American Society of Anesthesiologists grade 2, weight 34 kilograms) had resection of a juvenile nasopharyngeal angiofibroma. Preoperative computed tomography (CT) showed a mass in the posterior nasal space extending to the nasopharynx with bony erosion of the pterygoid plates, and extension into the pterygopalatine fossa (). Preoperative embolisation had been of limited success because of large collaterals that communicated with the internal carotid artery ().

Leaflet to aid postoperative placement of elastics after orthognathic surgery

A.F. Nocher, R.E. McMullan, D. Pierse — 2011-06-23

Orthognathic surgery moves the maxilla or mandible, or both, into a new position. After operation the resting length of the musculature, connective tissue, and bones are changed and must adapt to their new position. Postoperative interdental elastic traction helps this to be maintained, and if placed correctly, promotes an optimal final occlusion and helps to alleviate muscle spasm ().

Surgical (open) gastrostomy and repair of the radial forearm donor site

Andrew M. Felstead, Ceri W. Hughes — 2011-06-13

Highlights: ► Head and neck cancer patients may require perioperative nutrition via gastrostomy ► Surgical (open) gastrostomy reduces risk of tumour seeding ► Mini laparotomy provides opportunity for skin graft harvest to repair radial donor site. ► Synchronous procedures reduce overall operating time. ► The technique has many advantages and minimal morbidity.

Re: L.A. Shanks, T.W. Walker, P.J. McCann, M.J. Kerin, Oral cavity examination: beyond the core curriculum? [Br J Oral Maxillofac Surg 2011]

David Dunleavy — 2011-12-28

I read with interest the study by Shanks et al. on the experience of medical students in learning how to examine the oral cavity. They correctly point out that current teaching in this skill is hit and miss; many students graduate with no formal teaching whatsoever and often they have little perception that it may be a necessary skill for their future practice.

Re: Herd MK, Anand R, Brennan PA. Use of propofol emulsion for intraoperative lubrication of oral and maxillofacial surgical instruments [Br. J. Oral Maxillofac. Surg. 49 (2011) 666–667]

David Dunleavy — 2012-01-09

I found the recent technical note by Herd et al. interesting. All too often we find ourselves in the position of trying to complete surgery with less than ideal tools. Often when the problem presents during an operation the choices are to wait for a replacement pack to be found and opened, or to make-do and complete the case.

Response to letter from Dunleavy [Br. J. Oral Maxillofac. Surg., doi:10.1016/j.bjoms.2011.12.005]

P.A. Brennan, M.K. Herd, R. Anand — 2012-02-15

We would like to thank Mr. Dunleavy for his interest in our paper. We agree that allergy to propofol (particularly its soya-containing carrying medium) is widely reported. However, as stated in the paper, the whole point of our technique was to use an already opened vial of propofol to lubricate any stiff instruments during surgery. Therefore any potential previous allergy or contra-indication to using this agent would have been known by the anaesthetist, and a different drug used. Furthermore, any unexpected allergic reaction to propofol would have most likely occurred followed its earlier administration for the induction of anaesthesia. Even if such an allergic reaction was delayed, the small amount used for lubrication (a few drops) would be unlikely to play any role in the process when compared to the large volume of drug given intravenously for anaesthesia.

Mobile elogbook app for maxillofacial trainees

Nabeela Ahmed, Kavit Amin, Michael Williamson, Kathleen F.M. Fan — 2012-02-03

We wish to bring to the attention of the wider readership a smartphone app that has been co-written by a current maxillofacial trainee, Matthew Kennedy. The mobile elogbook app, which is currently only available on the iPhone platform (the Android version is in production), allows users to enter data directly into their smartphone and upload it at leisure to the elogbook site. It was designed in co-operation with the Royal College of Surgeons of Edinburgh.

Journal Oracle

2012-04-01

Notices

2012-04-01

Not all radiolucencies of the jaw require enucleation: a case of brown tumour

Srikanth Gangidi, Robert Dyer, David Cunliffe — 2011-09-19

Abstract: We describe a case of brown tumour from primary hyperparathyroidism, which presented with radiolucency in the jaw. It was treated by parathyroidectomy, which resulted in complete resolution of the lytic lesion without any surgery to the jaw. It is important to be aware of endocrine causes of a common radiological sign to avoid unnecessary local surgical intervention.

Preservation of the temporalis muscle during cranioplasty

Sunil Dutt Sharma, Bernard Lim, Robert P. Bentley — 2011-08-31

It is necessary to detach the temporalis muscle to enable adequate access to the cranial vault for neurosurgical procedures. Failure to handle and reattach the temporalis muscle carefully during cranioplasty can lead to temporal hollowing. Previously described methods of reattaching the temporalis muscle include titanium miniplates and microscrews, but these can lead to problems of palpable screws and muscle slippage.

Intraoral high condylotomy for a case of chronic mandibular dislocation

Biju Pappachan, Mohan Alexander, B. Snehal — 2011-09-23

A 27-year-old man tripped and fell, striking the right side of his face on the floor. Despite his immediate facial asymmetry and abnormal bite, the diagnosis of dislocation was not made for 4 months. Repeated attempts to reduce it manually had failed, and he was subsequently referred to us. On examination there was deviation of the jaw towards the left with restricted opening (). Chronic dislocation of right condyle was confirmed by panoramic radiography and computed tomography (). Our initial attempt at manual reduction under local anaesthesia was unsuccessful. Finally, the right temporomandibular joint (TMJ) was exposed through a transoral approach for a high condylotomy.

Use of in-house, full-colour printed three-dimensional model for training in endoscopic periradicular surgery for molar radicular cyst

Toshinori Iwai, Naohito Tamai, Yoshiro Matsui, Iwai Tohnai — 2011-09-26

Treatment of molar radicular cysts is challenging and many molars may be removed if endodontic treatment is unsuccessful. Conventional periradicular surgery of molars is not always done, because of the technical difficulties and poor visualisation. Endoscopic periradicular surgery (EPS) has been introduced to avoid having to remove molars. If filling of the root canal is insufficient, we use EPS after endodontic treatment. However, it is difficult to train oral surgeons to resect roots and fill the root of the molar precisely in a retrograde manner under endoscopic guidance, and a training system has yet to be established. We have therefore created in-house, full-colour printed three-dimensional model for training in EPS for molar radicular cyst.

Polyglycolic acid sheets with fibrin glue (MCFP technique) for resection of oral mucosa

Hisanobu Yonezawa, Souichi Yanamoto, Goro Kawasaki, Masahiro Umeda — 2011-10-05

Early oral cancers (stage I and II) or precancerous lesions are often treated by partial resection. If the resection is so great that primary closure is not possible, a tieover dressing may be used.

Increased systemic side effects of prostaglandin analogue eye drops in patients with palatal defects

Anna Maria Gruener, Michael Frederick Peter Griffiths — 2011-09-07

Prostaglandin eye drops (see e.g. Lumigan; Allergan, Inc., Irvine, California, USA) are commonly used as first-line therapy in glaucoma. Side effects are mainly ocular and include conjunctival hyperaemia and increased eyelash growth.

Potential risks: Re: a method for the extraction of impacted upper third molars

Yang Yao, Ping Gong, Xiaohua Zeng, Hwa Tang — 2011-09-02

We were interested in this paper about a method of extraction of impacted upper third molars. The method described is ingenious, but we write to mention some potential risks. Firstly, there is the possibility of fracture of the root as it requires a hole of about 5–7mm to be drilled at the enamel–bone junction. From the mechanical point of view this may reduce the strength of the tooth. In the case of multirooted upper third molars, intraoperative fracture of the root is likely and this is significantly more likely to perforate the sinus than if the root is not fractured (27% compared with 14%). Lodgement of the fragment of the root in the ostium of the maxillary sinus has also been reported. It would therefore be better if the method took the different types of root of upper third molars into consideration.

Not the same key for all the locks: Re: Reasons for delayed presentation in oral and oropharyngeal cancer: the patients’ perspective

Chaudhry Kirti, Gurvanit Lehl, Manjit Talwar — 2011-09-23

The study by Rogers et al. reaffirmed the point that the diagnosis of oropharyngeal cancer is more likely to be delayed than that of other high profile malignancies throughout the world. Immediate corrective measures should be taken to hasten its diagnosis and improve survival. Formulation of these corrective steps requires the knowledge of the exact reasons behind the delay in diagnosis, and these reasons are not the same throughout the world. Socioeconomic status is one of the main factors that governs the cause of this delay. In developed countries the main reasons cited are lack of knowledge among general, medical, and dental practitioners, whether or not the patient has health insurance, and lack of awareness among the general public.

Letter to the Editor

Anastasios Kanatas — 2011-10-05

I read with interest the calls on the government from the Cancer Research UK, on the 14th of September press release. Harpal Kumar, CEO of Cancer Research UK, stated the critical need for government input and pointed out the recent government commitments in the spending review and Plan for Growth through its research and innovation strategy announced in the Higher Education White Paper. In the same report Lord Willis of Knaresborough, chair of the Association of Medical Research Charities (AMRC), said: “AMRC and our 127 members welcome this report and its proposals for sustaining and strengthening the UK research environment.”