The current state of play in the histopathologic assessment of alopecia: two for one or one for two?

The histopathologic assessment of a scalp biopsy for alopecia relies largely on the quality of the specimen provided for evaluation. There are a number of different protocols in the literature which have been proposed over the years, but no consensus has yet been reached as to the appropriate number of biopsies to be taken, or to which sectioning technique is the gold standard for achieving the best diagnostic yield. We herein review the pros and cons of the various protocols and share the experience with our St John's protocol.

Opinions of the ePortfolio and workplace-based assessments: a survey of core medical trainees and their supervisors.

Since the introduction of Modernising Medical Careers in 2005, the electronic portfolio (ePortfolio) and workplace based assessments (WPBAs) have become integral, yet anecdotally controversial, components of postgraduate medical training. In this multi-centre, survey-based study, we looked at core medical trainees and trainers in the Northwest London region and their opinions of the ePortfolio and WPBAs. Our results demonstrate mixed feelings regarding these tools, with 60% of trainees stating that their training had not benefited from the use of an ePortfolio. 53% of trainers felt that feedback sessions with their trainees were useful; however 70% of them cited difficulties in fitting the required number of assessments within their clinical schedule. Overall, if implemented correctly, the ePortfolio and WPBAs are potentially powerful tools in the education and development of trainee doctors. However, improvements in mentoring and feedback may be needed to experience the full benefits of this system.

An update on the prevalence of the metabolic syndrome in children and adolescents.

OBJECTIVE: Our goal was to provide an update on the worldwide prevalence of the metabolic syndrome (MetS) in children and adolescents. EVIDENCE ACQUISITION: The Medline and Embase databases were searched for articles published between August 2007 and January 2009, in which the prevalence of the metabolic syndrome was analyzed in populations aged between 2 and 19 years, using several recognized definitions. Diagnostic criteria were extracted for the MetS and prevalence rates by sex, age group, body mass index status and ethnicity. EVIDENCE SYNTHESIS: A total of 36 studies were included. The prevalence estimates from general population and community-based sampling ranged form 1.2% to 22.6% with rates of up to 60% observed in the overweight and obese. CONCLUSIONS: This update shows that the metabolic syndrome remains a major worldwide health concern in children and adolescents, particularly amongst the obese. Suggestions for future research include establishing which individual components of the MetS cluster confer the most risk on future morbidity.