Dudley Group NHS Foundation Trust runs Russells Hall Hospital and Guest Hospital in Dudley and Corbett Hospital Outpatient Centre, in Stourbridge, West Midlands, England. It also provides community health services to the borough.It agreed in July 2015 to join the Black Country Alliance with Sandwell and West Birmingham Hospitals NHS Trust and Walsall Healthcare NHS Trust. The trusts plan to create a jointly owned Company Limited by Guarantee which will enable them to jointly bid for contracts. There will also be some consolidation of administrative functions like payroll, information technology and estates.
Complete edentulism significantly impacts masticatory function, aesthetics, and quality of life. The selection between fixed and removable prosthetic modalities is a critical clinical decision. This systematic review aims to compare the clinical and patient-reported outcomes of fixed versus removable prosthetic rehabilitations for completely edentulous patients. A systematic search of PubMed/MEDLINE, Scopus, Embase, and Web of Science databases was conducted up to December 2025. Studies were selected based on predefined PICOS criteria, including randomized controlled trials and observational studies. Risk of bias was assessed using the Cochrane RoB 2 tool and the Newcastle-Ottawa Scale. A narrative synthesis was performed due to significant heterogeneity. Ten studies were included. Fixed implant-supported prostheses demonstrated high long-term survival rates and superior masticatory efficiency and occlusal stability compared to removable options. Patient-reported outcomes, particularly oral health-related quality of life, were significantly better with any implant-supported prosthesis (fixed or removable) than with conventional complete dentures. Fixed prostheses (FPs) were associated with technical complications, while removable overdentures (ODs) presented challenges with occlusal wear. Conventional denture satisfaction was primarily linked to retention, comfort, and aesthetic quality. Implant-supported prostheses offer substantially better clinical and patient-reported outcomes than conventional dentures for completely edentulous patients. The choice between a fixed and removable modality involves a trade-off: FPs provide superior function and stability but require more complex maintenance, whereas removable ODs offer easier hygiene and a favorable balance of benefits. Treatment must be individualized based on anatomical factors, patient priorities, and clinical feasibility.
Malignant melanoma is the most common tumour to metastasise to the gastrointestinal (GI) tract; however, symptomatic involvement is uncommon during life. We report a case of small bowel metastatic melanoma presenting as a large aneurysmal jejunal mass in an elderly man with chronic iron-deficiency anaemia and weight loss many years after excision of early-stage cutaneous melanomas. Despite cross-sectional imaging and endoscopic investigations, diagnosis remained uncertain until exploratory laparotomy was performed. En bloc resection of the jejunal segment with associated mesentery achieved complete excision and histopathology confirmed metastatic melanoma. Although molecular analysis identified a BRAF mutation, severe cardiac comorbidity precluded systemic therapy. This case highlights the diagnostic challenges of GI melanoma metastasis, the uncharacteristic radiological appearance of aneurysmal dilatation and the continued role of surgical resection for symptom control and definitive diagnosis in selected patients.
