Occupational airways disease
Airway diseases can be either caused or made worse by workplace exposures; early recognition of occupational disease is crucial to achieving a successful outcome for patients. Population research estimates that 10 –15% of adult asthma presentations (new cases or exacerbations of existing disease) can be attributed to a work exposure. Work-exacerbated and occupational asthma have different causal pathways and therefore require different approaches by healthcare professionals in partnership with patients and their employers. (Source: Medicine)
Source: Medicine - August 26, 2023 Category: Internal Medicine Authors: Joanna Szram Tags: Airways disease Source Type: research
Hyper-eosinophilia in the asthma clinic
This article sets out a diagnostic pathway for people presenting with features of eosinophilic lung disease and covers important differential diagnoses. Many eosinophilic lung diseases are responsive to corticosteroid therapy, but this is associated with significant risk and adverse effects as prolonged courses of treatment are often necessary. (Source: Medicine)
Source: Medicine - August 26, 2023 Category: Internal Medicine Authors: Jessica Gates, Jaideep Dhariwal, Alexandra M Nanzer Tags: Airways disease Source Type: research
Chronic obstructive pulmonary disease: aetiology, pathology, physiology and outcome
Chronic obstructive pulmonary disease (COPD) is diagnosed on the basis of airflow obstruction, although the definition also encompasses emphysema. It develops when someone with an (often undefined) genetic susceptibility encounters sufficient inhaled triggers. Genetic susceptibility is complex and determined by multiple alleles; α1-antitrypsin deficiency is the best example of genetic risk. Cigarette smoke is the most common trigger in high-income countries, but globally important contributors include the burning of biomass fuel in under-ventilated spaces, and systematic disadvantage across the life-course affecting lun...
Source: Medicine - August 26, 2023 Category: Internal Medicine Authors: Dheera D.D.D. Ralalage, John R. Hurst Tags: Airways disease Source Type: research
Self-assessment/CPD answers
Question 1 (Source: Medicine)
Source: Medicine - August 26, 2023 Category: Internal Medicine Tags: Self-assessment/CPD answers Source Type: research
Contents
(Source: Medicine)
Source: Medicine - August 24, 2023 Category: Internal Medicine Source Type: research
Editorial Board
(Source: Medicine)
Source: Medicine - August 24, 2023 Category: Internal Medicine Source Type: research
Corrigendum to “Cancer screening” [Medicine 2023; 51(1): 69–74]
On page 71 of the above article, the following two websites should have been included at the base of Table 2. (Source: Medicine)
Source: Medicine - August 8, 2023 Category: Internal Medicine Authors: Karol Sikora Tags: Corrigendum Source Type: research
Contents
(Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Source Type: research
Editorial Board
(Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Source Type: research
Stroke: management and prevention
Acute stroke treatment requires clear protocols to rapidly triage patients – using appropriate investigations – for mechanical thrombectomy and intravenous thrombolysis. Computed tomography (CT) excludes haemorrhage, CT angiography locates the occluded vessel, and CT perfusion and perfusion magnetic resonance imaging identify viable tissue. An organized approach to str oke care in a specialist environment reduces disability and saves lives. Adoption of a ‘care bundle’ approach, including the active management of pyrexia and hyperglycaemia, and early screening for swallowing difficulties, is beneficial. (Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Gina Hadley, Ivie I. Gbinigie, Joyce S. Balami, Alastair M. Buchan Tags: Acute neurology Source Type: research
Stroke: causes and clinical features
Stroke is a clinically defined syndrome of acute, focal neurological deficit attributed to vascular injury (infarction, haemorrhage) of the central nervous system. It is the second leading cause of death and disability worldwide. Stroke is not a single disease but is caused by a wide range of risk factors, disease processes and mechanisms. Hypertension is the most important modifiable risk factor, although its contribution differs for different subtypes. Most (85%) strokes are ischaemic, predominantly caused by small vessel arteriolosclerosis, cardioembolism and large artery athero-thromboembolism. (Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Stephen JX. Murphy, David J. Werring Tags: Acute neurology Source Type: research
Parkinson's disease and related conditions
Parkinson's disease (PD) is a common neurodegenerative condition, affecting 2 –3% of individuals>65 years of age. It is characterized by a loss of dopaminergic neurons in the midbrain leading to a movement disorder encompassing bradykinesia, rest tremor, rigidity and postural stability. However patients also experience a range of non-motor symptoms, reflecting more widespread pathology in the peripheral and autonomic nervous systems as well as the brainstem and cortex. Some non-motor symptoms emerge years before motor problems. (Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Caroline H. Williams-Gray, Paul F. Worth Tags: Movement disorders Source Type: research
Headache and facial pain
Pain involving structures of the head, including the face, is a common symptom presenting to different specialties and comprises>25% of neurology outpatient referrals in the UK. Facial manifestations of headache disorders, and the common involvement of the neck in both primary and secondary headache disorders, can cause presentation of these conditions to specialties such as maxillofacial surgery, ENT and spinal surgery. Such phenotypes may lead to diagnostic dilemma amongst treating clinicians. (Source: Medicine)
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Nazia Karsan, Peter J. Goadsby Tags: Acute neurology Source Type: research
Neurological rehabilitation and the management of spasticity
This review describes the approach to patients with neurological disability using careful assessment, goal-setting, intervention and evaluation. This approach can be used throughout the patient journey to improve function, prevent complications and minimize distress to patients, families and carers. As patients with long-term conditions make up a large proportion of general medical admissions and general practitioner consultations, every practitioner who looks after people with neurological disability should have rehabilitation skills including shared decision-making and goal-setting. (Source: Medicine)
Source: Medicine - July 24, 2023 Category: Internal Medicine Authors: Valerie L. Stevenson, Diane Playford Tags: Neurological rehabilitation Source Type: research
Multiple sclerosis
(MS) is an inflammatory neurological condition that primarily affects young adults. The incidence is increasing. Most people with MS initially present with a clinically isolated syndrome, which is an initial subacute neurological deficit otherwise known as a relapse. Most are subsequently diagnosed with relapsing –remitting MS, the most common form of the disease. Some develop secondary progressive MS; primary progressive MS is the least common form. Treatments are based on immunomodulation or immunosuppression. (Source: Medicine)
Source: Medicine - July 24, 2023 Category: Internal Medicine Authors: Sara Leddy, Ruth Dobson Tags: Multiple sclerosis Source Type: research
