Medical science, drawn into focus.

Complex Regional Pain Syndrome (CRPS) 

Overview CRPS is a disproportionate, regional pain syndrome of a limb that typically follows injury or surgery and features sensory, vasomotor, sudomotor/oedema, and motor/trophic changes. The prevalence after limb fracture/surgery varies widely (≈1–7% overall, higher in some distal radius cohorts) and early recognition with rehabilitation improves outcome. Important risk factors include fracture (especially wrist/ankle), immobilisation,…

Somatoform Disorders

Overview Doctors and patients often experience frustration and helplessness in consultations around medically unexplained symptoms. Up to 50 percent of primary care patients present with physical symptoms that cannot be explained by a general medical condition. Although most do not meet the strict psychiatric diagnostic criteria for one of the somatoform disorders, they can be referred to…

Endometrial Cancer

Overview Endometrial carcinoma is an epithelial malignancy of the uterine corpus mucosa, usually an adenocarcinoma. Endometrial carcinoma is the most common female genital tract malignancy. Postmenopausal bleeding always needs to be investigated because it can indicate malignant disorders and premalignant conditions, such as endometrial hyperplasia. The most common etiology of postmenopausal bleeding is atrophic endometritis or vaginitis. Menopause:…

Lambert-Eaton Myasthenic Syndrome

Overview Lambert–Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of the presynaptic neuromuscular junction. It causes impaired acetylcholine release, producing the characteristic triad of proximal muscle weakness, reduced reflexes and autonomic dysfunction. LEMS may occur as a paraneoplastic syndrome—most commonly associated with small-cell lung cancer (SCLC)—or as a non-tumour-associated autoimmune disorder.  Neuromuscular junction: connection…

Mesenteric Ischaemia

Aetiology and Risk Factors Aetiology Acute mesenteric ischemia can result from occlusion of a mesenteric vessel arising from an embolus, which may emanate from an atheroma of the aorta or cardiac mural thrombus, or from primary thrombosis of a mesenteric vessel, usually at a site of atherosclerotic stenosis. Embolic occlusion is more common in the…

Digoxin Toxicity

75 year old presents to emergency with a 2 day history nausea, vomiting, abdominal pain and diarrhoea. He has not been tolerating oral fluids and is currently confused with a GCS of 14. He has a past medical history of heart failure, atrial fibrillation and chronic kidney injury. He is on digoxin, metoprolol and an…

Birth Defects

Overview Birth defects are the leading cause of perinatal and post- neonatal deaths, and result in substantial morbidity and disability in developed countries. There is a wide variety of mechanisms including genetic, environmental and multifactorial. Major birth defects affect 2–3% of live-borns, and minor birth defects affect 15%. Preventative strategies remain limited, but include maternal folic acid supplementation,…

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