Brit J Hosp Med
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One of the major modern advances in the organization and delivery of health care has been the introduction of multidisciplinary team management. This approach has reduced mortality levels in patients suffering with cancer and other complex multiorgan pathologies. Many centres of excellence and teaching hospitals have established multidisciplinary teams in order to streamline treatment pathways and optimize patient care. This article presents an overview of multidisciplinary teams, their history, their introduction into mainstream medical care and the issues resulting from their introduction to the treating organizations as well as clinicians.
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Biography Historical Article
Sir William Osler: an outstanding teacher of clinical medicine.
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The last two decades have witnessed major advances in genetic sequencing which have led to more accurate identification of women at risk of developing breast cancer and calculating the associated cancer risk. This review discusses the current genetic mutations conferring risk of developing breast cancer and the management pathway for these women with identifiable mutations as well as those with a strong family history for breast cancer. ⋯ There are several treatment options ranging from surveillance to risk-reducing surgery. Risk reduction surgery has been popularised by celebrities who are carriers of breast cancer genes, and raised public awareness of breast cancer genetics and associated risk.
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Neurogenic heterotopic ossification is a condition whereby bone forms in an extra-skeletal site. It may occur in the context of major neurological insult involving the brain or spinal cord. It causes pain and restricts movement, most commonly at the hip joints. ⋯ This article highlights its key features to promote better awareness and recognition, by reviewing clinical findings and imaging of patients across various modalities including plain radiographs, ultrasound and computed tomography. The management of neurogenic heterotopic ossification is limited by late identification and consequently clinicians should always be aware of this potentially significant diagnosis. Recognition in the acute hospital setting before transfer to rehabilitation services may prevent further clinical sequelae including urinary tract infection and pressure ulcers.