Brit J Hosp Med
-
Skin cancer is the most common malignancy in the world, and the majority of cases affect the skin of the head and neck. The face is a particularly emotive area for patients who often present with a lesion that is causing them concern. This article reviews the identification, diagnosis and principles of management of non-melanoma skin cancer of the head and neck. ⋯ The vast majority of non-melanoma skin cancer are basal cell carcinoma, followed by squamous cell carcinoma. These and the other types of non-melanoma skin cancer are described and illustrated. Current methods of clinical identification, diagnosis and evaluation of skin cancers are clarified, and contemporary treatment paradigms are presented.
-
Cognitive complaints are very common in people diagnosed with epilepsy. These difficulties are often another manifestation of the same pathology responsible for seizures. ⋯ There is surprisingly little overlap between memory complaints and performance on formal memory tests in this population. This article examines the multifactorial and heterogeneous nature of cognitive difficulties in epilepsy and makes the case for the provision of basic psychoeducation as the foundation for all interventions aimed at ameliorating these difficulties in this patient population.
-
Epidural analgesia is the gold standard for labour analgesia. Dural puncture epidural analgesia is a modification of the conventional technique, where the dura is intentionally perforated with a spinal needle but no intrathecal medication is given. This article reviews the evidence for and against the clinical use of dural puncture epidural.
-
Fractures of the humeral shaft represent roughly 5% of all fractures. They occur in an approximate bimodal distribution, typically affecting young adults following trauma and older females after low energy falls in the presence of osteoporosis. ⋯ While most humeral shaft fractures are conservatively managed, operative management is indicated in certain circumstances. This article provides an overview of these fractures, including their initial management approach and definitive treatment.
-
Review
Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings.
Autistic people experience significant health disparities and reduced life expectancy. Barriers to accessing healthcare are associated with adverse health outcomes. Autism training and healthcare professionals' knowledge about autism is variable, and heterogeneity among autistic people leads to additional educational and clinical complexities. ⋯ This encompasses five core autistic needs: Sensory needs, Predictability, Acceptance, Communication and Empathy. Three additional domains are represented by physical space, processing space and emotional space. This simple yet memorable framework encompasses commonalities shared by autistic people.