Introduction Recent decades have seen major changes in patterns of cardiovascular disease. In the developed world, syphilitic and tuberculous involvement of the cardiovascular system has become rare, and the incidence of rheumatic disease has declined considerably. Myocardial and conducting tissue…
Introduction Diseases of the respiratory system account for up to a third of deaths in most countries and for a major proportion of visits to the doctor and time away from work or school. As with every aspect of diagnosis…
Introduction Pain is a familiar phenomenon that is part of our everyday life and is a feature of various diseases. It most commonly accompanies an injury, where it serves its most important purpose, namely, to protect us, alert us and…
Introduction Fever is one of the most common presenting features in the practice of any doctor who sees patients with acute illness. It is the hallmark of the body’s response to infection or inflammation. Before looking at the causes of…
Introduction A medical emergency requires swift recognition and prompt action. Recognition of urgency does not necessarily require a precise diagnosis; the fact that the patient is dangerously unwell is usually obvious owing to an abnormality revealed by the internationally recognized…
Introduction Psychiatry is the ultimate clinical speciality. At one level, it is about one unique organ—the brain. Unlike other organs, our brains can argue, change jobs, vote and perform many other things. However, the practice of psychiatry is concerned with…
Introduction ‘In the end, it’s not the years in your life that count. It’s the life in your years.’ Abraham Lincoln At the turn of the twentieth century, there were 65000 people in the UK aged 85 or older. By…
Introduction The skill of clinical examination is the true art of medicine and nowhere more so than in the examination of children. Children are not small adults and, as such, the approach to their examination differs. The examiner needs to…
Introduction All medical history taking, examination, investigation and management plans are intensely personal matters for patients. In obstetric and gynaecological practice, intimate details must be elicited; this requires tact, discretion, consideration and the maintenance of proper confidentiality. Women may have…
Introduction The cornerstone of a good relationship between doctor and patient is trust. In primary care, this relationship (often in the context of caring for the whole family) may be built up over several years, but in hospital practice or…