Articles

Over the last decade, intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents have been increasingly used in the management of various…

Some of you may have read my EMJ blog titled ‘The Four Pillars of Living Well with COPD’, which was published last year.

To mark this year’s World Osteoporosis Day (WOD) on the 20th October 2017, the European Medical Journal spoke to the International Osteoporosis…

Spasmodic dysphonia (SD) was described in 1871 as ‘nervous hoarseness’, known as ‘spastic dysphonia’.1 It was not until 1976 that it was acknowledged as…

Over the years, various allergen inhalation challenge models have been developed to study the pathophysiology and pharmacology of allergen-induced asthma.

Recently, there have been enormous developments in the endoscopic management of central airway obstruction secondary to benign or malignant processes.

The process of successfully weaning patients from invasive mechanical ventilation is a great challenge for all healthcare providers working in critical care.

Lung cancer is the most common cancer worldwide and is a fundamental health problem in the UK. Mortality rates are much higher in the UK than other…

Although thymomas and thymic carcinomas only represent 0.2–1.5% of all malignancies, they are the most common tumour found in the anterior mediastinum.

Currently, evidence concerning electronic cigarette (e-cigarette) use in the West Indies is unavailable. This study examines the prevalence and…

Pancreatic cancer (PC) still represents an unresolved therapeutic challenge due to the associated poor prognosis and the lack of responsiveness to…

Radical prostatectomy is widely used as the primary modality of treatment for clinically localised prostate cancer.

FDG-PET is widely used for cancer staging before treatment and detection of recurrence during post-treatment surveillance.

Melanoma is the most aggressive and deadly form of skin cancer. The high rate of patient death is related to advanced melanoma metastasis, which usually…

Extracranial germ cell tumours are derived from dysregulated, unipotent to totipotent, primordial germ cells and can arise from heterogeneous sites and…

Pleural malignancies constitute either primary pleural malignancies, such as malignant pleural mesothelioma (MPM), or secondary pleural tumours, either…

Dr Maxine Szramka is a Rheumatologist in Sydney Australia. She blogs regularly at Dr Maxine Speaks10 and is a passionate advocate for the health and…

Blue is the colour of hope that brings a broader awareness to a rare cancer called mesothelioma.

Cardiac disease often impacts cancer therapy, from direct toxicity of cancer therapeutic agents to the coronary endothelium, the myocardium, heart valves…

Second-generation drug-eluting stents are currently considered the standard of care in patients undergoing treatment for coronary artery disease…

Ischaemic mitral prolapse (IMP) is a pathologic entity encountered in about one-third of patients undergoing surgery for ischaemic mitral regurgitation.

Cardiac diseases have complex molecular origins. However, current clinical diagnostic tools are often inadequate to uncover specific molecular components…

Acute coronary syndrome (ACS) encompasses a spectrum of clinical disorders of myocardial ischaemia or infarction, with atherosclerosis leading to…

Premature atrial and ventricular contractions, or ectopic beats, are frequently detected on routine electrocardiogram monitoring.

Arrhythmogenic cardiomyopathy (ACM) affects mainly young athletes <35 years old and has a potential risk of malignant arrhythmias and sudden death.

This review gathers evidence to enable recognition of cardiac cachexia and improve identification of patients with terminal heart failure.

Quality of life in asthma patients is severely impacted, with many heavily limited in their day-to-day activities, and a worrying proportion experiencing…

Spasmodic dysphonia (SD) is a rare neurological condition and diagnosis is often missed, which can potentially cause immense suffering for patients, both…

Several healthcare professionals at the European Respiratory Society (ERS) International Congress 2017 expressed concerns with patient-doctor communication

Myelofibrosis (MF), either primary or secondary to polycythaemia vera or essential thrombocythaemia, is the most symptomatic and has the worst prognosis…

Hypereosinophilic syndromes are a group of disorders characterised by significant eosinophilia and organ damage.

Multiple myeloma (MM) is a plasma cell disorder that represents almost 10% of haematologic malignancies.

Cardiogenic shock (CS), a state of inadequate tissue perfusion due to cardiac dysfunction, remains the leading cause of death following acute myocardial…

Peyronie’s disease (PD), which is characterised by fibrous plaque formation in the tunica albuginea of the penis, is associated with pain, erectile…

Since the recognition of asymptomatic bacteriuria (ABU), several studies have questioned its significance.

During this review, the action and role of serotonin reuptake inhibitors at different levels will be discussed, along with their relevance and effectiveness in the treatment of premature ejaculation.

To evaluate whether alpha blockers facilitate the navigation of the ureteroscope through the ureteric orifice, if administered preoperatively, based on…

Chronic total occlusions (CTOs) are detected incidentally in ˜20% of patients undergoing coronary angiography and are often associated with…

The aim of fetal pericardiocentesis is to reduce the risk of pulmonary hypoplasia, the development of cardiac tamponade and fetal hydrops, and in some cases to allow fetal lung maturity, improving fetal extraction with a better haemodynamic and respiratory condition.

The purpose of this review is to provide the haematologist with a working knowledge of the common inherited bone marrow failure syndromes (iBMFS)…

Chronic neutrophilic leukaemia (CNL), chronic eosinophilic leukaemia-not otherwise specified (CEL-NOS), and myeloproliferative neoplasm (MPN)…

Acute lymphoblastic leukaemia (ALL) in adults has a survival rate of 40–50% at 5 years, with a high relapse rate after first-line chemotherapy.

Ovarian cancer (OC) is a disease that almost invariably relapses even after optimal primary cytoreductive surgery and standard first-line platinum-based…

The industrialised world is truly a marvel; through years of innovation and invention, society has been rewarded with extreme technological advances.

Patients with polycystic ovary syndrome (PCOS) have unique endocrine and metabolic characteristics, whereby the incidence and potentiality of obesity, as…

Maternal ovarian torsion in pregnancy is very rare. Non-specific symptoms, signs, and imaging findings make the diagnosis difficult.

The multitude of research clarifying critical factors in embryonic organ development has been instrumental in human stem cell research. Mammalian…

The use of donor oocytes has expanded the scope of assisted reproductive technology (ART) for women with poor oocyte quantity and quality.

Endometriosis is a chronic condition that affects ˜10% of young women worldwide. Pain and infertility are the two most common features..

It is well known that consumption of a balanced diet throughout adulthood is key toward maintenance of optimal body weight and cardiovascular health.

Migraine is a leading cause of disability worldwide. Despite increasing knowledge about its pathophysiology and neurobiology over recent times, treatment…

Additional efficacious treatment options for stroke are urgently needed as thrombolysis and endovascular thrombectomy are too rarely utilised due to the…

Headaches are common in children and adolescents, and are the most common pain complaint when seeking medical advice.

Viral haemorrhagic fever (VHF) viruses cause infectious diseases that are of public health importance. Billions of people from all over the world are at…

Neurosyphilis can manifest as recurrent brain infarction, although not frequently, but can be challenging to diagnose due to atypical presentations.

Migraine prophylaxis represents a better choice than symptomatic drugs, both for safety and for effectiveness.

Spasmodic dysphonia (SD): what about it? That is the million-dollar question.

There are ˜3,000 children, as well an additional ˜7,000 adults, diagnosed with acute lymphoblastic leukaemia (ALL) each year in the USA.

The actin cytoskeleton plays many important roles in the lifecycle of platelets, from biogenesis from megakaryocytes, to activation and clearance from…

The management of acute lymphoblastic leukaemia (ALL) remains challenging.

In 2016, an update on the classification of lymphoid neoplasm was published, and one of the modifications made focussed on B-cell lymphoma…

The myelodysplastic syndromes form a heterogeneous group of clonal disorders with an increasing incidence in the elderly population and an emerging…

Sickle cell disease is a genetic disorder caused by sickle haemoglobin. In many forms of the disease, the red blood cells can change shape upon…

I have been asked to share my opinion about the diagnostics of anaphylaxis and how to treat it.

Microbiological occupational allergens usually originate from a part or products of bacteria, fungi, or arthropods.

Emerging technologies are profoundly changing the landscape of allergy diagnoses and future allergy treatments.

The incidence and prevalence of food allergies have dramatically increased in recent decades, especially in children.

In effort to improve food-allergic patients’ quality of life, there is a continuous effort to provide novel treatment options for food allergy

MAS is a complication of SJIA which increases morbidity and mortality and can be rapidly fatalif left untreated. Read the article to know more

How many of us know we observe World Breastfeeding Week (WBW) from 1st–7th August, every year? World Breastfeeding Week is co-ordinated by the World…

Uveitis is an inflammatory disease with significant disease burden, as it causes ≤10% of legal blindness in the USA.

In this review, the role of the organic osmolytes taurine, betaine, myo-inositol, and sorbitol in skeletal muscles in general, and in myositis in…

Systemic lupus erythematosus is a chronic, multi-organ disease that predominantly affects young women of childbearing age.

Rheumatoid arthritis, the most frequent chronic inflammatory autoimmune disease, can lead to pain, bone and articular destruction, and limb…

Vitamin D acts as a steroid hormone possessing important functions in calcium and phosphorus balance and bone health.

Acute kidney injury in tropical countries is strikingly different from that in countries with a temperate climate.

Vitamin D (VD) is a key factor in calcium-phosphorus metabolism. In addition, it has increasing popularity due to its pleiotropic effects: renal…

Intra-abdominal candidiasis (IAC) is the second most common form of invasive candidiasis after candidaemia.

Acute kidney injury (AKI) is a common complication of critical illness and is associated with high morbidity and mortality.

Autosomal dominant polycystic kidney disease is the most common inherited kidney disease and results from mutations in the polycystin 1 gene (PKD1) or…

Echocardiography has an important role in the diagnosis, treatment, and management of patients who require transcatheter valvular interventions.

Stent thrombosis (ST) is uncommon yet constitutes the most feared complication following percutaneous coronary intervention.

Congenital heart disease represents the most prevalent birth defect, and surgical and interventional advances have translated to a burgeoning adult…

Early discontinuation of dual antiplatelet therapy (DAPT) has been identified as a risk factor for late stent thrombosis after the implantation of…

Bifurcation coronary lesions still represent a challenge for interventional cardiologists.

Percutaneous coronary intervention for chronic total occlusion (CTO) remains a challenging prospect for many interventional cardiologists.

As any rheumatologist knows, most non-medical individuals don’t really know what ‘rheumatology’ is. Not so much of a bad reputation, as no reputation.

The Liver Meeting®, the official meeting of the American Association for the Study of Liver Diseases (AASLD), held in Boston, Massachusetts, USA…

One of the major complications of cirrhosis is the development of portal hypertension and variceal bleeding. Varices develop at a rate of 5% per year…

This review will cover the epidemiology, risk factors, pathogenesis, and pathology of hepatocellular carcinoma (HCC).

Clinical presentation of hepatocellular carcinoma (HCC) can vary from asymptomatic patients to patients presenting variable symptoms such as pain, lethargy…

Hepatocellular carcinoma (HCC) treatment is variable and depends on the size, location, and presence of extra hepatic metastasis and vascular invasion.

Many complications can occur during the evolution of chronic Hepatitis C virus (HCV) infection. Some of them can be…

Like it or hate it, social media, such as Twitter, Facebook, and Instagram, is having an impact on medicine. It is changing the way healthcare providers…

A tour of the stands at the 41st International Urogynaecology Association (IUGA) Annual Meeting in August 2016 revealed a growing number of companies…

The implications of the low tissue regenerative potential in humans are severe and widespread. Several of our major diseases are direct results of this…

To evaluate the efficacy of the ZSI 375 artificial urinary sphincter (AUS) (Zephyr Artificial Sphincter, Geneva, Switzerland) for the treatment of…

In 2015, the world recorded its highest numbers of international migrants and forced displacement since World War II. With this historic rise in migrants…

Management of chronic pain, usually associated with comorbid conditions, remains challenging. General practitioners, together with multidisciplinary…

Significant variation in health outcomes exists around the world. The International Consortium for Health Outcomes Measurement (ICHOM) has developed…

Castration-resistant prostate cancer (CRPCa) is an advanced stage of prostate cancer in which a tumour progresses even under androgen deprivation…

Non-high-density lipoprotein (non-HDL) cholesterol is the sum of low-density lipoprotein (LDL) cholesterol and very-low-density lipoprotein (VLDL)…

An estimated 11 million workers in the USA are potentially exposed to agents that can become a cause of allergic diseases such as occupational asthma and…

Improved Clinical, Laboratory, Molecular, and Pathological (CLMP) 2017 criteria for myeloproliferative neoplasms (MPN) define the JAK2V617F trilinear…

Many autoimmune diseases, such as lupus and Sjögren’s syndrome, have a female bias and adult onset. One possible explanation for this bias is disruption…

Previous studies have demonstrated that the vision of one’s own body, or of external embodied limbs, can lead to pain relieving outcomes. Analgesic…

Intravenous thrombolysis (IVT) and intra-arterial thrombolysis (IAT) are useful therapeutic tools to improve functional outcomes after recanalisation of…

Adrenal cortical carcinoma (ACC) is a rare malignant tumour which arises from the adrenal cortex with diverse clinical manifestations due to excessive…

Renal arteriovenous malformations and fistula are an uncommon, underdiagnosed condition that can be asymptomatic.

Prostate-specific antigen (PSA) is the main tool of detection for prostate cancer (PCa).

Anterior urethral strictures affect the male urethra between the tip of the penis and the apex of the prostate.

Premature ejaculation (PE) can be a very distressing condition and has been studied for many years.

Renal stones are a common condition causing significant morbidity and economic burden.

MENTAL HEALTHCARE within the UK and globally has come under increasing scrutiny. With mental health problems being the main cause of overall disease…

The National Health Service (NHS) in the UK is set to introduce major changes to the NHS Choices website in the following months, after an increased…

Global warming remains one of the largest global threats to our health. The size of the challenge is immense but political interventions have so far…

Three-dimensional (3D) printing is an additive manufacturing process. This technology provides us with the opportunity to create 3D structures by adding…

The emergence of B cell receptor (BCR) kinase inhibitors has recently changed the treatment landscape in chronic lymphocytic leukaemia (CLL). The…

Haemangiomas are benign tumours growing by vascular endothelial hyperplasia, commonly occurring in females.

In recent decades, tremendous medical advances have been made. Therapeutic cardiac catheterisation for repair of congenital heart defects has become the…

Transcatheter aortic valve implantation (TAVI) is an alternative, less invasive method to use for aortic valve replacement in high-risk patients. This…

Osteoarthritis (OA) is the most common form of arthritis, yet has historically lagged far behind rheumatoid arthritis in terms of drug development.

Cardiovascular disease is a leading cause of death and disability worldwide. Current treatment strategies aimed at treating the consequences of coronary…

Metabolic syndrome (MS) is a highly prevalent disease related to the risk of cardiovascular disease and diabetes. A large body of evidence has suggested…

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterised by recurrent thromboembolic events (arterial or venous) and/or morbidity…

The micro and macrovascular complications of Type 2 diabetes mellitus are influenced by several well described cardiovascular risk factors such as…

Duchenne muscular dystrophy (DMD) is a severe and fatal muscle condition affecting young children. Without interventions, affected boys lose the ability…

The Liver Meeting 2016, held by the American Association for the Study of Liver Diseases (AASLD) in Boston, Massachusetts, USA, supported the…

Clostridium difficile infection (CDI) rates have been increasing, with a corresponding rise of morbidity and mortality. The primary treatment modality of…

When looking at the relationship between young people and health, the question must be considered: what does ‘healthy’ mean or look like today?

Coffey et al.1 justify the designation of mesentery as an individual organ. Various news outlets have posted articles on this topic with sensational…

A growing stream of literature argues for a more active role for patients and caregivers in healthcare delivery, namely in…

Last year in England alone there were approximately 57 million failed attempts to book general practitioner appointments.

Digital technologies are changing how we practice and experience healthcare. This review focusses on the role of eHealth technologies in facilitating…

Personalised medicine, with the aid of companion diagnostics, is a burgeoning field. The potential benefits of personalised medicine…

Self-management programmes for epilepsy have been developed and studied for several decades but have proven difficult to implement and sustain…

The purpose of this study was to calculate the prevalence and nature of item construction flaws within one large medical school and to identify several…

In the past decade, imaging has advanced to become a crucial tool in fundamental and biomedical research and it has become increasingly important…

Objective: The utility of virtual reality (VR) pain management to reduce visceral or autonomic responses is presented in 115 cases…

The relationship between intestinal microbiota and the brain has been the focus of attention of the scientific world in recent years; >90% of the…

To better understand what may be considered ‘innovative’ in healthcare, we suggest criteria for innovation and identify potential challenges to newly introduced innovations in the field.

Mobile health (mHealth) is the utilisation of mobile technologies in healthcare and has particular relevance in improving lifestyle behaviours…

…The findings of the study showed that patients with chronic obstructive pulmonary disease (COPD) who received the drug Relvar…

Since the early 2000s, an increasing number of studies have focussed on the adverse health effects of sitting. Sitting, together with other activities…

Introduction: Whiplash or indirect injuries to the neck are a common occurrence because of motor vehicle collisions, in which the frequency of ocular…

The European Society for Medical Oncology (ESMO) Congress was held in Copenhagen, Denmark from 7th–11th October 2016. The use of the promiscuous…

Endoscopic lung volume reduction (ELVR) mainly comprises endobronchial valves (EBV) and endobronchial coil (EBC) implants. EBV aims to occlude the most…

Non-transfusion-dependent thalassaemia (NTDT) is a rather broad term that encompasses a group of thalassaemia syndromes, most commonly β-thalassaemia…

Parkinson’s disease is a complex, progressive neurodegenerative disorder associated with both motor and non-motor symptoms. Current treatment strategies…

Occupational allergies are groups of work-related disorders that are accompanied by immunologic reaction to workplace allergens and include occupational…

Allergen-specific immunotherapy remains the only causal treatment of allergic disease to date. Its efficacy in symptom reduction was demonstrated in…

People with Type 2 diabetes mellitus (T2DM), compared with non-diabetic individuals, have increased cardiovascular risk. Part of this excess risk is…