Assessment and management of medically unexplained symptoms
People who present with medically unexplained symptoms are known perjoratively as "frequent flyer", "heart sink" or "thick folder" patients. This is a difficult area for both them and doctors. Patients often suspect that they not being believed, and doctors can feel their competence is being challenged, This clinical review by Simon Hatcher and Bruce Arroll looks at how widespread the issue and how to handle it.
Teaching procedural rounds
"See one, do one" is not the best way to teach the complex technical procedures needed in many hospital based specialties. This paper aims to provide an evidence based algorithm for procedural skills training. It focuses on teaching technical skills, which are just one component of a successful procedure - others are clinical judgement, communication, and team work.
Medical management of Crohn's disease
About 690 000 people in Europe have Crohn's disease, including some 90 000 in the United Kingdom. The estimated healthcare costs are €3.04bn. Current treatment options include biological therapy and use of immunomodulators. J R Fraser Cummings and colleagues review therapeutic potential and associated adverse events.
Investigation of abdominal pain to detect pancreatic cancer
In the latest article in our Rational imaging series, J Ashley Guthrie and Maria B Sheridan discuss the most suitable investigations in a patient with abdominal pain, to establish whether the pain is due to pancreatic cancer.
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Risk of surgery for inflammatory bowel disease: record linkage studies
What can you learn from this BMJ paper? Read Leanne Tite's Paper+
