Recent Posts by Aimee Lettis

Frozen shoulder

There's no cure, but there are plenty of treatment options to try. At least frozen shoulder doesn't last forever. Frozen shoulder is one condition I dread diagnosing. Not only will your patient have to suffer a painful, debilitating condition for at least 12-18 months but it’s also a pain (literally!) to treat. The DTB have…
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Testicular cancer

Aimee Lettis from GP Update on how the management of testicular cancer has come a long way in the last 50 years. Testicular cancer survival has been one of the real success stories in cancer treatment in recent years, with cure rates of 95% in patients diagnosed with testicular cancer and 80% in those with…
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GP-Update | Asthma-COPD overlap syndrome

I’m sure we’ve all had patients, perhaps smokers with childhood asthma, who present with breathlessness +/- cough and maybe odd spirometry findings? Is this COPD or asthma? As GPs, we know most patients don’t fit neatly into one diagnosis as guidelines often suggest! Thankfully, GOLD and GINA have produced guidance on asthma-COPD overlap syndrome (ACOS)…
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Vertigo

An elderly patient enters your room appearing unsteady, ‘No, I haven’t had too much to drink, Doc!’. You probably already have a differential diagnosis in your head, labyrinthitis being one of them. But, as this BMJ editorial reminds us, not all vertigo is labyrinthitis (BMJ 2012; 345:e5809). The authors stress that the terms vertigo and…
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Viral warts

This BMJ Review looks at management options (BMJ 2014;348:g3339). Here we are considering skin warts not oral/genital lesions. Key points Common condition, with 7-12% prevalence in general population, higher in children. Majority resolve spontaneously, but can take years! No treatments are guaranteed to work, therefore side effects and cost should be minimised. Which warts need…
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Molluscum contagiosum

Until now, the best treatment was to do nothing, but could a new drug, MolluDab, offer a cure? This DTB article reviews the evidence (DTB 2014;52(10):110). MolluDab is 5% potassium hydroxide solution applied twice daily with a dabber. An inflammatory response should occur after 4-6d with lesions disappearing over the next 1-5w. It is available…
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Motor neurone disease – MND

Motor neurone disease (MND) has been in the spotlight recently courtesy of the film, ‘The Theory of Everything’. This summary produced by the MND Association with the RCGP aims to aid GPs in diagnosing this rare condition, and has been reproduced with kind permission of the MND Association. Diagnosis of MND Remember that MND can…
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QOF 2015-16 (England): clinical indicators

April brings us showers and the start of a new QOF year! Here’s a quick summary of the key changes to the clinical aspects only: CKD has disappeared, with the exception of needing to keep a register. Interesting the year after NICE produced a whole guideline on it! In AF, CHADS2 will no longer be…
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Blepharitis, flashers and floaters

If like me, Ophthalmology training in medical school seemed like a blur (and that was just the view through the fundoscope!), you’ll hopefully find this update on blepharitis and flashes and floaters helpful. Blepharitis Taken from the BMJ 10 minute consultation series (BMJ 2012;345:e3328), this useful reminder summarises management of this common condition. Assessment Look…
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Trigeminal neuralgia

Although rare, trigeminal neuralgia can have a huge impact on a patient’s quality of life. This useful BMJ review gives us guidance on how to spot it and treat it effectively, something your patients with trigeminal neuralgia will no doubt thank you for! (BMJ 2014;348:g474). What is trigeminal neuralgia? A facial pain syndrome which usually…
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