My baby smells like fish – trimetylaminuria: a case report

Trimethylaminuria, also known as fish-odor syndrome, is a rare metabolic disorder characterized by the inability to convert trimethylamine, a strongly odorous compound, into its odorless derivative, trimethylamine N-oxide. The accumulation of trimethylamine in the body leads to a strong fish-like odor. Although clinically benign, the disorder has a significant psychosocial impact, affecting self-esteem, social interactions, and overall quality of…

Unmasking Neuroleptic Malignant : A Comprehensive Biological Profile .

Patients referred to ED for suspected Neuroleptic Malignant Syndrome ( NMS) often present with clinical instability and marked biological abnormalities. Understanding their biological profile is essential to support diagnosis and guide early management.To describe the clinical parameters and biological findings observed at ED admission in patients evaluated for suspected NMS.This retrospective, observational, XXcenter study was…

Communication of safety-netting advice for acutely unwell children in urgent primary care: a scoping review

Demand for urgent primary care services for children has risen substantially, yet the quality and safety of communication during brief, high-risk consultations is uncertain. Safety-netting advice is a tool to manage risk and includes information to support recognition of deterioration, ongoing management and when and where to seek further help. This is considered central to…

From orbital telemedicine to rural primary care: Ensuring autonomy and equity with space-derived health innovations

Space agencies like NASA and ESA have developed advanced telemedicine tools to support astronaut health. These include autonomous diagnostics, wearable sensors, AI-driven triage, and satellite connectivity. Many of these innovations are now being transferred to civilian health systems and offer solutions to persistent challenges in rural primary care—especially in under-resourced or geographically isolated regions. Yet…

Prevalence of Burnout Among General Practitioners in a Portuguese Local Health Unit

Family physicians are the healthcare professionals who ensure patients initial access to the care system, maintaining a closer and continuous relationship with each patient. However, this proximity may have negative implications for the physician’s mental health, leading to physical and mental exhaustion. Burnout among family physicians is an increasingly common and multifactorial phenomenon, associated with…

Unconjugated hyperbilirubinemia in an adolescent with ulcerative colitis: a clinical diagnostic challenge

Unconjugated hyperbilirubinemia in adolescents with chronic inflammatory disorders may suggest hemolysis, hepatocellular injury, or immune-mediated hepatobiliary disease. In patients on biologic therapy, distinguishing benign hereditary conditions from drug-related adverse effects is crucial. We describe evaluation of mild scleral icterus in a 16-year-old with ulcerative colitis.A 16-year-old female with ulcerative colitis maintained on anti-TNF therapy presented…

Changes in Clinical Supervision During Emergency Shifts After National Resident Advocacy Efforts: Preliminary Results from the 2026 Spanish Follow-Up Survey

Clinical supervision during emergency department shifts is both a legal and educational requirement in residency programs. However, the 2024 nationwide survey conducted by Asociación MIR España (AME) identified widespread inadequate supervision among Spanish residents. Since then, AME has carried out national advocacy, media campaigns, and institutional negotiations aimed at improving supervision standards. A follow-up survey…