Cleared for Space? Medico-Legal Risk in Recreational Spaceflight

Civilian spaceflight is expanding, creating new clinical and legal responsibilities for general practitioners (GPs). Pre-flight medical clearance involves high-risk certification, disclosure duties, and potential liability if relevant conditions are missed. Post-flight symptoms may trigger insurance disputes over causation, non-disclosure, or operator responsibility. This workshop uses a staged clinical vignette to examine screening, diagnosis, documentation, and…

Polycythemia vera presenting with aquagenic pruritus in primary care: a case report

Pruritus is frequently encountered in primary care and is often attributed to benign dermatologic or allergic conditions. Aquagenic pruritus (AP), however, is a recognized early manifestation of polycythemia vera (PV). Awareness of AP is important because timely interpretation of subtle symptoms and routine laboratory abnormalities can enable rapid referral and help prevent thrombotic complications.A 46-year-old…

Sleep Hygiene Disorder as the Underlying Cause of Chronic Insomnia: The Importance of a Holistic Approach in Primary Care

Chronic insomnia is a frequent presentation in primary care and often results in referrals to psychiatry or neurology. However, behavioral and environmental determinants—specifically sleep hygiene disturbances—are highly prevalent yet commonly underrecognized. Early detection of sleep hygiene problems can prevent unnecessary pharmacologic treatment and reduce the need for specialist referrals.A 38-year-old man presented with persistent insomnia…

Genetic predisposition and epigenetics of anxiety disorders

Anxiety disorders (ADs) are highly prevalent, heterogeneous group of psychiatric conditions with an impressive public health impact. Twin and family studies confirm a moderate heritability (typically 30-50%), suggesting a clear genetic predisposition. However, the complexity and polygenic nature of ADs, where many common genetic variants each contribute only a small effect, have meant that Genome-Wide Association Studies (GWAS) have…

From Pruritus to Persistent Cough: Early clues to an underlying Lymphoproliferative Disorder

Early manifestations of lymphoproliferative disorders can be subtle and easily overlooked. Cough and pruritus frequently mimic benign dermatological or respiratory conditions.36 year old lady presenting to the clinic with a 6 week history of worsening cough, white phlegm, no systemic symptoms. Smokes 25 cigartettes daily. Normally fit and well.  She was on anxiolytics which were…

Early-Onset Hypersensitivity to Intravenous Iron Isomaltoside: A Case Report of Real- Time Management in Primary Care

Awareness of iron deficiency and its early manifestations has grown in recent years. Although oral iron remains first-line therapy, many patients fail to tolerate or adequately respond to it, leading to broader use of intravenous iron isomaltoside in primary care settings. While IV iron is generally safe, both pseudoallergic and true allergic hypersensitivity reactions can…

Unexpected intracranial finding after minor trauma

Incidental findings on neuroimaging performed after mild traumatic brain injury (TBI) are increasingly reported, partly due to the growing availability and use of Computed Tomography (CT) in Emergency Departments (ED). Current evidence indicates that up to 2–3% of neuroimaging studies for this cause reveal unrelated intracranial abnormalities, most of them benign. These findings can create…

Complicated pneumococcal pneumonia case review

A 28-year-old woman presents with productive cough and left-sided chest pain three days long. Initial chest X-ray is does not show infiltrates, so symptomatic management is started. Three days later, the patient goes to the emergency department with worsening symptoms, as she is found to have markedly elevated CRP (500 mg/L) and procalcitonin (4.8 mg/dL),…

Cardiac alterations following an electric shock

Post-electric shock cardiothoracic symptoms in a 25-year-old female with normal cardiac evaluation.A 25-year-old woman, with no significant medical history, presented to Primary Healthcare following an occupational electric shock two days prior. Since the incident, she has experienced chest oppression, asthenia and bradykinesia. On physical examination, cardiopulmonary auscultation was rhythmic without murmurs or additional sounds; transient tachycardia…