Artificial intelligence (AI) is a powerful and disruptive area of computer science, with the potential to fundamentally transform the practice of medicine and the delivery of healthcare. In this review article, we outline recent breakthroughs in the application of AI in healthcare, describe a roadmap to building effective, reliable and safe AI systems, and discuss the possible future direction of AI augmented healthcare systems.

Synaptic loss correlates closely with cognitive deficits in Alzheimer's disease and represents a new target for intervention. Souvenaid® is the first medical nutrition product to be designed to support synapse formation and function in early Alzheimer's disease, and has undergone an extensive, 12-year development programme. The relatively large amount of clinical data available for Souvenaid® is unusual for a medical nutrition product. Souvenaid® contains omega-3 polyunsaturated fatty acids (docosahexaenoic acid and eicosapentaenoic acid), uridine (as uridine monophosphate) and choline which are nutritional precursors required for synaptic membrane phospholipid synthesis, together with phospholipids and other cofactors. Souvenaid® has demonstrated cognitive benefits in patients with mild Alzheimer's disease but not in patients with mild-to-moderate Alzheimer's disease. Two randomised, double-blind, controlled trials (duration 12 and 24 weeks) in patients with mild Alzheimer's disease untreated with acetylcholinesterase inhibitors and/or memantine have demonstrated that Souvenaid® is well tolerated and improves episodic memory performance. The daily intake of Souvenaid® has not been associated with any harmful effects or interactions with medications and none are anticipated. The ongoing, 24-month, European Union-funded LipiDiDiet trial in subjects with prodromal Alzheimer's disease is evaluating the potential benefits of Souvenaid® on memory and in slowing progression to Alzheimer's dementia. If Souvenaid® induces synaptogenesis and improved synaptic function, it may provide benefits in other clinical conditions characterised by neurodegeneration. A number of trials are ongoing and planned to evaluate the potential wider benefits of Souvenaid®.

Lumps in the neck are a common clinical finding, affecting all age groups. Neck lumps may be extremely worrying for both physician and patient, as a wide variety of pathological conditions can present with a lump in the neck. This can therefore result in difficulties in diagnosis.

Otitis externa encompasses all inflammatory conditions of the external auditory canal. It is a common problem in General Practice and affects all ages, with a slightly higher incidence in women compared to men. Basic treatment measures cure 90% of cases without complications.

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As GP trainees our curriculum puts an emphasis on acquiring valuable skills in communication, and managing clinical complexities. Once we complete our training schemes, and venture into the complex world of general practice, we may face challenges that our training did not prepare us for.Traditionally, GP trainees would complete their training and aim to become partners in a GP practice, or alternatively, bid for open lists in order to set up their own practices. With the recent advent of salaried GP positions, some GPs are resisting partnership positions and opting for alternative positions within a general practice. Regardless of the position, it is inevitable that at some point the GP will recognise that general practice involves complex contracts with Primary Care Trusts (PCTs), which to some degree dictate how we can deliver our services to our local populations. With this article we hope to introduce you to some of these concepts.

Welcome to Update 92 where we concentrate on chapter 3: Contracts and Finance.The financial year of 2013 -2014 has been challenging to say the least. The reorganisation of the NHS in March 2013 has taken a full twelve months to settle down. Only now are the new organisations finding their feet. This has caused a degree of angst in practices as many of our historical contacts are no longer in post or are working in new roles creating a gap with lost expertise. Practice Managers have been required to work with new and evolving systems and develop new contacts in the new organisations.