Medicine and Science from The BMJ

Francesca Conway, from the Department of Primary Care and Public Health at Imperial College London is co-author of an article on diagnosis of COPD. She joins us to discuss the major guideline recommendations, and highlights where they concur and where they differ. Read the full article: http://www.bmj.com/content/351/bmj.h6171

Larger portions of food increase consumption. Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge, joins us to discuss how government action to tackle portion size and packaging could help reset our appetites and make us thinner. Read the full analysis: http://www.bmj.com/content/351/bmj.h5863

The UK Parliament's Health Select Committee's recent report on childhood obesity says 1 in 5 children are obese by the time they leave school. The committee calls for legislation to turn the tide by taxing sugary drinks, a pre-watershed ban on junk food advertising, and investment in public health. We joined Sarah Wollaston, conservative MP for Totnes, and chair of the committee for lunch (thai ch...

PTSD may develop after exposure to exceptionally threatening or horrifying events. About 3% of the adult population has PTSD at any one time, and more than 50% in survivors of rape. In this podcast Jonathan Bisson, professor of psychiatry at the School of Medicine in Cardiff joins us to talk about the evidence for diagnosis and treatment, and Sarah Cosgrove, the patient author of the paper, discus...

Doctors considering strike action may worry about the effect on patients. David Metcalfe and colleagues examine the evidence and find that “patients do not come to serious harm during industrial action provided that provisions are made for emergency care.” Read the full analysis: http://www.bmj.com/content/351/bmj.h6231

In the podcast, we’ll hear from Kevin Hines the survivor of such an attempt, and Alys Cole-King, a psychiatrist who wants to break down the stigma of suicide. Originally broadcast in 2010 For more on suicide risk assessment and prevention, read our latest clinical review: http://www.bmj.com/content/351/bmj.h4978

When healthy volunteers are scanned as part of a research project, unexpected findings, with uncertain implications, can be thrown up. Joanna Wardlaw, professor of applied neuroimaging and honorary consultant neuroradiologist at the University of Edinburgh, joins us to discuss how her group deals with these incidental findings, and what volunteers and patients want to happen when they are found. R...

Medicine has long been a rewarding career, but doctors say the profession needs to overcome the frustrations of working in the NHS to ensure it remains so. During the Big Debate at BMJ Live in London last week six speakers argued for and against the motion, “This house believes that medicine is the best career in the world.” After presentations from the six speakers and questions from the floor, t...

Shivani Misra, clinical research fellow and specialist trainee in metabolic medicine from Imperial College London, joins us to discuss diagnosis and management of diabetic ketoacidosis in adults. She talks us through UK and US guidelines, and explains what the latest evidence tells us about prescribing fluid and insulin. Read the full clinical review: http://www.bmj.com/content/351/bmj.h5660

Europe's common agricultural policy (CAP) on sugar is due to change, and Emilie Aguirre, from the UKCRC Centre for Diet and Activity Research at the University of Cambridge, argues that an influx of cheap high fructose corn syrup (HFCS, isoglucose) into the European market will have a negative effect on on the health of the continent. Read the full analysis here: http://www.bmj.com/content/351/bmj...

“The people of the UK are right to treasure their NHS,” writes Mark Britnell in his new book In Search of the Perfect Health System (Palgrave Macmillan). Currently chairman of KPMG Global Health, Britnell has worked in healthcare systems in over 60 countries. For his book he analysed 25 healthcare systems in search of what was working and what wasn’t in times of challenging demographic and economi...

Thousands of NHS staff have demonstrated against the government’s threatened “imposition” of an “unsafe and unfair” contract for junior doctors. At a London rally on Saturday 17 October junior doctors and supporters noisily defended their trade union, as speakers accused England’s health secretary, Jeremy Hunt, of misleading the public about research evidence on weekend mortality rates in hospital...

Given the number of effective treatments for type II diabetes, which have good evidence about safety and efficacy, should any new drugs for the condition be subject to a higher regulatory bar? In this podcast, Huseyin Naci from the London School of Economics, John Yudkin from Univerity College London, and Ben Goldacre from the University of Oxford, explain why they believe the current process is i...

The current orthodoxy is that home is the best and preferred place of death for most people, but in this podcast, Kristian Pollock a sociologist from Nottingham University questions these assumptions and calls for greater attention to improving the experience of dying in hospital and elsewhere. Read the full analysis: http://www.bmj.com/content/351/bmj.h4855

The “correct” rates of discretional interventions are difficult to define. However, David Hamilton and Colin Howie point out that discrepancies in usage of knee arthroscopy within the UK suggest the organisation of the care pathway may be an important determinant Read their full analysis: http://www.bmj.com/content/351/bmj.h4720

With improved survival and and ageing population, the number of people living with coronary heart disease in the UK has increased to an estimated 2.3 million. There is increasing evidence that cardiac rehabilitation benefits these patients, and as such it has been included in international clinical guidelines. To discuss cardiac rehabilitation in this podcast, we're joined by Hasnain Dalal, a GP a...

With improved survival and and ageing population, the number of people living with coronary heart disease in the UK has increased to an estimated 2.3 million. There is increasing evidence that cardiac rehabilitation benefits these patients, and as such it has been included in international clinical guidelines. ​In this podcast, we're joined by Kevin Paul, who explains what it's like to receive car...

They have a big impact on the diet of American citizens, and those of most Western nations, so why does the expert advice underpinning US government dietary guidelines not take account of all the relevant scientific evidence asks Nina Teicholz. Read the full investigation: http://www.bmj.com/content/351/bmj.h4962

Around two fifths of the world’s population (those in tropical and subtropical countries), or up to 2.5 billion people, are at risk of dengue infection. An estimated 50 million infections occur annually worldwide, with 0.5 million of these cases being admitted to hospital for dengue haemorrhagic fever. Approximately 90% of these cases are in children aged less than 5 years. The epidemiology is, ho...

Pleural effusions are common, with an estimated 1-1.5 million new cases in the United States and 200 000-250 000 in the United Kingdom each year. Rahul Bhatnagar, academic clinical lecturer at the University of Bristol, describes how pleural effusions may be investigated and treated in the community and secondary care, with a particular focus on the emerging phenomenon of ambulatory management. We...

Ovarian cancer is the 7th most common cancer in women world wide, and 5 year survival continues to remain low - in the UK this has been attributed to delayed diagnosis. In this podcast Sophie Cook is joined today by two women who have had, and been treated for, ovarian cancer. Adele and Rosemary describe their experience, and what they think doctors should know about what patients are feeling. Rea...

Ovarian cancer is the 7th most common cancer in women world wide, and 5 year survival continues to remain low - in the UK this has been attributed to delayed diagnosis. In this podcast Sudha Sundar, senior lecturer in gynaecological oncology at the University of Birmingham, discusses how doctors can identify women at risk, and who to refer for specialist evaluation. Read the full clinical review:...

Although overuse in medicine is gaining increased attention, many questions remain unanswered. At the Preventing Overdiagnosis conference in Washington, Dan Morgan, associate professor at the University of Maryland School of Medicine, and Sanket Dhruva, research fellow at Yale University, propose an agenda for coordinated research to improve our understanding of the problem. Read the full agenda a...

Hepatic encephalopathy constitutes a spectrum of neuropsychiatric abnormalities, beginning with subtle psychomotor changes and progressing to confusion with asterixis, somnolence, and then coma, arising in patients with impaired liver function. In this podcast, Tim Cross, a consultant hepatologist from the Royal Liverpool University Hospital, describes how to diagnose and manage the condition. We'...

Following on from the clinical review "Caring for sex workers", we spoke to the team at Open Doors, a sex worker outreach clinic in east London, run from the Homerton University Hospital NHS Foundation Trust. Kim Leveret and Anca Doczi join us to give practical advice on reaching out to sex workers, what barriers exist to them accessing care, and how to take a sex worker sexual history. Listen to...