Medicine and Science from The BMJ

Peter Lepping, consultant psychiatrist and honorary professor at Betsi Cadwaladr University Health Board in North Wales, joins us to discuss his experience dealing with patients who have delusional infestations. He talks about how to broach the diagnosis, and gives practical tips on how to investigate this difficult condition. Read his practice pointer: http://www.bmj.com/content/350/bmj.h1328

Flaws in the Department of Health’s interim evaluation of an alcohol industry pledge to remove one billion alcohol units from the market raise questions about the claimed success argue John Holmes, Colin Angus and Petra Meier from the Sheffield Alcohol Research Group at the University of Sheffileld. They say that the report should be withdrawn and revised targets set Read the full analysis: http:/...

Sudden cardiac death in athletes aged less than 35 years is the leading cause of medical death in this subgroup, with an estimated incidence of 1 in 50 000 to 1 in 80 000 athletes per year. it is most commonly caused by an underlying genetic heart disorder, such as hypertrophic cardiomyopathy. In this podcast Christopher Semsarian, professor of medicine at the University of Sydney, joins us to dis...

A BMJ Clinical Evidence systematic overview looks at the evidence for medical and surgical treatments of trigeminal neuralgia, and the uncertainties that exist due to gaps in the evidence. This has been summarised in The BMJ. The authors of the overview and bmj.comsummary, Prof. Joanna Zakrzewska from the Facial Pain Unit at the Eastman Dental Hospital, London, and Mark Linskey, Professor of Neuro...

In the US the licence, or marketing authorisation, for alteplase is limited to 0-3 hours after onset of stroke, but some other countries - including the UK and Australia - have extended the licence to 4.5 hours. In an analysis article on thebmj.com Brian Alper, vice president of evidence based medicine research and development at Dynamed, and colleagues, interpret the evidence to suggest increased...

Chris Moulton is VP of the Royal College of Emergency Medicine and an A&E consultant in the Royal Bolton Hospital. He believes that the majority of patients who attend A&E cannot be adequately treated elsewhere, and that measures to try and reduce emergency presentations may be counterproductive. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj...

Katherine Henderson is the clinical lead of the emergency department at St Thomas's hospital in London. She worries that lack of ward space is having a domino effect throughout A and E and is the cause of increased waiting time for both patients and ambulances. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and...

Obioma Ezekobe is a GP in an urgent care centre in Central Middlesex Hospital. She believes that the public need to be educated about the use of NHS resources, and be taught when it is appropriate to seek care. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Ple...

BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. Patrick Keating, a GP from Enfield, is concerned that small practices are under pressure to increase list size, but aren't able to muster resources to meet this increased demand. If you would like to con...

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they rupture, which is fatal in more than 80% of cases. Screening aims to detect the aneurysm before it ruptures, enabling preventive surgery and hence reducing morbidity and mortality. However, preventive surgery has a mortality of 3.9-4.5%. As the prevalence of risk factors, ie smoking, decreases and the definition of the condition...

Ashish Jha, professor of health policy and management at Harvard School of Public Health, talking about how the Affordable Care Act has fostered new models of integrated service delivery in the United States Read more from the summit: http://www.bmj.com/content/350/bmj.h1172

Bastiaan Bloem, consultant neurologist at Radboud University Nijmegen Medical Centre, Netherlands, discussing his revolutionary approach to patient centred care. Read more from the summit: http://www.bmj.com/content/350/bmj.h1172

Overdiagnosis means different things to different people. Stacy Carter, associate professor at the Centre for Values, Ethics and the Law in Medicine at the University of Sydney argues that we should use a broad term such as too much medicine for advocacy and develop precise, case by case definitions of overdiagnosis for research and clinical purposes. Read the full analysis article: http://www.bmj...

In this podcast Alexandra Barratt, professor of public health at the University of Sydney, discusses how questions about overdiagnosis in breast cancer screening programmes were first raised 45 years ago, and why it has taken so long for the concept to become mainstream. Read her full analysis: http://www.bmj.com/content/350/bmj.h867

The BMJ held a breakfast roundtable at the annual health policy summit held by the Nuffield Trust think tank to explore some of the key policy discussions that took place during the ​proceeding day. These included NHS England chief executive Simon Stevens' five year plan, whether politics can be removed from the NHS, and what the creation of a central unit to coordinate care for Manchester means f...

As the level of alcohol consumption goes up, so the risk of physical, psychological, and social problems increases. In this podcast we’re joined by Ed Day, consultant addiction psychiatrist at Kings College London, Alex Copello, professor of addiction research at the University of Birmingham, and Martyn Hull, GP with a special interest in substance misuse at the Ridgacre Medical Centres in Birming...

Jackie Applebee is a GP in Tower Hamlets in London, and is concerned that the way the GP funding formula is working doesn't take account of the earlier health needs of people in deprived areas. For more about the Tower Hamlets Save Our Surgery campaign, visit their facebook page https://www.facebook.com/SaveOurGPsurgeries BMJ Voices is a collection of readers’ experiences of working in the NHS. Fo...

Michelle Sinclar, a GP in Hampshire who is concerned that GP premises aren't fit for purpose and limit her ability to provide fully rounded patient care. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. If you would like to contribute to this collectio...

Mark Folman, a GP in Nottinghamshire, is concerned that more and more work, with more and more patients, means less time with those who really need him. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. If you would like to contribute to this collection...

Participants in our discussion on person centred care in January agreed that a change in culture and better use of technology could benefit both patients and doctors. At the roundtable: Fiona Godlee (chair), editor in chief, The BMJ Tessa Richards, senior editor, patient partnership, The BMJ Rosamund Snow, patient editor, The BMJ Navjoyt Ladher, clinical editor, The BMJ Angela Coulter, director of...

In our accompanying roundtable discussion,we hear views from a group of patients and clinicians based largely in the UK on the actions required  to advance  progress towards providing patient centred care. To extend the conversation we talked to members of the BMJ's international patient advisory panel and other patient advocates - and what follows are short clips of hour long conversations with p...

Karen Grépin, assistant professor of global health policy at New York University, has been examining the pledges made by the international community to help fight the ebola virus outbreak - was it really too little, too late? Read her full analysis: http://www.bmj.com/content/350/bmj.h376

Katie Sidle is a consultant neurologist at the National Hospital for Neurology and Neurosurgery, in London. She helped actor Eddie Redmayne in his portrayal of theoretical physicist and cosmologist Stephen Hawking in the film The Theory of Everything. She joins us to describe how that process worked, and what Motor Neurone Disease patients thought about how their condition was depicted. Read the f...

Bone pain is the most common type of pain from cancer and is present in around one third of patients with bone metastases, currently, improvements in cancer treatments mean that many patients are living with metastatic cancer for several years. Christopher Kane, NIHR academic clinical fellow in palliative medicine at Leeds University School of Medicine, and Michael Bennett, St Gemma’s professor of...

Private hospital chains have been “buying” referrals by offering clinicians lucrative packages, including free facilities in sought after locations. And the doctors’ regulator is turning a blind eye to those who are tempted, Reporter Jonathan Gornall joins us to discuss the investigation. Read the full report: http://www.bmj.com/content/350/bmj.h396