Medicine and Science from The BMJ

UTIs are often diagnosed in secondary care, but often that diagnosis isn't accurate. In this podcast Gavin Barlow from the Department of infection and tropical medicine at Hull & East Yorkshire Hospitals NHS Trust joins us to discuss when and how to test for the infection​. Read the full clinical review Investigation of suspected urinary tract infection in older people http://www.bmj.com/content/3...

The BMJ has been investigating the “cosy relationship” between the alcohol industry and the British government. In a series of articles Under the influence, journalist Jonathan Gornall has been looking into UK government’s consultation into introducing a minimum unit price for alcohol in England and Wales, and also at the wider responsibility deal between government and industry which is meant to...

A new analysis article on bmj.com discusses the story of a surgical colon cancer trial, that was started 30 years ago and then abandoned, and the data lost. In this podcast Helen Macdonald talks to Tom Treasure from Imperial College London, who has unearthed the data and now published the research. Also joining the discussion is Peter Doshi, one of the instigators of the RIAT initiative set up to...

Digital technology introduces new concerns for confidentiality and information security. In this podcast Bradley Crotty and Arash Mostaghimi, both from Harvard Medical School, outline the regulations governing confidentiality and medical privacy and provide practical advice on how to safeguard patient information Read their article for more details: http://www.bmj.com/content/348/bmj.g2943

The International Olympic Committee (IOC) and other international sports federations have recently introduced policies which require a medical investigation of women athletes known or suspected to have hyperandrogenism. Women who are found to have naturally high testosterone levels and tissue sensitivity are banned from competition unless they have surgical or pharmaceutical interventions to lower...

Michael Farrell, professor and director of the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney, talks to Mabel Chew, The BMJ's practice editor, about prescription of cannabinoids. They discuss the latest evidence on nausea and appetite, when cannabinoids may be effective for chronic pain, and which common problems to watch out for. Read the full article: ht...

Glycated Haemoglobin (HbA1c) is used to measure glucose control in patients with diabetes, but can now be used as an alternative test to glucose concentration for diagnosing type 2 diabetes or identifying people at high risk of developing the disease. in this podcast Eric Kilpatrick, from the Department of Clinical Biochemistry at Hull York Medical School, and Stephen Atkin, from Weill Cornell Med...

First seizure covers a wide range of manifestations, but picking up the minor events can prevent a patient from experiencing a major event, so early diagnosis is key. Heather Angus-Leppan, consultant neurologist and epilepsy lead at the Royal Free Hospital in London, talks to Navjoyt Ladher about how to manage the first seizure in an adult. Read the full clinical review at: http://www.bmj.com/cont...

Tamiflu (oseltamivir) is a neuraminidase inhibitor, developed by Roche, for the treatment of seasonal and pandemic influenza. Yet for the first time a comprehensive review of the data, by independent researchers, has shown that the claims for Tamiflu’s effectiveness have been overestimated, and that harms have been underreported. Here is the audio of a recent press conference where researchers and...

Mabel Chew talks to Tamara Pringsheim, from the University of Calgary, about the use of triptans for acute treatment of migraine. When, how, and what contraindications a physician should be aware of. Read the full article: http://www.bmj.com/content/348/bmj.g2285

The NHS has been collecting data on patients’ experience of care for over 10 years but few providers are systematically using the information to improve services. Angela Coulter joins us to discuss the new Friends and Family test, and why it will fail to change services until it asks the right questions. read the full paper: http://www.bmj.com/content/348/bmj.g2225

Meticillin resistant Staphylococcus aureus (MRSA) remains one of the foremost hospital acquired pathogens. Patients colonised or infected with MRSA provide a reservoir within hospitals, although infection prevention and control measures minimise the risk of transmission. Although there is broad agreement on the control measures required for patients colonised or infected with MRSA, there is consid...

Read the full analysis of ParkinsonNet: http://www.bmj.com/content/348/bmj.g1838 Patients with Parkinson’s disease need long term support to manage their condition. In this podcast Bastiaan Bloem, medical director at the Parkinsons Institute in Nijmegen, and Marko van der Vegt, a Parkinsons patient, describe the benefits of ParkinsonNet; a model of integrated care provided by a network of speciali...

Subdural haematoma is more common in elderly patients, yet the condition is easy to miss in this group. John Young, a consultant geriatrician at Bradford Teaching Hospitals NHS Foundation Trust, describes what clinical signs to look out for, and what tests can confirm a diagnosis of subdural haematoma.

Each year at the Nuffield Trust Health Policy Summit, The BMJ hosts a breakfast roundtable. It has been one year since the Health and Social Care Bill for England was enacted, and the reconfiguration of the NHS continues, so this year we asked our panel to give the bill an end of year report. Taking part were: John Richards – Southampton Clinical Commissioning Group Nigel Edwards - CEO Nuffield Tr...

Read the open access research: http://www.bmj.com/cgi/doi/10.1136/bmj.g1458 Australia was one of the first countries to introduce HPV vaccination, and due to it's cervical cancer screening programme, is one of the first to be able to measure the effectiveness of the vaccine. In this podcast, 3 of the authors of a new paper on bmj.com discuss their findings and talk about implications for cervical...

Most doctors are familiar with patients who describe chronic pain all over the body, which is associated with a range of other symptoms including poor sleep, fatigue, and depression. This complex of symptoms is sometimes referred to as fibromyalgia. Management of patients with this condition is often complex and challenging. The diagnosis of fibromyalgia has long been controversial, with some expe...

Complete implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) recommends policies in China that would prevent almost 13m smoking related deaths by 2050, suggests a paper published on bmj.com. China is home to about one third of the world’s smokers and reducing smoking in China could have an enormous public health impact, even on a global scale. To disc...

Controversy rages over the relative benefits or harms of screening for breast cancer, with evidence suggesting that in younger women at least it does more harm than good. Now a new paper on bmj.com reports the results of 25 years of follow up of women who have taken part in a breast cancer screening trial in Canada, and suggests that annual screening does not cut breast cancer deaths. Anthony Mill...

Read the full article online: http://www.bmj.com/content/348/bmj.g401 When you prescribe a drug, do you ever stop to wonder if it's suitable for vegetarians? Kinesh Patel and Kate Tatham from Imperial College London have found that 74 of the 100 drugs most commonly prescribed by GPs in the UK contain ingredients which may have been derived from animals.

Read the full article: http://www.bmj.com/content/348/bmj.g129 Erectile dysfunction is a common problem, and novel treatments mean that patient’s options have widened. In this podcast Asif Muneer, consultant urological surgeon and andrologist at University College Hospital in London, explains the aetiology, treatment, and prognosis for the condition.

Two articles on bmj.com look at high risk devices for rare conditions, and how the US Food and Drug Administration regulates them. Joining us to discuss the problems are Rita Redberg, professor of medicine at the University of California San Francisco, and Aaron Kesselheim, assistant professor of medicine at the Harvard School of Public health. Read the articles Presumed safe no more: lessons from...

Read the article: http://www.bmj.com/content/348/bmj.f7003 The 2013 World Health Organization guidelines continue to recommend rapid fluid resuscitation for children with shock, despite evidence from the FEAST trial that this can increase mortality. Katheryn Maitland, professor of tropical paediatric infectious disease at Imperial College London, who led the FEAST trial, joins us to discuss it.

Read the head to head: http://www.bmj.com/content/348/bmj.g171 The BMJ no longer publishes research funded by tobacco companies. Richard Smith says that research funded by drug companies is also flawed and published to encourage sales, but Trish Groves says that the industries are fundamentally different and that moves are afoot to increase integrity Join the authors live on Twitter to debate the...

When searching for clues to reach a diagnosis, neurologists often empathise with the detective who is trying to solve a case, write Peter Kempster and Andrew Lees in BMJ sister journal Practical Neurology bit.ly/1dqReQq. In this podcast, journal editor Phil Smith and Andrew Lees, director of the Queen Square Brain Bank in London, discuss how neurologists draw upon detective skills. They also talk...