Medicine and Science from The BMJ

Carotid atherosclerosis and patient participation

A clinical review this week looks at the diagnosis and treatment of carotid atherosclerosis, including when to screen and the threshold for intervention. Alun Davies, professor of vascular surgery at Imperial College London, also answers how useful or harmful screening offered commercially is.Also this week, the BMJ’s editorial board met to discuss how patient participation should be represented and encouraged by the journal. We captured some of their views.

All trials registered | All results reported

The issues of hidden data are well known, and the BMJ’s open data campaign page documents some of the problems which have arisen as a result of clinical trial data remaining undisclosed.At Evidence Live 2013 in Oxford this week, Fiona Godlee, BMJ editor in chief, convened a group of those closely involved with the AllTrials campaign, to discuss where we are now and what still needs to be done

Tackling hypertension in India

The World Health Organization has chosen hypertension as the public health threat it will focus on for the next year. The problem is particularly pressing in India, and Anita Jain, the BMJ's India editor, spoke to François Decaillet, Coordinator for Health Programs, WHO India, about what needs to be done to tackle hypertension in the country's population.

Dealing with delirium

Delirium is often missed in primary and secondary care. Edison Vidal, assistant professor in internal medicine at the Universidade Estadual Paulista, Brazil, advises on diagnosing and managing the condition.Rheumatoid arthritis, non-biological drug treatments, or both, might suppress tumour surveillance and in theory increase the risk of melanoma. Pauline Raaschou, consultant in clinical pharmacology at the Karolinska Institutet, Sweden, explains what she found while investigating the association.

Warts and all

This week, we discuss how Australia’s national human papillomavirus (HPV) vaccination programme has caused a dramatic drop in genital warts. Does this foretell elimination of all disease caused by HPV in the country?And some advice on how to diagnose and manage pulmonary hypertension.

Dying patients in hospital, e-patients online

Patients are increasingly going online to find and discuss information about their condition. What are they getting on the web that they’re not getting from clinicians, and how is this changing healthcare?Also, how to care for a dying patient in hospital.

Suspected heart failure

Mabel Chew, practice editor at the BMJ, talks to Tushar Kotecha, a cardiology specialist registrar at Charing Cross Hospital in London, about when to suspect heart failure, and how to diagnose the condition.

The BMJ Awards: Medical Team of the Year

The BMJ Awards were held last Thursday. Fiona Godlee, the BMJ's editor in chief, announced that the Britain Nepal Otology Service (BRINOS) was named Medical Team of the Year.BRINOS (brinos.org.uk) started out in 1988 by setting up joint British and Nepalese surgical camps to treat ear disease among patients living outside the reach of hospitals in the capital of Kathmandu. A national survey in 1991 found that among the 19m people in Nepal, 2.7m were deaf and 1.5m had abnormal ear drums indicative of ear disease. BRINOS has performed more than 4000 major ear operations at 49 surgical day camps since its first expedition in 1989. Furthermore, there have been many anecdotal stories of improved education and employment opportunities in social isolation after surgery. The organisation expanded in 2000 to introduce community ear assistants, who are specially trained in the diagnosis and treatment of ear disease and dispense hearing aids passed on from the NHS.

Vulnerable adults, and the road to cycle safety

In a drive to improve safety, many cyclists now wear helmets. But how useful is legislation that mandates their use when compared with all the other safety initiatives available? Jessica Dennis, a PhD candidate from the Dalla Lana School of Public Health at the University of Toronto, tells us about her research into accident trends.Also this week, doctors play a key role in spotting when a vulnerable person is experiencing abuse, but it can be difficult to know how to tackle the issue. A clinical review sets out some advice. We're joined by the authors, Billy Boland, consultant psychiatrist and lead doctor for safeguarding adults, and Jemima Burnage, head of social work and safeguarding, at Hertfordshire Partnership NHS Foundation Trust in the UK.

Think then scan, don’t scan then think

Until now, the increased risk of cancer from CT scans has been modelled from the data gathered from survivors of the Hiroshima and Nagasaki bombings. However, new BMJ research, based on a large Australian cohort, offers new evidence to support the modelling. John Matthews, from the university of Melbourne, joins us to explain what they found.Also this week, social media is relatively new – but did you realise that doctors had been using social networks to improve health for centuries? Enrico Coiera, director of the Centre for Health Informatics at the University of New South Wales, explains more, and how in the digital age we might try and use virtual networks to do the same job on a larger scale.