Medicine and Science from The BMJ

Cats, dogs, and biomarkers of ageing.

The notion that animal companionship might be linked to human health can be traced to ancient writings and, with the first population based study conducted at least four decades ago.
Although some empirical evidence links animal companionship with apparent protection against a series of important health outcomes in middle aged populations, including premature mortality, obesity, hypertension, and hyperlipidaemia, systematic reviews and position statements suggest that these associations are not universal.
To investigate this further, the authors of this observational study, looked at the prospective link between pet ownership and a selected range of objective biomarkers of ageing proposed for use in large scale population based studies of older people.
Richard Watt, professor of dental public health at University College London joins us to discuss their results.
http://www.bmj.com/content/359/bmj.j5558

Small, medium, or a pint of wine?

Wine glasses come in a range of sizes, but the average wine glass in the UK today can hold almost ½ a litre.
That wasn’t always the case - and a new analysis, on bmj.com takes a look at the changing size of wineglasses from 1700 until now.
To discuss how the size of glass affects consumption we're joined by Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge and Zorana Zupan, a research associate in the Unit.
We're also joined by Matthew Winterbottom, curator of decorative arts at the Ashmolean Museum in Oxford, to tell us about the history of wine drinking in the UK.
Read the full analysis:
http://www.bmj.com/content/359/bmj.j5623

Taking the temperature of 37°C

Average body temperature is 37°C, right?
That was the conclusion of Carl Wunderlich in his magnum opus, The Course of Temperature in Diseases - Wunderlich published that in 1868, following his extensive collection of body temperature readings - and 37°C stuck. But, it’s not as simple as that
Philip Mackowiak, emeritus professor of medicine, and now history of medicine scholar in residence, at the University of Maryland School of Medicine, has been interested in temperature for a long time. He joins us to explain how Wunderlich measured temperature, and what he actually found.
Read his editorial:
http://www.bmj.com/content/359/bmj.j5697

Manflu - are men immunologically inferior?

Manflu, the phenomenon that men experience the symptoms of viral illness more than woman, is usually used with derision - but a new review, published in the Christmas edition, is asking - is there a plausible biological basis for this sex difference?
Kyle Sue is a clinical assistant professor in family medicine at Memorial University of Newfoundland, and a GP in northern Canada - and has been looking at the research on sex difference in immune response.
Read the full article:
http://www.bmj.com/content/359/bmj.j5560

I thought I wasn’t thin enough to be anorexic

Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk.
In this podcast we speak to the mother and daughter authors of a What you patient is thinking article, who describe what it's like for a family to experience a child with an eating disorder.
In a linked podcast, we talk with the authors of two practice articles, which give advice on spotting and treating eating disorders in young people.
Read the articles:
http://www.bmj.com/content/359/bmj.j5328
http://www.bmj.com/content/359/bmj.j5378
http://www.bmj.com/content/359/bmj.j5245

Early detection of eating disorders

Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk.
In this podcast we talk with the authors of two practice articles, which give advice on spotting and treating eating disorders in young people.
In a linked podcast, we speak to the mother and daughter authors of a What you patient is thinking article, who describe what it's like for a family to experience a child with an eating disorder.
Read the articles:
http://www.bmj.com/content/359/bmj.j5328
http://www.bmj.com/content/359/bmj.j5378
http://www.bmj.com/content/359/bmj.j5245

Should all fetuses be monitored electronically during birth?

Our latest H2H debate asks: Is continuous electronic fetal monitoring useful for all women in labour?
Peter Brocklehurst is professor of women’s health at the University of Birmingham. He argues that continuous electronic fetal monitoring during labour can lead to harm and increase the risk of caesarean section.
Christoph Lees is reader in obstetrics and fetal medicine at Imperial College London. He argues that continuous electronic fetal monitoring is useful for all women in labour as it helps avoid fetal and neonatal morbidity

”Obesity is the last thing it’s OK to discriminate on the basis of”

We have a problem in obesity research — clinical trials continue to prioritise weight loss as a primary outcome and rarely consider patients’ experience, quality of life, or adverse events - and now a new analysis article, "Challenging assumptions in obesity research" questions that focus on weight.
Navjoyt Ladher discusses this thorny topic with Liz Sturgiss, GP, obesity researcher at Australian National University Medical School, and one of the authors of that paper.
Read the full analysis:
http://www.bmj.com/content/359/bmj.j5303

Dieting, cardiovascular disease, cancer, and mortality

We know that adults with obesity have an increased risk of premature mortality, cardiovascular disease, some cancers, type 2 diabetes, and many other diseases.
However, the effect of dieting on 3 of those outcomes (cancer, cvd, and mortality) is surprisingly little studied.
However a new systematic review and meta-analysis does bring together what we know of that effect, and to explain the evidence we're joined by Alison Avenell, professor in the Health Services Research Unit, University of Aberdeen.
Read the full systematic review and meta-analysis: http://www.bmj.com/content/359/bmj.j4849

Antibiotic prescription course - an update

In July, The BMJ published an analysis article called “The Antibiotic Course has had it’s day” - a provocative title that turned out the garner a lot of debate on our site. The article said that the convention for the length of a course of antibiotics was set by Flemming, in his Nobel Prize acceptance speech - “If you use penicillin, use enough!” - and that the evidence base hasn’t moved on since then.
The article has had over 40 substantive responses, both agreeing and vehemently not - and so we thought it worth revisiting that argument, now the dust has settled.
Discussing that are Martin Llewellyn, professor of infectious disease at Brighton and Sussex Medical School, and Paul Little, professor of primary care at the University of Southampton.
Read the original analysis:
http://www.bmj.com/content/358/bmj.j3418