Medicine and Science from The BMJ

Management of a multiple sclerosis relapse

Nicki Ward-Abel, a lecturer practitioner in MS at Birmingham City University, joins us to explain how to treat patients who are experiencing a relapse of their MS symptoms. She discusses what constitutes a relapse, which treatments are available, and what effect a relapse can have on a patient.
Read more at:
http://www.bmj.com/content/350/bmj.h1765

Health apps for well people - problematic or panacea?

Some apps have the potential to encourage healthier habits and are accessible to most people, argues Iltifat Husain, but Des Spence notes the lack of any evidence of effectiveness and the potential for encouraging unnecessary anxiety.
Read more about in our head to head "Can healthy people benefit from health apps?" - http://www.bmj.com/content/350/bmj.h1887

Foodbanks - is supply or demand increasing their usage

Doctors are witnessing increasing numbers of patients seeking referrals to food banks in the United Kingdom. Rachel Loopstra, a post-doctoral researcher at the University of Oxford and colleagues have been asking if that rise is due to supply or demand?
Read their full analysis:
http://www.bmj.com/content/350/bmj.h1775

How to talk to a patient about delusional infestation

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

Withdraw the interim report on the UK’s billion unit pledge

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 They say that the report should be withdrawn and revised targets set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://www.bmj.com/content/350/bmj.h1301

Preventing sudden cardiac death in athletes

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 discuss the diagnosis of cardiac changes and prevention of death in this population.
Read the full clinical review:
http://www.bmj.com/content/350/bmj.h1218

Trigeminal neuralgia - the evidence base for medical and surgical treatments

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 Neurological Surgery at the University of California Irvine, discuss the evidence, the issues around it, and put this all into a clinical context.
Read the full systematic overview:
http://clinicalevidence.bmj.com/x/systematic-review/1207/overview.html
Disclaimer:
The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions.
By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.
BMJ does not warrant the accuracy of the information contained in the podcast and to the fullest extent permitted by law, BMJ Publishing Group Limited is not responsible for any loss whatsoever resulting from the application of, or reliance upon, the information contained in this podcast.

Thrombolysis in acute ischaemic stroke - time for a rethink?

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 mortality with uncertain benefit for its use beyond three hours.
Read their full analysis:
http://www.bmj.com/content/350/bmj.h1075

Chris Moulton A and E - patients are usually justified in presenting as an emergency

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.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of work.

Patrick Keating GP - under pressure to increase list size

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 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. Please include your name, job title, and place of work.