Medicine and Science from The BMJ

How not to miss kawasaki disease

Kawasaki Disease presents as fever and rash, which makes diagnosis difficult.
In this podcast, Anthony Harnden, professor of primary care at the University of Oxford, describes what to watch out for to ensure you don’t miss the diagnosis.
Read the full article:
http://www.bmj.com/content/349/bmj.g5336

Risky Business - Kevin Fong - learning too much from aviation?

Is medicine trying to learn too much from aviation?
Kevin Fong, consultant anaesthetist at UCLH is currently working with Kent, Surrey and Sussex air ambulance. At Risky Business he talked to The BMJ about why he thinks medicine is trying to learn too much from aviation.

Preventing overdiagnosis - the problems with screening

Screening tests were central to many of the discussions taking place at the Preventing Overdiagnosis conference (preventingoverdiagnosis.net)
To sum up some of the problems with screening we’re joined by Carl Heneghan, director of the Centre for Evidence Based Medicine at the University of Oxford, and John Broderson, associate professor in the Research Unit and Section of General Practice at the University of Copenhagen.
For more on over diagnosis, visit
www.bmj.com/too-much-medicine

Trans-sphenoidal surgery, a patient’s experience

A recent clinical review in The BMJ discusses diagnosis and management of prolactinomas and non-functioning pituitary adenomas.
One management option is surgery to remove the tumour, often this can done trans-sphenoidally. Though major complications of this type of surgery are low (~1%), there are still effects that can be distressing to patients, and should be discussed.
In this interview the patient wished to remain anonymous, so we have re-recorded her words. She describes the way in which attempts to reassure her about the surgery made he under-estimate the risks involved.
Read the full review:
http://www.bmj.com/content/349/bmj.g5390

Overtreating mild hypertension, are we doing more harm than good?

Stephen Martin, an associate professor at the University of Massachusetts Medical School, thinks we're overtreating otherwise healthy patients who have mild hypertension.
In this podcast he sets out his argument, and explains why prescribing drugs to these people may actually be doing more harm than good.
Read the full analysis article:
http://www.bmj.com/cgi/doi/10.1136/bmj.g5432

Should patients be able to email their doctor?

Demand for better access to primary care is ever rising, but is email the answer? In this podcast, Elinor Gunning, a clinical teaching fellow in London says that patients want it and that careful planning can mitigate worries about safety and security. Emma Richards, trainee academic GP, is not so sure and thinks clearer guidance and resourcing are needed first.
Read the head to head online:
http://www.bmj.com/content/349/bmj.g5338

Ebola virus disease, a long terms perspective

David Heymann, professor of infectious disease epidemiology, and head and senior fellow, at the Chatham House Centre on Global Health Security was sent to investigate the first outbreaks of Ebola in 1976. In this podcast he gives a longer term perspective on the disease, and talks about the importance and challenges of introducing novel treatments.
For more information on ebola virus disease, including working in a front line clinic, visit bmj.com/ebola
David Heymann's analysis article, Prevention is better than cure for emerging infectious diseases: http://www.bmj.com/content/348/bmj.g1499

How to test for an immediate food allergy

A new rational testing article, published on thebmj.com, looks at how to diagnose an immediate food allergy. Mabel Chew, The BMJ's practice editor, is joined by Cathal Steele from the Belfast Trust Regional Immunology Service - they discuss which tests are appropriate, and the common pitfalls in diagnosis.Read the full article:http://www.bmj.com/content/349/bmj.g3695

Diagnosing and managing spasticity in adults

Management of spasticity requires a balanced approach, weighing the benefits of treatment against the usefulness of the spasticity. Current interventions to treat spasticity lack a robust evidence base, and guidelines often depend on expert recommendations. A new clinical review published on thebmj.com discusses the assessment and treatment of spasticity in adults.In this podcast we're joined by one of the authors of that review, Siva Nair, from the Department of Neurology at The Royal Hallamshire Hospital, and by a patient with spasticity, Ian, who is chairman of the Hereditary Spastic Paraplegia (HSP) Support Group.Read the clinical review: http://www.bmj.com/content/349/bmj.g4737For more information on HSP visit http://hspgroup.org/

Are essential medicines essential?

Global endorsement as a WHO essential medicine is big step. But Corrado Barbui, from the Department of Public Health and Community Medicine at the University of Verona, has found that the quality of applications for antidepressants and antipsychotics is poor and calls on applicants and WHO to raise standards.
Read the analysis article:
http://www.bmj.com/content/349/bmj.g4798