Medicine and Science from The BMJ

Operating to remove recurrent colorectal cancer: have we got it right?

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 encourage this kind of work to correct the scientific record.Read the full article: http://www.bmj.com/content/348/bmj.g2085

Patient confidentiality in the digital age

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 informationRead their article for more details:http://www.bmj.com/content/348/bmj.g2943

The problems with testosterone testing in female athletes

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 their testosterone levels. But a recent analysis published on bmj.com says that these tests and procedures are at best not medically necessary, and at worst totally unethical. In this podcast we're joined by two of the authors, Rebecca Jordan-Young, professor women’s gender and sexuality studies at Barnard College, and Katrina Karkazis, bioethicist at Stanford centre for biomedical ethics.Read the full analysis article online:http://www.bmj.com/content/348/bmj.g2926

Should doctors be prescribing cannabinoids?

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:http://www.bmj.com/content/348/bmj.g2737

Using HbA1c to diagnose type 2 diabetes

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 Medical College Qatar, describe when testing HbA1c may be appropriate for diagnosis, and what comorbidities would rule it out.Read the full rational testing article: http://www.bmj.com/content/348/bmj.g2867

How to manage the first seizure in an adult

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/content/348/bmj.g2470

Tamiflu US Press Conference

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 the BMJ's editors describe the findings of that research, and the systematic regulatory failures those findings expose.Taking part were:Fiona Godlee - BMJ editor in chiefCarl Heneghan - Director of Oxford University's Centre for Evidence Based MedicinePeter Doshi - Assistant Professor of Pharmaceutical Health Services ResearchElizabeth Loder - The BMJ clinical epidemiology editor David Tovey - Editor in chief, Cochrane LibraryBen Goldacre - Founder of the AllTrials campaign

Triptans for the acute treatment of migraine

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

Friends and family test: Don’t just collect data, use it

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

Who, when and how: Screening for MRSA

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 considerable controversy over who, when and how to screen for the bacteria. John Coia, a consultant microbiologist at Glasgow Royal Infirmary, discusses when screening may be appropriate, how it should be carried out, and the best strategy for decolonisation.Read the full article: http://www.bmj.com/content/348/bmj.g1697