Medicine and Science from The BMJ

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

ParkinsonNet: a new approach to management of chronic disease

Read the full analysis of ParkinsonNet: http://www.bmj.com/content/348/bmj.g1838
Patients with Parkinson’s disease need long term support to manage their condition. In this podcast Bastiaan Bloem, medical director at the Parkinsons Institute in Nijmegen, and Marko van der Vegt, a Parkinsons patient, describe the benefits of ParkinsonNet; a model of integrated care provided by a network of specialists and suggest it has promise for other long term conditions

Recognising a subdural haematoma in the elderly

Subdural haematoma is more common in elderly patients, yet the condition is easy to miss in this group.John Young, a consultant geriatrician at Bradford Teaching Hospitals NHS Foundation Trust, describes what clinical signs to look out for, and what tests can confirm a diagnosis of subdural haematoma.

The Health and Social Care bill: An end of year report

Each year at the Nuffield Trust Health Policy Summit, The BMJ hosts a breakfast roundtable. It has been one year since the Health and Social Care Bill for England was enacted, and the reconfiguration of the NHS continues, so this year we asked our panel to give the bill an end of year report.Taking part were:John Richards – Southampton Clinical Commissioning GroupNigel Edwards - CEO Nuffield TrustJennifer Dixon - CEO Health FoundationTerence Stephenson - president Academy of Medical Royal CollegesMaureen Baker - Chair RCGPHugh Taylor - Chairman Guys and St Thomas' Foundation TrustNick Hicks - CEO COBIC LtdJeremy Taylor - National VoicesTim Ferris - VP for population health management, Partners Healthcare, MANick Timmins - Senior Associate Nuffield Trust

HPV vaccination and cervical cancer screening in Australia

Read the open access research: http://www.bmj.com/cgi/doi/10.1136/bmj.g1458
Australia was one of the first countries to introduce HPV vaccination, and due to it's cervical cancer screening programme, is one of the first to be able to measure the effectiveness of the vaccine.
In this podcast, 3 of the authors of a new paper on bmj.com discuss their findings and talk about implications for cervical cancer screening in Australia.

Recognising and treating fibromyalgia

Most doctors are familiar with patients who describe chronic pain all over the body, which is associated with a range of other symptoms including poor sleep, fatigue, and depression. This complex of symptoms is sometimes referred to as fibromyalgia. Management of patients with this condition is often complex and challenging. The diagnosis of fibromyalgia has long been controversial, with some experts questioning whether it exists as a separate entityIn this podcast Anisur Rahman, professor of rheumatology at University College London, joins us to discuss diagnosis and management of the condition.Read the full clinical review article:http://goo.gl/MYryTJ