BMJ Best Practice Podcast

Fibrocystic breasts: an update on diagnosis and management

Fibrocystic breasts are common. The incidence peaks at 400 per 100,000 woman-years at the age of 40 to 44.
The condition can cause  pain and tenderness that fluctuate with the menstrual cycle. And there is a higher prevalence of cysts as women approach the menopause.
In this BMJ Best Practice podcast, Kieran Walsh talks with Professor Ingrid Lizarraga, Clinical Associate Professor at the Division of Surgical Oncology and Endocrine Surgery, University of Iowa Hospitals and Clinics. Competing interests: None
For more on fibrocystic breasts, visit BMJ Best Practice.

Menopause

The diagnosis of menopause is clinical, based on the absence of menses for 12 months, and does not require further testing for appropriately presenting patients.
Oestrogen therapy is an effective treatment for the management of menopausal symptoms including hot flushes, night sweats, and urogenital symptoms.
In this podcast, Bradford W. Fenton, Independence Park Medical Services, Anchorage, Alaska, gives us further details of diagnosis and management.
For more on menopause, visit BMJ Best Practice.
Disclosures: BWF declares that he has no competing interests.

How to model safe clinical practice

There are concerns that junior healthcare professionals do not use decision support as they don’t see senior staff using it. There are concerns that seniors don't use clinical decision support as they worry about looking things up people in front of people. So a complex issue to discuss.
To find out more about this, listen to this interview with Dr Tom Foley, Consultant Child and Adolescent Psychiatrist with expertise in digital health.

Adhesive capsulitis

Adhesive capsulitis affects 2% to 5% of the population. It is slightly more common in women than in men, and is most common in people between the ages of 40 and 70.
And it can cause a range of problems - including pain, stiffness, and loss of function. So it is important that we get the diagnosis and management of this condition right.
To give us more details about this problem and what we can do about it, Kieran Walsh, Clinical Director at BMJ, speaks with Professor Lance LeClerc, Associate Professor of Orthopedic Surgery at Vanderbilt University Medical Centre in Nashville.
For more on adhesive capsulitis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/1043
Competing interests: None

Gastro-oesophageal reflux disease (GORD)

Gastro-oesophageal reflux disease (GORD) is a common condition that affects between 10% and 30% of people in developed countries.
There can be a range of complications from haemorrhage to stricture to Barrett's oesophagus. So it is important that we get the diagnosis and management of this condition right.
In this BMJ Best Practice podcast on GORD, Kieran Walsh talks with Dr Andres Carrion, Associate Professor of Clinical Medicine at The Division of Digestive Health and Liver Diseases in University of Miami Miller School of Medicine.
For more on GORD, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/82
Competing interests: None

Snoring

Snoring is common. In the 30- to 35-year-old age group, 20% of men and 5% of women snore. By 60, 60% of men and 40% of women will snore habitually.
And snoring can affect the quality of life - of both the patient and their partner.
In this BMJ Best Practice podcast on snoring, Kieran Walsh talks with Dr Showkat Mirza, Consultant in Otorhinolaryngology and Head & Neck Surgery, Sheffield Teaching Hospitals NHS Trust.
For more on snoring, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/1035
Competing interests: SM has no competing interests

Age-related macular degeneration: an update on diagnosis and management

Age-related macular degeneration is the third most common cause of visual impairment worldwide. The main risk is advanced disease and resultant visual loss.
Prompt diagnosis and treatment can make a big difference to the outcome - so it is vital that we get the diagnosis and management of this condition right.
In this BMJ Best Practice podcast on macular degeneration, Kieran Walsh talks with Dr. Sajjad Mahmood, Consultant Ophthalmic Surgeon, Medical Retina Specialist, and Honorary Clinical Lecturer at the University of Manchester.
For more on age-related macular degeneration, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/554
Competing interests: SM has done consultancy work and received honoraria for lecturing and travel from Bayer Pharmaceuticals and Novartis. He has also been a principal investigator for clinical trials on behalf of Bayer, Novartis, and Roche.

Cluster headache: an update on diagnosis and management

The prevalence of cluster headache is about one in 500. In people coming to a headache clinic, the prevalence is about 10%.
Cluster headaches are excruciating and incapacitating, and affect quality of life. Prompt diagnosis and treatment can make a big difference to the outcome - so it is vital that we get the diagnosis and management of this condition right.
In this BMJ Best Practice podcast on cluster headache, Kieran Walsh talks with Professor Amaal Starling, Associate Professor of Neurology at the Department of Neurology in the Mayo Clinic.
Further resources: clusterbusters.org/.
Competing interests: AS has received consulting fees from AbbVie, Allergan, Amgen, Axsome Therapeutics, Everyday Health, Lundbeck, Med-IQ, Medscape, Neurolief, Satsuma, and WebMD.
We release episodes fortnightly.

Spinal cord compression: an update on diagnosis and management

Spinal cord compression is an extremely serious disorder that can have devastating consequences. These include weakness of the legs, bladder and bowel dysfunction, and loss of sensation.
Rapid diagnosis and treatment can make a big difference to the outcome - so it is vital that we get the diagnosis and management of this condition right.
In this BMJ Best Practice podcast on spinal cord compression, Kieran Walsh talks with Professor Kenneth Casey, Clinical Associate Professor in Neurosurgery at Michigan State University and Clinical Associate Professor in Physical Medicine and Rehabilitation at Wayne State University School of Medicine.
Competing interests: none declared
We release episodes fortnightly.

Halitosis: an update on diagnosis and management

Halitosis is common and can affect people of all ages. Severe halitosis is less common but it can affect confidence and quality of life. It can even result in social isolation. So it is important that we get the diagnosis and management of this condition right.
In this BMJ Best Practice podcast on halitosis, Kieran Walsh talks with Professor Stephen Porter, Director of the UCL Eastman Dental Institute in London.
Competing interests: none declared