BMJ Best Practice Podcast

Constipation in children

Childhood constipation is typically characterised by infrequent bowel evacuations, large stools, and difficult or painful defecation.
Symptoms may result from low fibre, poor nutrient, and/or insufficient water intake, which leads to excessive hardening of the stool. This often starts as an acute problem but can progress to faecal impaction and chronic constipation.
Claire Zar-Kessler, Instructor in Pediatric Gastroenterology, Massachusetts General Hospital for Children, Boston gives us a clinical overview of the condition.
Please always check the licensed indications for medications in your own country.
For more on constipation in children, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/784
-
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.

Raynaud’s phenomenon

Raynaud's phenomenon (RP) is characterised by vasospasm that causes digits to change colour to white (pallor) from lack of blood flow, usually brought on by cold temperatures.
Affected areas subsequently turn blue due to de-oxygenation and/or red due to reperfusion. It can be a painful condition and can lead to complications.
Janet Pope, Professor of Medicine, Division of Rheumatology, Department of Medicine, University of Western Ontario, gives a clinical overview of the condition.
For more on Raynaud's phenomenon, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/193
-
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.

Chronic kidney disease

Chronic kidney disease (CKD) is a common condition that is often unrecognised until the most advanced stages.
The most common causes are diabetes mellitus and hypertension.
Manisha Singh, Assistant Professor, Division of Nephrology, Department of Internal Medicine, University of Arkansas for Medical Sciences, gives us an overview of the condition.
For more, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/84
-
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.

Covid-19 update: Management, vaccination and chronic conditions

Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to covid-19.
Matt Castleden, GP and section editor, updates us on pulse oximetry, prognostic scoring, and management in hospital.
And Abigail Davis, GP and section editor, covers Covid-19 vaccination and chronic conditions, including advice for patients with thrombocytopenia, and those taking immunosuppressive drugs, ACE inhibitors or ARBs.
For more, see:
BMJ Best Practice's topic on management of coexisting conditions in the context of COVID-19: bestpractice.bmj.com/topics/en-gb/3000190
BMJ Best Practice's topic on covid-19: bestpractice.bmj.com/topics/en-gb/3000168
BMJ Learning's quick tips module: proning in critical care: learning.bmj.com/learning/modules/elucidat/10065419
BMJ Learning module on COVID-19 rapid guideline on critical care (NICE): new-learning.bmj.com/course/10065100
BMJ Learning covid-19 in primary care module: new-learning.bmj.com/course/10065230

Depression in children

Depression in children is characterised by sad or irritable mood, anhedonia, decreased capacity to have fun, decreased self-esteem, sleep disturbance, social withdrawal or impaired social relationships, and impaired school performance.
It is one of the most common paediatric psychiatric disorders, especially among girls during adolescence.
David A. Brent, Endowed Chair in Suicide Studies, Professor of Psychiatry, Pediatrics, Epidemiology, and Clinical and Translational Science, University of Pittsburgh, gives us an overview of the condition.
For more on depression in children, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/785
-
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.

Covid-19 update: Vaccination, long covid-19, endocrine conditions, bronchiolitis

Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to covid-19.
Matt Castleden, GP and section editor, updates us on vaccination and long covid-19.
And Abigail Davis, GP and section editor, covers Covid-19 and comorbidities, namely endocrine conditions and bronchiolitis.
For more, see:
BMJ Best Practice's topic on management of coexisting conditions in the context of COVID-19: bestpractice.bmj.com/topics/en-gb/3000190
BMJ Best Practice's topic on covid-19: bestpractice.bmj.com/topics/en-gb/3000168
BMJ Learning module on COVID-19 rapid guideline on critical care (NICE): new-learning.bmj.com/course/10065100
BMJ Learning covid-19 in primary care module: new-learning.bmj.com/course/10065230
JCVI independent report published by the Department of Health: www.gov.uk/government/publications/prioritising-the-first-covid-19-vaccine-dose-jcvi-statement/optimising-the-covid-19-vaccination-programme-for-maximum-short-term-impact
Online covid-19 recovery platform: www.yourcovidrecovery.nhs.uk

Covid-19: Vaccination, remdesivir, and comorbidities

Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to covid-19.
Matt Castleden, GP and section editor, updates us on vaccination and the use of remdesivir.
And Emma Scott, section editor, covers Covid-19 and comorbidities, namely COPD, learning disabilities and obesity.
For more, see:
BMJ Best Practice's topic on management of coexisting conditions in the context of COVID-19: bestpractice.bmj.com/topics/en-gb/3000190
BMJ Best Practice's topic on covid-19: bestpractice.bmj.com/topics/en-gb/3000168
BMJ Learning module on COVID-19 rapid guideline on critical care (NICE): new-learning.bmj.com/course/10065100
BMJ Learning covid-19 in primary care module: new-learning.bmj.com/course/10065230
UK Gov guidance on covid vaccinations: gov.uk/government/publications/covid-19-vaccination-programme-guidance-for-healthcare-practitioners
UK Gov Green Book covid chapter: gov.uk/government/publications/covid-19-the-green-book-chapter-14a
-
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.

Acute asthma exacerbations in children

Asthma exacerbations present with acute or sub-acute onset of wheeze and respiratory distress, the symptoms and signs of which vary depending on the developmental and maturational age of the child.
Triggers include viral or bacterial infection, inhaled allergens, environmental irritants, emotion, medications, and poor adherence with preventive therapy.
Paul D. Robinson, Respiratory and Sleep Physician, The Children's Hospital at Westmead and Associate Professor, Discipline of Paediatrics and Child Health, University of Sydney, gives a clinical overview of acute asthma exacerbations in children.
For more on acute asthma exacerbations in children, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/1098
-
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.

Covid-19 and comorbidities

A recent meta-analysis by Espinosa and colleagues, “Prevalence of Comorbidities in Patients and Mortality Cases Affected by SARS-CoV2”, found that 42% of patients with Covid-19 had comorbidities.
Furthermore, 61% of those with Covid-19 admitted to the Intensive Care Unit had comorbidities, and 77% of those who died had comorbidities.
Hypertension was the most prevalent comorbidity (affecting 32% of patients). Other common comorbidities included diabetes (22%), heart disease (13%), and COPD (8%).
In this podcast Andrew Lewington, Consultant Renal Physician and Honorary Clinical Associate Professor, St James’s University Hospital, Leeds, gives us an overview of managing patients with Covid-19 and common comorbidities.
For more on Covid-19 and comorbidities, see BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/3000201/treatment-algorithm
Read the meta analysis: Espinosa OA, Zanetti ADS, Antunes EF, Longhi FG, Matos TA, Battaglini PF. Prevalence of comorbidities in patients and mortality cases affected by SARS-CoV2: a systematic review and meta-analysis. Rev Inst Med Trop Sao Paulo. 2020;62:e43. Published 2020 Jun 22. doi:10.1590/S1678-9946202062043

Gestational diabetes

Gestational diabetes develops during pregnancy and is usually diagnosed at 24 to 28 weeks of gestation on the basis of elevated plasma glucose levels on glucose tolerance testing.
The goal of therapy is to achieve maternal glucose levels that are as close to normal as possible in order to avoid fetal macrosomia and complications.
Chloe Zera, Assistant Professor, Harvard Medical School gives us a clinical overview of the condition.
For more on gestational diabetes, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/665
-
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.