Medicine and Science from The BMJ

Drugs to encourage weight loss have a chequered past, with many of them having been withdrawn from the market due to increased morbidity and mortality. In this podcast Raj Padwal, associate professor of medicine at the University of Alberta, takes us through the remaining therapy Orlistat, and discusses the potential for two new therapies, Phentermine-ER topiramate, and Lorcaserin, which are being licensed in some countries Read the full article: http://www.bmj.com/content/348/bmj.g3526

Two articles on bmj.com look at helicobacter pylori; a systematic review and meta-analysis examines if eradication treatment reduces rates of gastric cancer, and an uncertainties article asks who we should be testing and treating for the infection. Two of the authors of those articles, Alex Ford from the Leeds Gastroenterology Institute, and Paul Moayyedi from the Gastroenterology Division of McMaster University, join us to discuss the bacterium. Read the full articles www.bmj.com/content/348/bmj.g3174 www.bmj.com/content/348/bmj.g3320

New NICE guidance says that smokers should be encouraged to cut down on the number of cigarettes they smoke, as well as trying to quit. In a head to head, published on bmj.com, Paul Aveyard, professor of behavioural medicine at the University of Oxford, says that reducing smoking is a worthwhile step towards cessation, but Gerard Hastings, professor of social marketing at Stirling and Open Universities, argues that the lifelong nicotine replacement therapy being recommended in support may benefit industry more than public health. Read the full head to head: http://www.bmj.com/content/348/bmj.g2787

UTIs are often diagnosed in secondary care, but often that diagnosis isn't accurate. In this podcast Gavin Barlow from the Department of infection and tropical medicine at Hull & East Yorkshire Hospitals NHS Trust joins us to discuss when and how to test for the infection​. Read the full clinical review Investigation of suspected urinary tract infection in older people http://www.bmj.com/content/348/bmj.g3861

The BMJ has been investigating the “cosy relationship” between the alcohol industry and the British government. In a series of articles Under the influence, journalist Jonathan Gornall has been looking into UK government’s consultation into introducing a minimum unit price for alcohol in England and Wales, and also at the wider responsibility deal between government and industry which is meant to champion public health. In his latest article, he looks at the billion unit pledge, and how it's actually being used as a marketing tool to attract new drinkers. Read all of the articles discussed on www.bmj.com/alcohol

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

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

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

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

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