Medicine and Science from The BMJ

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 (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 chief Carl Heneghan - Director of Oxford University's Centre for Evidence Based Medicine Peter Doshi - Assistant Professor of Pharmaceutical Health Services Research Elizabeth Loder - The BMJ clinical epidemiology editor David Tovey - Editor in chief, Cochrane Library Ben Goldacre - Founder of the AllTrials campaign

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

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

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

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

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.

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 Group Nigel Edwards - CEO Nuffield Trust Jennifer Dixon - CEO Health Foundation Terence Stephenson - president Academy of Medical Royal Colleges Maureen Baker - Chair RCGP Hugh Taylor - Chairman Guys and St Thomas' Foundation Trust Nick Hicks - CEO COBIC Ltd Jeremy Taylor - National Voices Tim Ferris - VP for population health management, Partners Healthcare, MA Nick Timmins - Senior Associate Nuffield Trust

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.

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 entity In 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