BMJ Best Practice Podcast

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

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.

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.

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 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.

Kieran Walsh, clinical director at BMJ, asks Matt Castleden, GP and editor for BMJ Best Practice and BMJ Learning, to summarise the latest clinical guidance in acute medicine. Dr Castleden updates us on recent recommendations on pulmonary embolism, and also acute respiratory distress and vaping associated lung injury. For more information, take a look at the BMJ Best Practice topic on pulmonary embolism: bestpractice.bmj.com/topics/en-gb/3000115 The BMJ Best Practice topic on acute respiratory distress syndrome: bestpractice.bmj.com/topics/en-gb/374

Colonic diverticulosis refers to herniation of the mucosa and submucosa through the muscular layer of the colonic wall and may be the result of colonic smooth muscle over-activity. Diverticular disease may be defined as any clinical state caused by symptoms pertaining to colonic diverticula and includes a wide-ranging spectrum from asymptomatic to severe and complicated disease. Mohamed Thaha, Senior Lecturer & Lead Consultant in Colorectal Surgery, National Bowel Research Centre, Barts and The London School of Medicine and Dentistry, tells us more. For more on diverticular disease, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/16 - 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.

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 updates us on the clinical use of antibody testing. And Abigail Davis discusses the impact of the pandemic on other conditions, including mental health and other infectious diseases. She also covers recommendations for influenza vaccination. 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 BMJ Practice Pointer article: Testing for SARS-CoV-2 antibodies: bmj.com/content/370/bmj.m3325 WHO guidance on Diagnostic testing for SARS-CoV-2: who.int/publications/i/item/diagnostic-testing-for-sars-cov-2 CDC Interim guidance on antibody testing: cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html CDC Influenza vaccination: cdc.gov/flu/professionals/acip/index.htm Public Health England annual flu programme: gov.uk/government/collections/annual-flu-programme Royal College of Paediatrics and Child Health advice for parents and carers: rcpch.ac.uk/sites/default/files/2020-04/covid19_advice_for_parents_when_child_unwell_or_injured_poster.pdf

Anaphylaxis is a severe, generalised or systemic hypersensitivity reaction. It is characterised by rapidly developing life-threatening airway and/or breathing and/or circulation problems usually associated with skin and mucosal changes. Adriana Andreae, Assistant Professor, Department of Pediatrics Division of Allergy and Immunology, Penn State University, gives us an overview of the condition. For more on anaphylaxis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/3000099 - 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.

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 updates us on treatment with steroids, PPE and symptoms of covid-19 which are present weeks or months after infection. And Emma Scott talks about surveys on the mental health of populations during the pandemic. 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 Public Health England: COVID-19: mental health and wellbeing surveillance report: gov.uk/government/publications/covid-19-mental-health-and-wellbeing-surveillance-report Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States: cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm