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. Abigail Davis, GP and section editor, covers the latest evidence around vaccine immunogenicity in different immunosuppressed populations, as well as the use of interleukin-6 inhibitors in COVID-19 patients. And Emma Scott, section editor, updates us on mucormycosis, or black fungus infection in COVID-19 patients. For more, see: 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 Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00676-0/fulltext Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2100433 WHO Therapeutics and COVID-19: living guideline: https://app.magicapp.org/#/guideline/nBkO1E/section/LrV7OL Indian Council of Medical Research advice on mucormycosis: https://www.icmr.gov.in/pdf/covid/techdoc/Mucormycosis_ADVISORY_FROM_ICMR_In_COVID19_time.pdf

BMJ Best Practice Podcast

COVID-19: Vaccine immunogenicity, interleukin-6 inhibitors, mucormycosis

Bulimia nervosa is an eating disorder, characterised by severe preoccupation about weight and body shape. Includes recurrent episodes of binge eating with compensatory mechanisms, such as self-induced vomiting, to prevent weight gain. Debra Safer, Associate Professor, Co-Director of Stanford Eating and Weight Disorders Program, Stanford University School of Medicine, gives us an overview of the condition. For more on bulimia nervosa, see BMJ Best Practice: https://bestpractice.bmj.com/topics/en-gb/441 - 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.

Bulimia nervosa

Giant cell arteritis is a common form of vasculitis in people aged 50 years or older. The extracranial branches of the carotid artery are usually affected. Kenneth J. Warrington, Professor of Medicine, Mayo Clinic College of Medicine, gives us an overview of the condition. For more on giant cell arteritis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/177 - 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.

Giant cell arteritis

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. Emma Scott, section editor, updates us on vaccination for pregnant and breastfeeding women. And Abigail Davis, GP and section editor, covers myocardial infarction and pre-existing respiratory conditions. For more, see: 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

COVID-19: Vaccination in pregnancy, myocardial infarction, and respiratory 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. Emma Scott, section editor, updates us on vaccination and the risk of blood clots. And Abigail Davis, GP and section editor, covers acute kidney injury, venous thromboembolism prevention, and secondary bacterial pneumonia. For more, see: 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 EMA: ema.europa.eu/en/news/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood MHRA: gov.uk/government/news/mhra-issues-new-advice-concluding-a-possible-link-between-covid-19-vaccine-astrazeneca-and-extremely-rare-unlikely-to-occur-blood-clots JCVI: gov.uk/government/publications/use-of-the-astrazeneca-covid-19-vaccine-jcvi-statement/jcvi-statement-on-use-of-the-astrazeneca-covid-19-vaccine-7-april-2021 WHO: who.int/news/item/07-04-2021-interim-statement-of-the-covid-19-subcommittee-of-the-who-global-advisory-committee-on-vaccine-safety COVID-19 rapid guideline: managing COVID-19: nice.org.uk/guidance/NG191 - 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: Blood clots, acute kidney injury, VTE prevention, secondary bacterial pneumonia

Depression can describe both a mood and an illness. Major depressive disorder is a clinical syndrome involving mood, neurovegetative functions, cognition, and behaviour. It affects 5% to 10% of patients in the primary care setting. Dean F. MacKinnon, Associate Professor, Psychiatry and Behavioral Sciences, The Johns Hopkins Hospital, Baltimore, gives us an overview of how to diagnose and manage depression in adults. For more on depression in adults, visit BMJ Best Practice: https://bestpractice.bmj.com/topics/en-gb/55 - 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.

Depression in adults

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.

Constipation in children

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.

Raynaud's phenomenon

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.

Chronic kidney disease

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

Covid-19 update: Management, vaccination and chronic conditions

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.

Depression in children

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 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 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.

Covid-19: Vaccination, remdesivir, and comorbidities

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.

Acute asthma exacerbations in children

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

Covid-19 and comorbidities

The BMJ Best Practice podcast publishes interviews with clinical experts, aimed at healthcare professionals and students with an interest in keeping up to date with the latest scientific developments, evidence-based medicine and guidelines. BMJ Best Practice is ranked one of the best clinical decision support tools for health professionals worldwide.* Structured around the clinical workflow and updated daily, BMJ Best Practice uses the latest evidence-based research, guidelines and expert opinion to offer step-by-step guidance on diagnosis, prognosis, treatment and prevention. bestpractice.bmj.com *Kwag KH, González-Lorenzo M, Banzi R, Bonovas S, Moja L. Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries 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.

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BMJ Best Practice Podcast

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