Influenza is a viral infection prevalent in the Winter months, and outbreaks in hospitals and local communities can be deadly if vulnerable people are not vaccinated. BMJ Best Practice has a lot of information on influenza infection, diagnosis and prevention. Read more here
In this monthly alert from BMJ Best Practice there are 2 new topics.
Follow the BMJ link above and log-in to see all of the available evidence-based content.
- Heparin-induced thrombocytopenia
- Sepsis in children
For the latest updates and best practice for hepatitis B, see the update summary below.
Best Practice writes “Most people with hepatitis B infection are asymptomatic, although some present with complications such as cirrhosis, hepatocellular carcinoma, or liver failure. Serological markers are essential in making the diagnosis and evaluating disease activity, including for differentiation of acute and chronic infection, and for identifying chronic asymptomatic carriers. Therapy for acute infection is almost always supportive care alone. However, some patients with acute infection may develop liver failure, and these patients may require referral to liver transplant centre. Therapy for chronic infection includes nucleoside/nucleotide analogues, interferon-alfa, and pegylated interferon-alfa”. Click for more.
“This month’s topic is MRSA, one of BMJ BP’s most recently updated topics and an important cause of infection in both healthy people in the community and in people in healthcare facilities.
The prevalence of MRSA infection is increasing globally. MRSA is an important cause of infection in both healthy people in the community and in healthcare institutions, but the two presentations and therapies differ.
Children and younger adults are more commonly afflicted with community-acquired MRSA, while hospital-acquired MRSA is more common in older age groups. It is also important to distinguish MRSA colonisation from infection.
You can also review the available evidence on MRSA and find further reading here.
A reminder to check out this excellent resource from BMJ Best Practice. In this module looking at Labyrinthitis which if you weren’t aware is an:
- Inflammatory condition affecting the labyrinth in the cochlea and vestibular system of the inner ear.
- Viral infections are the most common cause of labyrinthitis. Bacterial labyrinthitis is a complication of otitis media or meningitis.
- Typical presentation includes vertigo, imbalance, and hearing loss.
- Diagnosis is supported by history, physical examination, and audiometry.
- Treatment is typically symptomatic and primarily involves the use of vestibular suppressants and anti-emetics.
Best Practice is very helpful and provides further information on basics, diagnosis, treatments, follow up and recommended resources. Remember to register for an Athens account in order to gain full access to all the BMJ sites.
In this module Best Practice begins with an overview, then goes on to emergencies, diagnosis and finally resources relating to this increasingly common syndrome.
Dementia is a syndrome characterised by an appreciable deterioration in cognition resulting in behavioural problems and impairment in the activities of daily living. Decline in cognition is extensive, often affecting multiple domains of intellectual functioning.  
The prevalence of dementia is approximately 1% at the age of 60 years, and doubles every 5 years, to reach 30% to 50% by the age of 85 years.
Continue reading at BMJ Best Best Practice
Finally: make sure you keep checking Google Play for the new Android version of the Best Practice App, and the app store for the updated version of the IOS Best Practice App.
Extract from BMJ Best Practice, looking this month, at Sickle Cell Anaemia
Sickle cell anaemia is a disease of red blood cells caused by an autosomal-recessive single gene defect in the beta chain of haemoglobin. The characteristic crescent-shaped haemoglobin can disrupt blood flow and break. There is a predisposition for obstruction of small blood capillaries, causing painful crises, organ damage, and increased vulnerability to severe infections. Infants are screened, with findings confirmed by haemoglobin electrophoresis, FBC, reticulocyte count, and peripheral blood smear. Treatment goals include fluid replacement therapy, pain management, and symptom control.
- Sickle cell anaemia
- Best Practice app updates
- Updated Best Practice topics
- Assessment of lymphadenopathy
- Assessment of elevated creatinine
- Thyroid function testing
and related conditions
- Hereditary spherocytosis
- Glucose-6-phosphate dehydrogenase deficiency
Athens account required
Dementia is a syndrome characterised by an appreciable deterioration in cognition resulting in behavioural problems and impairment in the activities of daily living. Decline in cognition is extensive, often affecting multiple domains of intellectual functioning. The most common causes of dementia are degenerative or vascular; other causes include infection, inflammatory diseases, neoplasm, toxic insults, metabolic disorders, or trauma. It is important to consider potentially reversible conditions during diagnosis. A number of conditions can present in a similar way to dementia syndrome and need to be considered during the evaluation. These include mild cognitive impairment (MCI), delirium, depression, amnesic syndromes, aphasia, or normal ageing.
Log into BMJ Best Practice with your Athens account to view a wide range of topics, their conditions, diagnosis, treatment and evidence:
Extract from BMJ Best Practice
Measles is an epidemic disease prevalent worldwide whose incidence has been curtailed markedly in countries where immunisation is widespread. It is characterised by cough, coryza, conjunctivitis, a characteristic exanthem, and a pathognomonic enanthem (Koplik spots). Measles is preventable by immunisation, but high levels of coverage are required to prevent outbreaks of disease. Treatment is primarily supportive, and complications of measles are more common in immunocompromised and poorly nourished individuals and include pneumonia, laryngotracheitis, otitis media, and encephalitis.
Following the recent outbreak of measles in the UK, BMJ Learning is offering its modules on the subject for free for one month only!