Clinical Update

Meeting respiratory challenges in primary care with Dr Steve Holmes

Up to one-third of patients with a previous asthma diagnosis show no evidence of the condition upon further evaluation – so GPs should be prepared to re-evaluate, according to respiratory GP Dr Steve Holmes.Dr Holmes says: ‘When I see somebody and I think it’s asthma but the FeNO is normal and the eosinophils are normal, and then I send them for spirometry and that test is normal too, quite often at each time they come back with those normal results, I’m re-evaluating whether it is actually asthma or not.’As well as asthma diagnosis, this podcast covers current challenges in asthma management, including overuse of short-acting bronchodilator inhalers, and the shift towards maintenance and reliever therapy (MART) and on-demand anti-inflammatory reliever (AIR) therapy. Dr Holmes also touches on current developments in management of COPD, and pitfalls in acute respiratory assessment.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Recall the percentage of people with an asthma diagnosis who do not actually have asthmaEnsure that they are following guideline-based recommendations for asthma diagnosisProactively find patients who are overusing short-acting bronchodilator inhalersReflect on how best to transfer patients to MART and AIR therapy Consider how to promote face-to-face inhaler technique coaching by healthcare professionalsIdentify normalised breathlessness so as to pick up more cases of COPDConsider how to identify COPD patients who might benefit from referral for biologic therapyPrioritise respiratory rate in acute assessment, and be aware of the limitations of pulse oximetersYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.Useful resourcesMIMS LearningGuidance update: BTS/NICE/SIGN guidelines on diagnosis, monitoring and chronic asthma managementChallenges in respiratory care learning planMIMSMIMS table on asthma and COPD preparations and compatible devices Hosted on Acast. See acast.com/privacy for more information.

Space-Comm Expo: Jamming, spoofing, FOMO and farming

What did the Space-Comm Expo conference and exhibition tell us about connecting space and wider business? How does this manifest as tech connectivity in telecoms and why do farmers care about that? What did we learn about the benefits of extreme cold in manufacturing laboratories and why do pharmas care about that? How vulnerable are global logistics to the spoofing of navigation signals? And why is the UK government centralising space strategy in the Department for Science, Innovation and Technology? Join Alice and Jonners as they reflect on the UK space sector’s largest trade event and the “energy, diversity and …sheer scope of what this industry has to offer”. Contributors:Alice Bunn, President of UKspace Dr Alice Bunn OBE FIMechE FRAeS CEng | LinkedInUKspace: Overview | LinkedIn Jonathan Daves, The Karman LineJonathan Daves | LinkedIn Subscribe to The Karman LineApple: https://podcasts.apple.com/ca/podcast/the-k%C3%A1rm%C3%A1n-line/id1876605462Spotify: https://open.spotify.com/show/3qED4CgdRDxfKKzYNKZCIH?si=lZ-I4a19SPGLAJL-dHi4DQYouTube: https://www.youtube.com/@TheKármánLineUKKey topics covered:Space-Comm Expo, London, March 2026Conference overviewSector integrationInsuranceCustomer utilityGovernment roleFuture outlook Technological advancements· Telecoms· Manufacturing Defence and security· Satellite capabilities· Current threats Hosted on Acast. See acast.com/privacy for more information.

Diabetes risk factors, diagnosis, management, and complications

Primary care professionals have broadly welcomed the 2026 update to the NICE type 2 diabetes guidelines because it focuses on reducing the risk of diabetes-related complications, such as cardiovascular disease, as well as optimising glycaemic control. With this in mind, MIMS Learning medical editors Dawn and Sangeeta take a deep dive into the extensive diabetes content available on MIMS Learning. They look at how both latent autoimmune diabetes (LADA) and type 3c diabetes can be misdiagnosed as type 2 diabetes, risk factors for diabetes (such as obesity), and multiple diabetes-related complications (including cardio-renal-metabolic disease).Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Describe the different types of diabetes that might present in primary careDiscuss how ethnicity can affect both the risk of diabetes and the risk of diabetes-related complicationsReview the overlap in management of type 2 diabetes, heart failure, and chronic kidney diseaseRecall potential diabetes-related complications, including cardio-renal-metabolic disease and foot ulcers. You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountCardio-renal-metabolic disease: clinical reviewCase study: latent autoimmune diabetes in adultsCKD podcourse with Dr Andrew Frankel, part 1: diagnosis and classificationDiabetes-related skin conditions and diseasesIdentifying and managing young-onset type 2 diabetesPodcast: Dr Patrick Holmes on identifying type 3c diabetes in primary careType 2 diabetes in South Asian and African-Caribbean populationsUnderstanding painful diabetic neuropathyOther resourcesPetition launched for routine diabetes testing after death of two-year-old wrongly diagnosed with tonsilitis Hosted on Acast. See acast.com/privacy for more information.

Evidence-based prescribing and medication safety in breastfeeding with pharmacist Rachel Pilgrim

In this episode of the Clinical Update podcast, MIMS Learning deputy editor Rhiannon talks to pharmacist Rachel Pilgrim about the impact of medication on breastfeeding cessation. Rachel describes how her own experience inspired her research into this area, and discusses how primary care can support patients with consistent, evidence-based information (and where to find this):‘Medicines shouldn't be a barrier to breastfeeding but ... uncertainty, conflicting guidelines, conservative licensing, and probably patchy training as well, creates a huge amount for prescribers and mums to navigate.’The discussion covers the public health importance of breastfeeding, physiological factors influencing drug transfer into breast milk, and the relationship between health inequalities and breastfeeding. Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Explain the public health importance of breastfeeding and recall the WHO recommendation for breastfeeding to 2 years and beyondNote UK breastfeeding rates and how these compare with global statisticsIdentify physiological factors that influence drug transfer into breast milkUnderstand the relationship between health inequalities and breastfeedingYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.Key prescribing resources:MIMSHale's Medications & Mothers' MilkThe Breastfeeding NetworkUK Drugs in Lactation Advisory Service e-lactanciaLactMedSpecialist Pharmacy Service (SPS)MIMS LearningRegister for a FREE account Hosted on Acast. See acast.com/privacy for more information.

Infant and child nutrition problems encountered in primary care

This episode of the Clinical Update podcast discusses the range of feeding, nutritional and gastroenterology problems a GP might encounter in a paediatric population, including gastro-oesophageal reflux disease (GORD), cow’s milk allergy (CMA), and malnutrition.The podcast discusses learning points for primary care professionals around infant feeding and childhood nutrition. It also looks at the stepwise management of GORD, clinical diagnosis of CMA, and the hidden prevalence of malnutrition. How to accurately plot faltering growth and when to trigger specialist referrals or safeguarding protocols is also highlighted.You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to: Differentiate between gastro-oesophageal reflux and GORD Identify red flag symptoms in vomiting infants that might indicate urgent secondary care referralRecognise the clinical presentation of IgE- and non-IgE-mediated cow’s milk allergyUnderstand the impact of ultra-processed foods on malnutrition in children with obesityApply UK-WHO growth chart thresholds to accurately identify significant faltering growthRecall the medical and behavioural differentials for suboptimal weight gain in infantsEvaluate the role of multidisciplinary teams in managing avoidant-restrictive food intake disorder (ARFID) and sensory aversionsUnderstand the GP’s professional responsibility regarding safeguarding in cases of growth failurePlease note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.PresentersSangeeta Krishnan, medical editorPat Anderson, editorMIMS LearningTwickenhamUK Episode produced by Jude OwenMIMS Learning resourcesMalnutrition in childrenNICE guidance on GORD in childrenFeeding difficulties in infantsFaltering growthPodcast: Dr Joy Shacklock on child safeguarding in primary care Hosted on Acast. See acast.com/privacy for more information.