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"To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all."
William Osler

 

Robotic surgery for prostate cancer

In a world-first randomised trial comparing robot-assisted laparoscopic prostate surgery with radical retropubic prostatectomy, no significant difference in outcome was found at 12 week follow-up. This Australian study found those in the robotic surgery group reported significantly less pain soon after surgery; however by 6 and 12 weeks this difference had disappeared. To establish if significant differences in functional outcome, including urinary and sexual function, become apparent over time authors will continue follow-up for a further two years.

Source: Lancet 2016; online first: 26 July

 

Suboptimal footwear: implications for fall prevention

Investigating 22 high fall-risk wards in a large metropolitan hospital in Brisbane, researchers found 99% of eligible in-patients used footwear with ‘suboptimal' features. Examples of suboptimal included slippers, bare feet or backless slippers. Lack of access to suitable footwear was not reported as the primary cause for bare foot ambulation, rather patients cited pain, oedema, foot wounds or personal choice as their main reason. The authors therefore suggest a multidisciplinary team approach to address mobility and safety issues associated with hazardous footwear in at-risk patients.

Source: Australian Health Review 2016; 40(4): 399-404
Full text available for Austin & MHW Heidelberg staff via document delivery

 

Buruli ulcer: Australian cohort study

Buruli ulcer, a necrotizing skin disease caused by Mycobacterium ulcerans, is endemic to specific geographic regions of Victoria. In this Australian cohort study, researchers found evidence that "primary rifampin-based oral medical therapy, combined with either clarithromycin or a fluoroquinolone, has an excellent rate of cure and an acceptable toxicity profile".

Source: Antimicrobial Agents and Chemotherapy 2016; 60(5): 2692-2695
Full text available for Austin & MHW Heidelberg staff via document delivery

Further reading:
Clinical outcomes of Ghanaian Buruli ulcer patients who defaulted from antimicrobial therapy
"Although numbers were small, and a potential for bias exists, our findings suggest that a reduction in the duration of antimicrobial therapy in BU in small, early lesions is feasible. These findings can serve as a basis for future well-designed studies."
Source: Tropical Medicine & International Health 2016; online first 26 July

Buruli ulcer in the media
Source: Austin Health Newsroom

 

Depression & breastfeeding - is there a link?

Melbourne researchers suggest that women who reported depressive symptoms three months after giving birth had significantly lower rates of breastfeeding at four, five and six months post-delivery compared to women without depressive symptoms. The researchers were unable to establish whether maternal depression was a cause or consequence of ceasing breastfeeding. However, they encourage clinicians supporting women in the postnatal period to be aware that maternal depression may be contributing to breastfeeding difficulties; or breastfeeding difficulties may be exacerbating maternal distress.

Source: Women and Birth 2016; online first: 19 July
Full text available for Austin & MHW Heidelberg staff via document delivery

 

Suicide prevention framework 2016-2025

In Victoria in 2014, 646 people lost their lives to suicide. The highest rate of suicide among men is those aged 85 and over (37.6 per 100,000), and the highest rate among women is in the 35-39 age group (9.2 per 100,000). The Victorian Department of Health and Human Services has released the Victorian suicide prevention framework to provide a whole-of-government coordinated strategy to reduce the suicide toll.

Source: Victorian suicide prevention framework 2016-2025

 

Acute coronary syndrome – new Australian guidelines

Mortality and morbidity rates from acute coronary syndrome (ACS) remain significant in Australia and New Zealand. The National Heart Foundation and the Cardiac Society of Australia and New Zealand have revised guidelines for the management of ACS. The guidelines address troponin testing, antithrombotic therapies and discharge management as well as simplifying risk classification for cardiac causes of chest pain.

Key recommendations:

  • Patients with acute chest pain or other symptoms suggestive of an ACS should receive a 12-lead ECG and the ECG assessed within 10 minutes of first contact
  • Primary percutaneous coronary intervention (PCI) should be performed within 120 minutes of first medical contact or within 90 minutes of presentation to a PCI-enabled hospital
  • If not possible, thrombolysis should be administered unless there are contraindications. Early and immediate transfer to a PCI-capable hospital for angiography or PCI within 24 hours is recommended
  • Aspirin (100-150mg/day) should be continued indefinitely unless not tolerated or there is an indication for anticoagulant therapy
  • Clopidogrel should be prescribed if aspirin is contraindicated or not tolerated
  • Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor (such as clopidogrel or ticagrelor) should be prescribed for up to 12 months in patients with ACS regardless of whether coronary revascularisation is performed
  • Attendance at cardiac rehabilitation is recommended for all patients hospitalised with ACS

Source: Heart, Lung and Circulation 2016; 25(9): 895-951

Further reading:
Improving outcomes in coronary artery disease - editorial
Source: Medical Journal of Australia 2016; 205 (3): 111-112

 

Austin Health Research Online - recent submissions

Sensitivity, specificity, and predictors of positive 68Ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: A systematic review and meta-analysis
Perera M, Papa N, Christidis D. European Urology 2016; online first: 28 June

A randomised controlled trial of peri-operative lidocaine infusions for open radical prostatectomy
Weinberg L, Rachbuch C, Ting S. Anaesthesia 2016; 71(4): 405-410

Prostate cancer outcomes for men who present with symptoms at diagnosis
Beckmann KR, O'Callaghan ME, Ruseckaite R. BJU International 2016; online first: 4 August

Two distinct symptom-based phenotypes of depression in epilepsy yield specific clinical and etiological insights
Rayner G, Jackson GD, Wilson SJ. Epilepsy & Behavior 2016; online first: 27 July

See more at AHRO, Austin Health Research Online

 

eBooks spotlight

Dermatological signs of systemic disease / [edited by] Jeffrey P. Callen ... et al. - 5th ed. Elsevier, 2017.
This edition helps with early identification of a full range of common and rare systemic diseases. It takes an evidence-based approach to diagnosis and treatment, offering clinical recommendations.

Sabiston textbook of surgery : the biological basis of modern surgical practice / [edited by] Courtney M. Tounsend ... et al. - 20th ed. Elsevier Saunders, 2017.
Regarded as a pre-eminent source for definitive guidance in all areas of general surgery.

Print Books

Mindfulness for life / Stephen McKenzie and Craig Hassed - Exisle Publishing, 2012.
This book clearly sets out the benefits of practising mindfulness, by taking time to pay attention to the present moment, free of judgment or distraction, in order to increase our capacity to give full attention to everything we do.

Textbook of neonatal resuscitation / edited by Gary M. Weiner - 7th ed. American Academy of Pediatrics, 2016.
This edition uses a blended learning approach, which includes online testing, online case-based simulations and hands-on case based simulation/debriefing that focus on critical leadership, communication and teamwork skills.

 

Journals spotlight

These links provide access to the current table of contents:

BJU International

Breastfeeding Review

Child Development

Clinics in Dermatology

Current Opinion in Microbiology

Journal of Antimicrobial Chemotherapy

The Prostate

Prosthetics and Orthotics International

Tropical Medicine & International Health

Wound Repair and Regeneration

Looking for the latest journal issues?
All our journal titles with electronic access are available via the Journal List
(outside the Austin Health network use your Library barcode no. & PIN for access)

If you require an article from a journal that is not in the Journal List, please use our online document delivery form.

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