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"It is a great nuisance that knowledge can be acquired only by hard work."
W. Somerset Maugham


Disclosure of medical error

The Journal of the American Medical Association has introduced a new section titled JAMA Professionalism. Each article will present a clinical scenario where professionalism is required to address difficult problems. The first article explores the topic of disclosure using a case study in which a clinician unintentionally uses non-sterile instruments to perform procedures on two patients.

Source: Journal of the American Medical Association 2016; 316(7): 764-5

Further reading:
Introducing JAMA Professionalism
Source: Journal of the American Medical Association 2016; 316(7): 720-721

Australian Open Disclosure Framework
Source: Australian Commission on Quality and Safety in Health Care


Bariatric surgery & long term weight loss

In severely obese patients, bariatric surgery results in significant weight loss, however evidence for the durability of the weight loss is limited. A cohort study of US veterans, examined if weight loss following Roux-en-Y gastric bypass (RYGB) surgery was maintained over a 10 year period compared with nonsurgical matches. RYGB resulted in significantly greater and sustained weight loss compared with both nonsurgical matches and other bariatric procedures such as adjustable gastric banding or sleeve gastrectomy.

Source: JAMA Surgery 2016; online first: 31 August


Diabetic foot ulcer - global epidemiology

Diabetic foot ulceration, a global public health issue, has a higher prevalence in males than females, and an increased prevalence in patients with type 2 diabetes compared to patients with type 1 diabetes. Research indicates Australia has the lowest prevalence (1.5%) and Belgium has the highest prevalence (16.6%). Patients who are older, have lower body mass index, increased hypertension, a history of smoking and longer diabetic duration are more likely to develop diabetic foot ulcer.

Source: Annals of Medicine 2016; online first: 1 September

Further reading:
Dressing and diabetic foot ulcers: a current review of the evidence
Source: Plastic and Reconstructive Surgery 2016; 138(3S): 158S-164S


Preterm birth & risk of acute childhood leukaemia

Evidence has shown that preterm birth infants are at increased risk of developing diabetes, cardiovascular disease, respiratory disease, neurological disease or psychiatric disorders in adult life. Researchers performed a meta-analysis to investigate whether preterm birth is also associated with increased risk of acute childhood leukaemia. The results suggested that preterm birth was significantly associated with an increased risk of acute childhood leukaemia and acute myeloid leukaemia; however it was not significantly associated with an increased risk of acute lymphoblastic leukaemia.

Source: Cellular Physiology and Biochemistry 2016; 39(3): 1229-1238


Medical marijuana - psychiatric indications

Medical marijuana has been approved in the United States for several psychiatric conditions including agitation in Alzheimer's disease; posttraumatic stress disorder; and Tourette's disorder. In evaluating the effectiveness of medical marijuana in psychiatric conditions, the authors conclude that the strength of the evidence is very low at present. Several directions for future research are proposed including: an urgent need for evidence-based research with appropriately powered studies to minimise confounders; standardisation of marijuana dosage; the use of validated outcome measures; and research to address the safety and efficacy of cannabinoids.

Source: Journal of Clinical Psychiatry 2016; 77(8): 1050-1064


New from NICE

The UK's National Institute for Health and Care Excellence (NICE) has published the following new (or revised) guidelines and quality standards:


Austin Health Research Online - recent submissions

Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) in the management of primary mediastinal B-cell lymphoma: a subgroup analysis of the UK NCRI R-CHOP 14 versus 21 trial
Gleeson M, Hawkes EA, Cunningham D, et. al. British Journal of Haematology 2016; online first: 1 August

Identity by descent fine mapping of familial adult myoclonus epilepsy (FAME) to 2p11.2-2q11.2
Henden L, Freytag S, Afawi Z, et. al. Human Genetics 2016; online first: 1 July

L-Tyrosine confers residualizing properties to a d-Amino acid-rich residualizing peptide for radioiodination of internalizing antibodies
Lee FT, Burvenich IJG, Guo N, et. al. Molecular Imaging 2016; online first: 25 July

Predicting Alzheimer disease from a blood-based biomarker profile: A 54-month follow-up
Burnham SC, Rowe CC, Baker D, et. al. Neurology 2016; online first: 17 August

Randomised controlled trials of psychological & pharmacological treatments for body dysmorphic disorder: A systematic review
Phillipou A, Rossell SL, Wilding HE, et. al. Psychiatry Research 2016; 245: 179-185

See more at AHRO, Austin Health Research Online


eBooks spotlight

Basic immunology : functions and disorders of the immune system / Abul K Abbas, Andrew H Lichtman & Shiv Pillai - 5th ed., Elsevier, 2016.
With an emphasis on clinical relevance, this illustrated text provides a "concise, accessible introduction to the workings of the human immune system."

Clinical dermatology : a color guide to diagnosis and therapy / Thomas P. Habif - 6th ed., Elsevier, 2016.
Updated to reflect current best practice, this new edition contains over 1000 photographs to assist in the identification, treatment and management of skin diseases.

New books on display
Diet and nutrition in dementia and cognitive decline / edited by Colin R. Martin, Victor R. Preedy. Elsevier, 2015.
This comprehensive text explores the interrelationships between diet, nutrition, dementia and cognitive decline.

Wong's nursing care of infants and children / edited by Marilyn J. Hockenberry, David Wilson - 10th Ed., Elsevier Mosby, 2015.
With an emphasis on providing innovative and excellent family centred care, this text provides an evidence-based, clinical perspective that illustrates how quality of nursing care impacts patient outcomes.

Case files. Psychiatry / Eugene C. Toy, Debra Klamen. - 5th ed., McGraw-Hill Education, 2016.
This edition provides cases that illustrate essential concepts in psychiatric care and has been updated to reflect new DSM-5 criteria. Each case includes concise discussion, clinical pearls and review questions to improve diagnostic and problem solving skills.


Journals spotlight

These links provide access to the current table of contents:

Advances in Skin & Wound Care

Australian and New Zealand Journal of Public Health

Emergency Medicine Australasia

Journal of Speech, Language & Hearing Research

Journal of Substance Abuse Treatment


Leukemia & Lymphoma

Manual Therapy


Obesity Surgery

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