30 days after surgery: crucial indicator of quality of care

Women, older people and those with more comorbidities are more likely to have complications, discharge to a care facility, hospital readmissions or death in the 30 days after surgery than other population groups, according to research published on 15 August by the Medical Journal of Australia.

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Multiple Sclerosis and immunisation

Vaccination for people with MS needs to be planned: MJA.
Image: Shutterstock

The immunisation status of patients newly diagnosed with multiple sclerosis (MS) must not be overlooked when beginning treatment with immunomodulatory or immunosuppressive disease-modifying therapies (DMTs), according to the authors of a Perspective published 19 April by the Medical Journal of Australia.

“Determining immunisation status when commencing DMTs is key, as is an individualised approach to risk–benefit assessment when considering vaccinations,” wrote the authors, led by Dr Cassie Nesbitt, a neurologist at Alfred Health in Melbourne.

Multidisciplinary teams key to best outcomes for patients with hepatocellular carcinoma

Associate Professor John Lubel

A new consensus statement produced by the Gastroenterological Society of Australia (GESA) Liver Faculty on the management of hepatocellular carcinoma (HCC) will ultimately lead to better outcomes for Australian patients, according to the authors, published 14 Dec 2020 in the Medical Journal of Australia.

HCC is a leading cause of cancer deaths both globally and in Australia. Surveillance for HCC in at-risk populations allows diagnosis at an early stage, when potentially curable. However, most Australians diagnosed with HCC die of the cancer or of liver disease.

COVID-19 update from Prof Allen Cheng: MJA podcast 9 March 2020

Image: Coronavirus (MJA)

COVID-19 in Australia, with Professor Allen Cheng

MJA Podcasts 2020 Episode 8:  Vol 212, Issue 5: 9 March, 2020.

Professor Allen Cheng is Director of the Infection Prevention and Healthcare Epidemiology Unit at Alfred Health in Melbourne. He discusses how COVID-19 may behave in Australia and how doctors can protect themselves as well as patients. With MJA news and online editor Cate Swannell. 16 mins, 0 secs.

Link: www.mja.com.au/podcast/212/5/mja-podcasts-2020-episode-8-covid-19-australia-prof-allen-cheng

National Diabetes Strategy critiqued by Prof Paul Zimmet

Professor Paul Zimmet critiques the National Diabetes Strategy.
Video: 1:05 mins

Professor Paul Zimmet was on the National Diabetes Strategy Advisory Group (NDSAG), which made recommendations for the Commonwealth government's National Diabetes Strategy (NDS), published in November 2015.

Substantial NDSAG advice including rationale and key recommendations were omitted. Prof Zimmet published a letter in the Medical Journal of Australia (20 Feb 2017) agreeing with Jane Speight, a critic of the plan, that its rollout will be fragmented and delayed, thereby reducing its effectiveness.

Prostate cancer: we’re punching above our weight

Adjunct Clinical Associate Professor Jeremy Grummet is a
practising urologist at Alfred Health and researcher in Central
Clinical School's Department of Surgery. Twitter @JGrummet

"Prostate cancer is the second biggest cancer killer of men in Australia, and Australia is a world leader in its diagnosis and treatment. If you’re unfortunate enough to be diagnosed with prostate cancer, you can at least be thankful you’re living in this country", writes Jeremy Grummet in the 12 September Medical Journal of Australia.

Building the evidence base for burns care with BRANZ

Miss Heather Cleland with a patient. She is Director of the
Victorian Adult Burns Service at Alfred Health.

The Burns Registry of Australia and New Zealand (BRANZ) is providing crucial data to burn units across the region, improving practice and outcomes for patients, according to research published in the Medical Journal of Australia (MJA) on the first four years of data from BRANZ.

An enhanced recovery after surgery (ERAS) program for hip and knee arthroplasty

Knee arthroplasty. Image: www.jaaos.org

Osteoarthritis is the leading cause of pain and disability among the elderly and affects 15% of the population. Despite a range of treatments for osteoarthritis (OA), joint replacement remains the main treatment option for patients in whom the disease has progressed. The researchers aimed to assess the extent to which a predefined enhanced recovery after surgery (ERAS) program for orthopaedic surgical patients could be achieved, and to evaluate improvements in quality of care and patient outcome across three public hospitals in Victoria. They found that a multidisciplinary ERAS program could be successfully implemented in elective joint arthroplasty, leading to a shorter duration of hospital stay, and they recommend this orthopaedic ERAS pathway.

Reference: Christelis N, Wallace S, Sage CE, Babitu U, Liew S, Dugal J, Nyulasi I, Mutalima N, Tran T, Myles PS. An enhanced recovery after surgery program for hip and knee arthroplasty. Med J Aust. 2015 Apr 20;202(7):363-8.

Opt-in cardio-pulmonary (CPR) debate

Image: www.mja.com.au

A controversial proposal to end cardiopulmonary resuscitation as the “universal default” for hospital inpatients and replace it with an opt-in system has generated heated debate among doctors and lawyers. In a “For debate” article published on 28 July by the MJA, Associate Professor Michele Levinson, head of the Cabrini-Monash Department of Medicine and research fellow Dr Amber Mills, challenged the idea that cardiopulmonary resuscitation (CPR) was a patient’s right, arguing that “a CPR discussion should occur on admission for all elderly hospital inpatients”. Story link.

Head injury prevention for bicyclists: Helmets make a difference

Helmets are still vital to the safety of cyclists according to an article recently published in the Medical Journal of Australia. Peter A Cameron (Department of Epidemiology and Preventive Medicine), Frank McDermott (Department of Surgery) and Jeffrey V Rosenfeld (Department of Surgery) write that with the increase of cyclists on the road, helmets are becoming more and more important. To read the full article see: http://ow.ly/rRUmu 

Review: Head injury prevention for bicyclists - helmets make a difference

Peter Cameron, Frank McDermott and Jeffrey V. Rosenfeld write in the 21 Oct issue of the MJA how wearing helmets does improve cyclists' safety in the event of accidents. "There is good evidence that preventing head injuries in cyclists will prevent most major morbidity and mortality... [H]elmet wearing appreciably lessens the risk of serious injury and death in bicycle crashes..." Link.