Narrative reviews

Maternal influenza and pertussis vaccine coverage rates appear to be increasing, at least in parts of Australia, but significant gaps remain

Jocelynne E McRae · Lisa McHugh · Catherine King · Frank H Beard · Christopher C Blyth · Margie H Danchin · Michelle L Giles · Hassen Mohammed · Nicholas Wood · Kristine Macartney

Accurate peri-operative risk assessment is important to enable shared decision making and to optimise the multidisciplinary management of patients undergoing major non-cardiac surgery

Shehane Mahendran · Aravinda Thiagalingam · Graham Hillis · Richard Halliwell · Henry CC Pleass · Clara K Chow

Pregnancy can be seen as a stress test for cardiometabolic conditions, where the physiological demands of pregnancy can unmask women at risk for CVD

Simone Marschner · Anushriya Pant · Amanda Henry · Louise J Maple‐Brown · Lisa Moran · N Wah Cheung · Clara K Chow · Sarah Zaman

The management of cutaneous melanoma has been revolutionised in the past decade, with ongoing efforts to improve patient outcomes centred on rich translational research endeavours and robust clinical trials

Prachi Bhave · Jessica Wong · Aideen McInerney‐Leo · Anne E Cust · Craig Lawn · Monika Janda · Victoria J Mar

The ever-increasing novelty and complexity of modern medicine brings decisional uncertainty for clinicians; various strategies can be used to minimise and manage this uncertainty without compromising the clinician–patient relationship or clinician credibility

Ian A Scott · Jenny A Doust · Gerben B Keijzers · Katharine A Wallis

More effective, coordinated approaches are needed to improve and secure the universality of public health care

Mary Rose Angeles · Paul Crosland · Martin Hensher

Five medications are currently indicated for obesity management in Australia, all of which have beneficial effects on obesity-related complications

Rosalind Walmsley · Priya Sumithran

Management of young-onset dementia needs to be age-appropriate and multidisciplinary

Samantha M Loi · Monica Cations · Dennis Velakoulis

The role of spinal surgery in the management of degenerative low back pain is not supported by the studies currently available

Lachlan Evans · Thomas O’Donohoe · Andrew Morokoff · Katharine Drummond

An increase in options available would appear to be our best chance at living alongside SARS-CoV-2

Adam Polkinghorne · James M Branley

Over the past decade, detection and management of prostate cancer have evolved, with the focus now placed on harm minimisation, reducing overdiagnosis and avoiding overtreatment

Isabella SC Williams · Aoife McVey · Sachin Perera · Jonathan S O’Brien · Louise Kostos · Kenneth Chen · Shankar Siva · Arun A Azad · Declan G Murphy · Veeru Kasivisvanathan · Nathan Lawrentschuk · Mark Frydenberg

Increased understanding of how to predict who is most at risk of breast cancer is leading to the possibility of risk-based screening, allowing better and more targeted early detection and treatment for women at high risk

Christobel M Saunders

For too long gender-based violence has been seen as the domain of social services or justice, with policy failing to resource an integrated response by the health system

Kelsey L Hegarty · Shawana Andrews · Laura Tarzia

Using a multidisciplinary, pragmatic, patient-centred, non-judgemental approach may allow people who inject drugs to achieve improved outcomes for invasive infections and reduce their risk of subsequent admissions

Lucy O Attwood · Megan McKechnie · Olga Vujovic · Peter Higgs · Martyn Lloyd‐Jones · Joseph S Doyle · Andrew J Stewardson

We need intellectual investment that prioritises Indigenous ways of knowing, being and doing, and acknowledges the historical and contemporary colonisation, dispossession and racism that continue to have an impact on health outcomes today

Michelle Kennedy · Jessica Bennett · Sian Maidment · Catherine Chamberlain · Kate Booth · Romany McGuffog · Bree Hobden · Lisa J Whop · Jamie Bryant

Ongoing elucidation of genetic and inflammatory pathways responsible for atopic dermatitis holds promise for new targeted treatments and increasingly personalised atopic dermatitis therapy

Michelle SY Goh · Jenny SW Yun · John C Su

Neglected tropical diseases represent a threat to the health, wellbeing and economic prosperity of billions of people worldwide, often causing serious disease or death

Johanna Kurcheid · Catherine A Gordon · Naomi E Clarke · Kinley Wangdi · Matthew Kelly · Aparna Lal · Polydor N Mutombo · Dongxu Wang · Mary L Mationg · Archie CA Clements · Stephen Muhi · Richard S Bradbury · Beverley‐Ann Biggs · Wendy Page · Gail Williams · Donald P McManus · Darren Gray

We suggest five potential strategy areas that could begin to address nequities

Sharon Goldfeld · Elodie O'Connor · Valerie Sung · Gehan Roberts · Melissa Wake · Sue West · Harriet Hiscock

Women who undergo bariatric surgery should be managed in the perinatal period with a multidisciplinary team to improve pregnancy-related outcomes

Sarah Cheah · Yijun Gao · Shirley Mo · Georgia Rigas · Oliver Fisher · Daniel L Chan · Michael G Chapman · Michael L Talbot

Rectal bleeding is common in pregnancy, with a reported prevalence of 10–43%

Ralley Prentice · Aysha Al‐Ani · Tiffany Cherry · Julia Dixon‐Douglas · Jade Eccles‐Smith · Julia Matheson · Jeanne Tie · Iniyaval Thevathasan · Jacob J McCormick · Britt Christensen

COPD is the fifth greatest contributor to burden of disease and fifth overall cause of death among Australians

Alan M Carew · Jonathan P Williamson · Claude S Farah · Tajalli Saghaie · Martin Phillips · Alvin Ing

It is critical primary care clinicians dedicate specific attention to the management of both depression and insomnia when they co-occur

Alexander Sweetman · Leon Lack · Emer Van Ryswyk · Andrew Vakulin · Richard L Reed · Malcolm W Battersby · Nicole Lovato · Robert J Adams

▪ Obesity is reaching pandemic proportions globally, with overweight or obesity affecting at least two‐thirds of Australian adults. ▪ Bariatric surgery is an effective weight loss strategy but is constrained by high resource requirements and low patient acceptance. ▪ Multiple endoscopic bariatric therapies have matured, with well established and favourable safety and efficacy profiles in multiple randomised controlled trials (RCTs), and are best used within a multidisciplinary setting as an adjuvant to lifestyle intervention. ▪ Three types of intragastric balloon are currently in use in Australia offering average total weight loss ranging from 10% to 18%, with others available internationally. ▪ Endoscopic sleeve gastroplasty produces average total weight loss of 15–20% with low rates of severe complications, with RCT data anticipated in December 2021. ▪ Bariatric and metabolic endoscopy is rapidly evolving, with many novel, promising therapies currently under investigation.

Dominic A Staudenmann · Zhixian Sui · Payal Saxena · Arthur J Kaffes · George Marinos · Vivek Kumbhari · Patrick Aepli · Adrian Sartoretto

A patent foramen ovale (PFO) is an interatrial shunt, with a prevalence of 20–34% in the general population. While most people do not have secondary manifestations of a PFO, some reported sequelae include ischaemic stroke, migraine, platypnoea–orthodeoxia syndrome and decompression illness. Furthermore, in some cases, PFO closure should be considered for patients before neurosurgery and for patients with concomitant carcinoid syndrome. Recent trials support PFO closure for ischaemic stroke patients with high risk PFOs and absence of other identified stroke mechanisms. While PFOs can be associated with migraine with auras, with some patients reporting symptomatic improvement after closure, the evidence from randomised controlled trials is less clear in supporting the use of PFO closure for migraine treatment. PFO closure for other indications such as platypnoea–orthodeoxia syndrome, decompression illness and paradoxical embolism are based largely on case series with good clinical outcomes. PFO closure can be performed as a day surgical intervention with high procedural success and low risk of complications.

Kenneth K Cho · Shaun Khanna · Phillip Lo · Daniel Cheng · David Roy

Prostate cancer continues to be the most commonly diagnosed cancer, and the second leading cause of cancer death among Australian men

Xuan Rui S Ong · Dominic Bagguley · John W Yaxley · Arun A Azad · Declan G Murphy · Nathan Lawrentschuk