Topics
Digestive system diseases
Australian Pathways for Specialist Pain Management and Early Palliative Care for People With Pancreatic Cancer: Developed Using a Community Consensus Approach
IntroductionDespite evidence of improved outcomes, people with pancreatic cancer have highly variable access to effective pain relief and palliative care. We aimed to develop evidence-based, community-informed standardised pathways to timely pain management and early palliative care for people with pancreatic cancer.Main RecommendationsUsing a multi-method, comprehensive, community engagement and evidence-informed approach, we developed pathways to standardise referral to pain management and early palliative care for people with pancreatic cancer. Community engagement included representation from multidisciplinary clinicians, community groups and people with lived experience from across regions and all Australian states. We developed two pathways: (i) a pathway for pain management for people with resectable pancreatic cancer and (ii) an integrated pathway for pain management and palliative care for people with unresectable pancreatic cancer (https://www.pancare.org.au/pancreatic-cancer-roadmap-projects/pancreatic-cancer-pathways). Clinical guidance providing practical steps and links to evidence accompany the pathways. Key elements of the pathways included:screening for pain at each encounter, comprehensive holistic assessment and management;early consideration of interventional pain management in the event of refractory pain;introduction of palliative care at time of diagnosis of metastatic or unresectable pancreatic cancer with links to suggested language to address potential community hesitancy; andrecommendation to discuss referrals for palliative care and interventional pain management at cancer multidisciplinary meetings.Changes in Management as a Result of the GuidelinesThe pathways developed have set forth best practice standards grounded in evidence and expert consensus. The extensive clinical and community engagement ensures the relevance and ownership of these pathways. Implementation of the pathways will reduce existing variation in access and enhance the quality of care for people with pancreatic cancer. Furthermore, the pathways offer an opportunity to benchmark practice within and between services.
Jennifer Philip, Melanie R. Lovell, Kylee Bellingham, Gail Garvey, Gregory B. Crawford, Nicole M. Rankin, Kara Burns, Isabel Young, Vivienne Milch, Dorothy Keefe, Katrina Anderson, James Lawson, Meinir Krishnasamy
Cause‐specific mortality among Queensland people with cirrhosis, by cirrhosis aetiology and decompensation status, 2007–22: a retrospective cohort study
Targeted public health measures for particular patient subgroups are required to save lives among people with cirrhosis
Vikas Bhasker · Jessica R Fong · Paul J Clark · Gunter F Hartel · Richard Skoien · James O’Beirne · Elizabeth E Powell · Patricia C Valery
Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations
A summary of recommendations and practice points for key population subgroups who were identified as potentially benefitting from routine hepatocarcinoma surveillance in the form of ultrasound scans, with or without ?-fetoprotein testing
Jacob George · Nicole L Allard · Stuart K Roberts · Leon A Adams · Jane Davies · Behzad Hajarizadeh · Jennifer H MacLachlan · Suzanne E Mahady · Rosalie Altus · Catherine Brown · David C Fry · Belinda Greenwood‐Smith · Natali Smud · Patricia C Valery · Nafisa Yussf · Kate Broun · Denise Campbell · Karen Canfell · Chelsea Carle Harrison · Victoria Freeman · Paul Grogan · Catherine Holliday · Suzanne Hughes · Anna Kelly · Cathelijne Kemenade · Claire Latumahina · Amanda McAtamney · Megan Varlow · Joachim Worthington · Susan Yuill · Eleonora Feletto
Treatment outcomes for people with hepatitis C referred to tertiary care in Victoria, 2021–22: a retrospective observational study
Greater awareness of care integrated into primary care services for people who use drugs would support HCV elimination strategies
Elly Layton · Nicole Matthews · Brendan Quinn · Nasra Higgins · Gabrielle Lindeman · Mielle Abbott · Jennifer MacLachlan · Elizabeth Birbilis · Margaret E Hellard · Joseph Doyle · Benjamin C Cowie · Mark Stoové
Assessment of metabolic dysfunction‐associated fatty liver disease in primary care: a consensus statement summary
In recognition of the increasing burden of metabolic dysfunction-associated fatty liver disease (MAFLD) in Australia, and the lack of clear guidelines for general practitioners, this consensus statement summary presents 21 recommendations on the assessment and monitoring of MAFLD in adult patients in primary care
Leon A Adams · William W Kemp · Kate R Muller · Elizabeth E Powell · Stuart K Roberts · Luis Calzadilla Bertot · Stephanie Best · Gary Deed · Jon D Emery · Samantha L Hocking · Graham R Jones · John S Lubel · Sinead Sheils · Stephen M Twigg · Gerald F Watts · Jacob George
Participation in the National Bowel Cancer Screening Program by people with severe mental illness, Australia, 2006–2019: a national data linkage study
Oyedeji Ayonrinde · Sara Mohamed · Jenna Nensi
Hyperkalaemic cardiac arrest due to cream of tartar ingestion
A 70-year-old woman presented to the emergency department with symptomatic hyperkalaemia after excessive ingestion of potassium bitartrate to relieve constipation
Daniel Yee Lee Ng · Laksmi Govindasamy · Andrew Hughes · Hwee Min Lee
The potential benefits of a needle and syringe program in Australian prisons
Needle and syringe programs are evidence-based best practice interventions that reduce the harm associated with needle sharing
Alexander J Thompson · Michael H Levy
Management challenges and prognostic uncertainties in heat‐induced acute liver failure
A 26-year-old man with central obesity (body mass index, 32.7 kg/m2) and a history of drinking up to 22 standard drinks over weekends, collapsed 5 minutes following a 5 km run in hot and humid conditions in Brisbane, Australia
Nicholas Smith · Richard Skoien · Melita Andelkovic
A summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) hypertension in pregnancy guidelines
Cathy Latino · Oyekoya T Ayonrinde
Disorders of gut–brain interaction, eating disorders and gastroparesis: a call for coordinated care and guidelines on nutrition support
Current knowledge and service limitations in treating the complex interplay between eating disorders, gut–brain disorders and motility disorders
Trina Kellar · Chamara Basnayake · Rebecca E Burgell · Michael Kamm · Hannah W Kim · Kate Lane · Kate Murphy · Nicholas J Talley
Hepatocellular carcinoma surveillance in Australia: current and future perspectives
Naomi CA Whyler · Sushena Krishnaswamy · Michelle L Giles
A case of visceral leishmaniasis masquerading as autoimmune hepatitis
A 72-year-old man with a history of well controlled type 2 diabetes was admitted to a tertiary metropolitan hospital for investigation of fevers, night sweats and unintentional weight loss of 18kg over six months
Vinny Ea · Brigitte Papa · Rimma Goldberg
Overcoming disparities in hepatocellular carcinoma outcomes in First Nations Australians: a strategic plan for action
Key action measures to help address disparities in hepatocellular carcinoma incidence and mortality in First Nations Australians
Jessica Howell · Troy Combo · Paula Binks · Kylie Bragg · Sarah Bukulatjpi · Kirsty Campbell · Paul J Clark · Melissa Carroll · Jane Davies · Teresa de Santis · Kate R Muller · Bella Nguyen · John K Olynyk · Nicholas Shackel · Patricia C Valery · Alan J Wigg · Jacob George · Stuart K Roberts
Group A streptococcal colitis: an under‐recognised entity?
In August 2023, an otherwise healthy 54-year-old woman presented to hospital with acute onset fevers and sweats, followed by four days of nausea, vomiting, generalised severe abdominal pain and diarrhoea.
Samuel WL‐W Baumgart · Suzanne English · Tony Sebastian · Sarika Suresh · Timothy J Gray
Mimics of inflammatory bowel disease: commonly encountered differentials of an uncommon condition
Even when it looks, smells and sounds like inflammatory bowel disease, it might not be
Kathryn Demase · Mark G Ward
Post‐operative gastric pneumatosis
A 47-year-old woman who had undergone a Hartmann procedure for sigmoid colon perforation, developed sepsis a week after surgery
Siti Soraya Ab Rahman · Mohamad Farhan Mohamad Yusoff
Steatotic liver disease in rural and regional Victoria, according to the NAFLD and newer diagnostic criteria: retrospective cohort analyses of 2001–03 and 2016–18 data
The rising prevalence of steatotic liver disease parallels that of obesity in regional and rural Victoria
Karl Vaz · William W Kemp · Ammar Majeed · John Lubel · Dianna Magliano · Kristen Glenister · Lisa Bourke · David Simmons · Stuart K Roberts
Considerations of delayed gastric emptying with peri‐operative use of glucagon‐like peptide‐1 receptor agonists
There is emerging evidence on peri-operative risk and retained gastric products with GLP-1 receptor agonists
Lisa M Raven · Campbell Brown · Jerry R Greenfield
Hepatocellular carcinoma surveillance in Australia: current and future perspectives
Hepatocellular carcinoma is a leading cause of cancer-related death worldwide, and is increasing in incidence in Australia
Samuel Hui · Sally Bell · Suong Le · Anouk Dev
Diabetes and non‐alcoholic fatty liver disease: a bittersweet symphony
Screening for and monitoring diabetes mellitus in people with NAFLD/NASH, and proactively managing it, are important
Daniel Clayton‐Chubb · Stuart K Roberts
Dietary management of eosinophilic oesophagitis
Multidisciplinary models of care including dietary therapy are needed in Australia
Jessica Fitzpatrick · Sarah L Melton · Rebecca E Burgell
Haemophagocytic lymphohistiocytosis secondary to disseminated tuberculosis in a young adult with Crohn's disease
A 25-year-old male patient reported four weeks of chills, night sweats, weight loss and dyspnoea following one week in Bali, Indonesia, seven weeks prior
Rattanak Visal Hean · David A Sheffield · Kirsten Herbert · David Brewster