Surgery

The rates of surgical intervention are rising, but the evidence for benefit is limited

Vishal Kapoor · Pamela S Douglas · Peter S Hill · Laurence J Walsh · Marc Tennant

His gravelly voice became one of the successful politician’s most defining features

Evangelos Tseros · Faruque Riffat · Carsten E Palme · Hedley G Coleman · Narinder P Singh

Mr Ken Garoo presented with worsening severe bilateral lower limb pain

Peter Reed

This novel use of a punch biopsy blade is so quick, easy and effective that it is worth sharing

George Rahmani · John L Kelly

A prospective quality improvement register will reduce variations in outcomes and care following emergency laparotomy

Katherine J Broughton · Robert J Aitken

Communication in surgical practice

Christopher J Young

A recent trial provides high quality new evidence

Paul Bird · Terrence Diamond · William A Clark

The untapped potential in Australia for DCD, particularly of kidneys and lungs, is significant

Sandeep S Rakhra · Helen I Opdam · Laura Gladkis · Byron Arcia · Michael A Fink · John Kanellis · Peter S Macdonald · Gregory I Snell · David V Pilcher

Recent advances are likely to further improve the incremental benefit of radiation over and above surgery and systemic therapy and thus increase survival rates

John Boyages

A likely causal link between breast implants and lymphoma highlights the importance of a prospective registry

Ingrid Hopper · Susannah Ahern · John J McNeil · Anand K Deva · Elisabeth Elder · Colin Moore · Rodney Cooter

Lessons from practice•Diagnosis of adult-onset asthma should be made with caution.•The presence of an inhaled foreign body in the upper airway may be misdiagnosed as asthma.•Direct visualisation with an endoscope is required to exclude the presence of a foreign body.

Amy SM Wong · Bing Mei Teh · Glen Burgess · Michael CS Ho

A 73-year-old farmer presented with a finger injury after the spontaneous rupture of a hydraulic hose

Anna T Ryan · Bruce R Johnstone

The brain–computer interface is an exciting advance in neuroscience and engineering

Jeffrey V Rosenfeld · Yan Tat Wong

Transparency is key to achieve affordability of health care

David J Hillis · David AK Watters · Lawrie Malisano · Nick Bailey · David Rankin

A common abdominal examination manoeuvre, but a common understanding is elusive

Phillip L Jeans

The surgical critical care handbook. Guidelines for care of the surgical patient in the ICU

Richard C Turner

Reducing regional variations in treatment rates for pancreatic cancer requires an inclusive standardised approach and cooperation

Robert C Gandy · Koroush Haghighi

Caution is advised for those tempted to listen to Oz rock while undertaking high-risk tasks

Daisy Fancourt · Thomas MW Burton · Aaron Williamon

N/A

Helen Zorbas

Modifiable lifestyle factors may reduce the risk of developing breast cancer. Obesity is associated particularly with post-menopausal breast cancer. Diet is important, and exercise equivalent to running for up to 8 hours each week reduces the risk of breast cancer, both in its own right and through reducing obesity. Alcohol consumption may be responsible for 5.8% of breast cancers in Australia and it is recommended to reduce this to two standard drinks per day. Drinking alcohol and smoking increases the risk for breast cancer and, therefore, it is important to quit tobacco smoking. Prolonged use of combined oestrogen and progesterone hormone replacement therapy and oral contraceptives may increase breast cancer risk and this must be factored into individual decisions about their use. Ionising radiation, either from diagnostic or therapeutic radiation or through occupational exposure, is associated with a high incidence of breast cancer and exposure may be reduced in some cases. Tamoxifen chemoprevention may reduce the incidence of oestrogen receptor positive cancer in 51% of women with high risk of breast cancer. Uncommon but serious side effects include thromboembolism and uterine cancer. Raloxifene, which can also reduce osteoporosis, can be used in post-menopausal women and is not associated with the development of uterine cancer. Surgical prophylaxis with bilateral mastectomy and salpingo-oophorectomy can reduce the risk of breast cancer in patients carrying BRCA1 or BRCA2 mutations. For preventive treatments, mammographic screening can identify other women at high risk.

Ian N Olver

We have the will to improve cancer services for patients outside major cities but, thus far, not the way

Elizabeth Tracey BSc(Hons), MPH, PhD · Brian C McCaughan MB BS, FRACS · Jane M Young MPH, PhD, FAFPHM · Bruce K Armstrong MB BS(Hons), DPhil, FRACP

Major changes are occurring in breast surgery to help improve quality-of-life outcomes for women who survive breast cancer

Andrew J Spillane MD, FRACS

Draft guidance on the ethical review and conduct of xenotransplantation trials

Ian N Olver