High value health care is low carbon health care
Med J Aust. 2021 Oct 26. doi: 10.5694/mja2.51331. Online ahead of print.ABSTRACTWe are in a health emergency precipitated by climate change.1 As well as physical health threats, climate change and its effects are adversely affecting Australians' mental health,2 and worsening the health inequities suffered by vulnerable populations. In response, the Australian health care community must both adapt to increased demand and to deteriorating environmental conditions, and mitigate the carbon footprint of health care, currently 7% of our national carbon emissions.3 Using economic data from 360 sectors, Malik and colleagues3 estim...
Source: Medical Journal of Australia - October 26, 2021 Category: General Medicine Authors: Alexandra L Barratt Katy Jl Bell Kate Charlesworth Forbes McGain Source Type: research

Clinical care of children and adolescents with COVID-19: recommendations from the National COVID-19 Clinical Evidence Taskforce
Med J Aust. 2021 Oct 24. doi: 10.5694/mja2.51305. Online ahead of print.ABSTRACTINTRODUCTION: The epidemiology and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are different in children and adolescents compared with adults. Although coronavirus disease 2019 (COVID-19) appears to be less common in children, with milder disease overall, severe complications may occur, including paediatric inflammatory multisystem syndrome (PIMS-TS). Recognising the distinct needs of this population, the National COVID-19 Clinical Evidence Taskforce formed a Paediatric and Adolescent Care P...
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: David Fraile Navarro Britta Tendal David Tingay Nan Vasilunas Lorraine Anderson James Best Penelope Burns Saskia Cheyne Simon S Craig Simon J Erickson Nicholas Ss Fancourt Zoy Goff Vimbai Kapuya Catherine Keyte Lorelle Malyon Steve McDonald Heath White Da Source Type: research

Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
Med J Aust. 2021 Oct 23. doi: 10.5694/mja2.51313. Online ahead of print.NO ABSTRACTPMID:34689331 | DOI:10.5694/mja2.51313 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: Penni L Blazak Kim Greaves Source Type: research

Cancer Australia consensus statement on COVID-19 and cancer care: embedding high value changes in practice
This article summarises the full statement, which is available at https://www.canceraustralia.gov.au/covid-19/covid-19-recovery-implications-cancer-care.MAIN RECOMMENDATIONS: The statement is informed by a desktop literature review and input from cancer experts and consumers at a virtual roundtable, held in July 2020, on key elements of cancer care that changed during the pandemic. It describes targeted strategies (at system, service, practitioner and patient levels) to retain, enhance and embed high value changes in practice. Principal strategies include: implementing innovative models of care that are digitally enabled a...
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: Vivienne Milch Rhona Wang Carolyn Der Vartanian Melissa Austen Debra Hector Cleola Anderiesz Dorothy Keefe Source Type: research

Clinical care of children and adolescents with COVID-19: recommendations from the National COVID-19 Clinical Evidence Taskforce
Med J Aust. 2021 Oct 24. doi: 10.5694/mja2.51305. Online ahead of print.ABSTRACTINTRODUCTION: The epidemiology and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are different in children and adolescents compared with adults. Although coronavirus disease 2019 (COVID-19) appears to be less common in children, with milder disease overall, severe complications may occur, including paediatric inflammatory multisystem syndrome (PIMS-TS). Recognising the distinct needs of this population, the National COVID-19 Clinical Evidence Taskforce formed a Paediatric and Adolescent Care P...
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: David Fraile Navarro Britta Tendal David Tingay Nan Vasilunas Lorraine Anderson James Best Penelope Burns Saskia Cheyne Simon S Craig Simon J Erickson Nicholas Ss Fancourt Zoy Goff Vimbai Kapuya Catherine Keyte Lorelle Malyon Steve McDonald Heath White Da Source Type: research

Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
Med J Aust. 2021 Oct 23. doi: 10.5694/mja2.51313. Online ahead of print.NO ABSTRACTPMID:34689331 | DOI:10.5694/mja2.51313 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: Penni L Blazak Kim Greaves Source Type: research

Cancer Australia consensus statement on COVID-19 and cancer care: embedding high value changes in practice
This article summarises the full statement, which is available at https://www.canceraustralia.gov.au/covid-19/covid-19-recovery-implications-cancer-care.MAIN RECOMMENDATIONS: The statement is informed by a desktop literature review and input from cancer experts and consumers at a virtual roundtable, held in July 2020, on key elements of cancer care that changed during the pandemic. It describes targeted strategies (at system, service, practitioner and patient levels) to retain, enhance and embed high value changes in practice. Principal strategies include: implementing innovative models of care that are digitally enabled a...
Source: Medical Journal of Australia - October 24, 2021 Category: General Medicine Authors: Vivienne Milch Rhona Wang Carolyn Der Vartanian Melissa Austen Debra Hector Cleola Anderiesz Dorothy Keefe Source Type: research

Progressive multifocal leukoencephalopathy: a complication of prolonged immunosuppression for plasma cell myeloma
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51315. Online ahead of print.NO ABSTRACTPMID:34687047 | DOI:10.5694/mja2.51315 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 23, 2021 Category: General Medicine Authors: Sophie C Burn Akash Kalro Source Type: research

Erratum
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51326. Online ahead of print.NO ABSTRACTPMID:34687057 | DOI:10.5694/mja2.51326 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 23, 2021 Category: General Medicine Source Type: research

Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
Med J Aust. 2021 Oct 23. doi: 10.5694/mja2.51321. Online ahead of print.NO ABSTRACTPMID:34688223 | DOI:10.5694/mja2.51321 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 23, 2021 Category: General Medicine Authors: James A Black James E Sharman Thomas H Marwick Source Type: research

Outcomes of COVID-19 patients admitted to Australian intensive care units during the first four months of the pandemic
Med J Aust. 2021 Oct 23. doi: 10.5694/mja2.51311. Online ahead of print.NO ABSTRACTPMID:34688226 | DOI:10.5694/mja2.51311 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 23, 2021 Category: General Medicine Authors: Rochelle Wynne Caleb Ferguson Patricia M Davidson Source Type: research

Outcomes for patients with COVID-19 admitted to Australian intensive care units during the first four months of the pandemic
Med J Aust. 2021 Oct 21. doi: 10.5694/mja2.51314. Online ahead of print.NO ABSTRACTPMID:34676553 | DOI:10.5694/mja2.51314 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Aidan Jc Burrell Tessa Broadley Andrew A Udy Source Type: research

The absence of women involved in the criminal justice system from Australia's national discussion on preventing family and domestic violence
Med J Aust. 2021 Oct 21. doi: 10.5694/mja2.51319. Online ahead of print.NO ABSTRACTPMID:34676556 | DOI:10.5694/mja2.51319 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Melissa Willoughby Stuart A Kinner Source Type: research

Universal genetic testing of patients with newly diagnosed breast cancer - ready for prime time?
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51317. Online ahead of print.NO ABSTRACTPMID:34676562 | DOI:10.5694/mja2.51317 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Dilanka L De Silva Paul A James G Bruce Mann Geoffrey J Lindeman Source Type: research

Reframing palliative care to improve the quality of life of people diagnosed with a serious illness
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51307. Online ahead of print.NO ABSTRACTPMID:34676567 | DOI:10.5694/mja2.51307 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Peter Hudson Anna Collins Mark Boughey Jennifer Philip Source Type: research

Sexual relationships between health practitioners and former patients
Med J Aust. 2021 Oct 21. doi: 10.5694/mja2.51320. Online ahead of print.NO ABSTRACTPMID:34676583 | DOI:10.5694/mja2.51320 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Paul M McGurgan Katrina L Calvert Christine M Jorm Source Type: research

Unnecessary ultrasound imaging in the management of undescended testis
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51324. Online ahead of print.NO ABSTRACTPMID:34676886 | DOI:10.5694/mja2.51324 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Dharshini Selvarajah Dermot McDowell Susan Jehangir Grahame Smith Source Type: research

It is time for governments to support retailers in the transition to a smoke-free society
Med J Aust. 2021 Oct 22. doi: 10.5694/mja2.51312. Online ahead of print.NO ABSTRACTPMID:34676887 | DOI:10.5694/mja2.51312 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 22, 2021 Category: General Medicine Authors: Coral E Gartner April Wright Marita Hefler Andrew Perusco Janet Hoek Source Type: research

The 2021 report of the MJA-Lancet Countdown on health and climate change: Australia increasingly out on a limb
Med J Aust. 2021 Oct 20. doi: 10.5694/mja2.51302. Online ahead of print.ABSTRACTThe MJA-Lancet Countdown on health and climate change in Australia was established in 2017, and produced its first national assessment in 2018, its first annual update in 2019, and its second annual update in 2020. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. Our special report in 2020 focused on the unprecedented and catastrophic 2019-20 ...
Source: Medical Journal of Australia - October 20, 2021 Category: General Medicine Authors: Paul J Beggs Ying Zhang Alice McGushin Stefan Trueck Martina K Linnenluecke Hilary Bambrick Helen L Berry Ollie Jay Lucie Rychetnik Ivan C Hanigan Geoffrey G Morgan Yuming Guo Arunima Malik Mark Stevenson Donna Green Fay H Johnston Celia McMichael Ian Ham Source Type: research

Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study
CONCLUSIONS: Two in three young people with emerging mental disorders did not experience meaningful improvement in social and occupational functioning during two years of early intervention care. Most functional trajectories were also quite volatile, indicating the need for dynamic service models that emphasise multidisciplinary interventions and measurement-based care.PMID:34664282 | DOI:10.5694/mja2.51308 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 19, 2021 Category: General Medicine Authors: Frank Iorfino Joanne S Carpenter Shane Pm Cross Jacob Crouse Tracey A Davenport Daniel F Hermens Hannah Yee Alissa Nichles Natalia Zmicerevska Adam Guastella Elizabeth M Scott Ian B Hickie Source Type: research

Barbiturate-related hospitalisations, drug treatment episodes, and deaths in Australia, 2000-2018
CONCLUSIONS: While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.PMID:34658038 | DOI:10.5694/mja2.51306 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 18, 2021 Category: General Medicine Authors: Shane Darke Agata Chrzanowska Gabrielle Campbell Emma Zahra Julia Lappin Source Type: research

Breakthrough climate litigation positions courts to combat the health impacts of climate change
Med J Aust. 2021 Oct 17. doi: 10.5694/mja2.51288. Online ahead of print.NO ABSTRACTPMID:34657282 | DOI:10.5694/mja2.51288 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 17, 2021 Category: General Medicine Authors: Katherine Owens Source Type: research

Angiosarcoma presenting as unexplainable unilateral leg pain and purpuric toes
Med J Aust. 2021 Oct 16. doi: 10.5694/mja2.51310. Online ahead of print.NO ABSTRACTPMID:34657290 | DOI:10.5694/mja2.51310 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 17, 2021 Category: General Medicine Authors: Genevieve Ho Dedee F Murrell Source Type: research

News briefs
Med J Aust. 2021 Oct 18;215(8):340-341. doi: 10.5694/mja2.51296.NO ABSTRACTPMID:34657294 | DOI:10.5694/mja2.51296 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 17, 2021 Category: General Medicine Authors: Cate Swannell Source Type: research

Climate, extreme heat and human health: risks and lessons for Australia
Med J Aust. 2021 Oct 17. doi: 10.5694/mja2.51293. Online ahead of print.NO ABSTRACTPMID:34657295 | DOI:10.5694/mja2.51293 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 17, 2021 Category: General Medicine Authors: Tarun S Weeramanthri Simon Quilty Sharon L Campbell Source Type: research

Australian case of multisystem inflammatory syndrome in adults (MIS-A) occurs two months into 2021 SARS-CoV-2 Delta outbreak in New South Wales
We report, to our knowledge, the first Australian case of multisystem inflammatory syndrome in adults, a rare but severe systemic inflammatory syndrome occurring 4-6 weeks after COVID-19 infection. Clinicians should be aware of this syndrome in children or adults with shock, mucocutaneous and/or gastrointestinal features, even without prior symptomatic COVID-19 infection.PMID:34651316 | DOI:10.5694/mja2.51325 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 15, 2021 Category: General Medicine Authors: Annaleise R Howard-Jones Sam R Orde Zoe Jennings Source Type: research

Increasing ICU capacity to accommodate higher demand during the COVID-19 pandemic
CONCLUSIONS: The number of currently available staffed ICU beds was lower than in 2020. Equipment shortfalls have been remediated, with sufficient ventilators to equip every ICU bed. ICU capacity can be increased in response to demand, but is constrained by the availability of appropriately trained staff. Fewer than half the potentially additional physical ICU beds could be opened with currently available staff levels while maintaining pre-pandemic models of care.PMID:34642941 | DOI:10.5694/mja2.51318 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 13, 2021 Category: General Medicine Authors: Edward Litton Sue Huckson Shaila Chavan Tamara Bucci Anthony Holley Evan Everest Sean Kelly Steven McGloughlin Johnny Millar Nhi Nguyen Mark Nicholls Paule Secombe David Pilcher Source Type: research

Eczema coxsackium
Med J Aust. 2021 Oct 10. doi: 10.5694/mja2.51297. Online ahead of print.NO ABSTRACTPMID:34632588 | DOI:10.5694/mja2.51297 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Hsing-Jou Su Chun-Bing Chen Source Type: research

The impact of re-opening the international border on COVID-19 hospitalisations in Australia: a modelling study
CONCLUSIONS: If highly transmissible SARS-CoV-2 variants are circulating locally or overseas, large and disruptive COVID-19 outbreaks will still be possible in Australia after 80% of people aged 16 years or more have been vaccinated. Continuing public health measures to restrict the spread of disease are likely to be necessary throughout 2022.PMID:34633100 | DOI:10.5694/mja2.51291 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Mark J Hanly Timothy Churches Oisin Fitzgerald Jeffrey J Post C Raina MacIntyre Louisa Jorm Source Type: research

Eczema coxsackium
Med J Aust. 2021 Oct 10. doi: 10.5694/mja2.51297. Online ahead of print.NO ABSTRACTPMID:34632588 | DOI:10.5694/mja2.51297 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Hsing-Jou Su Chun-Bing Chen Source Type: research

The impact of re-opening the international border on COVID-19 hospitalisations in Australia: a modelling study
CONCLUSIONS: If highly transmissible SARS-CoV-2 variants are circulating locally or overseas, large and disruptive COVID-19 outbreaks will still be possible in Australia after 80% of people aged 16 years or more have been vaccinated. Continuing public health measures to restrict the spread of disease are likely to be necessary throughout 2022.PMID:34633100 | DOI:10.5694/mja2.51291 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Mark J Hanly Timothy Churches Oisin Fitzgerald Jeffrey J Post C Raina MacIntyre Louisa Jorm Source Type: research

Eczema coxsackium
Med J Aust. 2021 Oct 10. doi: 10.5694/mja2.51297. Online ahead of print.NO ABSTRACTPMID:34632588 | DOI:10.5694/mja2.51297 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Hsing-Jou Su Chun-Bing Chen Source Type: research

The impact of re-opening the international border on COVID-19 hospitalisations in Australia: a modelling study
CONCLUSIONS: If highly transmissible SARS-CoV-2 variants are circulating locally or overseas, large and disruptive COVID-19 outbreaks will still be possible in Australia after 80% of people aged 16 years or more have been vaccinated. Continuing public health measures to restrict the spread of disease are likely to be necessary throughout 2022.PMID:34633100 | DOI:10.5694/mja2.51291 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 11, 2021 Category: General Medicine Authors: Mark J Hanly Timothy Churches Oisin Fitzgerald Jeffrey J Post C Raina MacIntyre Louisa Jorm Source Type: research

Mucormycosis: early treatment is the key to survival
Med J Aust. 2021 Oct 9. doi: 10.5694/mja2.51290. Online ahead of print.NO ABSTRACTPMID:34628643 | DOI:10.5694/mja2.51290 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 10, 2021 Category: General Medicine Authors: Timothy R Holmes Jenny L Hepschke Ian Jacobson Anthony Maloof Source Type: research

Consensus guidelines for the management of adult immune thrombocytopenia in Australia and New Zealand
Med J Aust. 2021 Oct 10. doi: 10.5694/mja2.51284. Online ahead of print.ABSTRACTINTRODUCTION: The absence of high quality evidence for basic clinical dilemmas in immune thrombocytopenic purpura (ITP) underlines the need for contemporary guidelines relevant to the local treatment context. ITP is diagnosed by exclusions, with a hallmark laboratory finding of isolated thrombocytopenia.MAIN RECOMMENDATIONS: Bleeding, family and medication histories and a review of historical investigations are required to gauge the bleeding risk and possible hereditary syndromes. Beyond the platelet count, the decision to treat is affected by ...
Source: Medical Journal of Australia - October 10, 2021 Category: General Medicine Authors: Philip Yi Choi Eileen Merriman Ashwini Bennett Anoop K Enjeti Chee Wee Tan Isaac Goncalves Danny Hsu Robert Bird Source Type: research

Paediatric dermatofibrosarcoma protuberans: a neglected scar-like plaque in a child
Med J Aust. 2021 Oct 9. doi: 10.5694/mja2.51301. Online ahead of print.NO ABSTRACTPMID:34628658 | DOI:10.5694/mja2.51301 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 10, 2021 Category: General Medicine Authors: Yi-Teng Hung Jennifer Wu Chun-Yu Cheng Source Type: research

Voluntary assisted dying and telehealth: Commonwealth carriage service laws are putting clinicians at risk
Med J Aust. 2021 Oct 10. doi: 10.5694/mja2.51287. Online ahead of print.NO ABSTRACTPMID:34628662 | DOI:10.5694/mja2.51287 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 10, 2021 Category: General Medicine Authors: Eliana Close Katrine Del Villar Lindy Willmott Ben P White Source Type: research

Violaceous skin lesions on a returned traveller
Med J Aust. 2021 Oct 9. doi: 10.5694/mja2.51298. Online ahead of print.NO ABSTRACTPMID:34628671 | DOI:10.5694/mja2.51298 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 10, 2021 Category: General Medicine Authors: David Wj Griffin Jenny Sj Wong Orla Morrissey Cristina Mateevici Source Type: research

A non-healing ulcer: amelanotic melanoma
Med J Aust. 2021 Oct 7. doi: 10.5694/mja2.51294. Online ahead of print.NO ABSTRACTPMID:34622449 | DOI:10.5694/mja2.51294 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 8, 2021 Category: General Medicine Authors: Michelle Ky Chen Deshan Sebaratnam Source Type: research

Switching Australian patients with moderate to severe inflammatory bowel disease from originator to biosimilar infliximab
Med J Aust. 2021 Oct 7. doi: 10.5694/mja2.51295. Online ahead of print.NO ABSTRACTPMID:34622453 | DOI:10.5694/mja2.51295 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 8, 2021 Category: General Medicine Authors: David Lim Rhiannon Bandiera Elizabeth Handsley Source Type: research

Switching Australian patients with moderate to severe inflammatory bowel disease from originator to biosimilar infliximab
Med J Aust. 2021 Oct 7. doi: 10.5694/mja2.51303. Online ahead of print.NO ABSTRACTPMID:34622467 | DOI:10.5694/mja2.51303 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 8, 2021 Category: General Medicine Authors: Ashish Srinivasan Craig Haifer Lena Thin Source Type: research

Screening for hydroxychloroquine retinopathy in Australia
Med J Aust. 2021 Oct 8. doi: 10.5694/mja2.51299. Online ahead of print.NO ABSTRACTPMID:34622959 | DOI:10.5694/mja2.51299 (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - October 8, 2021 Category: General Medicine Authors: Adrian T Fung Vicky Lu Heather G Mack Source Type: research