AU GP Research Review

18/01/2024

Trifarotene reduces risk for atrophic acne scars

Dr Annika Smith, consultant dermatologist at several private clinics, including Melanoma Institute Australia and Mater Hospital Foundation says "it is the most recent topical retinoid to receive regulatory approval for the treatment of acne. Of note, it has very low systemic absorption, making it well-suited for the treatment of large skin areas.

In this study, trifarotene was effective and well tolerated in treating moderate-to-severe facial acne and reducing atrophic acne scars, with a reduction of total atrophic scar counts as early as week 2.

This topical agent promises to be a valuable adjunct to the acne treatment space, not only treating acne but addressing acne sequelae."

Acne Research Review Issue 3 - https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/Dermatology/Acne/Acne-Research-Review,-Issue-3.aspx

16/01/2024

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08/01/2024

Thoughtful prescribing for patients with difficult-to-treat depression

This article discusses the management of difficult-to-treat depression and provides practical recommendations.

Professor Gerard Gill says "this is a good evidence-based summary from Canada on how to treat treatment-resistant depression. Professor Jan Gunn gave a presentation at World Organization of Family Doctors - WONCA 23. She says we as GPs see is different to what psychiatrists see is very relevant.

This article will help you attempt to bring relief to your patients.

General Practice Research Review Issue 115 - https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/General-Practice.aspx

03/01/2024

Getting ready for the year ahead! Subscribe to Australian GP Research Review with Professor Gerard Gill and earn CPD from the Australian College of Rural and Remote Medicine (ACRRM) and RACGP

Go to https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/General-Practice.aspx

02/01/2024

How safe is IVF for the woman going through it and how can the risks be reduced? The latest Fertility Watch features a presentation by Associate Professor Peter Illingworth, IVF Australia

Login and watch at https://www.researchreview.com.au/au/Clinical-Area/Other-Health/Fertility.aspx

Claim CPD for watching this video - https://www.researchreview.com.au/au/CPD.aspx

28/12/2023

Effect of behavioural interventions on the uptake of colonoscopy for colorectal cancer screening - this study strongly suggests that behavioural interventions should be routinely integrated into colonoscopy screening programmes to increase uptake.

Specifically, patient navigation and multicomponent interventions were consistently effective at increasing completion rates. Interestingly, primary care counselling was found to be highly effective in a single study and this result deserves further investigation.

Gastroenterology Practice Review Issue 36 - content reviewed by Dr Andrew Buckle, Gastroenterology Services Tasmania Pty LTD https://tinyurl.com/6dab8puz

27/12/2023

The global prevalence of HF is steadily increasing. Effective treatments for reducing incident HF rates exist, but strategies for identifying high-risk individuals for targeted treatment are needed.

Dr Mark Nolan, non-invasive Cardiologist working at Peter MacCallum Cancer Centre in Melbourne and Bendigo Health says "it may be reasonable to consider VAI measurements when determining a patient’s incident HF risk."

Read full article in Heart Failure Research Review Issue 80 - https://www.researchreview.com.au/au/Clinical-Area/Internal-Medicine/Cardiology/Heart-Failure/Heart-Failure-Research-Review,-Issue-80.aspx

13/12/2023

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10/12/2023

Patients with IBD at increased risk for respiratory syncytial virus infection

Data from this study involving adults with IBD and a group without IBD showed a significant association between IBD and respiratory syncytial virus (RSV) risk. This risk is present across all age groups, especially among those with comorbidities and those taking specific IBD medications.

Gastroenterology providers should educate their IBD patients about the risks of RSV and encourage eligible individuals to receive the RSV vaccine, which is presumed to be safe for this population.

https://tinyurl.com/ydh88vte

IBD Practice Review Issue 15 - content has been reviewed by Associate Professor Britt Christensen

VANCOUVER, British Columbia — Adult patients with inflammatory bowel disease are at increased risk for respiratory syncytial virus infection and hospitalization, especially those with comorbidities, according to data presented here. “Respiratory syncytial virus, or RSV, is a common viral...

10/12/2023

Join us at the Frontline Mental Health Conference in 2024 and unite to cultivate a mentally resilient workforce.

Together, we can shape a frontline sector that thrives.

Be part of the change: https://hubs.li/Q02c55Z40

08/12/2023

Debunking myths about screening: How to screen more judiciously

Dr Gerard Gill of Kardinia Health says "All of us have been exposed to Hippocrates’ plea “First do no harm”. This is a most easy to-read article by Canadian academics asking us to be more critical of the pressure to do screening for more diseases. Latrogenesis remains an unrecognised harm in most of modern medicine.

One of the messages of the World Organization of Family Doctors - WONCA conference plenaries was that the traditional approach and role of GPs remains the most potent and effective means of improving community health.

It is important that we have the time and ability to pay attention to what we are being told by our patients rather than attempting to prevent or find diseases using demands to do so driven by vested interest medical or pressure groups.

Article at https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/General-Practice/General-Practice-Research-Review,-Issue-115.aspx?hash=f717225f98b043d2a0cebd7f3e2abe269aa14eab85235675997f51fa643d2779

07/12/2023

We have just released the new issue General Practice Research Review

Dr Gerard Gill from Kardinia Health gives his opinion on these top papers:

- A Canadian examination of screening myths
- Evidence-based lipid-lowering therapy
- A new approach to spotting the sick kid with a LRTI
- What system failures frustrate GPs?
- Can a simple intervention improve LUTS?
- Use of GPs by Norwegian adolescents
- A meta-analysis of group A strep antibiotic therapy
- Is enteric-coated aspirin better?
- How to treat treatment-resistant depression
- A randomised trial of weekly insulin in type 1 diabetes mellitus

Read your copy here https://t.ly/LbzR6

07/12/2023

Join us at in March as we bring together the sector to progress mental health and wellbeing for children and adolescents.
Find out more: https://hubs.li/Q02c5hVG0

24/11/2023

Recommendations on the use of updated COVID-19 vaccines in infants

Dr Minh Cuong Duong, UNSW highlights "given the emergence of the SARS-CoV-2 virus, the original monovalent Novavax COVID-19 vaccines based on the ancestral SARS-CoV-2strain and the bivalent mRNA COVID-19 vaccines based on this strain and BA.4/BA.5 variants are no longer authorised for use in the U.S.

The U.S. Advisory Committee on Immunisation Practices has recommended vaccination with Moderna, Novavax, and Pfizer-BioNTech updated COVID-19 vaccines, which are the 2023–2024 Formula monovalent XBB.1.5 component–containing COVID-19 vaccines, for all individuals aged ≥6 months.

Based on available evidence, this report confirms that COVID-19 vaccination remains a cost-effective intervention. The 2023–2024 Formula strengthens the immune response against the currently circulating XBB-sublineage variants.

This report also reviews recommendations for the use of these updated vaccines in individuals aged ≥6 months with and without moderate or severe immunocompromised conditions and implementation considerations.

COVID 19 Research Review Issue 18 - login to read at https://www.researchreview.com.au/au/Clinical-Area/Internal-Medicine/Infectious-Diseases/COVID-19.aspx

20/11/2023

Caffeine intake & severe headache/migraine

Professor Tissa Wijeratne from Western Health says "the findings of this study indicate a positive association between dietary caffeine intake and the prevalence of severe headaches or migraines among adults in the US. However, it's essential to note that further studies may be necessary to establish a causal relationship between caffeine intake and severe headaches or migraines."

Migraine Research Review Issue 13 - https://www.researchreview.com.au/au/Clinical-Area/Neurology/Migraine/Migraine-Research-Review,-Issue-13.aspx?hash=a753f0d67f0eae31ad620cbc11cc68879bb4ee3c5896cce726476e5bbaffdc61

20/11/2023

This International Men’s Day let's talk men's health! 🩺

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17/11/2023

📢 Last chance to attend a workshop in 2023!
Our popular certificate courses in skin cancer and aesthetic medicine are coming to Perth on the weekend of 25/26 November! This is your last chance to attend a practical workshop before the end of the year.
🛠️ The workshops offer an excellent opportunity to gain hands-on skills in high-demand areas of general practice.
🏆 Tick off your annual 50 hours CPD requirement with the completion of one single course.
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13/11/2023

High processing of foods and IBD risk

Associate Professor Jonathan Segal from the The The University of Melbourne says "data are now emerging about the impact of specific foods on the risk of IBD. A lot of interest has gathered about processed foods, with signals probably suggesting that these are where possible to be avoided.

This study pulled together all the data and suggested that higher processed food was associated with a higher risk of CD but not UC. For me, I don’t believe the data are strong enough yet to suggest avoidance of processed foods.

I suggest to patients to have a healthy balanced diet, but do not suggest total avoidance of processed foods. I think it’s important to consider that for some patients this may be all they can afford or is available."

Inflammatory Bowel Disease Research Review Issue 73 - https://www.researchreview.com.au/au/Clinical-Area/Internal-Medicine/Gastroenterology/Inflammatory-Bowel-Disease/Inflammatory-Bowel-Disease-Research-Review,-Is-(3).aspx

09/11/2023

Exercise and physical activity in cardiac rehabilitation

Cardiovascular disease (CVD) places a significant burden on individuals and healthcare systems alike. Patients with CVD stand to benefit substantially from cardiac rehabilitation, which comprises structured exercise and physical activity as core components.

The The Cardiac Society of Australia and New Zealand Position Statement offers contemporary, evidence-based guidance for clinicians engaged in cardiac rehabilitation in Australia.

The key recommendations are listed below:

• Comprehensive individual assessment: A thorough evaluation of aerobic exercise capacity, muscle strength, and physical activity levels will lead to effective rehabilitation. A comprehensive assessment will allow limiting factors to be identified and guide the safe prescription of personalised exercise regimens tailored to the patient's abilities, needs, preferences, and goals.

• Monitoring and evaluation: To gauge the patient's response to exercise and physical activity accurately, assessments of aerobic exercise capacity, muscle strength, and physical activity should be conducted both at enrolment and discharge. This ongoing evaluation informs the determination of target exercise intensities during their program and allows for the measurement of program effectiveness.

• Exercise variety: Cardiac rehabilitation should encompass a diverse range of exercise and physical activity options. The overarching goal is to achieve moderate-to-vigorous intensity exercise and physical activity, as this offers optimal health benefits and aids in the prevention of recurrent CV events.

• Exercise modalities: While moderate-intensity continuous training (MICT) is well established as safe and effective for cardiac patients, emerging evidence suggests that high-intensity interval training can be well-tolerated by select cardiac patient groups, offering potential improvements in aerobic exercise capacity beyond what MICT can achieve in certain cases.

• Leveraging technology: To enhance patient support, consider making use of available resources such as wearable activity trackers and telehealth. These tools have the potential to increase patient engagement, improve quality of life, empower patients to self-monitor and manage their symptoms, and boost their confidence in maintaining long-term physical activity.

https://tinyurl.com/3ue8senh

09/11/2023

08/11/2023

Ketamine vs ECT for major depression

Professor Nicholas Keks says "this study was for treatment-resistant nonpsychotic major depression, not acute or psychotic depression, where the best efficacy of ECT lies.

An intravenous infusion of ketamine was used. Where therapeutic
ketamine is available in Australia, it is being mostly administered by
alternative routes, such as subcutaneous injection. Whether the findings of this study would apply to intranasal ketamine is unlikely in my view.

ECT was associated with memory problems, which persisted after treatment. Perhaps surprisingly, deterioration was more marked in patients who had received ECT than those who had been given ketamine.

On the face of it, this study provides further support for the use
of intravenous ketamine infusions in nonpsychotic treatment-resistant depression. Other studies have demonstrated that patients with more severe treatment-resistant depression are more likely to benefit from ECT than ketamine."

Psychiatry Research Review Issue 82 - https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/General-Practice/General-Practice-Research-Review,-Issue-114.aspx

08/11/2023

Are you an experienced rural health practitioner passionate about sharing your knowledge and guiding the next generation of rural doctors and healthcare providers? ACRRM is on the lookout for mentors to participate in our Mentor Match program, and we need YOU!

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06/11/2023

Prevalence and risk factors of acne scars

Dr Jo-Ann See, key opinion leader in Acne in Australia and co-chair of the All About Acne group and website www.acne.org.au says "this recent meta-analysis reminds us that all forms of acne have the potential to cause scarring and that early treatment, regardless of acne severity, may prevent acne scar formation, which can be permanent.

This an important factor to explain to patients and parents to highlight the necessity for treatment and not brush it under the carpet as “something that will go away” as it may not.

Adult acne is more likely to scar, and clinicians should bear this in mind as well as recognise atrophic scarring, which is the most common form of scarring.

The most relevant risk factors for the development of acne scarring were male gender, a positive family history and acne severity. So always ask regarding family history!

Acne Research Review Issue 1 - https://www.researchreview.com.au/au/Clinical-Area/General-Medicine/Dermatology/Acne/Acne-Research-Review,-Issue-1.aspx

02/11/2023

An excellent quick read on acne by HealthCert Education for Medical Professionals...

Dr Dianne King gives her top three tips for managing acne patients and discusses how to take acne patient history.

02/11/2023

Life expectancy according to age at type 2 diabetes diagnosis - Dr Mathis Grossmann from Austin Health and The University of Melbourne says "youth or early-onset type 2 diabetes is rapidly increasing in global prevalence, and is characterised by an aggressive course, with more insulin resistance and less β-cell reserve, and glycaemic control is more difficult to achieve.

This pathophysiology combined with the longer time lived with the disease places people with early-onset diabetes at greater risk of diabetes-related complications.

The most common causes of mortality related to causes other than CV disease or malignancy, but rather to adiverse array, including death from respiratory, digestive and central nervous system causes, mental health, infections and renal disease."

Diabetes Research Review Issue 137

https://www.researchreview.com.au/au/Clinical-Area/Internal-Medicine/Diabetes-Obesity/Diabetes-and-Obesity/Diabetes-Research-

19/10/2023

Interesting read from HealthCert Education for Medical Professionals.....

Learn about medical nutrition strategies for reducing pain and swelling and improving quality of life for your patients with osteoporosis.

26/09/2023

RMA attracts a diverse and collaborative community of junior doctors, students, educators, academics, and medical practitioners who are passionate about generalist medicine in rural and remote communities. With a packed program full of innovative and informative presentations, interactive workshops and social events, along with a heap of exhibitors, you’re not going to want to miss out on the biggest rural networking event of the year! More here: https://rma.acrrm.org.au/about