Atopic dermatitis in adults: An Australian management consensus.

Background/objectives: Atopic dermatitis (AD) has significant negative impact on health-related quality of life, mood, sleep, work productivity and everyday activities. Research into the use of new drugs in the management of AD continues to develop, and international updates and recommendations have been published. However, questions remain in the Australian setting.

Food avoidance and restriction in adults: a cross-sectional pilot study comparing patients from an immunology clinic to a general practice.

Background: With the introduction of avoidant/restrictive food intake disorder (ARFID) in the Diagnostic and Statistical Manual - fifth edition, there is an increased need to understand the prevalence and pattern of food avoidance and restriction in adults. High rates of food allergy and intolerance in immunology clinic populations, and subsequent high rates of elimination diets, place these individuals at a greater risk of developing pathological eating behaviours. This descriptive cross sectional pilot study aims to provide preliminary data on the prevalence and nature of food avoidance and restriction in an adult population, and to explore the reasons for this behaviour.

Salicylate elimination diets in children: is food restriction supported by the evidence?

A review of case notes from our Sydney-based paediatric allergy services, between 1 January 2003 and 31 December 2011, identified 74 children who had been prescribed diets that eliminated foods containing natural salicylates before attending our clinics. The most common indications for starting the diets were eczema (34/74) and behavioural disturbances (17/74) including attention deficit hyperactivity disorder (ADHD). We could find no peer-reviewed evidence to support the efficacy of salicylate elimination diets in managing these diseases.

Poor efficacy of oral tacrolimus in the treatment of severe generalized atopic eczema in adults: a small retrospective case series.

We report a small, but novel case series of four adults with severe generalized atopic eczema (AE) not responsive to several other immunomodulatory therapies, who were treated with oral tacrolimus (5 mg twice-daily). Three of the four patients failed therapy with systemic tacrolimus, despite two of these showing an initial clinical response; the fourth patient remains on tacrolimus monotherapy with good control of skin disease. Although oral tacrolimus was well-tolerated in this small group of adults, the clinical efficacy in this series for severe AE was poor.

Chronic human herpes virus 8 infection successfully treated with valganciclovir.

Background: : A 57 year old Italian female with a 3 year history of constituitional symptoms with non-HIV Kaposi sarcoma was referred to the immunology clinic. She was previously diagnosed with chronic human herpes virus 8 (HHV8) infection with positive HHV8 polymerase chain reaction in serum.

Objective: : Is valganciclovir effective in treating chronic human herpes virus 8 infection without Multicentric Castleman's Disease (MCD)?

Results: : She was started on valganciclovir, resulting in remission of her symptoms, improvement in inflammatory markers and clearing of detectable HHV8 viraemia

Conclusion: : Valganciclovir is effective in treating symptomatic HHV8 infections without MCD.

Reforming New South Wales public hospitals: an assessment of the Garling inquiry.

The final report of the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals was published on 27 November 2008. The report acknowledges the challenges facing the New South Wales health system, including increasing numbers of patients, rising treatment costs, workforce pressures, and the breakdown of working relations between clinicians and management. Many of Commissioner Garling's 139 recommendations formalise aspects of clinical care that should and could be happening now if the system were better managed, including better supervision and training of junior staff.