The utility of 18 F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification.

Background: The incremental value of 18FDG PET/CT in patients with breast cancer (BC) compared to conventional imaging (CI) in clinical practice is unclear. The aim of this study was to evaluate the management impact and prognostic value of 18 F-FDG PET/CT in this setting.

Methods: Sixty-three patients who were referred to our institution for suspicion of BC relapse were retrospectively enrolled.

Tonsillar cancer: the Peter MacCallum experience with unilateral and bilateral irradiation.

Background: The primary purpose of this study was to review the efficacy of unilateral treatment of lateralized tonsil primaries, in particular whether laterality of the primary is a more powerful determinant of contralateral neck failure than advanced ipsilateral nodal classification.

Methods: A retrospective study of all patients with tonsillar cancer treated with curative intent between January 1990 and December 2002 was performed.

Results: There were 167 patients, 76% men, median age 58 years, 86% current or ex-smokers.

Oral cyclophosphamide in recurrent ovarian cancer.

Aims: Cyclophosphamide was widely used as a single agent prior to the advent of platinum-based regimens for epithelial ovarian cancer, and, in combination with platinum, prior to the adoption of platinum and paclitaxel as standard first-line therapy. As cyclophosphamide currently has no defined role in ovarian cancer we aimed to assess its activity in women with recurrent disease.

Methods: A retrospective review was conducted of patients from three centers in Melbourne, Australia who had received oral cyclophosphamide treatment for recurrent ovarian cancer.

Being satisfied at work does affect burnout among psychiatrists: a national follow-up study from New Zealand.

Background: Burnout and job satisfaction in psychiatrists has been an area of considerable interest. Longitudinal studies on the subject are lacking, rendering it difficult to establish whether burnout changes with time or whether low job satisfaction may predict high burnout with time in psychiatrists.

Aims: This longitudinal study of burnout and job satisfaction in a cohort of New Zealand psychiatrists was conducted to examine if initial scores on the Job Diagnostic Survey (JDS) predicted scores on the Maslach Burnout Inventory (MBI) three years later and vice versa.

Difficulties with defining lymphoedema after axillary dissection for breast cancer.

Aim: Axillary lymph node dissection(AND) is a common treatment for breast cancer. An important side effect of the surgery is lymphoedema (LO). The primary aims of this study were to assess the local prevalence of LO in patients who had undergone AND and how the subjective symptoms described by patients compare with objective measurements.

A dietitian-led clinic for patients receiving (chemo)radiotherapy for head and neck cancer.

Purpose: Malnutrition is prevalent in head and neck cancer patients and is associated with poorer outcomes and increased health care costs. This study aimed to evaluate the acceptability, organisational efficiency and clinical outcomes of a dietitian-led head and neck cancer clinic.

Methods: Two consecutive, independent, patient cohorts were studied with a pre-post-test design of 98 patients prior to the introduction of a dietitian-led clinic (DLC) and the subsequent 100 patients who attended the newly formulated DLC.

The utility of PET/CT in staging and assessment of treatment response of nasopharyngeal cancer.

Introduction: The aim of this study was to evaluate the impact of positron emission tomography/computerised tomography (PET/CT) as an adjunct to conventional imaging (CI) in the management of nasopharyngeal cancer (NPC) both for initial staging and assessment of post-treatment response.

Methods: All NPC cases referred to the Peter MacCallum Centre for Metabolic Imaging between January 2002 and December 2007 were identified. In patients undergoing initial staging, any differences between the pre-PET/CT management plan based on CI and that following performance of the PET/CT scan were noted.

Risk and response adapted therapy for early stage Hodgkin lymphoma: a prospective multicenter study of the Australasian Leukaemia and Lymphoma Group/Trans-Tasman Radiation Oncology Group.

In this prospective, multicenter, non-randomized study for patients with stage I-II Hodgkin lymphoma, group 1 (without risk-factors [RF]) had three cycles of ABVD chemotherapy (adriamycin, bleomycin, vinblastine, and dacarbazine) and group 2 (any of bulk, extranodal site, >3 regions, raised erythrocyte sedimentation rate [ESR]) and group 3 (B-symptoms) received four cycles. Involved field radiotherapy (IFRT) 30 Gy was given after adequate chemotherapy response. Five-year overall survival and freedom from progression (FFP) were 96% (95% confidence interval [CI] 91-98%) and 90% (84-94%), respectively.

Stresses experienced by psychiatrists and their role in burnout: a national follow-up study.

Background: Many studies have looked at sources of stress in psychiatrists, yet the role played by different factors in the causation of burnout in psychiatrists remains unclear. We had two aims, first, to develop a predictive model for the onset of burnout. Second, we aimed to study the differences in the perception of what caused stress between psychiatrists who rated themselves high on Emotional Exhaustion compared to those who rated themselves as low on Emotional Exhaustion.

Long-term mortality after primary percutaneous coronary intervention for high-risk myocardial infarction.

Background: Primary percutaneous coronary intervention (PPCI) has evolved, including the introduction of stents and platelet glycoprotein IIb/IIIa receptor inhibitors (GPI). The effects of these changes and other variables on long-term survival for a single-centre service were studied.

Methods: A prospective database of clinical and angiographic variables were kept for patients treated with PPCI in Waikato Hospital from 1996 to 2006 (n=527).

Palliative care provision by rural general practitioners in New Zealand.

Objectives: The aim of this study was to ascertain the workload for rural general practitioners providing palliative care and to identify barriers to care for patients living in rural areas of New Zealand.

Design And Methods: This was a cross-sectional survey of rural general practitioners using a postal questionnaire.

Results: One hundred eighty-six questionnaires were returned.

Views and experiences of family/whanau carers of psychiatric service users on diagnosis and classification.

Background: Family (whanau) and other carers can play a central part in the natural history of psychiatric service users. Diagnoses or the classification of mental disorders play a significant role in communications between clinicians, psychiatric service users, and family. Despite that centrality, the views and experiences of family on the utility of the present classification systems have been little studied.

General practitioners' views on the major psychiatric classification systems.

Aim: To understand the views of general practitioners on the utility of diagnostic schema as used by specialist psychiatrists and principles that would increase the value of diagnostic schema to general practitioners.

Method: A postal survey of 1000 vocationally registered general practitioners in New Zealand

Results: Diagnostic schema such as the DSM-IV and ICD-10 are seldom used by general practitioners due primarily to their complexity and a lack of familiarity with them. Providing decision support on pharmaceutical treatment, appropriate secondary care referrals and improving communication across the primary/secondary care divide are principles that should guide the development of future diagnostic schema.

Use of mobile phone cameras for after-hours triage in primary care.

Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices.

CAOS contribution to understanding cultural/ethnic differences in the prevalence of bipolar affective disorder in New Zealand.

Objective: To examine whether data on the clinical profiles of psychiatric service users can inform the claim that Māori in the New Zealand community have an increased rate of bipolar disorder.

Method: The standardized recordings of a variety of clinical phenomena previously collected in a New Zealand study of psychiatric service users was extracted for those persons who were diagnosed with a bipolar mental disorder. The individual clinical phenomena were then compared by ethnicity.

New Zealand psychiatrists views on global features of ICD-10 and DSM-IV.

Objective: The present accepted classificatory systems (ICD-10 and DSM-IV) represent the culmination of 100 years of post-Kraepelinian evolution. The present paper reports on a study to ascertain the views of New Zealand psychiatrists on their requirements of a classificatory system, and their opinions on those currently in use.

Method: An anonymous postal survey of 542 psychiatrists and trainees was undertaken in New Zealand.

Population-based funding formulae cultural coefficients: seeking a more equitable distribution of health dollars in New Zealand.

Evidence and argument for the allocation of funds to forensic psychiatric services to take account of the ethnic disparities in the use of the Justice System is presented. This would reflect the reality of the distribution of Service demand.