Clindamycin and bacterial load reduction as prophylaxis for surgical site infection after below-knee flap and graft procedures: A trial protocol.

Background And Objectives: Management of skin cancer comprises a substantial proportion of general practitioner (GP) workload in Australia. Flap and graft procedures below the knee have an increased risk of infection. Antibiotic resistance is a threat to global health, and any decision about antibiotic prophylaxis must balance adverse outcomes of antibiotic use with patient morbidity.

Clinical prediction rules for surgical site infection after minor surgery in general practice.

Background And Objectives: Surgical site infection (SSI) after dermatological surgery is associated with poor outcomes. Developing clinical prediction rules based on the predicted probability of infection might encourage guided prophylaxis and judicious prescribing. The purpose of this study was to develop a clinical prediction rule based on identified risk factors for SSI in a large general practice patient cohort.

Planned dose reduction of ocrelizumab in relapsing-remitting multiple sclerosis: a single-centre observational study.

Background: Ocrelizumab, a humanised anti-CD20 monoclonal, is a highly effective treatment for relapsing-remitting multiple sclerosis (RRMS). The long-term safety of B-cell depletion in RRMS, however, is uncertain and there are no data on dose reduction of ocrelizumab as a risk mitigation strategy. This study aimed to evaluate the effectiveness and safety of reducing ocrelizumab dose from 600 to 300 mg in patients with RRMS.

Interventions aimed at increasing syphilis screening among non-pregnant individuals in healthcare settings: a systematic review and meta-analysis.

Syphilis remains a pressing public health concern with potential severe morbidity if left untreated. To improve syphilis screening, targeted interventions are crucial, especially in at-risk populations. This systematic review synthesises studies that compare syphilis screening in the presence and absence of an intervention.

The effect of COVID-19 on medical student clinical skill practice and self-perceived proficiency.

The coronavirus disease 2019 (COVID-19) pandemic significantly impacted medical education. This study aimed to determine how COVID-19 affected students' opportunity to practice core clinical skills across specialty rotations and their self-perceived proficiency at performing these. Routinely administered surveys of fifth year medical student' experiences and perceptions of medical training from 2016 to 2021 were analysed.

Impact of new diagnostic pathway for gestational diabetes in time of COVID-19.

Background: In April 2020, the diagnostic criteria for gestational diabetes mellitus (GDM) changed in Queensland, with the goal of reducing exposure of pregnant women to COVID-19.

Methods: A retrospective clinical audit was conducted at a regional hospital to compare the incidence of GDM, and specific maternal and neonatal outcomes four months before and after the change in guidelines was implemented.

Results: Less than 50% of diagnostic tests were performed according to new guidelines.

Validation of shear wave elastography as a noninvasive measure of pelvic floor muscle stiffness.

Objectives: To investigate the validity of shear wave elastography (SWE) as a measure of stiffness of the puborectalis muscle by examining: (1) the relationship between puborectalis muscle stiffness and pelvic floor muscle (PFM) activation at different intensities; and (2) the relationship between puborectalis stiffness and pelvic floor morphometry during contractions at different intensities.

Methods: Fifteen healthy asymptomatic women performed 6-s isometric PFM contractions at different intensities (0, 10%, 20%, 30%, 50%, 75%, and 100% of maximal voluntary contraction) guided by intravaginal electromyography (EMG). Stiffness of the puborectalis muscle was measured using SWE by calculating the average shear modulus in regions of interest that contained puborectalis muscle fibers parallel to the transducer.

Muscle spindles of the multifidus muscle undergo structural change after intervertebral disc degeneration.

Purpose: Proprioceptive deficits are common in low back pain. The multifidus muscle undergoes substantial structural change after back injury, but whether muscle spindles are affected is unclear. This study investigated whether muscle spindles of the multifidus muscle are changed by intervertebral disc (IVD) degeneration in a large animal model.

A study protocol for a randomised controlled trial of ice to reduce the pain of immunisation: The ICE trial.

Background And Objectives: Vaccine injections commonly cause iatrogenic pain. Ice may reduce pain. This is a study protocol for a prospective randomised controlled trial aiming to investigate the efficacy of ice packs to decrease vaccine-related pain in adults.

Risk factors for low back pain outcome: Does it matter when they are measured?

Background: The early identification of factors that increase risk of poor recovery from acute low back pain (LBP) is critical to prevent the transition to chronicity. Although most studies of risk factors for poor outcome in LBP tend to investigate the condition once it is already persistent, there is evidence to suggest that this differs from risk factors measured during the early-acute stage. This study aimed to identify early risk factors for poor outcome in the short- and long-term in individuals with acute LBP, and to compare this with factors identified at 3 months in the same cohort.

Feasibility Study for a Randomised Controlled Trial for the Topical Treatment of Impetigo in Australian General Practice.

Impetigo affects millions of children worldwide. Most guidelines recommend antibiotics as first-line treatment; however, topical antiseptics present a potentially valuable, understudied, antibiotic-sparing treatment for mild impetigo. We aimed to determine the feasibility of a randomised controlled trial (RCT) comparing efficacy of soft white paraffin (SWP), hydrogen peroxide (HO) and mupirocin for mild impetigo.

Characterisation of motor cortex organisation in patients with different presentations of persistent low back pain.

Persistence of low back pain is thought to be associated with different underlying pain mechanisms, including ongoing nociceptive input and central sensitisation. We hypothesised that primary motor cortex (M1) representations of back muscles (a measure of motor system adaptation) would differ between pain mechanisms, with more consistent observations in individuals presumed to have an ongoing contribution of nociceptive input consistently related to movement/posture. We tested 28 participants with low back pain sub-grouped by the presumed underlying pain mechanisms: nociceptive pain, nociplastic pain and a mixed group with features consistent with both.

A Randomised Controlled Trial of Ice to Reduce the Pain of Immunisation-The ICE Trial.

Background And Objectives: vaccine injections are a common cause of iatrogenic pain and anxiety, contributing to non-compliance with scheduled vaccinations. With injection-related pain being recognised as a barrier to vaccination uptake in both adults and children, it is important to investigate strategies to effectively reduce immunisation pain. This prospective randomised controlled trial investigated the effects of applying an ice pack on vaccine-related pain in adults.

Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis.

Purpose: Associations between rheumatic heart disease (RHD) in pregnancy and fetal outcomes are relatively unknown. This study aimed to review rates and predictors of major adverse fetal outcomes of RHD in pregnancy.

Methods: Medline (Ovid), Pubmed, EMcare, Scopus, CINAHL, Informit, and WHOICTRP databases were searched for studies that reported rates of adverse perinatal events in women with RHD during pregnancy.

International comparison of guidelines for management of impetigo: a systematic review.

Background: Impetigo is a common superficial skin infection that affects people worldwide and is usually treated with antibiotics; therefore, its management has implications for global antibiotic stewardship.

Objective: This systematic review and narrative synthesis compares and contrasts international impetigo management guidelines.

Methods: Guidelines for treatment of impetigo that were produced by a national authority; available to primary care physicians; and published since 2008 were included.

Effect of a Consumer-Focused Website for Low Back Pain on Health Literacy, Treatment Choices, and Clinical Outcomes: Randomized Controlled Trial.

Background: The internet is used for information related to health conditions, including low back pain (LBP), but most LBP websites provide inaccurate information. Few studies have investigated the effectiveness of internet resources in changing health literacy or treatment choices.

Objective: This study aims to evaluate the effectiveness of the MyBackPain website compared with unguided internet use on health literacy, choice of treatments, and clinical outcomes in people with LBP.

Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey.

Background: The global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic.

Methods: An electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020.

Cooling to reduce the pain associated with vaccination: A systematic review.

Background: Vaccine injections are the most common cause of iatrogenic pain in childhood and a cause of anxiety in adulthood. Skin cooling techniques, including icepacks and vapocoolants, may provide pain relief during intramuscular injections.

Objective: To identify the effects of skin cooling techniques on pain associated with immunisation.

Systematic Review and Synthesis of Mechanism-based Classification Systems for Pain Experienced in the Musculoskeletal System.

Objectives: Improvements in pain management might be achieved by matching treatment to underlying mechanisms for pain persistence. Many authors argue for a mechanism-based classification of pain, but the field is challenged by the wide variation in the proposed terminology, definitions, and typical characteristics. This study aimed to (1) systematically review mechanism-based classifications of pain experienced in the musculoskeletal system; (2) synthesize and thematically analyze classifications, using the International Association for the Study of Pain categories of nociceptive, neuropathic, and nociplastic as an initial foundation; and (3) identify convergence and divergence between categories, terminology, and descriptions of each mechanism-based pain classification.

Design, Delivery, Maintenance, and Outcomes of Peer-to-Peer Online Support Groups for People With Chronic Musculoskeletal Disorders: Systematic Review.

Background: Online support groups (OSGs) are one way for people with chronic diseases, their family or friends, and health professionals to communicate, gain information, and provide social support. As the number of peer-to-peer OSGs for chronic musculoskeletal conditions grows, it is important to gain insight into the different designs of groups available, who is accessing them, if and how they may be effective, and what strategies are being used to implement or increase consumer engagement.

Objective: The objectives of this systematic review of people with musculoskeletal conditions were to (1) describe the design features (functions, usage options, moderation, and expert input) of peer-to-peer OSGs, (2) describe the characteristics of the individuals using peer-to-peer OSGs, (3) synthesize the evidence on outcomes of participation, and (4) identify strategies used in the delivery and maintenance of OSGs.

Imaging to improve agreement for proximal humeral fracture classification in adult patient: A systematic review of quantitative studies.

Proximal humeral fracture classification has low reproducibility. Many studies have tried to increase inter- and intra-observer agreement with more sophisticated imaging. The aim of this review was to determine which imaging modality produces the best inter- and intra-observer agreement for proximal humeral fracture classification in adults and to determine if this varies with observer experience or fracture complexity.

Do features of randomized controlled trials of pelvic floor muscle training for postprostatectomy urinary incontinence differentiate successful from unsuccessful patient outcomes? A systematic review with a series of meta-analyses.

Aims: Efficacy of pelvic floor muscle training (PFMT) for postprostatectomy incontinence (PPI) differs between randomized clinical trials (RCT). This might be explained by variation in content/delivery of PFMT (eg, biofeedback, muscles targeted, and time of commencement of training). This review investigated whether outcome of meta-analysis differs based on presence or not of specific RCT features.

Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy.

Urinary incontinence is common after radical prostatectomy. Pelvic floor muscle training provides a plausible solution. Although early trials provided promising results, systematic reviews have questioned the efficacy of this intervention.

Exploring the Characteristics and Preferences for Online Support Groups: Mixed Method Study.

Background: Osteoarthritis (OA) is a chronic, disabling, and prevalent disorder. As there is no cure for OA, long-term self-management is paramount. Support groups (SGs) can facilitate self-management among people living with OA.