Breaking the general practice-hospital divide: Engaging primary care practitioners in multidisciplinary cancer care.

Aims: To integrate primary care into multidisciplinary cancer meetings and improve communication between hospital- and community-based care providers.

Methods: A 12-week pilot study was conducted at Western Health, implementing a model of care, where two general practitioners (GPs) were recruited from the local community to attend weekly breast and lung multidisciplinary meetings in a liaison role as a primary care representative (PCR). Community GPs and hospital specialists were surveyed at the end of the study to assess the impact of this model of care.

Unmet information needs predict anxiety in early survivorship in young women with breast cancer.

Purpose: To examine variations in anxiety and longitudinal associations between unmet supportive care needs and elevated anxiety in young women (< 50 years) within 13 months of their breast cancer diagnosis.

Methods: Two hundred and nine women recruited through Victorian Cancer Registry completed questionnaires at study entry (T1) (average 7 months post-diagnosis) then 3 (T2) and 6 months later (T3). Women completed the Hospital Anxiety and Depression Scale (HADS) and Supportive Care Needs Survey-Breast Cancer (SCNS-Breast) at each time point.

The PAPHIO study protocol: a randomised controlled trial with a 2 x 2 crossover design of physical activity adherence, psychological health and immunological outcomes in breast cancer survivors.

Background: The PAPHIO study; a randomized controlled trial with 2X2 crossover design will implement a self-directed physical activity program in which participants will engage in self-monitoring and receive motivational interviewing to enhance physical activity adherence. The study aims to determine the effects of 24 weeks self-directed activity combined with motivational interviewing (MI) on (i) psychological health, (ii) quality of life (QoL) and (iii) immune function in female breast cancer survivors.

Methods: The study will recruit 64 female breast cancer survivors within 3 years of diagnosis and at least 6 months post primary treatments at Western Health Sunshine Hospital, Melbourne, Australia.

Pyoderma gangrenosum of the breast 17 years after breast cancer treatment.

We present a case of pyoderma gangrenosum (PG) affecting the breast of a 74-year-old woman, with a history of breast cancer treated with breast conserving surgery and adjuvant radiotherapy 17 years prior. She presented to the hospital with worsening breast ulceration, after a punch biopsy was performed at the site. She had surrounding cellulitis and concurrent infection to that breast which required antibiotics.

Physical activity and breast cancer survivors: Importance of adherence, motivational interviewing and psychological health.

Behavioral change theories have been used to support interventions that increase both motivation for and adherence to physical activity programs for breast cancer survivors. Most of the programs can improve psychological health-related quality of life. Depressive and anxious symptoms seem to be associated with some stressors, such as the perception of breast cancer, prognosis, long-term treatment-related side-effects and fear of cancer recurrence.

Does access to an information-based, breast cancer specific website help to reduce distress in young women with breast cancer? Results from a randomised trial.

To assess the effectiveness of a purpose-built information-based website to reduce distress among young women with breast cancer. A total of 337 participants (Intervention Group [IG] n = 202; Usual Care Group [UCG] n = 177) returned the completed baseline questionnaires (T1). Details regarding accessing the website were provided to IG participants.

: A Rare Cause of Adult Intussusception.

Intussusception is a relatively rare condition in the adult population and is commonly secondary to a malignant process. Eight to twenty percent of cases of adult intussusception are thought to be idiopathic. In children, infection has been proven to precipitate intussusception in the absence of any other cause.

Immediate autologous breast reconstruction after neoadjuvant chemoradiotherapy for breast cancer: initial results of the first 29 patients.

Background: Breast reconstruction after mastectomy in the treatment of locally advanced breast cancer is often done in stages and before radiotherapy. We have previously published an algorithm for immediate free autologous reconstruction after neoadjuvant chemotherapy and preoperative radiotherapy. This protocol was designed to provide a shorter and simpler reconstructive path whilst improving cosmesis and maintaining oncological efficiency.

Laparoscopic or open appendicectomy for suspected appendicitis in pregnancy and evaluation of foetal outcome in Australia.

Background: Recent data suggest that laparoscopic appendicectomy (LA) in pregnancy is associated with higher rates of foetal loss when compared to open appendicectomy (OA). However, the influence of gestational age and maternal age, both recognized risk factors for foetal loss, was not assessed.

Method: This was a multicentre retrospective review of all pregnant patients who underwent appendicectomy for suspected appendicitis from 2000 to 2012 across seven hospitals in Australia.

Implementation and evaluation of a checklist to improve patient care on surgical ward rounds.

Background: Key aspects of care may be overlooked on a busy surgical ward round. This study assessed the use of a checklist to correct these omissions. Its use as the basis of structured ward round documentation was then measured.

Improving the impact of didactic resident training with online spaced education.

Background: Educational programmes are frequently developed to improve the knowledge of medical trainees. The impact of a programme may be limited if there is no follow-up to reinforce the message. Online Spaced Education (SE) has been developed to address this limitation.

New treatment sequence protocol to reconstruct locally advanced breast cancer.

Background: Current treatment for locally advanced breast cancer (LABC) includes neoadjuvant chemotherapy and post-mastectomy radiotherapy, which may be deleterious for immediate reconstruction. A few trials have instead combined neoadjuvant chemotherapy followed by preoperative radiotherapy. If safe and oncologically efficacious, mastectomy with immediate free autologous reconstruction (transverse rectus abdominis myocutaneous (TRAM)/deep inferior epigastric perforator (DIEP) flap) could then achieve a shorter, simpler reconstructive journey with better cosmesis.

Sacral ganglioneuroma in a 19-year-old woman.

Ganglioneuroma is a rare benign neural crest tumour, located usually in the posterior mediastinum and retroperitoneum. It tends to acquire significant size before symptoms or clinical signs become apparent. We report a 19-year-old female who underwent excision of a pelvisacral ganglioneuroma via a Pfannenstiel incision, after an abdominopelvic CT scan for investigation of left iliac fossa pain and menorrhagia detected a pelvic mass.

Estrogen-related pancreatitis in the setting of normal plasma lipids: case report.

A case of recurrent acute pancreatitis occurring in conjunction with intermittently used estrogen therapy over 7 years is presented. Estrogens have been associated with pancreatitis in the past, and a causal link involving elevated plasma triglyceride levels has usually been assumed. The current case is distinct in that the plasma lipids of this patient have always been normal, suggesting that a different mechanism must be responsible for the onset of pancreatitis.