The Management of an Intraperitoneal Leak Following Transgastric Stenting of a Pancreatic Pseudocyst.

The traditional management of pancreatic pseudocyst (PP) is surgical drainage; however, there is significant morbidity associated with this approach. An endoscopic ultrasound (EUS)-guided transgastric endoscopic approach is preferred if there is favourable access to the PP. This case report describes a rare complication of an EUS-guided transgastric drainage of a PP secondary to a suboptimally positioned stent.

Estimation of clinical and economic effects of prophylaxis against venous thromboembolism in medical patients, including the effect of targeting patients at high-risk.

Background: The clinical and economic effects of medical thromboprophylaxis (MT) using low molecular weight heparin in Australia are unknown.

Aim: To estimate the effects of MT in Australia.

Methods: A decision tree model of MT was populated with national data for medical admissions.

Effect of medical thromboprophylaxis on mortality from pulmonary embolus and major bleedingy.

Background: Several studies have failed to discover a beneficial effect of medical thromboprophylaxis on mortality.

Aims: To examine the relative influence of acute fatal pulmonary embolism (PE) and fatal major haemorrhage on overall mortality in medical patients treated with low molecular weight heparin (LMWP) for prophylaxis.

Methods: The author compared deaths from the above factors using data from a recent Cochrane Collaboration meta-analysis.

Potential cost to Western Australia of proposed patient co-payments according to healthcare organisational structure: A preliminary analysis.

Background: The Australian federal government has proposed an AUD $7 patient co-payment for a general practitioner (GP) consultation. One effect of the co-payment may be that patients will seek assistance at public hospital emergency departments (EDs), where currently there is no user charge.

Aims: We studied the possible financial impact of patient diversion on the Western Australia (WA) health budget.

Current state of medical thromboprophylaxis in Australia.

Background: Australia has two published national guidelines for general medical thromboprophylaxis (MT), but the two differ in detail and the basis for patient selection remains uncertain. Several aspects of current guidelines are controversial, as is the proposed design of a dedicated prescribing box in the National Inpatient Medication Chart.

Aim: To discuss and comment on the current standing of medical thromboprophylaxis in Australia.

Measures of risk and their relationship to the relative size of a high-risk group: application to medical thromboprophylaxis.

Background: The aim of this study was to establish the meaning of "high-risk" when the subgroup so defined by risk factor analysis is a substantial proportion of the population. This is clinically important when patients, deemed to be at high risk as a result of risk factor analysis, become eligible for a clinical intervention to decrease the risk, especially if the intervention has adverse effects. One example in clinical practice is the assessment of eligibility for medical thromboprophylaxis.

Eligibility for medical thromboprophylaxis based on risk-factor weights, and clinical thrombotic event rates.

Objectives: To measure eligibility for medical thromboprophylaxis using two Australasian guidelines - the Australia and New Zealand Working Party Guidelines [WPG] and the National Health and Medical Research Council Guidelines [NHMRCG]) - and proposed new guidelines based on risk-factor weights; and to measure the incidence of clinical venous thromboembolism (VTE) events in medical patients ("ensuing VTE").

Design, Setting And Patients: Prospective case-note audit in an acute medical ward of Southland Hospital, a regional hospital in Invercargill, New Zealand, among all 595 patients who were discharged consecutively from 21 November 2010 to 7 March 2011. Of these, 245 were excluded on clinical grounds or because they were under the care of the authors.