Category: Review Articles

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Review Articles

What do medical students think about pharmaceutical promotion?

Abstract

Aim: The aim of this review was to produce an overview of surveys of medical students’ exposure to and attitudes towards pharmaceutical promotion. Methods: PubMed was searched for studies featuring surveys of medical students regarding their interactions with pharmaceutical promotion and tabulated the findings for survey questions relating to the main themes. Results: Students have significant exposure to promotion, and they generally view receiving gifts as acceptable, but do regard some gifts as more appropriate than others. Most students think pharmaceutical sales representative (PSR) presentations are biased but still of educational value and should not be banned. Most students do not believe promotion will affect their prescribing behaviours. A large majority of students want more education in their curricula on how to interact with PSRs. Conclusions: Many medical students think that pharmaceutical promotion is biased and feel underprepared for interactions with the pharmaceutical industry. Despite this, they accept exposure to pharmaceutical promotion believing that it will not influence them. There is scope for improved education in medical schools about this issue.

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Review Articles

Information and support needs of adolescents with Familial Adenomatous Polyposis

Familial adenomatous polyposis: the mucosal surface of the colon is carpeted by numerous polypoid adenomas. (Copyright, UNSW Department of Pathology, from the ‘Images of Disease’ collection.)

Abstract

Familial Adenomatous Polyposis (FAP) is a dominantly inherited bowel cancer predisposition syndrome presenting with hundreds of premalignant polyps in the colon. The standard form of treatment is preventative surgery which involves removal of the entire colon. The rectum and colon may also be removed. Predictive testing is usually done at ten to fourteen years of age, and surgery is recommended by the age of 20. Thus, adolescents face a wide variety of difficult decisions and situations. The aim of this review is to critically evaluate existing literature which examines the experiences of these young people and their families, including their information and support needs, psychosocial adjustments and satisfaction with current genetic services.

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Review Articles

Complementary and alternative medicine use among children with asthma in Australia

Abstract

Aim: To explore current complementary and alternative medicine (CAM) use by children with asthma in Australia. Methods: The results of an audit of CAM use by one of the authors (AMD) in 212 parents of children with a history of asthma, recruited from three different settings (outpatient clinic at a tertiary paediatric hospital, metropolitan and rural practices) were compared to three published studies of CAM use in children with asthma in Australia, as identified by literature review. Results: The prevalence of CAM use amongst children with asthma in Australia is 45-61%. Common CAM modalities used include chiropractic methods, vitamins and minerals, homeopathy/naturopathy, spiritual/psychological modalities and diet therapy. CAM was used more commonly in female children and those with persistent asthma, poor control of symptoms or using high doses of medication. Importantly, only a small number of parents report their child’s CAM use to their doctors. Conclusion: Recent surveys of CAM use among children with asthma in Australia demonstrate a high prevalence which has important implications for those managing paediatric asthma.

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Review Articles

An overview of respiratory disease in Indigenous communities: A comparison to the wider Australian population

Abstract

Aim: The objective of this article is to compare the differences in long term health outcomes between Indigenous and non-Indigenous populations with respect to respiratory disease. In order to gain a deeper understanding of the knowledge presented regarding differences in Indigenous and non-Indigenous health, the epistemological grounds for the study will be considered. Methods: A literature review was conducted. The data for this review was assembled through searching Medline, Informit, PubMed and the Indigenous Healthinfonet for English language peer- reviewed publications containing the keywords: respiratory disease, Indigenous, rural and Queensland. Thirty-two documents were selected. Results: Respiratory disease is distributed disproportionately and occurs with peculiar frequency among Indigenous Australians. Key health indicators such as the disability adjusted life year highlight the inequality between Indigenous and non-Indigenous Australians in terms of health outcomes, although to a much lesser extent than in the past. Conclusions: An innovative approach to public health has seen Indigenous communities become more actively engaged in medical care. Of particular note is the increasing frequency with which Indigenous health workers are being integrated into rural practice to follow up patients and bridge cultural and societal gaps. Environmental antecedents are important contributors to health which may be responsible for the high burden of disease seen in many Indigenous communities. These challenges must be addressed as part of a new public health drive to bring health equality to all Australians.

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Review Articles

Novel approaches to cancer therapeutics

Abstract

Advancements in our understanding of the biology of cancer have progressed dramatically over the past decade. The application of cutting-edge molecular profiling techniques analysing the cancer genome is elucidating an appreciable amount of information. This data is now being integrated into a catalogue that is providing researchers with a revolutionary roadmap of the molecular mechanisms behind cancer. Recent accomplishments in cancer research are also being introduced into the clinic through the development of innovative diagnostic technologies and targeted therapies. Lessons from the past, along with novel therapeutic approaches being developed today, have stimulated an optimistic promise for tomorrow’s fight against cancer.

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Review Articles

Ovarian carcinoma: Classification and screening challenges

Removal of a large ovarian tumour

Abstract

Primary ovarian cancer is the leading cause of death from gynaecological malignancy and the sixth most common cause of cancer death in Australian women. Our understanding of the underlying pathophysiology of epithelial ovarian cancers is incomplete, which poses difficulties for screening, diagnosis and treatment. This review summarises the current knowledge and debate regarding classification of epithelial ovarian cancers, including a proposed new classification system. Current screening methods and the evidence behind them are also presented. The outcomes of large, ongoing trials are awaited to provide more conclusive evidence regarding the effectiveness of screening for ovarian cancer.

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Review Articles

Minimally invasive mitral valve repair: A new surgical option for mitral insufficiency

Long-shafted instruments in use during mitral valve repair

Abstract

Minimally invasive mitral valve repair (MIMVR) is a relatively new alternative to median sternotomy for valvular heart surgery, and has become increasingly appealing due to its improved cosmetic results and more rapid recovery time. Patients suffering mitral valve disease are increasingly turning to their medical practitioners for advice regarding this procedure. It is the aim of this article to provide a review of MIMVR to allow students and doctors to better understand this recent development in cardiac surgical therapy.