Honey research prompts response from FSANZ
RESEARCH published in Food Additives & Contaminants: Part A, which found that “all but five Australian honeys tested had more contaminants than the European Food Safety Authority would consider safe or tolerable”, prompted a media frenzy – here, here, and here – late last week which convinced Food Standards Australia and New Zealand (FSANZ) to issue a calming update. “FSANZ is aware of the recent reports on total PA [pyrrolizidine alkaloid] levels in Australian and New Zealand honey. However, based on the type of PAs present and honey consumption levels in Australia and New Zealand, they are unlikely to pose a health risk. Although acute poisoning incidents have occurred in other countries from contamination of PAs in plant products derived from wheat and other crops, there have been no reports of acute poisoning from honey, and no other reports of poisoning in Australia and New Zealand … the predominant PA in Australian and New Zealand honey, echimidine, has a lower toxicity than the PA used as a standard by some authorities to set values. FSANZ is taking account of recent research conducted in Australia and New Zealand on the presence and toxicity of these substances in honey and is waiting on the outcomes of the international risk assessment of PAs by [the WHO expert group].”

Prostate cancer testing guidelines released
AUSTRALIAN health professionals will now have access to evidence-based recommendations for using the prostate-specific antigen (PSA) blood test to assess prostate cancer risk in patients. The PSA testing and early management of test-detected prostate cancer: a guideline for health professionals was developed in partnership with the Prostate Cancer Foundation of Australia (PCFA) and Cancer Council Australia and has now been approved by the National Health and Medical Research Council (NHMRC). PCFA Chief Executive Officer, Associate Professor Anthony Lowe, said contention about the PSA test has made it difficult for health professionals to take a consistent, evidence-based approach to the test. “The guidelines cut through the contention and provide guidance in relation to an individual man’s circumstances and on how to manage a patient if he requests and consents to taking the test,” he said. The report gives recommendations on what risk factors should be considered when deciding on testing, at what age men should consider testing, how often and what treatment options are available. It highlights that digital rectal examination is not recommended for asymptomatic men in addition to PSA testing and says there is no evidence to support a national PSA screening program to all men of a certain age group. The guideline is available for download at www.pcfa.org.au and Cancer Council Australia. For more information, visit doctorportal.com.au

Patient traits moderate predictors of glycaemic control
PATIENT characteristics are moderately good predictors of whether a patient with diabetes is in glycaemic control, whereas general practice characteristics appear to predict only the likelihood of patients completing an annual cycle of care (ACC), according to research published in the MJA. The ACC is an established indicator of good diabetes management. According to the authors, the study was the first to report a positive association between having completed an ACC and the patient being in glycaemic control. The researchers, from Adelaide and Cairns, used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. “Data were available from 147 general practices in three Australian states and for 5455 patients with established type 1 or type 2 diabetes,” the authors wrote. “After adjustment for other patient characteristics, only the patient completing an ACC was a statistically significant predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having completed an ACC.” For the full study, visit the MJA.

Nasal spray relief for women in labour
WOMEN may soon be able to use a nasal spray for pain relief during childbirth following successful trials by an Australian midwifery researcher. The nasal spray analgesic drug, fentanyl, was shown to be just as effective in relieving labour pain and have fewer side effects than pethidine injections, which are commonly used. Fentanyl nasal spray is commonly used for pain relief in children and in patients being transferred by ambulance. As a result of the Flinders University and the University of Adelaide study involving 156 women, fentanyl is expected to be offered as an alternative medication in South Australian maternity hospitals this year. Pethidine and fentanyl are opioids, which cross from the mother to the baby. But when pethidine is processed by the body, it’s converted into another active drug and remains in the baby’s body for 3 or more days, potentially causing breathing trouble, drowsiness and irritability. For more information, visit doctorportal.com.au.

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