Professor Leslie Cleland

Professor Leslie Cleland, a former trainee and long-term colleague of Dr Milazzo, was accorded the honour of delivering the Oration. As an example of the collegiality of the association in its formative years, Professor Cleland paid tribute to Dr Milazzo's predecessors, who had extended to him the privilege of attending the founding meeting of the ARA in absentia, whilst a trainee in the UK This gesture extended to Dr Milazzo the honour of founding membership of the ARA, for which he was honoured at the ARA Jubilee Meeting in 2007. Professor Cleland described mannerisms of Dr Milazzo that had made working with him enjoyable.

The academic component of Professor Cleland's address centred on the importance of critical thinking and the application of physiological principles to management decisions in rheumatology. Two illustrative examples of failure in this regard were provided. The first was the long delayed application of combination DMAHD therapies for rheumatoid arthritis with agents of known efficacy and different modes of action, for which additive therapeutic effects could be anticipated. The second example was the interpretation of data regarding cardiovascular risk with COX-2 inhibitors. Positive counter examples were recent successes with early application of combination DMARD therapy for rheumatoid arthritis and opportunities for use of fish oil in anti-inflammatory doses as an alternative to NSAIDs.

History

Dr Milazzo graduated from the University of Adelaide in 1949 and became a registrar at the Royal Adelaide Hospital. One of his mentors was Dr Christopher Sangster, who was the first general physician in SA to demonstrate an interest in rheumatology.

Dr Milazzo moved to England in 1954, to gain postgraduate training in rheumatology where he worked with Professor Eric Bywaters at Taplow.

In 1955, he was appointed as an Empire Rheumatism Council Research Fellow in London.

In 1956,joined the ARA as a founding member. In 1957, he returned to Adelaide as Senior Registrar at the Royal Adelaide Hospital and after nine months, entered private practice as a consultant rheumatologist. Soon after, he was appointed honorary assistant physician in the professorial medical unit at The Queen Elizabeth Hospital and in 1959 became the first honorary
rheumatologist in SA and one of the first in Australia. He was a mentor to a number of subsequently well-known rheumatologists such as Professor Les Cleland and Associate Professor Mkhael Ahern.

In May 1977, he was appointed full-time director of the unit atTQEH.ln 1982, Dr Milazzo assisted Dr Cleland in establishing a dedicated, full-time rheumatology servke with associated clinical and more basic research activities at the Royal Adelaide Hospital.

The formation of a South Australian ARA took place in April 1967 with Dr Milazzo as Chairman and eight full members and three associate members, including Drs Alpers and Drew and Dr Malcolm Begg as secretary. In 1974, Dr Milazzo served as Secretary of the Federal ARA and as a member of a RACP Specialist Advisory Committee on Rheumatology, he helped prepare the first advanced training programme whkh was issued in 1974. He was involved in a landmark manpower survey that contributed to an increase in the numbers of training positions. He is unique in having served two terms as President of the Federal ARA - in 1964 and again in 1982-83.

He retired in the 1990s.