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New Zealand Medical Journal

Matloob Husain, Andrew Gray, Richard Carlos Torr
No abstract text is available yet for this article.
October 14, 2016: New Zealand Medical Journal
Neil Stewart, Kevin Karpik
Neuropathic Arthropathy or Charcot joint is a progressive, destructive arthritis that is associated with an underlying neurological disorder. We present a case of a 30 year-old male who, three years prior, had ruptured his right distal biceps tendon with subsequent development of a deep infection. At representation, the patient's clinical picture was consistent with the re-emergence of a deep elbow infection. Laboratory testing found no evidence of infection. Magnetic Resonance Imaging (MRI) of the patient's spine revealed a syringomyelia and a NA was diagnosed...
October 14, 2016: New Zealand Medical Journal
Pallav Patni, Mona J Patni
No abstract text is available yet for this article.
October 14, 2016: New Zealand Medical Journal
Alison Vogel, Diana Lennon, Emma Best, Alison Leversha
Admissions for skin and soft-tissue infections have been increasing steadily in children and in the general population. Concerns have been raised recently about the increasing widespread use of topical fusidic acid and concurrent increase of fusidic acid-resistant Staphylococcus aureus. Fusidic acid resistance and methicillin resistant Staphylococcus aureus (MRSA) are both more prevalent in youngest age group (<5 year-olds) and particularly in the North island. In New Zealand, fusidic acid is recommended for treatment of minor impetigo and is the only fully-funded topical antibiotic...
October 14, 2016: New Zealand Medical Journal
Joshua Freeman, Louise Dawson, Deborah Jowitt, Margo White, Hayley Callard, Christine Sieczkowski, Ron Kuriyan, Sally Roberts
AIM: To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level. METHOD: HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement...
October 14, 2016: New Zealand Medical Journal
Sam Taylor, Ian Thomson, Jo Krysa
AIM: A ruptured abdominal aortic aneurysm (rAAA) remains a significant threat to life, with a 30-50% in-hospital mortality rate. The recent introduction of emergency endovascular aneurysm repair (rEVAR) in New Zealand presents an alternative to open repair for rAAAs. The aim of this paper is to review the current experience in New Zealand in the repair of rAAAs. METHODS: Data from the Australasian Vascular Audit (AVA) was reviewed, with data pertaining to rAAAs collected for the five-year period from January 2010 to December 2014...
October 14, 2016: New Zealand Medical Journal
Manar Khashram, Rachel Falconer, Afif Mahmud, Adib Khanafer, Peter Laws, Tim Beresford, Justin Roake
AIMS: Rapid access carotid endarterectomy (RACE) is the gold standard for stroke prevention in symptomatic patients with 50-99% internal carotid artery stenosis. Diagnosis and referral of eligible patients may be delayed by disruption to local health services. The aim of this study was to evaluate whether service provision was maintained at an appropriate standard (<2 weeks) following a natural disaster. METHODS: Consecutive symptomatic patients who underwent carotid endarterectomy (CEA) at a tertiary hospital between January 2006 and December 2014 were identified...
October 14, 2016: New Zealand Medical Journal
Siva T Gounder, Delendra Rasith Wijayanayaka, Rinki Murphy, Delwyn Armstrong, Richard G Cutfield, David Dw Kim, Michael Graham Clarke, Nicholas J Evennett, Martyn Lee Humphreys, Steven John Robinson, Michael Wc Booth
AIM: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. METHODS: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery...
October 14, 2016: New Zealand Medical Journal
Judith Riley, Anna Hunt, Alice McDouall, Steve Waqanivavalagi, Irene Braithwaite, Mark Weatherall, Thorsten Stanley, Richard Beasley, Edwin A Mitchell, Stuart R Dalziel
AIM: To undertake a randomised controlled trial (RCT) of paracetamol versus ibuprofen use during infancy to determine if paracetamol is associated with an increased risk of developing asthma, the preferred method of recruitment needs to be determined. We assessed three different recruitment domains to determine the likely enrolment rates of newborn infants into a three-year or six-year RCT of paracetamol versus ibuprofen and the development of asthma symptoms. The proposed RCT would require 1,806 participants...
October 14, 2016: New Zealand Medical Journal
Suneela Mehta, Sue Wells, Rod Jackson, Jeff Harrison, Andrew Kerr
AIM: Publicly-funded atorvastatin required prior approval until September 2010 whereas simvastatin did not. Our aim was to examine if overall statin dispensing and atorvastatin dispensing among patients hospitalised for cardiovascular disease (CVD) differed systematically across sociodemographic groups during and after special authority criteria. METHOD: National medication dispensing data were anonymously linked to patients hospitalised across New Zealand with CVD and discharged between 1/07/2009-31/12/2009 when special authority criteria applied and 1/09/2010-28/02/2011 after restrictions ceased...
October 14, 2016: New Zealand Medical Journal
Jennifer Weller, Ian Civil, Jane Torrie, David Cumin, Alexander Garden, Arden Corter, Alan Merry
AIM: Unintended patient harm is a major contributor to poor outcomes for surgical patients and often reflects failures in teamwork. To address this we developed a Multidisciplinary Operating Room Simulation (MORSim) intervention to improve teamwork in the operating room (OR) and piloted it with 20 OR teams in two of the 20 District Health Boards in New Zealand prior to national implementation. In this study, we describe the experience of those exposed to the intervention, challenges to implementing changes in clinical practice and suggestions for successful implementation of the programme at a regional or national level...
October 14, 2016: New Zealand Medical Journal
Ian Bissett
No abstract text is available yet for this article.
October 14, 2016: New Zealand Medical Journal
Bashar Matti, Ruben Cohen-Hallaleh
The last few years have witnessed numerous publications addressing the management of thyroid nodules and differentiated thyroid cancers. The purpose of this review is to provide a simplified summary of the newly released guidelines by the American Thyroid Association. A systematic approach has been recommended to evaluate a thyroid nodule through clinical assessment, measurement of serum Thyroid Stimulating Hormone, neck ultrasonography and Fine Needle Aspiration where appropriate. This is followed by cytology analysis using the Bethesda scoring system to detect malignancy...
September 9, 2016: New Zealand Medical Journal
Grant Martin Schofield, George Henderson, Simon Thornley
Humans can derive energy from carbohydrate, fat, or protein. The metabolism of carbohydrate requires by far the highest secretion of insulin. The central pathology of diabetes is the inability to maintain euglycaemia because of a deficiency in either the action or secretion of insulin. That is, because of either insulin resistance often accompanied by hyperinsulinaemia, or insulin deficiency caused by pancreatic beta cell failure. In individuals dependent on insulin and other hypoglycaemic medication, the difficulty of matching higher intakes of carbohydrates with the higher doses of medication required to maintain euglycaemia increases the risk of adverse events, including potentially fatal hypoglycaemic episodes...
April 1, 2016: New Zealand Medical Journal
James Church
No abstract text is available yet for this article.
March 11, 2016: New Zealand Medical Journal
Frank Houghton
No abstract text is available yet for this article.
March 11, 2016: New Zealand Medical Journal
Suheelan Kulasegaran, Marcel Fernando, Brendon Fraser-Jones, Hisham Hammodat
No abstract text is available yet for this article.
March 11, 2016: New Zealand Medical Journal
Nick Wilson, Vanessa Selak, Tony Blakely, William Leung, Philip Clarke, Rod Jackson
Based on new systematic reviews of the evidence, the US Preventive Services Task Force has drafted updated guidelines on the use of low-dose aspirin for the primary prevention of both cardiovascular disease (CVD) and cancer. The Task Force generally recommends consideration of aspirin in adults aged 50-69 years with 10-year CVD risk of at least 10%, in who absolute health gain (reduction of CVD and cancer) is estimated to exceed absolute health loss (increase in bleeds). With the ongoing decline in CVD, current risk calculators for New Zealand are probably outdated, so it is difficult to be precise about what proportion of the population is in this risk category (roughly equivalent to 5-year CVD risk ≥5%)...
March 11, 2016: New Zealand Medical Journal
Michael Legge, Ruth Fitzgerald
An argument put forward against gamete and embryo donation, sale and research, is that to do so would treat the gametes or embryos as objects with no intrinsic value as human. Instead, gametes and embryos created and used for donation, sale or research, can be considered more like a commodity created and traded for economic exchange--something that is valuable only for the amount of money or other goods and services that others are willing to exchange. While Kant asserts that humans have dignity rather than object worth, the provision of human gametes and embryos are progressively becoming utilities for resolving childlessness and for certain research investigations...
March 11, 2016: New Zealand Medical Journal
Jennifer Yeo, Lifeng Zhou, Yogini Ratnasabapthy
No abstract text is available yet for this article.
March 11, 2016: New Zealand Medical Journal
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