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New Zealand Medical Journal

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https://www.readbyqxmd.com/read/28384150/acute-confusion-in-a-64-year-old-woman-diagnostic-value-of-mri
#1
Joe James, C G Kamalasanan, N K Thulaseedharan, James Jose
No abstract text is available yet for this article.
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384149/the-proposal-for-a-third-medical-school-in-new-zealand-a-community-engaged-graduate-entry-medical-program
#2
Ross Lawrenson, G Ian Town, Roger Strasser, Sarah Strasser, Judy McKimm, Rees Tapsell, Nigel Murray
New Zealand has a maldistributed workforce that is heavily dependent on recruiting international medical graduates. Shortages are particularly apparent in high needs communities and in general scope specialties in provincial regions. The University of Waikato in partnership with the Waikato District Health Board has proposed a third medical school for New Zealand which will concentrate on addressing the workforce needs of disadvantaged rural and provincial communities. The proposed program is a community engaged, graduate entry medical course...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384148/provision-of-stroke-thrombolysis-services-in-new-zealand-changes-between-2011-and-2016
#3
Qiliang Liu, Annemarei Anna Ranta, Ginny Abernethy, P Alan Barber
AIMS: To obtain an overall picture of the organisation of stroke thrombolysis provision in New Zealand hospitals and compare changes between 2011 and 2016. METHODS: Surveys were distributed to all New Zealand district health boards (DHBs) in 2011 and 2016, and included questions about the infrastructure, staffing, training, guidelines and audit provided for stroke thrombolysis. RESULTS: Responses were received from all DHBs, with 86% offering stroke thrombolysis in 2011 and 100% in 2016...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384147/trends-in-new-zealand-stroke-thrombolysis-treatment-rates
#4
Qiliang Liu, Annemarei Anna Ranta, Ginny Abernethy, P Alan Barber
AIMS: To describe trends in treatment delays and short-term outcome over the first 18 months of the New Zealand stroke thrombolysis register. METHODS: The National Stroke Network introduced a central register of all ischaemic stroke patients treated with intravenous alteplase on January 1, 2015. The aim was to increase thrombolysis treatment rates and drive improvements in safety. RESULTS: From January 1, 2015 to June 30, 2016, alteplase was given to 623 patients [344 men, mean (range) age 70 (22-98) years] out of a total of 8,857 ischaemic and unspecified stroke patients, giving a thrombolysis rate of 7...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384146/effect-of-house-officer-clerking-on-short-term-outcomes-in-paediatric-orthopaedic-patients
#5
Yassar Alamri
AIM: Children who are admitted with acute orthopaedic problems are often fit and healthy. The house officer (ie, intern) is required to carry out the formal clerking/admission of inpatients. However, they are often also busy with sick ward patients, which leads to delays in formal clerking of these children until after they have been to the operating theatre (OT). The aim of this study was to assess what information, if any, is missed in children who were seen by a house officer prior to going to OT, compared to those who were not...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384145/prevalence-of-enduring-power-of-attorney-and-barriers-towards-it-in-community-geriatric-population-in-counties-manukau-health
#6
So-Jung Park, Heather Astell
AIM: Enduring power of attorney (EPA) is a simple and easy-to-set-up legal document which protects the wishes of the donor, as well as preventing significant psychological and social cost for the patient and their family when long-term residential care needs to be arranged due to the patient's increasing care requirements. It also reduces the significant cost in hospital beds days for the district health board involved while awaiting the Protection of Personal and Property Rights order...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384144/a-retrospective-observational-study-of-mortality-rates-in-elderly-patients-with-shock-in-a-new-zealand-district-hospital-icu
#7
COMPARATIVE STUDY
Owen Keet, Stephanie Chisholm, Jennifer Goodson, Troy Browne
AIM: Admitting very elderly, critically ill patients to ICU is controversial. We compared our mortality data in a subgroup of elderly patients to internationally published outcomes. METHODS: Tauranga Hospital ICU retrospectively investigated their mortality outcomes for patients with septic shock. The ANZICS adult database (AORTIC), Tauranga Hospital computer records and medical records were used to identify the study cohort and provide information on demographics, admission times and shock types between January 2009 and December 2014...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384143/a-decade-of-improvement-in-the-management-of-new-zealand-st-elevation-myocardial-infarction-stemi-patients-results-from-the-new-zealand-acute-coronary-syndrome-acs-audit-group-national-audits-of-2002-2007-and-2012
#8
John M Elliott, Tom Kai Ming Wang, Greg D Gamble, Michael Ja Williams, Philip Matsis, Richard Troughton, Andrew Hamer, Gerry Devlin, Stewart Mann, Mark Richards, John K French, Harvey D White, Chris J Ellis
AIMS: To audit the management of ST-segment elevation myocardial infarction (STEMI) patients admitted to a New Zealand Hospital over three 14-day periods to review their number, characteristics, management and outcome changes over a decade. METHODS: The acute coronary syndrome (ACS) audits were conducted over 14 days in May of 2002, 2007 and 2012 at New Zealand Hospitals admitting patients with a suspected or definite ACS. Longitudinal analyses of the STEMI subgroup are reported...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384142/does-new-zealand-need-a-third-medical-school
#9
EDITORIAL
Peter Crampton
No abstract text is available yet for this article.
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384141/admitting-elderly-patients-to-icu-is-it-just-about-survival
#10
EDITORIAL
Jay Ritzema, Paul Young
No abstract text is available yet for this article.
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28384140/improvements-in-acute-stroke-treatments-in-new-zealand-no-one-should-be-left-behind
#11
EDITORIAL
John Fink
No abstract text is available yet for this article.
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337045/pick-a-bogus-treatment%C3%A2
#12
LETTER
Mark Honeychurch
No abstract text is available yet for this article.
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337044/clostridium-difficile-infections-in-patients-with-inflammatory-bowel-disease
#13
Michael Chieng
Case report of a 23-year-old male presenting with a severe flare of Crohn's disease, exacerbated by community-acquired infection with Clostridium difficile. This case outlines the association between C. difficile infection and inflammatory bowel disease, as both a mimic and a precipitant of flares. The discussion concerns the latest literature consensus on assessment and management of Clostridium difficile infection in patients with inflammatory bowel disease.
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337043/poststreptococcal-episcleritis
#14
Nicholas Young
This report describes the case of a patient presenting with an unusual poststreptococcal syndrome that featured episcleritis as a prominent manifestation. To my knowledge, this is the first time that poststreptococcal episcleritis has been described in the literature.
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337042/household-transmission-of-ndm-producing-e-coli-in-new-zealand
#15
Matthew Blakiston, Sally A Roberts, Joshua T Freeman, Helen Heffernan
This report describes the introduction of an extensively antibiotic-resistant carbapenemase-producing Escherichia coli into a hospital in Auckland, New Zealand, by a patient who was a household contact of recent travellers to the Indian subcontinent. The carbapenemase was identified as New Delhi metallo-β-lactamase (NDM) and reflects probable household transmission in the context of a recent upsurge in NDM-producing Enterobacteriaceae isolation in New Zealand. The observations in this report suggest that hospital screening practices to identify carbapenemase-producing Enterobacteriaceae (CPE) colonised patients may need to be extended to include travellers to high-risk countries who were not hospitalised during their trip, and possibly also their close contacts...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337041/getting-the-foundations-right-for-the-measurement-of-medication-safety-the-need-for-a-meaningful-conceptual-frame
#16
Jerome Ng, Shane Scahill, Jeff Harrison
A number of initiatives aimed at improving medication safety in and across New Zealand public hospitals have been introduced over recent years. Clinicians, policymakers and patients now want to know whether patients are safer today from medicine use than they have been in the past. The challenge has been determining exactly what should be measured. In this viewpoint, we critically examine the suitability of adverse drug events (ADE) as a primary metric for assessing the progress of medication safety improvement...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337040/refining-metformin-prescribing-in-new-zealand
#17
Sisira Jayathissa, Paul Dixon, Raymond Bruce, David Reith
Metformin is the mainstay of treatment of type 2 diabetes. However, there has been significant concern on prescribing metformin in patients with renal impairment as a result of metformin-associated lactic acidosis (MALA). Recent studies have cast doubt on the existence of MALA purely related to metformin use. Medsafe recently initiated changes to datasheet so lower doses of metformin could be used in patients with GFR down to 15ml/min. In this paper we outline the context and implications of this change.
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337039/rationing-of-hip-and-knee-referrals-in-the-public-hospital-the-true-unmet-need
#18
Tom Inglis, Paul Armour, Grahame Inglis, Gary Hooper
AIM: The aim of this paper is to outline the development of a triage system for elective hip and knee referrals to the Orthopaedic Department of the Canterbury District Health Board (CDHB), and to determine the unmet need within this population for accessing first specialist assessment (FSA). METHODS: Between 1 August 2015 and 31 March 2016 data was collected from all elective hip and knee referrals that underwent triage for a FSA. The number of outpatient appointments available according to the government four-month waiting time is set by the CDHB...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337038/pilot-study-of-methods-for-assessing-unmet-secondary-health-care-need-in-new-zealand
#19
Philip Bagshaw, Susan Bagshaw, Christopher Frampton, Robin Gauld, Terri Green, Charlotte Harris, Andrew Hornblow, Ben Hudson, Antony Raymont, Ann Richardson, Carl Shaw, Les Toop
AIMS: In this pilot study, the primary aim was to compare four potential methods for undertaking a national survey of unmet secondary healthcare need in New Zealand (one collecting data from GPs, and three from community surveys). The secondary aim was to obtain an estimate of the prevalence of unmet secondary healthcare need, to inform sample size calculations for a national survey. METHODS: An electronic system was set up for GPs in Christchurch (Pegasus PHO) and Auckland (Auckland PHO) to record cases of unmet need as encountered in clinics...
March 24, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28337037/the-diagnostic-performance-of-ultrasound-in-the-detection-of-ectopic-pregnancy
#20
Lee Young, Cecilia Barnard, Elisabeth Lewis, Matthew Jones, Jana Furlan, Angela Karatasiou, Martin Necas
BACKGROUND: Accurate diagnosis of ectopic pregnancy is essential in reducing maternal mortality and morbidity. Transvaginal ultrasound (TVUS) is the accepted imaging modality of choice for the diagnosis of ectopic pregnancy (EP). AIMS: To assess the effectiveness of transvaginal ultrasound (TVUS) in the detection of EP in consecutive women presenting for ultrasound to a radiology department with a clinical suspicion of EP. METHODS: Retrospective analysis of 585 women presenting for TVUS over a 2...
March 24, 2017: New Zealand Medical Journal
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