Journal of the New Zealand Medical Association, 04-July-2008, Vol 121 No 1277
This Issue in the Journal
Demographic predictors of cervical cancer screening in Chinese women in New Zealand
Wanzhen Gao, Janis Paterson, Ruth DeSouza, Tongjing Lu
Research is scarce about the cervical cancer screening uptake of Asian or Chinese migrants in New Zealand; however coverage is thought to be lowest among Asian women. We surveyed 234 Mainland Chinese women living in Auckland to ascertain the uptake of cervical screening programme. Of the respondents, 65% reported having ever been screened in New Zealand and 56% reported they were screened in the last 3 years. For the sociodemographic factors, women aged under 30 or above 50 years and short duration of residence in New Zealand were associated with lower uptake of the screening programme. The study highlights the information needs of this group.
Prospective 10-year study of postmenopausal women with asymptomatic primary hyperparathyroidism
Mark J Bolland, Andrew B Grey, Brandon J Orr-Walker, Anne M Horne,
Margaret C Evans, Judy M Clearwater, Greg D Gamble, Ian R Reid
Primary hyperparathyroidism is common in older women. It is uncertain what the best form of management is (surgery or conservative management without surgery). To see whether they could be managed without surgery, we followed 23 women with primary hyperparathyroidism who did not have symptoms related to the disorder for up to 10 years. Despite 19 out of 23 women meeting the standard criteria for surgical management, few developed clinical events related to the disorder during follow-up. This suggests that many women with primary hyperparathyroidism who do not have symptoms from the disorder do not develop symptoms or complications of primary hyperparathyroidism over time and therefore can be managed without surgery.
The maternal outcome in placenta accreta: the significance of antenatal diagnosis and non-separation of placenta at delivery
Hong Soo Wong, John Hutton, Jane Zuccollo, John Tait, Kevin C Pringle
Placenta accreta (PA) refers to adherent placenta, which requires manual separation after delivery of the infant and is associated with severe haemorrhage during this procedure. It occurs at a rate of 1 in 1660 deliveries. Although previous Caesarean delivery appears to be a risk factor, PA also occurs in patients without it, and the location of the adherent placenta may not be related to the previous Caesarean scar. Diagnosis of the condition before delivery allows the decision to be made not to separate the placenta in selected cases, which results in improved maternal outcomes in terms of less blood loss and less units of blood transfused at delivery and a reduced risk of emergency hysterectomy, without an increase in other morbidity including DIC, ICU admission, infection, and the length of stay in the hospital.
Changes in cause of neonatal death over a decade
Annie Wong, Dawn Elder, Jane Zuccollo
Accurate assessment of the reason for deaths in the first month of life allows monitoring of change in cause of deaths in this age group over time. This review of neonatal deaths in Wellington over a 10-year period shows less neonatal deaths from congenital anomaly in this age group in the second 5-year period of review. This is likely due in part to better antenatal diagnosis with parents deciding to terminate the pregnancy but improved prognosis for liveborn infants with life threatening congenital anomalies is also a likely contributor. An increase in death secondary to infection is at least in part explained by the improved early survival of extremely preterm infants who remain vulnerable to infection particularly in the first month of life.
Unusual primary manifestations of multiple sclerosis
Yeşim Yetimalar, Yaprak Seçil, Ayşen Kendir İnceoğlu, Şölen Eren, Mustafa Başoğlu
Muliple sclerosis (MS) lesions in the brain and spinal cord can damage every function of the central nervous system. The protean symptoms included fatigue as well as disturbed function in sensory, motor, bladder, bowel, sexual, cerebellar, brainstem, optic nerve, and cognitive realms in other series. Most physicians consider the diagnosis of MS only in the presence of usual symptoms or signs and this may reflect underdiagnosis. Physicians should pay attention to those symptoms and consider they be the first manifestation of MS.
Cystic lesions of the liver: 6 years of surgical management in New Zealand
Jonathan B Koea
Cystic liver lesions can represent a spectrum of underlying conditions and liver cysts are very common. All cysts require investigation and complex cysts or symptomatic simple cysts require further treatment usually with minimally invasive surgery.
Risk and severity of injury in a population of BASE jumpers
Erik Monasterio, Omer Mei-Dan
BASE jumping is a high-risk adventure sport that developed out of skydiving, and uses specially adapted parachutes to jump from fixed objects. The research, which focuses on an international population of BASE jumpers, has been conducted by medical specialists with an interest and experience in adventure sports, and examines the risks of injury. BASE jumpers tend to participate in other adventure sports and are at significant risk of serious injury (from BASE jumping). The results are from a broader study that has also examined the personality characteristics of BASE jumpers. The long term goal of the researchers is to determine the risks associated with a range of other adventure sports, practiced in New Zealand.
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