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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 20-April-2012, Vol 125 No 1353

This Issue in the Journal
Great expectations: use of molecular tests and computerised prognostic tools in New Zealand cancer care
Deborah M Wright, Rob McNeill, Arend E H Merrie, Cristin G Print
There is an international drive to improve the survival of patients with cancer by tailoring treatment more precisely to the individual’s tumour; ‘personalised medicine’. Personalised medicine may include consideration of important clinical and pathological factors, e.g. tumour stage, and, increasingly, consideration of the molecular characteristics of individual tumours. We surveyed New Zealand cancer clinicians and discovered that molecular tests and computerised prognostic tools are used by many clinicians and influence the treatment provided to cancer patients. In addition we found that most clinicians predict that the impact and influence of these technologies will increase over the next 10 years. This has important clinical and economic implications for New Zealand’s cancer control strategy.

Clinical trials in New Zealand—an update
Vickie Currie, Andrew Jull
An average of 180 clinical trials per year were conducted 2005–2009, up from an average of 111 per year in 1998–2003. Early phase trials accounted for much of the increase, probably because of an increase in the number of early phase units in New Zealand. Most commercial trials were compliant with the Committee of Medical Journal Editors (ICMJE) requirement to register trials, but non-commercial trials were not so compliant.

Short and long term outcomes of oesophagectomy in a provincial New Zealand hospital
Fadhel Al-Herz, David Healey, Tarik Sammour, Josese Turagava, Bruce Rhind, Mike Young
Oesophagectomy (resection of the oesophagus) is a very complex surgical procedure associated with a significant morbidity and mortality rate. There is very little published data from New Zealand, with no published data from a non-Tertiary New Zealand hospital. Data from 68 patients who underwent oesophagectomy at Palmerston North Hospital were analysed. Survival outcomes of oesophageal resection in this provincial New Zealand hospital were comparable to published series from national and international tertiary centres.

Arcobacter species in diarrhoeal faeces from humans in New Zealand
Owen Mandisodza, Elizabeth Burrows, Mary Nulsen
Arcobacter species used to be classified as campylobacters but differ in a number of properties. Overseas studies have shown that arcobacters can be found in healthy, and occasionally, sick animals as well as in poultry and other meats, shell fish, seawater, fresh water and the environment. Our study found two Arcobacter species, A. butzleri and A. cryaerophilus, in 0.9% of 1380 patients with diarrhoea from the Hawke’s Bay region of New Zealand. A number of these patients had persistent or watery diarrhoea but one-third were also infected with another enteric pathogen. Arcobacters are considered emerging enteric pathogens but further studies would be valuable in determining their overall importance in disease of humans.

Is late-night salivary cortisol a better screening test for possible cortisol excess than standard screening tests in obese patients with Type 2 diabetes?
Elna Ellis, Paul K L Chin, Penelope J Hunt, Helen Lunt, John G Lewis, Steven G Soule
One of the rare causes of diabetes mellitus and obesity is having excessive production of cortisol, a steroid hormone. There are two routine tests available to check patients for excess cortisol, including: a 24 hour urine collection; or a blood test. A newer test involves checking for cortisol levels in saliva, which is potentially a more convenient test. Our study showed that the salivary cortisol test was inferior to the other two tests, and the urine collection test was the best.

     
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