Issue

Vol 123 No 1319: 30 July 2010

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Issue Summary

SUMMARY

Patients admitted with an acute coronary syndrome (ACS) in New Zealand in 2007: results of a second comprehensive nationwide audit and a comparison with the first audit from 2002

Chris Ellis, Greg Gamble, Andrew Hamer, Michael Williams, Philip Matsis, John Elliott, Gerard Devlin, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

Heart and circulatory diseases are the commonest cause of death in New Zealand, accounting for approximately 40% of all deaths. A heart attack is a common cause of death, with 17 New Zealanders dying each day. Cardiac services can significantly improve patients outcomes if new treatments, available especially over the last 5 to 15 years, are available. The 2nd National comprehensive Cardiac Society Audit, run by busy Senior Doctors and Nurses have shown in 2002 and now again in 2007 that significant limitations exist at present. Improvements are needed, based on a 'Hub and Spoke' service, from each of the 5 Regional centres, with significant guidance and input from current clinicians: senior Doctors and Nurses who understand the complexities of Healthcare, and can improve on the current, fragmented service.

SUMMARY

A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery

Tarik Sammour, Kamran Zargar-Shoshtari, Abhijith Bhat, Arman Kahokehr, Andrew G Hill

The enhanced recovery after surgery programme (ERAS) is a clinical pathway that has been implemented to improve patient recovery after colonic surgery. We compared the costs involved to put 50 patients through this programme, with the costs incurred in 50 historical controls. We identified a significant cost saving as a result of ERAS implementation, even when implementation costs are taken into account.

SUMMARY

Audit of cervical screening in women with HIV infection in the Auckland and Northland regions of New Zealand

Jasmin Grewal, Michele Lowe, Hilary Gerrard, Rebecca Henley, Nicky Perkins, Simon Briggs

Women with HIV infection have an increased risk of cervical cancer. It is recommended that women with HIV infection receive yearly cervical smears. Only 56% of women with HIV infection who were seen by the Infectious Diseases and Sexual Health Services at Auckland City Hospital had received a yearly cervical smear. It is very likely that seven women in this audit had undiagnosed HIV infection at the time of their first abnormal cervical smear. Health professionals performing cervical smear tests should consider offering an HIV test to all women with an abnormal cervical smear who have resided in areas with high rates of HIV infection.

SUMMARY

ACS patients in New Zealand experience significant delays to access cardiac investigations and revascularisation treatment especially when admitted to non-interventional centres: results of the second comprehensive national audit of ACS patients

Chris Ellis, Gerard Devlin, John Elliott, Philip Matsis, Michael Williams, Greg Gamble, Andrew Hamer, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

This is the second of 2 papers reporting on the 2nd National comprehensive Cardiac Society Audit, run by busy Senior Doctors and Nurses, which has shown in 2002 and now again in 2007 that significant limitations exist in the management of patients' who present with a heart attack or unstable angina to a New Zealand hospital. This paper focuses on the time delays experienced by patients who 'wait' for tests and treatments; the delays are significantly worse for patients admitted to a 'Non-Interventional' (mainly rural) Centre. Improvements are needed, based on a 'Hub and Spoke' service, from each of the 5 Regional centres, with significant guidance and input from current clinicians: senior Doctors and Nurses who understand the complexities of Healthcare, and can improve on the current, fragmented service.

ALL ARTICLES
SUMMARY

Homozygous familial hypercholesterolaemia and treatment by LDL apheresis

Richard I King, Russell S Scott, Christopher M Florkowski, Andrew D Laurie, Nicola Reid, Peter M George

Managing your student loan

Charles Ronaldson

Proceedings of the Health Research Society of Canterbury Seminar Series, Friday 16 July 2010

A case of intestinal-type gastric adenocarcinoma metastatic to a caecal tubulovillous polyp

James McKay

Irwin Bruce (Bill) Faris

A particular relationship

Paul Patten

The 1987 National Women’s Hospital (NWH) ‘Unfortunate Experiment’. Accusations of unethical experiments and undertreatment, resulting in excess deaths from cervical cancer. Facts and fables

Graeme H Overton

Patients admitted with an acute coronary syndrome (ACS) in New Zealand in 2007: results of a second comprehensive nationwide audit and a comparison with the first audit from 2002

Chris Ellis, Greg Gamble, Andrew Hamer, Michael Williams, Philip Matsis, John Elliott, Gerard Devlin, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

John Cuthbert Parr

Acute coronary syndromes in New Zealand hospitals

Robin Norris

A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery

Tarik Sammour, Kamran Zargar-Shoshtari, Abhijith Bhat, Arman Kahokehr, Andrew G Hill

Why won’t defenders of the Cartwright Inquiry provide evidence to justify their use of the term ‘conventional treatment’ for carcinoma in situ?

Iain Chalmers

Discussion of Morris and Jewell's editorial 'Array of hope for high-resolution genetic screening services in New Zealand' (with authors' response)

Clive Felix

A response to Ron Jones' letter of 30 April 2010

Helen Overton

Report of St Helen's Hospital, Dunedin

Audit of cervical screening in women with HIV infection in the Auckland and Northland regions of New Zealand

Jasmin Grewal, Michele Lowe, Hilary Gerrard, Rebecca Henley, Nicky Perkins, Simon Briggs

Angiomatosis: a case report

Hamesh Jina, Philippa Mercer, Malcolm Gordon, Harsh Singh, Martin Whitehead

The missing manuscript

Frank A Frizelle

Equipment of Yore: a contribution from the Cotter Medical History Trust

Max Abernethy

Medical image. Refractory ascites due to ascites praecox

Pazhanivel Mohan, Jayanthi Venkataraman

ACS patients in New Zealand experience significant delays to access cardiac investigations and revascularisation treatment especially when admitted to non-interventional centres: results of the second comprehensive national audit of ACS patients

Chris Ellis, Gerard Devlin, John Elliott, Philip Matsis, Michael Williams, Greg Gamble, Andrew Hamer, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

The Cartwright legacy: shifting the focus of attention from the doctor to the patient

Ron Paterson

A response to criticisms of The History of the 'Unfortunate Experiment' at National Women's Hospital

Linda Bryder

The Cartwright Papers: Essays on the Cervical Cancer Inquiry 1987–88 (Joanna Manning, editor)

Jennie Connor

Why did so many women develop cancer? Part 2 (with response by Linda Bryder)

Ronald W Jones

SUMMARY

Patients admitted with an acute coronary syndrome (ACS) in New Zealand in 2007: results of a second comprehensive nationwide audit and a comparison with the first audit from 2002

Chris Ellis, Greg Gamble, Andrew Hamer, Michael Williams, Philip Matsis, John Elliott, Gerard Devlin, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

Heart and circulatory diseases are the commonest cause of death in New Zealand, accounting for approximately 40% of all deaths. A heart attack is a common cause of death, with 17 New Zealanders dying each day. Cardiac services can significantly improve patients outcomes if new treatments, available especially over the last 5 to 15 years, are available. The 2nd National comprehensive Cardiac Society Audit, run by busy Senior Doctors and Nurses have shown in 2002 and now again in 2007 that significant limitations exist at present. Improvements are needed, based on a 'Hub and Spoke' service, from each of the 5 Regional centres, with significant guidance and input from current clinicians: senior Doctors and Nurses who understand the complexities of Healthcare, and can improve on the current, fragmented service.

SUMMARY

A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery

Tarik Sammour, Kamran Zargar-Shoshtari, Abhijith Bhat, Arman Kahokehr, Andrew G Hill

The enhanced recovery after surgery programme (ERAS) is a clinical pathway that has been implemented to improve patient recovery after colonic surgery. We compared the costs involved to put 50 patients through this programme, with the costs incurred in 50 historical controls. We identified a significant cost saving as a result of ERAS implementation, even when implementation costs are taken into account.

SUMMARY

Audit of cervical screening in women with HIV infection in the Auckland and Northland regions of New Zealand

Jasmin Grewal, Michele Lowe, Hilary Gerrard, Rebecca Henley, Nicky Perkins, Simon Briggs

Women with HIV infection have an increased risk of cervical cancer. It is recommended that women with HIV infection receive yearly cervical smears. Only 56% of women with HIV infection who were seen by the Infectious Diseases and Sexual Health Services at Auckland City Hospital had received a yearly cervical smear. It is very likely that seven women in this audit had undiagnosed HIV infection at the time of their first abnormal cervical smear. Health professionals performing cervical smear tests should consider offering an HIV test to all women with an abnormal cervical smear who have resided in areas with high rates of HIV infection.

SUMMARY

ACS patients in New Zealand experience significant delays to access cardiac investigations and revascularisation treatment especially when admitted to non-interventional centres: results of the second comprehensive national audit of ACS patients

Chris Ellis, Gerard Devlin, John Elliott, Philip Matsis, Michael Williams, Greg Gamble, Andrew Hamer, Mark Richards, Harvey White; for the New Zealand Acute Coronary Syndromes (NZACS) Audit Group

This is the second of 2 papers reporting on the 2nd National comprehensive Cardiac Society Audit, run by busy Senior Doctors and Nurses, which has shown in 2002 and now again in 2007 that significant limitations exist in the management of patients' who present with a heart attack or unstable angina to a New Zealand hospital. This paper focuses on the time delays experienced by patients who 'wait' for tests and treatments; the delays are significantly worse for patients admitted to a 'Non-Interventional' (mainly rural) Centre. Improvements are needed, based on a 'Hub and Spoke' service, from each of the 5 Regional centres, with significant guidance and input from current clinicians: senior Doctors and Nurses who understand the complexities of Healthcare, and can improve on the current, fragmented service.

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