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Issue

Vol 124 No 1331: 25 March 2011

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Issue Summary

SUMMARY

Return visits to the emergency department and related hospital admissions by people aged 65 and over

Diana Minnee, Jill Wilkinson

This research identified a group of people aged 65 and older who either returned to the emergency department or were readmitted within 3 months of a hospital stay. Information relating to illness, functioning and follow-up was then gathered from patient notes in order to identify trends. The most notable trend was that acute illness rather than failure to cope at home appears to drive a return to hospital. This finding has resulted in the authors suggesting further research around early primary healthcare follow-up after discharge from hospital.

SUMMARY

“It’s a small price to pay for life”: faecal occult blood test (FOBT) screening for colorectal cancer—perceived barriers and facilitators

Anthony I Reeder

A colorectal cancer screening programme, based on a Faecal Occult Blood Test (FOBT), is planned for New Zealand (NZ), but we currently lack insight into how such a screening programme is likely to be received among the NZ population. To a large extent, the success of such a programme will depend on achieving high levels of participation, which an informed, early official response to public perceptions could help optimise. The present study, based on interviews with European NZers, found generally positive perceptions of FOBT screening, including that it was painless, simple, relatively low-cost and that the test could be done at home and in private. However, it also identified concerns about FOBT accuracy and acceptability, particularly among men, and perceptions of a lack of health system capacity and resources to promote and deliver the programme. Participants considered that high-profile, mass-media education would be essential to promote the proposed programme.

SUMMARY

Carcinoid tumours of the appendix in children in Auckland, New Zealand: 1965–2008

Alison Scott, Vipul Upadhyay

Carcinoid tumours of the appendix are rare tumours in children. There are only small numbers of studies describing what happens to children who get this disease. Our article reviews 44 years of these tumours in the Auckland region. Our study has the largest number of children ever published. Our study, combined with previous published studies, suggests that children do not need as extensive surgery as used in adults. The study hopes to contribute to the knowledge of this rare disease.

SUMMARY

Frequent attenders at emergency departments: research regarding the utility of management plans fails to take into account the natural attrition of attendance

Suzanne Peddie, Sandra Richardson, Lisa Salt, Michael Ardagh

A previous 4 year study of frequent attenders presenting 10 or more times a year at Christchurch Hospital Emergency Department (ED) showed a decrease in the number of times this group of patients presented over the 4 years. A further similar group of frequent attenders all had management plans devised by their healthcare workers. These plans aimed to improve their care when they attended ED, and to encourage them to seek help from their GPs or other health professionals when appropriate. There was no difference in the pattern of attendance over the two 4 year periods of these studies. A natural fall-off in ED attendance by these patients must be taken into account when assessing the impact of any intervention.

SUMMARY

The colorectal cancer patients’ journey: the Auckland region

Melissa Murray, Julie Brown, Victoria Hinder, Arend Merrie, Andrew Hill, Michael Hulme-Moir, Katrina Sharples, Michael Findlay

Of 1128 patients diagnosed and treated for colorectal cancer in Auckland whom we studied, 68% were referred through their general practitioner and 58% saw a surgeon at their first specialist appointment. The median time from initial referral to first treatment was 35 days, with only 68% of patients being treated within the recommended 62 days of initial referral. The colorectal patient journey is complicated by multiple pathways of presentation and treatment and by patient choice.

SUMMARY

Chinese peoples’ perceptions of colorectal cancer screening: a New Zealand perspective

Genevieve Bong, Judith McCool

Chinese patients who are eligible for participating in the colorectal cancer screening would benefit from access to appropriately detailed and culturally relevant information on the risks, benefit and procedures associated with colorectal cancer screening.

SUMMARY

Challenging differential diagnosis of a wild-type gastrointestinal stromal tumour (GIST) or rare reticular perineurioma of the stomach? The role for mutational analysis

Konrad K Richter, Alexander Dempster, Angelo P D Tos, Rakesh Premkumar, Christopher Jackson

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal lesions of the gastrointestinal tract; 1-3% of all gastrointestinal malignancies. They are defined as tumours with mutations in the KIT or PDGFRA gene and stain usually positively for KIT (CD117). In 95% of all GISTs mutational analysis for KIT and PDGFRA genes can confirm the diagnosis. We present the challenging diagnoses of a typical GIST and an extremely rare reticular perineurioma in the stomach, so far reported for the second time worldwide. The here presented cases emphasise the benefits of performing a mutational analysis in difficult GISTs, including wt-GISTs, and demonstrates the importance and challenges in differentiating GISTs from other mesenchymal tumours.

SUMMARY

Gastric cancer location and histological subtype in Pacific people and Māori defies international trends

Magdalena Biggar, Sanket Srinivasa, Binula Wickramarachchi, Richard Babor, Garth H Poole, Andrew G Hill

This review of data from Middlemore hospital shows that Maori and Pacific patients have a higher incidence of Gastric cancer than NZ Europeans. These cancer are at a different location within the stomach and are different histologically (i.e. when looking at their structure under the microscope) implying subtly different risk factors and a greater possible role of unique genetic factors. Maori and PI patients are also younger at the time of diagnosis compared to European patients with gastric cancer.

ALL ARTICLES
SUMMARY

What influences recurrent presentations of older people to the emergency department?

Rebecca McMillan, Helen Stokes-Lampard , Ruth Large

NZ Nurses Organisation comments on NZMA Health Equity Position Statement

Jill Clendon, Leanne Manson

The Government’s Goal for a Smokefree New Zealand by 2025: more decisions, and more detail, are urgently needed

Nick Wilson, Tony Blakely, Janet Hoek, Heather Gifford, Richard Edwards, George Thomson

Pinnacle of life—Māori living to advanced age

Lorna Dyall, Ngaire Kerse, Karen Hayman, Sally Keeling

Ten-year dispensing trends of hypnotics in New Zealand

Andrew McKean, Jane Vella-Brincat

Screening for colorectal cancer: taking New Zealand from ‘among the worst’ to ‘the best’?

Sarah Derrett

Toxicity of Christchurch wood smoke

Pat Palmer

An unusual cause of abdominal pain

Imran Badshah, Abdullah Alhaidri, Itty Mathews, Mohammad I Khan

Response to Kingham's editorial on air pollution

John L Hoare

Return visits to the emergency department and related hospital admissions by people aged 65 and over

Diana Minnee, Jill Wilkinson

Medical image. Rupture of a benign mediastinal teratoma into left pleural space

Sibes K Das, Tapan D Bairagya, Somnath Bhattacharya, Bidyut K Goswami

Wood burning and air pollution

Peter W Moller

The Plunket Nurse: part 1

Brian Eden Oldham

Eric Crampton

“It’s a small price to pay for life”: faecal occult blood test (FOBT) screening for colorectal cancer—perceived barriers and facilitators

Anthony I Reeder

Carcinoid tumours of the appendix in children in Auckland, New Zealand: 1965–2008

Alison Scott, Vipul Upadhyay

Fraud Convictions Reflect Adversely on Doctor’s Fitness to Practise

Michael Hale, Norman Sharpe

Frequent attenders at emergency departments: research regarding the utility of management plans fails to take into account the natural attrition of attendance

Suzanne Peddie, Sandra Richardson, Lisa Salt, Michael Ardagh

The colorectal cancer patients’ journey: the Auckland region

Melissa Murray, Julie Brown, Victoria Hinder, Arend Merrie, Andrew Hill, Michael Hulme-Moir, Katrina Sharples, Michael Findlay

Relative risk according to the proportion of a population deemed to be at high risk after risk factor analysis

J Alasdair Millar

Chinese peoples’ perceptions of colorectal cancer screening: a New Zealand perspective

Genevieve Bong, Judith McCool

Challenging differential diagnosis of a wild-type gastrointestinal stromal tumour (GIST) or rare reticular perineurioma of the stomach? The role for mutational analysis

Konrad K Richter, Alexander Dempster, Angelo P D Tos, Rakesh Premkumar, Christopher Jackson

Gastric cancer location and histological subtype in Pacific people and Māori defies international trends

Magdalena Biggar, Sanket Srinivasa, Binula Wickramarachchi, Richard Babor, Garth H Poole, Andrew G Hill

SUMMARY

Return visits to the emergency department and related hospital admissions by people aged 65 and over

Diana Minnee, Jill Wilkinson

This research identified a group of people aged 65 and older who either returned to the emergency department or were readmitted within 3 months of a hospital stay. Information relating to illness, functioning and follow-up was then gathered from patient notes in order to identify trends. The most notable trend was that acute illness rather than failure to cope at home appears to drive a return to hospital. This finding has resulted in the authors suggesting further research around early primary healthcare follow-up after discharge from hospital.

SUMMARY

“It’s a small price to pay for life”: faecal occult blood test (FOBT) screening for colorectal cancer—perceived barriers and facilitators

Anthony I Reeder

A colorectal cancer screening programme, based on a Faecal Occult Blood Test (FOBT), is planned for New Zealand (NZ), but we currently lack insight into how such a screening programme is likely to be received among the NZ population. To a large extent, the success of such a programme will depend on achieving high levels of participation, which an informed, early official response to public perceptions could help optimise. The present study, based on interviews with European NZers, found generally positive perceptions of FOBT screening, including that it was painless, simple, relatively low-cost and that the test could be done at home and in private. However, it also identified concerns about FOBT accuracy and acceptability, particularly among men, and perceptions of a lack of health system capacity and resources to promote and deliver the programme. Participants considered that high-profile, mass-media education would be essential to promote the proposed programme.

SUMMARY

Carcinoid tumours of the appendix in children in Auckland, New Zealand: 1965–2008

Alison Scott, Vipul Upadhyay

Carcinoid tumours of the appendix are rare tumours in children. There are only small numbers of studies describing what happens to children who get this disease. Our article reviews 44 years of these tumours in the Auckland region. Our study has the largest number of children ever published. Our study, combined with previous published studies, suggests that children do not need as extensive surgery as used in adults. The study hopes to contribute to the knowledge of this rare disease.

SUMMARY

Frequent attenders at emergency departments: research regarding the utility of management plans fails to take into account the natural attrition of attendance

Suzanne Peddie, Sandra Richardson, Lisa Salt, Michael Ardagh

A previous 4 year study of frequent attenders presenting 10 or more times a year at Christchurch Hospital Emergency Department (ED) showed a decrease in the number of times this group of patients presented over the 4 years. A further similar group of frequent attenders all had management plans devised by their healthcare workers. These plans aimed to improve their care when they attended ED, and to encourage them to seek help from their GPs or other health professionals when appropriate. There was no difference in the pattern of attendance over the two 4 year periods of these studies. A natural fall-off in ED attendance by these patients must be taken into account when assessing the impact of any intervention.

SUMMARY

The colorectal cancer patients’ journey: the Auckland region

Melissa Murray, Julie Brown, Victoria Hinder, Arend Merrie, Andrew Hill, Michael Hulme-Moir, Katrina Sharples, Michael Findlay

Of 1128 patients diagnosed and treated for colorectal cancer in Auckland whom we studied, 68% were referred through their general practitioner and 58% saw a surgeon at their first specialist appointment. The median time from initial referral to first treatment was 35 days, with only 68% of patients being treated within the recommended 62 days of initial referral. The colorectal patient journey is complicated by multiple pathways of presentation and treatment and by patient choice.

SUMMARY

Chinese peoples’ perceptions of colorectal cancer screening: a New Zealand perspective

Genevieve Bong, Judith McCool

Chinese patients who are eligible for participating in the colorectal cancer screening would benefit from access to appropriately detailed and culturally relevant information on the risks, benefit and procedures associated with colorectal cancer screening.

SUMMARY

Challenging differential diagnosis of a wild-type gastrointestinal stromal tumour (GIST) or rare reticular perineurioma of the stomach? The role for mutational analysis

Konrad K Richter, Alexander Dempster, Angelo P D Tos, Rakesh Premkumar, Christopher Jackson

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal lesions of the gastrointestinal tract; 1-3% of all gastrointestinal malignancies. They are defined as tumours with mutations in the KIT or PDGFRA gene and stain usually positively for KIT (CD117). In 95% of all GISTs mutational analysis for KIT and PDGFRA genes can confirm the diagnosis. We present the challenging diagnoses of a typical GIST and an extremely rare reticular perineurioma in the stomach, so far reported for the second time worldwide. The here presented cases emphasise the benefits of performing a mutational analysis in difficult GISTs, including wt-GISTs, and demonstrates the importance and challenges in differentiating GISTs from other mesenchymal tumours.

SUMMARY

Gastric cancer location and histological subtype in Pacific people and Māori defies international trends

Magdalena Biggar, Sanket Srinivasa, Binula Wickramarachchi, Richard Babor, Garth H Poole, Andrew G Hill

This review of data from Middlemore hospital shows that Maori and Pacific patients have a higher incidence of Gastric cancer than NZ Europeans. These cancer are at a different location within the stomach and are different histologically (i.e. when looking at their structure under the microscope) implying subtly different risk factors and a greater possible role of unique genetic factors. Maori and PI patients are also younger at the time of diagnosis compared to European patients with gastric cancer.

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