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Issue

Vol 125 No 1358: 27 July 2012

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Issue Summary

SUMMARY

“I wouldn’t want to become a nuisance under any circumstances”—a qualitative study of the reasons some healthy older individuals support medical practices that hasten death

Phillipa J Malpas, Kay Mitchell, Malcolm H Johnson

In this study we explored the reasons older healthy New Zealanders held for supporting medical practices that hasten death. We undertook this study because we know (from two surveys) that a large percentage of the population support medical assistance to die in certain circumstances. This mirrors support in several other countries, including Australia. However we do not know their reasons for supporting such practices. This may have important implications for medical practice at the end of life, particularly where patients request that medical treatment be withheld of withdrawn.

SUMMARY

A retrospective review of notified human leptospirosis cases in the Waikato region of New Zealand, 2004 to 2010

George Cowie, Anita Bell

Human leptospirosis rates within the Waikato are higher than the national average. Dry stock farmers and meat processing workers are at the highest risk. It is speculated that the immunisation of all cattle herds may further reduce the incidence of leptospirosis although more accurate collection of work exposure data is needed to determine this.

SUMMARY

New Zealand Malayan war veterans’ exposure to dibutylphthalate is associated with an increased incidence of cryptorchidism, hypospadias and breast cancer in their children

Matthew Carran, Ian Shaw

Dibutylphthalate (DBP) was used to prevent New Zealand soldiers contracting diseases (e.g. bush typhus) transmitted by ticks and lice during their service in the Malayan Emergency (1948-1960) by applying it to the seams of their clothes (the point of access of disease vectors) before they went into the jungle. DBT is known to inhibit the synthesis of the male hormone, testosterone (it is an endocrine disruptor). The article reports the results of a questionnaire study that shows an increased incidence of diseases/disorders associated with exposure to endocrine disruptors (cryptorchidism [undescended testes], hypospadias [deformed penis] and breast cancer) in the children of DBP-exposed soldiers compared to the general population. It is proposed that DBP interferes with the function of genes (epigenetics) associated with testosterone synthesis and thus results in cellular feminisation and that this explains the increased incidence of the diseases seen in the children of the Malayan Emergency veterans.

SUMMARY

Phlebotomy patterns in haemochromatosis patients and their contribution to the blood supply

Deborah Walkden, Krishna Badami

Most haemochromatosis (iron overload in blood) patients have their blood removed by the NZ Blood Service. We audited data from the venesection (blood letting) clinic obtained during 2009. This data showed that 53% of HC patients were eligible to be blood donors and that these donors contributed 3.4% of whole blood units collected during 2009. The most commmon reasons for exclusion from donation included abnormal liver tests, immigration from countries with a perceived high risk of vCJD (mad cow disease), and having a chronic illness or cancer.

SUMMARY

Safety and efficacy of stroke thrombolysis at a secondary provincial hospital in New Zealand

Annemarei Ranta, Calvin Chan, Dorothea Rump, Pietro Cariga

Stroke thrombolysis consists of administering a clot-busting medications to selected stroke patients. This treatment has been shown to be effective and safe at large academic centres worldwide. Data regarding safety and efficacy at smaller centres, especially in New Zealand, is limited and service provision remains patchy throughout the country. This paper presents safety and efficacy data in a provincial hospital in New Zealand and discusses future steps toward making this potentially lifesaving therapy available to all New Zealanders.

ALL ARTICLES
SUMMARY

“I wouldn’t want to become a nuisance under any circumstances”—a qualitative study of the reasons some healthy older individuals support medical practices that hasten death

Phillipa J Malpas, Kay Mitchell, Malcolm H Johnson

A retrospective review of notified human leptospirosis cases in the Waikato region of New Zealand, 2004 to 2010

George Cowie, Anita Bell

No need to ban smoking in cars with children present—it’s almost snuffed out

Marewa Glover, Tim Maifeleni, Ching Jie Yeh, Arita Lee, Dudley Gentles

Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome

Ken G Teo, Namrata S Anavekar, Anosha Yazdabadi, Sophie Ricketts

Rex Livingstone Sinclair

New Zealand Malayan war veterans’ exposure to dibutylphthalate is associated with an increased incidence of cryptorchidism, hypospadias and breast cancer in their children

Matthew Carran, Ian Shaw

Phlebotomy patterns in haemochromatosis patients and their contribution to the blood supply

Deborah Walkden, Krishna Badami

PHARMAC's updated guidelines for cost-utility analyses, with new QALYs per $1M metric

Rachel Grocott, Scott Metcalfe

Patrick William Cotter

Professionalism in its time and place: some implications for medical education

Tim J Wilkinson, MaryLeigh Moore, Eleanor M Flynn

Safety and efficacy of stroke thrombolysis at a secondary provincial hospital in New Zealand

Annemarei Ranta, Calvin Chan, Dorothea Rump, Pietro Cariga

PHARMAC looks great value for money—an Australian perspective

Linda J Cobiac

Medical image. A rare tumour of the chest wall

Anirudh Aron, Alexander Hallock

The operative treatment of goitre

Debates on euthanasia

Sin 00e9ad Donnelly

SUMMARY

“I wouldn’t want to become a nuisance under any circumstances”—a qualitative study of the reasons some healthy older individuals support medical practices that hasten death

Phillipa J Malpas, Kay Mitchell, Malcolm H Johnson

In this study we explored the reasons older healthy New Zealanders held for supporting medical practices that hasten death. We undertook this study because we know (from two surveys) that a large percentage of the population support medical assistance to die in certain circumstances. This mirrors support in several other countries, including Australia. However we do not know their reasons for supporting such practices. This may have important implications for medical practice at the end of life, particularly where patients request that medical treatment be withheld of withdrawn.

SUMMARY

A retrospective review of notified human leptospirosis cases in the Waikato region of New Zealand, 2004 to 2010

George Cowie, Anita Bell

Human leptospirosis rates within the Waikato are higher than the national average. Dry stock farmers and meat processing workers are at the highest risk. It is speculated that the immunisation of all cattle herds may further reduce the incidence of leptospirosis although more accurate collection of work exposure data is needed to determine this.

SUMMARY

New Zealand Malayan war veterans’ exposure to dibutylphthalate is associated with an increased incidence of cryptorchidism, hypospadias and breast cancer in their children

Matthew Carran, Ian Shaw

Dibutylphthalate (DBP) was used to prevent New Zealand soldiers contracting diseases (e.g. bush typhus) transmitted by ticks and lice during their service in the Malayan Emergency (1948-1960) by applying it to the seams of their clothes (the point of access of disease vectors) before they went into the jungle. DBT is known to inhibit the synthesis of the male hormone, testosterone (it is an endocrine disruptor). The article reports the results of a questionnaire study that shows an increased incidence of diseases/disorders associated with exposure to endocrine disruptors (cryptorchidism [undescended testes], hypospadias [deformed penis] and breast cancer) in the children of DBP-exposed soldiers compared to the general population. It is proposed that DBP interferes with the function of genes (epigenetics) associated with testosterone synthesis and thus results in cellular feminisation and that this explains the increased incidence of the diseases seen in the children of the Malayan Emergency veterans.

SUMMARY

Phlebotomy patterns in haemochromatosis patients and their contribution to the blood supply

Deborah Walkden, Krishna Badami

Most haemochromatosis (iron overload in blood) patients have their blood removed by the NZ Blood Service. We audited data from the venesection (blood letting) clinic obtained during 2009. This data showed that 53% of HC patients were eligible to be blood donors and that these donors contributed 3.4% of whole blood units collected during 2009. The most commmon reasons for exclusion from donation included abnormal liver tests, immigration from countries with a perceived high risk of vCJD (mad cow disease), and having a chronic illness or cancer.

SUMMARY

Safety and efficacy of stroke thrombolysis at a secondary provincial hospital in New Zealand

Annemarei Ranta, Calvin Chan, Dorothea Rump, Pietro Cariga

Stroke thrombolysis consists of administering a clot-busting medications to selected stroke patients. This treatment has been shown to be effective and safe at large academic centres worldwide. Data regarding safety and efficacy at smaller centres, especially in New Zealand, is limited and service provision remains patchy throughout the country. This paper presents safety and efficacy data in a provincial hospital in New Zealand and discusses future steps toward making this potentially lifesaving therapy available to all New Zealanders.

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