Issue

Vol 126 No 1380: 16 August 2013

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Issue Summary

SUMMARY

IgE-mediated food allergy—diagnosis and management in New Zealand children

J Sinclair, S Brothers, P Jackson, T Stanley, M Ang, P Brown, A Craig, A Daniell, C Doocey, S Hoare, S Lester, P McIlroy, G Ostring, D Purvis, J Sanders, R Smiley, M Sutherland, T Townend, J Wilde, G Williams

Food allergy is a common problem for New Zealand children, and needs to be accurately diagnosed. Management includes avoiding specific foods, and managing the risk of accidental food exposure. With time many food allergies resolve, children need ongoing follow-up to work out when this occurs.

SUMMARY

Questions about New Zealand’s health system in 2013, its 75th anniversary year

Robin Gauld

This year, 2013, is a significant occasion for the New Zealand health system for it marks the 75th anniversary of the laying of its foundations. Such an anniversary is a time for celebration but also for reflection on whether we have achieved the goals sought in the passage, on 14 September 1938, of the Social Security Act under the government of Michael Joseph Savage. It is also a time for debate around how well our present health system functions and performs in the light of the 1938 Acts aims. This article, therefore, reflects on the goals of the Social Security Act for health care, whether we have achieved them and what the key barriers to this have been. It also asks whether we should recommit to the original 1938 aims for health care, or develop a new set of principles that reflect how the New Zealand health system is presently structured and performs.

SUMMARY

Malignant hypertension: a preventable emergency

Walter van der Merwe, Veronica van der Merwe

18 out of 565 (3.2%) consecutive patients seen in a difficult hypertension (high blood pressure) clinic presented with malignant hypertension. Malignant hypertension means blood pressure which is so high that the patient is at immediate risk of severe organ damage (blindness, stroke, kidney failure etc) and even death. All cases were thoroughly investigated and all were determined to have a background of essential hypertension this is the common type of high blood pressure which has no demonstrable underlying cause. All the patients survived, but most were left with a degree of chronic kidney disease. All cases of malignant hypertension could have been prevented with adequate blood pressure treatment, but most were not on blood pressure medication at the time of presentation. An annual blood pressure check in all adults to detect those with elevated pressures requiring treatment is one of the most cost-effective public health measures.

SUMMARY

Severe Clostridium difficile infection in New Zealand associated with an emerging strain, PCR-ribotype 244

Mary De Almeida, Helen Heffernan, Anne Dervan, Sarah Bakker, Joshua Freeman, Hasan Bhally, Susan Taylor, Thomas Riley, Sally Roberts

PCR-ribotype 244 is a newly recognised strain of Clostridium difficile (C. difficile) in New Zealand. C. difficile is a bacteria commonly associated with antibiotic-associated diarrhoea. A case-control study of hospitalised patients in Auckland found that cases infected with C. difficile PCR-ribotype 244 were more likely to have severe disease than patients infected with others strains.

ALL ARTICLES
SUMMARY

IgE-mediated food allergy—diagnosis and management in New Zealand children

J Sinclair, S Brothers, P Jackson, T Stanley, M Ang, P Brown, A Craig, A Daniell, C Doocey, S Hoare, S Lester, P McIlroy, G Ostring, D Purvis, J Sanders, R Smiley, M Sutherland, T Townend, J Wilde, G Williams

Questions about New Zealand’s health system in 2013, its 75th anniversary year

Robin Gauld

Medical image. Short metacarpal and metatarsals

Gopal Chandra Ghosh, Bhimarey Kategary, Arnab Sarkar, Krishnarpan Chatterjee, Brijesh Sharma

Medical image. Systemic retinoids for recurrent keratoacanthomas

Faisal Ali, John T Lear

The Legacy of Percy Pease

Kiarash Taghavi, James K Hamill

Malignant hypertension: a preventable emergency

Walter van der Merwe, Veronica van der Merwe

Medical image. A rare complication of cytarabine therapy

Praveen Ramakrishnan Geethakumari, Sreejith Nair

Scalp involvement by Sarcoptes scabiei var hominis resembling seborrhoeic dermatitis in two immunocompromised patients with systemic lupus erythematosus

Paul Jarrett, Antonia Birry

RMO patient safety forums in New Zealand: agents for change

Lucie Collinson, Katie Thorne, Stephen Dee, Kate MacIntyre, Grant Pidgeon

Severe Clostridium difficile infection in New Zealand associated with an emerging strain, PCR-ribotype 244

Mary De Almeida, Helen Heffernan, Anne Dervan, Sarah Bakker, Joshua Freeman, Hasan Bhally, Susan Taylor, Thomas Riley, Sally Roberts

Coroner's inquest

Lessons from the February 2011 Christchurch Earthquake for the training and preparation of Post Graduate Year 1 Doctors (Dale C Sheehan, John Thwaites, Blair York, Jaejin Lee)

The New Zealand health system after 75 years: let’s stop and smell the roses

Toni Ashton

SUMMARY

IgE-mediated food allergy—diagnosis and management in New Zealand children

J Sinclair, S Brothers, P Jackson, T Stanley, M Ang, P Brown, A Craig, A Daniell, C Doocey, S Hoare, S Lester, P McIlroy, G Ostring, D Purvis, J Sanders, R Smiley, M Sutherland, T Townend, J Wilde, G Williams

Food allergy is a common problem for New Zealand children, and needs to be accurately diagnosed. Management includes avoiding specific foods, and managing the risk of accidental food exposure. With time many food allergies resolve, children need ongoing follow-up to work out when this occurs.

SUMMARY

Questions about New Zealand’s health system in 2013, its 75th anniversary year

Robin Gauld

This year, 2013, is a significant occasion for the New Zealand health system for it marks the 75th anniversary of the laying of its foundations. Such an anniversary is a time for celebration but also for reflection on whether we have achieved the goals sought in the passage, on 14 September 1938, of the Social Security Act under the government of Michael Joseph Savage. It is also a time for debate around how well our present health system functions and performs in the light of the 1938 Acts aims. This article, therefore, reflects on the goals of the Social Security Act for health care, whether we have achieved them and what the key barriers to this have been. It also asks whether we should recommit to the original 1938 aims for health care, or develop a new set of principles that reflect how the New Zealand health system is presently structured and performs.

SUMMARY

Malignant hypertension: a preventable emergency

Walter van der Merwe, Veronica van der Merwe

18 out of 565 (3.2%) consecutive patients seen in a difficult hypertension (high blood pressure) clinic presented with malignant hypertension. Malignant hypertension means blood pressure which is so high that the patient is at immediate risk of severe organ damage (blindness, stroke, kidney failure etc) and even death. All cases were thoroughly investigated and all were determined to have a background of essential hypertension this is the common type of high blood pressure which has no demonstrable underlying cause. All the patients survived, but most were left with a degree of chronic kidney disease. All cases of malignant hypertension could have been prevented with adequate blood pressure treatment, but most were not on blood pressure medication at the time of presentation. An annual blood pressure check in all adults to detect those with elevated pressures requiring treatment is one of the most cost-effective public health measures.

SUMMARY

Severe Clostridium difficile infection in New Zealand associated with an emerging strain, PCR-ribotype 244

Mary De Almeida, Helen Heffernan, Anne Dervan, Sarah Bakker, Joshua Freeman, Hasan Bhally, Susan Taylor, Thomas Riley, Sally Roberts

PCR-ribotype 244 is a newly recognised strain of Clostridium difficile (C. difficile) in New Zealand. C. difficile is a bacteria commonly associated with antibiotic-associated diarrhoea. A case-control study of hospitalised patients in Auckland found that cases infected with C. difficile PCR-ribotype 244 were more likely to have severe disease than patients infected with others strains.

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