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Issue

Vol 126 No 1387: 12 December 2013

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Issue Summary

SUMMARY

Norovirus contamination of a drinking water supply at a hotel resort

Susan Jack, Derek Bell, Joanne Hewitt

This paper describes a waterborne Norovirus outbreak causing diarrhoea and vomiting in over 50 people in a hotel and resort close to major ski fields. Investigation of this gastroenteritis outbreak revealed drinking water and wider environmental contamination with Norovirus found in the drinking water bore, drinking water taps, surface water near the sewage disposal fields and in the nearby river. A strategy to decrease environmental contamination of drinking water supplies in this busy tourist location through improved management of sewage disposal and drinking water is urgently required.

SUMMARY

Risk stratification and timing of coronary angiography in acute coronary syndromes: are we targeting the right patients in a timely manner? (ANZACS-QI 1)

Andrew J Kerr, Aaron Lin, Mildred Lee, Ian Ternouth, Bridget Killion, Gerry Devlin

In this study from 3 New Zealand hospitals in 2007 to 2010 we have found there are significant and clinically important delays in how quickly patients presenting with heart attacks receive coronary angiography. These pictures of the heart arteries are required to decide on the best way to open up narrowed or blocked arteries. Often an angioplasty and stent procedure to open the arteries can be performed at the same time as the coronary angiogram. In 2013, the NZ Ministry of Health in conjunction with the NZ Cardiac Clinical Network has funded a national ACS and cardiac procedures registry and quality improvement programme to be known as the All NZ Acute Coronary Syndrome Quality Improvement programme (ANZACS QI). This will provide a platform to support initiatives to improve appropriate and timely access to coronary angiography.

SUMMARY

Diagnosis of cognitive impairment and the assessment of driving safety in New Zealand: a survey of Canterbury GPs

Petra A Hoggarth

We assessed how Canterbury GPs determine the driving ability of their older patients with cognitive impairment. A 10-item questionnaire was sent to 514 Canterbury GPs via the mail system of three Primary Health Organisations. 185 GPs returned completed questionnaires (36% response rate). Six of 10 items were rated in the middle of the response range, indicating a middling level of agreement. All but three GPs reported using a cognitive screening test and most talked to their patients about the need to plan for driving cessation. GPs did not frequently report referring for on-road driving assessments and many commented they would appreciate a more structured guideline with specific recommendations. There is room for improvement in the amount of information provided to GPs about how to best assess older patients with cognitive impairment for fitness to drive. Recommendations of specific cognitive screens and a flowchart format would be a valuable addition.

SUMMARY

Higher mortality in women undergoing coronary artery bypass grafting

Tom Kai Ming Wang, Tharumenthiran Ramanathan, Ralph Stewart, Greg Gamble, Harvey White

Women undergoing heart surgery had 6 times the death rate of men at 30 days and 5 times at 1 year after surgery. This could be explained by women having smaller heart arteries. Women had more elevated blood pressure, more were smokers and women had more anginas suggesting that women would benefit from earlier screening for risk factors and earlier treatment. The NZ National Guidelines recommend cardiovascular risk screening at 55 years for women which is 10 years later than in men and 10 years later than breast cancer screening is funded, yet more women die from cardiovascular disease than from breast cancer. The authors recommend cardiovascular risk screening to be done at the same age as men and the need to raise the awareness of the importance of early detection and appropriate treatment of women with heart disease.

ALL ARTICLES
SUMMARY

Norovirus contamination of a drinking water supply at a hotel resort

Susan Jack, Derek Bell, Joanne Hewitt

Medical image. Ethanol-related ecchymosis

Yassar Alamri, Steven Soule, Gary Lim

Why do patients choose the emergency department?

Increasing awareness of Rhodococcus equi pulmonary infection in the immunocompetent adult: a rare infection with poor prognosis

Samantha Herath, Christopher Lewis, Mitzi Nisbet

An unusual chest radiograph

Joseph M Pappachan, Gurmit Gill, Annbelle Machin, Adrian B Walker

A diagnosis staring you in the face

James Bedford, Mariappan Sivakumar, David A King, Julian Howes, Mostafa Abdel-Hafiz

National Heart Foundation Senior Fellowship

Risk stratification and timing of coronary angiography in acute coronary syndromes: are we targeting the right patients in a timely manner? (ANZACS-QI 1)

Andrew J Kerr, Aaron Lin, Mildred Lee, Ian Ternouth, Bridget Killion, Gerry Devlin

Survey of smoking areas at bars in central Wellington City: scope for further hazard reduction?

In Lighter Vein

Diagnosis of cognitive impairment and the assessment of driving safety in New Zealand: a survey of Canterbury GPs

Petra A Hoggarth

An apparent drop in synthetic cannabinoid presentations

Best practice rosters—are mandatory split nights rosters really the answer?

Parenteral poppy seed tea packs a powerful punch

Dominic Monaghan, Brad Peckler

Medical Benevolent Fund

National Heart Foundation 2014 Grant Applications

Bariatric surgery

Higher mortality in women undergoing coronary artery bypass grafting

Tom Kai Ming Wang, Tharumenthiran Ramanathan, Ralph Stewart, Greg Gamble, Harvey White

Increasing appropriate and decreasing inappropriate cardiac care

Andrew Hamer

Proceedings of the New Zealand Society of Gastroenterology Annual Scientific Meeting, 20–22 November 2013, Wellington

SUMMARY

Norovirus contamination of a drinking water supply at a hotel resort

Susan Jack, Derek Bell, Joanne Hewitt

This paper describes a waterborne Norovirus outbreak causing diarrhoea and vomiting in over 50 people in a hotel and resort close to major ski fields. Investigation of this gastroenteritis outbreak revealed drinking water and wider environmental contamination with Norovirus found in the drinking water bore, drinking water taps, surface water near the sewage disposal fields and in the nearby river. A strategy to decrease environmental contamination of drinking water supplies in this busy tourist location through improved management of sewage disposal and drinking water is urgently required.

SUMMARY

Risk stratification and timing of coronary angiography in acute coronary syndromes: are we targeting the right patients in a timely manner? (ANZACS-QI 1)

Andrew J Kerr, Aaron Lin, Mildred Lee, Ian Ternouth, Bridget Killion, Gerry Devlin

In this study from 3 New Zealand hospitals in 2007 to 2010 we have found there are significant and clinically important delays in how quickly patients presenting with heart attacks receive coronary angiography. These pictures of the heart arteries are required to decide on the best way to open up narrowed or blocked arteries. Often an angioplasty and stent procedure to open the arteries can be performed at the same time as the coronary angiogram. In 2013, the NZ Ministry of Health in conjunction with the NZ Cardiac Clinical Network has funded a national ACS and cardiac procedures registry and quality improvement programme to be known as the All NZ Acute Coronary Syndrome Quality Improvement programme (ANZACS QI). This will provide a platform to support initiatives to improve appropriate and timely access to coronary angiography.

SUMMARY

Diagnosis of cognitive impairment and the assessment of driving safety in New Zealand: a survey of Canterbury GPs

Petra A Hoggarth

We assessed how Canterbury GPs determine the driving ability of their older patients with cognitive impairment. A 10-item questionnaire was sent to 514 Canterbury GPs via the mail system of three Primary Health Organisations. 185 GPs returned completed questionnaires (36% response rate). Six of 10 items were rated in the middle of the response range, indicating a middling level of agreement. All but three GPs reported using a cognitive screening test and most talked to their patients about the need to plan for driving cessation. GPs did not frequently report referring for on-road driving assessments and many commented they would appreciate a more structured guideline with specific recommendations. There is room for improvement in the amount of information provided to GPs about how to best assess older patients with cognitive impairment for fitness to drive. Recommendations of specific cognitive screens and a flowchart format would be a valuable addition.

SUMMARY

Higher mortality in women undergoing coronary artery bypass grafting

Tom Kai Ming Wang, Tharumenthiran Ramanathan, Ralph Stewart, Greg Gamble, Harvey White

Women undergoing heart surgery had 6 times the death rate of men at 30 days and 5 times at 1 year after surgery. This could be explained by women having smaller heart arteries. Women had more elevated blood pressure, more were smokers and women had more anginas suggesting that women would benefit from earlier screening for risk factors and earlier treatment. The NZ National Guidelines recommend cardiovascular risk screening at 55 years for women which is 10 years later than in men and 10 years later than breast cancer screening is funded, yet more women die from cardiovascular disease than from breast cancer. The authors recommend cardiovascular risk screening to be done at the same age as men and the need to raise the awareness of the importance of early detection and appropriate treatment of women with heart disease.

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