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Issue

Vol 128 No 1425: 20 November 2015

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Issue Summary

SUMMARY

Intravenous magnesium sulphate as an adjuvant therapy in acute exacerbations of chronic obstructive pulmonary disease: a single centre, randomised, double-blinded, parallel group, placebo-controlled trial: a pilot study

S Mukerji, B Shahpuri, B Clayton-Smith, N Smith, P Armstrong, M Hardy, G Marchant, E Marsh

We were investigating whether magnesium sulphate could help treat an acute COPD attack in patients presenting to the emergency department. We gave about half of our patients magnesium sulphate whilst the other half received a placebo intravenously, on top of the standard treatment they would normally get currently in the emergency department. We found that Intravenous magnesium sulphate improved patients breathing function when compared to the placebo group. Further studies should be carried out to investigate this effect further.

SUMMARY

Potential new regulatory options for e-cigarettes in New Zealand

Nick Wilson, Richard Edwards, Janet Hoek, George Thomson, Tony Blakely, Frederieke Sanne van der Deen, Brent Caldwell, Julian Crane

While e-cigarette usage has grown rapidly in New Zealand and around the world, the scientific evidence-base regarding the net benefits and risks of these types of products at the population level remains uncertain. The health-based policy experience is also minimal. In this article we analyse plausible future regulatory options for e-cigarettes that the New Zealand Government could explore, and that further research could help clarify. These options include: (1) a full free market (an option we doubt is desirable for multiple reasons); (2) controlled increased access through: (a) pharmacy only, (b) pharmacy only plus sales by prescription/to licensed vapers; (c) additional controls through non-profit supply/distribution (eg, public hospital pharmacies); (3) increased restrictions compared with currently (eg, a complete ban on self-imports and use).

SUMMARY

Attitudes and risk of withdrawal in general surgical registrars

Rewena Keegan, Robyn Saw, Katie De Loyde, Christopher J Young

Attrition during surgical training program is an important issue which affects individual doctors, the medical workforce and the community. This study found that more than half of the respondents had thoughts about withdrawing from their surgical training program. Those that thought of withdrawing were more likely to be female and to be locally educated in Australia or New Zealand. These registrars at attrition risk were less satisfied with many aspects of their education and training. This study may help us in the future to identify at risk trainees and institute strategies to improve training experiences and attrition rates.

SUMMARY

Prevention of neonatal early onset GBS sepsis: A clear protocol is better than none—or several

Michelle Wise, Norma Campbell, Brian Darlow

Revised New Zealand consensus guidelines on the prevention of early-onset group B streptococcus sepsis in the newborn are presented in this issue of the Journal. We provide some context for these recommendations and discuss issues considered by the multidisciplinary group in formulating the guidelines.

SUMMARY

Is the statement that if a person is off work for 70 days the chance of ever getting back to work is 35% justified?

Gordon Purdie

Statements like, if a person is off work for 70 days, the chance of ever getting back to work is 35%, are being repeated by Government and non-Government agencies in New Zealand and Australia. The statements are not justified and appear to be based on an incorrect interpretation of a graph. The statements are being used to influence Government policies and doctors writing medical certificates. The statements should not be used.

SUMMARY

The experiences, motivations, and opinions of New Zealand’s live liver donors

Claire Gavin, Phillipa Malpas, Adam Bartlett

New Zealands live liver donors offer their motivations and experiences of undergoing a risky procedure due to a lack of deceased organs for transplant. They have a unique and valuable perspective on New Zealands current organ donation system. Most disagreed with the family veto on deceased organ donation and thought education was important in encouraging people to donate. New Zealands current organ donation system is unethical and needs balance from including a wider range of views including donors, potential recipients and the general public.

SUMMARY

Infertility and outcomes for infertile women in Otago and Southland

Antoinette Righarts, Nigel P Dickson, Lianne Parkin, Wayne R Gillett

Infertility, that is trying unsuccessfully to get pregnant for longer than 12 months or seeking medical help to conceive, was experience by a quarter of a sample of women aged 25-50 years in Otago and Southland surveyed in 2011 who had ever been or tried to get pregnant. Most women resolved their first episode of infertility with a live birth; however, a quarter had not done so. Furthermore, almost three quarters of women who had infertility accessed medical help for this. These results suggest infertility is an important problem, significant health resources are being used to address infertility and a substantial proportion of women are childless due to infertility and/or social circumstances (such as not having a male partner).

SUMMARY

Mandatory regulation or self-regulation in the age of the Volkswagen saga

Nick Wilson, Rob Quigley, Osman Mansoor, Moira Smith, Louise Signal

This Editorial briefly discusses the issues around self-regulation and mandatory regulation of food marketing (partly in response to food industry claims around the value of self-regulation). It discusses how self-regulation can failure in some areas, and the value of mandatory regulation. But even when there is regulation, given situations like the Volkswagen saga, policy-makers should also consider better funding of regulatory science. Mandatory regulations, combined with science-based monitoring may then start to provide further protection of the public from unhealthy products - including the marketing of unhealthy food.

ALL ARTICLES
SUMMARY

Trends and patterns in medical student research and publishing in New Zealand

Ibrahim S Al-Busaidi

Children’s positive attitudes towards the tobacco industry is associated with initiation of smoking

Anette Kira, Marewa Glover, Dudley Gentles, Judith McCool, Robert Scragg, Chris Bullen, Vili Nosa

Equitable care for those with rheumatic heart disease

Nigel Wilson, Rachel Webb, John Malcolm, Geoff Cramp, Andrew Marshall, Andrew Aitken, Nikki Blair, Nicola Culliford-Semmens, Andrew Chan Mow, Ross Nicholson, Adrian Trenholme, Roger Tuck, Clair Mills

Ticagrelor in the Real World: The Midland Regional Cardiac Network Experience

Marcus Lee, Sarah Green, Tina Cherian, Charles Heald, Gerard Devlin

TABLE - A case of botulism in New Zealand

Duncan Smyth, Eamonn Deverall, Michelle Balm, Annette Nesdale, Ian Rosemergy

Book review: Scheme for dealing with tuberculous persons

Intravenous magnesium sulphate as an adjuvant therapy in acute exacerbations of chronic obstructive pulmonary disease: a single centre, randomised, double-blinded, parallel group, placebo-controlled trial: a pilot study

S Mukerji, B Shahpuri, B Clayton-Smith, N Smith, P Armstrong, M Hardy, G Marchant, E Marsh

Fast, fair climate action crucial for health and equity

Scott Metcalfe, for the New Zealand College of Public Health Medicine and OraTaiao: The New Zealand Climate and Health Council.

Potential new regulatory options for e-cigarettes in New Zealand

Nick Wilson, Richard Edwards, Janet Hoek, George Thomson, Tony Blakely, Frederieke Sanne van der Deen, Brent Caldwell, Julian Crane

Bullous Mantoux Reaction

Nattusamy Loganathan, Vijay Hadda, Karan Madan, Anant Mohan, Gopi C Khilnani, Randeep Guleria

Attitudes and risk of withdrawal in general surgical registrars

Rewena Keegan, Robyn Saw, Katie De Loyde, Christopher J Young

Prevention of neonatal early onset GBS sepsis: A clear protocol is better than none—or several

Michelle Wise, Norma Campbell, Brian Darlow

Is the statement that if a person is off work for 70 days the chance of ever getting back to work is 35% justified?

Gordon Purdie

The experiences, motivations, and opinions of New Zealand’s live liver donors

Claire Gavin, Phillipa Malpas, Adam Bartlett

Infertility and outcomes for infertile women in Otago and Southland

Antoinette Righarts, Nigel P Dickson, Lianne Parkin, Wayne R Gillett

Perioperative care in hip and knee arthroplasty—a survey of New Zealand orthopaedic surgeons

Marinus DJ Stowers, Andrew G Hill, Brendan Coleman, Jacob T Munro

Mandatory regulation or self-regulation in the age of the Volkswagen saga

Nick Wilson, Rob Quigley, Osman Mansoor, Moira Smith, Louise Signal

Sydney Rae West

John Richards

Abstracts for the 218th Otago Medical School Research Society Scientific Meeting

Idarucizumab for dabigatran reversal

SUMMARY

Intravenous magnesium sulphate as an adjuvant therapy in acute exacerbations of chronic obstructive pulmonary disease: a single centre, randomised, double-blinded, parallel group, placebo-controlled trial: a pilot study

S Mukerji, B Shahpuri, B Clayton-Smith, N Smith, P Armstrong, M Hardy, G Marchant, E Marsh

We were investigating whether magnesium sulphate could help treat an acute COPD attack in patients presenting to the emergency department. We gave about half of our patients magnesium sulphate whilst the other half received a placebo intravenously, on top of the standard treatment they would normally get currently in the emergency department. We found that Intravenous magnesium sulphate improved patients breathing function when compared to the placebo group. Further studies should be carried out to investigate this effect further.

SUMMARY

Potential new regulatory options for e-cigarettes in New Zealand

Nick Wilson, Richard Edwards, Janet Hoek, George Thomson, Tony Blakely, Frederieke Sanne van der Deen, Brent Caldwell, Julian Crane

While e-cigarette usage has grown rapidly in New Zealand and around the world, the scientific evidence-base regarding the net benefits and risks of these types of products at the population level remains uncertain. The health-based policy experience is also minimal. In this article we analyse plausible future regulatory options for e-cigarettes that the New Zealand Government could explore, and that further research could help clarify. These options include: (1) a full free market (an option we doubt is desirable for multiple reasons); (2) controlled increased access through: (a) pharmacy only, (b) pharmacy only plus sales by prescription/to licensed vapers; (c) additional controls through non-profit supply/distribution (eg, public hospital pharmacies); (3) increased restrictions compared with currently (eg, a complete ban on self-imports and use).

SUMMARY

Attitudes and risk of withdrawal in general surgical registrars

Rewena Keegan, Robyn Saw, Katie De Loyde, Christopher J Young

Attrition during surgical training program is an important issue which affects individual doctors, the medical workforce and the community. This study found that more than half of the respondents had thoughts about withdrawing from their surgical training program. Those that thought of withdrawing were more likely to be female and to be locally educated in Australia or New Zealand. These registrars at attrition risk were less satisfied with many aspects of their education and training. This study may help us in the future to identify at risk trainees and institute strategies to improve training experiences and attrition rates.

SUMMARY

Prevention of neonatal early onset GBS sepsis: A clear protocol is better than none—or several

Michelle Wise, Norma Campbell, Brian Darlow

Revised New Zealand consensus guidelines on the prevention of early-onset group B streptococcus sepsis in the newborn are presented in this issue of the Journal. We provide some context for these recommendations and discuss issues considered by the multidisciplinary group in formulating the guidelines.

SUMMARY

Is the statement that if a person is off work for 70 days the chance of ever getting back to work is 35% justified?

Gordon Purdie

Statements like, if a person is off work for 70 days, the chance of ever getting back to work is 35%, are being repeated by Government and non-Government agencies in New Zealand and Australia. The statements are not justified and appear to be based on an incorrect interpretation of a graph. The statements are being used to influence Government policies and doctors writing medical certificates. The statements should not be used.

SUMMARY

The experiences, motivations, and opinions of New Zealand’s live liver donors

Claire Gavin, Phillipa Malpas, Adam Bartlett

New Zealands live liver donors offer their motivations and experiences of undergoing a risky procedure due to a lack of deceased organs for transplant. They have a unique and valuable perspective on New Zealands current organ donation system. Most disagreed with the family veto on deceased organ donation and thought education was important in encouraging people to donate. New Zealands current organ donation system is unethical and needs balance from including a wider range of views including donors, potential recipients and the general public.

SUMMARY

Infertility and outcomes for infertile women in Otago and Southland

Antoinette Righarts, Nigel P Dickson, Lianne Parkin, Wayne R Gillett

Infertility, that is trying unsuccessfully to get pregnant for longer than 12 months or seeking medical help to conceive, was experience by a quarter of a sample of women aged 25-50 years in Otago and Southland surveyed in 2011 who had ever been or tried to get pregnant. Most women resolved their first episode of infertility with a live birth; however, a quarter had not done so. Furthermore, almost three quarters of women who had infertility accessed medical help for this. These results suggest infertility is an important problem, significant health resources are being used to address infertility and a substantial proportion of women are childless due to infertility and/or social circumstances (such as not having a male partner).

SUMMARY

Mandatory regulation or self-regulation in the age of the Volkswagen saga

Nick Wilson, Rob Quigley, Osman Mansoor, Moira Smith, Louise Signal

This Editorial briefly discusses the issues around self-regulation and mandatory regulation of food marketing (partly in response to food industry claims around the value of self-regulation). It discusses how self-regulation can failure in some areas, and the value of mandatory regulation. But even when there is regulation, given situations like the Volkswagen saga, policy-makers should also consider better funding of regulatory science. Mandatory regulations, combined with science-based monitoring may then start to provide further protection of the public from unhealthy products - including the marketing of unhealthy food.

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