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Issue

Vol 129 No 1429: 29 January 2016

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Issue Summary

SUMMARY

Outcomes of bone density measurements in coeliac disease

Mark J Bolland, Andrew Grey, David S Rowbotham

We identified 137 adults with coeliac disease who had a bone density scan over 5 years at Auckland District Health Board and Counties Manukau District Health Board. The average bone density was slightly lower than expected, but well within the normal range, and only a small proportion of patients (12%) had low bone density. Low bone density was strongly related to low body weight. These results suggest that bone density measurement is not indicated routinely in coeliac disease, but could be considered on a case-by-case basis for individuals with strong risk factors for fracture.

SUMMARY

Gout in Aotearoa New Zealand: are we going to ignore this for another 3 years?

Nicola Dalbeth, Catherine Gerard, Peter Gow, Gary Jackson, Carl Shuker, Leanne Te Karu, Doone Winnard

Gout is the most common form of inflammatory arthritis affecting adults, with up to 4.9% of the New Zealand population affected. It is severely painful, and causes inability to work and interact with family. The New Zealand Atlas of Healthcare Variation shows M1ori and Pacific people are disproportionately affected - nearly half of Pacific men and over a third of M1ori men over 65 years of age are identified as having gout, as compared with 16.5% of European and other men of the same age. Despite this, M1ori and Pacific people receive the recommended treatment, called allopurinol, less than other groups, and are more likely to be prescribed more toxic drugs like colchicine and non-steroidal anti-inflammatory drugs (NSAIDs) instead, which risk joint damage. The Atlas has been publishing these data for three years - why has nothing improved?

SUMMARY

Long-term follow-up of patients with idiopathic inflammatory myopathy at Waitemata District Health Board

Ramanamma Kalluru, Hamish Hart, Michael Corkill, Kristine P Ng

Inflammatory myositis is a rare autoimmune disease that causes muscle weakness. Treatment usually involves use of high dose steroids and medications that modulate the immune system. Patients with IIM have a high risk of developing steroid induced related osteoporosis and lung infections.

SUMMARY

Antenatal screening for aneuploidy surveying the current situation and planning for non-invasive prenatal diagnosis in New Zealand

Ashley Eastwood, Dianne Webster, Juliet Taylor, Richard Mackay, Alison McEwen, Jan Sullivan, Rachel Pope-Couston, Peter Stone

New technology, called non-invasive prenatal testing (NIPT) is now available with markedly improved performance over previous methods of prenatal screening for chromosomal defects. The National Screening Unit (NSU) and the New Zealand Committee of RANZCOG collaborated on running 5 workshops for doctors and midwives around New Zealand. The workshops aimed to gauge clinical opinion about the current system and possible changes as well as providing a forum for education about Non-Invasive Prenatal Testing (NIPT). The NSU were informed from these workshops that over 60% of clinicians would support the introduction of NIPT in place of the current system. Issues of ensuring equity of availability and reducing barriers to prenatal screening were also highlighted in particular the costs of ultrasound scans in the current system as well as women s understanding the purpose of offering the screening tests.

SUMMARY

The changing paradigm of the doctor-patient relationship: Montgomery v Lanarkshire Health Board and developments in the ‘duty to warn’

Luke Sizer, Philip Arnold

The UK Supreme Court recently changed the standard of risk disclosure. While previously a doctor was not required to disclose a risk if a responsible body of medical doctors would also not have disclosed that risk, a doctor must now look at the patient before him or her and advise them of any risks that would be material to the patient s decision about whether to proceed with the course of treatment/intervention. This is the same as it has been in New Zealand.

SUMMARY

ABO blood group incompatible renal transplantation in New Zealand: a report of the first 20 cases

Enya Ho, Motohiko Yasutomi, Dhana Gounder, Ian Dittmer

We describe the first 20 blood group incompatible kidney transplants performed in New Zealand. We have achieved excellent transplant and patient short-term survival and this increases the options for treatment available to patients with end stage kidney failure.

SUMMARY

Urinalysis requests on the elderly residing in the Auckland community: tick box requesting?

Arlo Upton, M McEwan, Deborah Williamson

Requests for urine culture is common from elderly people. A significant portion of requests dont appear to be clinically indicated. Antibiotic prescription is common in elderly patients having urine culture requested. Widespread antibiotic use in the community can contribute to resistance.

ALL ARTICLES
SUMMARY

Outcomes of bone density measurements in coeliac disease

Mark J Bolland, Andrew Grey, David S Rowbotham

Gout in Aotearoa New Zealand: are we going to ignore this for another 3 years?

Nicola Dalbeth, Catherine Gerard, Peter Gow, Gary Jackson, Carl Shuker, Leanne Te Karu, Doone Winnard

Massive dilatation of the pulmonary arteries due to acute on chronic thromboembolic pulmonary hypertension

Hatice Kaya, Katherine Rider, Jalil Ahari

Medical examination of recruits

The risk of fall and fracture with the initiation of a prostate-selective α antagonist

Long-term follow-up of patients with idiopathic inflammatory myopathy at Waitemata District Health Board

Ramanamma Kalluru, Hamish Hart, Michael Corkill, Kristine P Ng

Marketing to children in New Zealand—the situation is seriously flawed

Sian Barry

Antenatal screening for aneuploidy surveying the current situation and planning for non-invasive prenatal diagnosis in New Zealand

Ashley Eastwood, Dianne Webster, Juliet Taylor, Richard Mackay, Alison McEwen, Jan Sullivan, Rachel Pope-Couston, Peter Stone

Ethnic counts on mortality, New Zealand Cancer Registry and census data: 2006 2011

Matt Boyd, June Atkinson, Tony Blakely

The changing paradigm of the doctor-patient relationship: Montgomery v Lanarkshire Health Board and developments in the ‘duty to warn’

Luke Sizer, Philip Arnold

Sharing Clinical Trial Data: A Proposal from the International Committee of Medical Journal Editors

Darren B Taichman, Joyce Backus, Christopher Baethge, Howard Bauchner, Peter W de Leeuw, Jeffrey M Drazen, John Fletcher, Frank Frizelle, Trish Groves, Abraham Haileamlak, Astrid James, Christine Laine, Larry Peiperl, Anja Pinborg, Peush Sahni, Sinan Wu

ABO blood group incompatible renal transplantation in New Zealand: a report of the first 20 cases

Enya Ho, Motohiko Yasutomi, Dhana Gounder, Ian Dittmer

Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre

Margaret Andre, Andrew S Day

Urinalysis requests on the elderly residing in the Auckland community: tick box requesting?

Arlo Upton, M McEwan, Deborah Williamson

SUMMARY

Outcomes of bone density measurements in coeliac disease

Mark J Bolland, Andrew Grey, David S Rowbotham

We identified 137 adults with coeliac disease who had a bone density scan over 5 years at Auckland District Health Board and Counties Manukau District Health Board. The average bone density was slightly lower than expected, but well within the normal range, and only a small proportion of patients (12%) had low bone density. Low bone density was strongly related to low body weight. These results suggest that bone density measurement is not indicated routinely in coeliac disease, but could be considered on a case-by-case basis for individuals with strong risk factors for fracture.

SUMMARY

Gout in Aotearoa New Zealand: are we going to ignore this for another 3 years?

Nicola Dalbeth, Catherine Gerard, Peter Gow, Gary Jackson, Carl Shuker, Leanne Te Karu, Doone Winnard

Gout is the most common form of inflammatory arthritis affecting adults, with up to 4.9% of the New Zealand population affected. It is severely painful, and causes inability to work and interact with family. The New Zealand Atlas of Healthcare Variation shows M1ori and Pacific people are disproportionately affected - nearly half of Pacific men and over a third of M1ori men over 65 years of age are identified as having gout, as compared with 16.5% of European and other men of the same age. Despite this, M1ori and Pacific people receive the recommended treatment, called allopurinol, less than other groups, and are more likely to be prescribed more toxic drugs like colchicine and non-steroidal anti-inflammatory drugs (NSAIDs) instead, which risk joint damage. The Atlas has been publishing these data for three years - why has nothing improved?

SUMMARY

Long-term follow-up of patients with idiopathic inflammatory myopathy at Waitemata District Health Board

Ramanamma Kalluru, Hamish Hart, Michael Corkill, Kristine P Ng

Inflammatory myositis is a rare autoimmune disease that causes muscle weakness. Treatment usually involves use of high dose steroids and medications that modulate the immune system. Patients with IIM have a high risk of developing steroid induced related osteoporosis and lung infections.

SUMMARY

Antenatal screening for aneuploidy surveying the current situation and planning for non-invasive prenatal diagnosis in New Zealand

Ashley Eastwood, Dianne Webster, Juliet Taylor, Richard Mackay, Alison McEwen, Jan Sullivan, Rachel Pope-Couston, Peter Stone

New technology, called non-invasive prenatal testing (NIPT) is now available with markedly improved performance over previous methods of prenatal screening for chromosomal defects. The National Screening Unit (NSU) and the New Zealand Committee of RANZCOG collaborated on running 5 workshops for doctors and midwives around New Zealand. The workshops aimed to gauge clinical opinion about the current system and possible changes as well as providing a forum for education about Non-Invasive Prenatal Testing (NIPT). The NSU were informed from these workshops that over 60% of clinicians would support the introduction of NIPT in place of the current system. Issues of ensuring equity of availability and reducing barriers to prenatal screening were also highlighted in particular the costs of ultrasound scans in the current system as well as women s understanding the purpose of offering the screening tests.

SUMMARY

The changing paradigm of the doctor-patient relationship: Montgomery v Lanarkshire Health Board and developments in the ‘duty to warn’

Luke Sizer, Philip Arnold

The UK Supreme Court recently changed the standard of risk disclosure. While previously a doctor was not required to disclose a risk if a responsible body of medical doctors would also not have disclosed that risk, a doctor must now look at the patient before him or her and advise them of any risks that would be material to the patient s decision about whether to proceed with the course of treatment/intervention. This is the same as it has been in New Zealand.

SUMMARY

ABO blood group incompatible renal transplantation in New Zealand: a report of the first 20 cases

Enya Ho, Motohiko Yasutomi, Dhana Gounder, Ian Dittmer

We describe the first 20 blood group incompatible kidney transplants performed in New Zealand. We have achieved excellent transplant and patient short-term survival and this increases the options for treatment available to patients with end stage kidney failure.

SUMMARY

Urinalysis requests on the elderly residing in the Auckland community: tick box requesting?

Arlo Upton, M McEwan, Deborah Williamson

Requests for urine culture is common from elderly people. A significant portion of requests dont appear to be clinically indicated. Antibiotic prescription is common in elderly patients having urine culture requested. Widespread antibiotic use in the community can contribute to resistance.

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