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Issue

Vol 129 No 1433: 22 April 2016

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Issue Summary

SUMMARY

New Zealand Health Survey 2012/13: characteristics of medicinal cannabis users

Megan J Pledger, Greg Martin, Jacqueline Cumming

This paper uses the New Zealand Health Survey 2012/13 to estimate the proportion of the New Zealand population aged 15 years and older who report that they use cannabis to treat a medical condition. It compares people who use cannabis for medicinal reasons with people who use cannabis solely for non-medicinal reasons across demographic factors to give an idea of the characteristics of medicinal cannabis users. It looks at what medical conditions medicinal users of cannabis report that they use cannabis to treat, and compares how likely medicinal and non-medicinal users of cannabis report physical harm, and harm to their mental health, from using cannabis.

SUMMARY

Achalasia: a 13-year, single-centre experience comparing endoscopic balloon dilatation and laparoscopic Heller myotomy

Alexander Huelsen, Ramadan Oumer, Anna Ashcroft, Ross H Roberts, Grant N Coulter, Steven J Kelly, Murray L Barclay

Achalasia is a rare non-curable disorder of the oesophagus causing severe difficulties with swallowing. The two most established long-term treatment options are a surgical intervention (laparoscopic Heller myotomy) and an endoscopic method (balloon dilatation). This study aimed to compare the outcome of both therapies and the risk of serious complications in a single-centre series. Such data may be useful in guiding and supporting decision-making in local practice. The results of this study revealed that both therapies were safe and appeared to be similarly effective treatments for achalasia. Furthermore the results were also comparable to international outcome and safety data.

SUMMARY

Influence of law changes affecting synthetic cannabinoid availability and frequency of hospital presentations: 4-year national survey

Paul Glue, Julie Courts, Andrew Gray, Tess Patterson

Synthetic cannabinoids (SC) such as Kronic and K2 are associated with a range of toxicities that often lead to hospital assessment. There were three law changes in New Zealand between 2011 and 2014 that affected availability of these drugs. On each occasion, these led to substantial decreases in hospital presentations associated with SC use.

SUMMARY

Child abuse in Australian camps whose business, and who should speak out?

Ian Hassall, Scott Metcalfe, Alison Blaiklock

The Australian government has interned asylum seekers including children in camps on Nauru and elsewhere. The Australian Human Rights Commission, medical profession organisations and others have condemned the practice because it is abusive of children. Physical, emotional and sexual abuse and self-harm of children has been reported. Yet Australian law now bars doctors in the camps from speaking out. Doctors in New Zealand, as anywhere, are bound by our ethical code to oppose practices such as the harm to children and others in the camps; and we oppose their doctors being gagged.

SUMMARY

Clinical utility and outcome analysis of faecal calprotectin in Hawkes Bay District Health Board

Wayne Bai, Thomas Boswell

IBS (irritable bowel syndrome) is a common condition affecting 10-20% of patients in the Western World and it is reported to be one of the top 10 reasons for general practitioner (GP) visits. To differentiate patients with IBS from inflammatory bowel disease (IBD) patients and also to detect flare of flare of disease in known IBD patients makes up a significant proportion of workload in the gastroenterology outpatients workload. Colonoscopy is the investigation in both these clinical situations, but it is resource intensive and it has its procedural risks. Hence, the use of faecal calprotectin (FCP) to effectively screen for patients with IBS from active IBD patients and to identify those with a flare of disease in known IBD patients is an effective way to reduce demand for colonoscopy. This local study at Hawkes Bay District Health Board (HBDHB) confirms its effectiveness and the results are consistent with international studies.

SUMMARY

The costs of elective and emergency abdominal aortic aneurysm repair: a comparative single centre study

Kevin Niall Peek, Manar Khashram, J Elisabeth Wells, Justin A Roake

Over a 3-year period at a tertiary hospital in the South Island, 217 patients presented with a large abdominal aortic aneurysm (AAA) for an arranged repair or with a rupture. On average, repairing a rupture AAA was ~11,000 NZD more expensive than arranged AAA repairs. The costs difference was primarily due to blood products used and when excluding patients that died within 4 days from rupture, the costs difference was ~17,000 NZD. Bearing this in mind, the costs incurred treating rupture AAA can be used to support the case for an AAA national screening program; a well-established and cost-effective program.

SUMMARY

After the legalisation of cannabis: the Cannabis Incorporated Society (CIS) regulatory model for recreational cannabis in New Zealand

Chris Wilkins

There is a growing appetite around the world for cannabis law reform, but this desire for change does not need to involve profit-driven commercial markets like we have for alcohol and tobacco. We propose the establishment of not-for-profit Cannabis Incorporated Societies (CIS) who will sell approved cannabis products to members only. CIS will have a number of statutory health objectives including providing information on the health risks of cannabis use, increasing awareness of local drug treatment and counselling services, preventing cannabis use by minors, and minimising cannabis dependency. CIS will only sell approved healthier cannabis products such as edibles or cannabis suitable for vaporising, with a maximum THC level and minimum CBD level. The government will be the sole producer of cannabis products and will only sell to licensed CIS. The tax revenue from these sales will be used to fund drug treatment, counselling and other health services.

SUMMARY

Pertussis control strategies: A consistent approach for New Zealand. Synopsis of Ministry of Health Workshop, April 2015

Mary Nowlan, Nikki Turner, Tomasz Kiedrzynski, Diana Murfitt, Nina Sawicki

Pertussis, commonly known as whooping cough, is a very serious and highly contagious disease, particularly for infants too young to be immunised. New Zealand experiences pertussis epidemics every 3 to 5 years, during which hundreds of infants are hospitalised who often require intensive care. The Ministry of Health held a workshop in 2015 that reviewed the current pertussis control strategies and immunisation coverage. The workshop concluded that although great improvements continue to be made in immunisation coverage, further work is required to encourage uptake of whooping cough vaccine during pregnancy to protect newborn babies and for infants, especially Mori and the most deprived, to be vaccinated on time.

ALL ARTICLES
SUMMARY

New Zealand Health Survey 2012/13: characteristics of medicinal cannabis users

Megan J Pledger, Greg Martin, Jacqueline Cumming

Achalasia: a 13-year, single-centre experience comparing endoscopic balloon dilatation and laparoscopic Heller myotomy

Alexander Huelsen, Ramadan Oumer, Anna Ashcroft, Ross H Roberts, Grant N Coulter, Steven J Kelly, Murray L Barclay

Hermaphrodism

Influence of law changes affecting synthetic cannabinoid availability and frequency of hospital presentations: 4-year national survey

Paul Glue, Julie Courts, Andrew Gray, Tess Patterson

Child abuse in Australian camps whose business, and who should speak out?

Ian Hassall, Scott Metcalfe, Alison Blaiklock

Clinical utility and outcome analysis of faecal calprotectin in Hawkes Bay District Health Board

Wayne Bai, Thomas Boswell

The costs of elective and emergency abdominal aortic aneurysm repair: a comparative single centre study

Kevin Niall Peek, Manar Khashram, J Elisabeth Wells, Justin A Roake

Cannabis in New Zealand: smoking gun or medicalised smokescreen?

Giles Newton-Howes, Sam McBride

Efficacy and safety of betahistine treatment in patients with Meniere s disease

After the legalisation of cannabis: the Cannabis Incorporated Society (CIS) regulatory model for recreational cannabis in New Zealand

Chris Wilkins

Pertussis control strategies: A consistent approach for New Zealand. Synopsis of Ministry of Health Workshop, April 2015

Mary Nowlan, Nikki Turner, Tomasz Kiedrzynski, Diana Murfitt, Nina Sawicki

Eric Charles Parr

Ron Jones and David Ansell

SUMMARY

New Zealand Health Survey 2012/13: characteristics of medicinal cannabis users

Megan J Pledger, Greg Martin, Jacqueline Cumming

This paper uses the New Zealand Health Survey 2012/13 to estimate the proportion of the New Zealand population aged 15 years and older who report that they use cannabis to treat a medical condition. It compares people who use cannabis for medicinal reasons with people who use cannabis solely for non-medicinal reasons across demographic factors to give an idea of the characteristics of medicinal cannabis users. It looks at what medical conditions medicinal users of cannabis report that they use cannabis to treat, and compares how likely medicinal and non-medicinal users of cannabis report physical harm, and harm to their mental health, from using cannabis.

SUMMARY

Achalasia: a 13-year, single-centre experience comparing endoscopic balloon dilatation and laparoscopic Heller myotomy

Alexander Huelsen, Ramadan Oumer, Anna Ashcroft, Ross H Roberts, Grant N Coulter, Steven J Kelly, Murray L Barclay

Achalasia is a rare non-curable disorder of the oesophagus causing severe difficulties with swallowing. The two most established long-term treatment options are a surgical intervention (laparoscopic Heller myotomy) and an endoscopic method (balloon dilatation). This study aimed to compare the outcome of both therapies and the risk of serious complications in a single-centre series. Such data may be useful in guiding and supporting decision-making in local practice. The results of this study revealed that both therapies were safe and appeared to be similarly effective treatments for achalasia. Furthermore the results were also comparable to international outcome and safety data.

SUMMARY

Influence of law changes affecting synthetic cannabinoid availability and frequency of hospital presentations: 4-year national survey

Paul Glue, Julie Courts, Andrew Gray, Tess Patterson

Synthetic cannabinoids (SC) such as Kronic and K2 are associated with a range of toxicities that often lead to hospital assessment. There were three law changes in New Zealand between 2011 and 2014 that affected availability of these drugs. On each occasion, these led to substantial decreases in hospital presentations associated with SC use.

SUMMARY

Child abuse in Australian camps whose business, and who should speak out?

Ian Hassall, Scott Metcalfe, Alison Blaiklock

The Australian government has interned asylum seekers including children in camps on Nauru and elsewhere. The Australian Human Rights Commission, medical profession organisations and others have condemned the practice because it is abusive of children. Physical, emotional and sexual abuse and self-harm of children has been reported. Yet Australian law now bars doctors in the camps from speaking out. Doctors in New Zealand, as anywhere, are bound by our ethical code to oppose practices such as the harm to children and others in the camps; and we oppose their doctors being gagged.

SUMMARY

Clinical utility and outcome analysis of faecal calprotectin in Hawkes Bay District Health Board

Wayne Bai, Thomas Boswell

IBS (irritable bowel syndrome) is a common condition affecting 10-20% of patients in the Western World and it is reported to be one of the top 10 reasons for general practitioner (GP) visits. To differentiate patients with IBS from inflammatory bowel disease (IBD) patients and also to detect flare of flare of disease in known IBD patients makes up a significant proportion of workload in the gastroenterology outpatients workload. Colonoscopy is the investigation in both these clinical situations, but it is resource intensive and it has its procedural risks. Hence, the use of faecal calprotectin (FCP) to effectively screen for patients with IBS from active IBD patients and to identify those with a flare of disease in known IBD patients is an effective way to reduce demand for colonoscopy. This local study at Hawkes Bay District Health Board (HBDHB) confirms its effectiveness and the results are consistent with international studies.

SUMMARY

The costs of elective and emergency abdominal aortic aneurysm repair: a comparative single centre study

Kevin Niall Peek, Manar Khashram, J Elisabeth Wells, Justin A Roake

Over a 3-year period at a tertiary hospital in the South Island, 217 patients presented with a large abdominal aortic aneurysm (AAA) for an arranged repair or with a rupture. On average, repairing a rupture AAA was ~11,000 NZD more expensive than arranged AAA repairs. The costs difference was primarily due to blood products used and when excluding patients that died within 4 days from rupture, the costs difference was ~17,000 NZD. Bearing this in mind, the costs incurred treating rupture AAA can be used to support the case for an AAA national screening program; a well-established and cost-effective program.

SUMMARY

After the legalisation of cannabis: the Cannabis Incorporated Society (CIS) regulatory model for recreational cannabis in New Zealand

Chris Wilkins

There is a growing appetite around the world for cannabis law reform, but this desire for change does not need to involve profit-driven commercial markets like we have for alcohol and tobacco. We propose the establishment of not-for-profit Cannabis Incorporated Societies (CIS) who will sell approved cannabis products to members only. CIS will have a number of statutory health objectives including providing information on the health risks of cannabis use, increasing awareness of local drug treatment and counselling services, preventing cannabis use by minors, and minimising cannabis dependency. CIS will only sell approved healthier cannabis products such as edibles or cannabis suitable for vaporising, with a maximum THC level and minimum CBD level. The government will be the sole producer of cannabis products and will only sell to licensed CIS. The tax revenue from these sales will be used to fund drug treatment, counselling and other health services.

SUMMARY

Pertussis control strategies: A consistent approach for New Zealand. Synopsis of Ministry of Health Workshop, April 2015

Mary Nowlan, Nikki Turner, Tomasz Kiedrzynski, Diana Murfitt, Nina Sawicki

Pertussis, commonly known as whooping cough, is a very serious and highly contagious disease, particularly for infants too young to be immunised. New Zealand experiences pertussis epidemics every 3 to 5 years, during which hundreds of infants are hospitalised who often require intensive care. The Ministry of Health held a workshop in 2015 that reviewed the current pertussis control strategies and immunisation coverage. The workshop concluded that although great improvements continue to be made in immunisation coverage, further work is required to encourage uptake of whooping cough vaccine during pregnancy to protect newborn babies and for infants, especially Mori and the most deprived, to be vaccinated on time.

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