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Issue

Vol 129 No 1444: 28 October 2016

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Issue Summary

SUMMARY

Gynaecological cancer pathway for faster cancer treatment: a clinical audit

Catherine Askew, Anand Gangji

Gynaecological cancers make up 10% of female cancer deaths in New Zealand. The Ministry of Health has set up a Faster Cancer Treatment programme to set about timelines for patients through the cancer pathway. This audit shows that Northland gynaecological cancer patients are meeting target of treatment within 62 days from first referral in only 39% of patient cases. Improvements that are needed include appropriate modernised tracking of cancer patients, increased frequency of meetings for treatment planning, prioritising operating lists for cancer diagnosis and standards of care that equate realistically to the targets set by the Ministry. With these improvements we can hope to provide more timely access to care for the women of New Zealand.

SUMMARY

An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee

Sheena Hunt, Debra McNamara, Simon Stebbings

Artemisia annua is medicinal plant used in Traditional Chinese Medicine. Extracts from this plant are used as the treatment of choice for resistant malaria and are supported by the World Health Organization. In TCM, extracts are also used to treat arthritis. In this study we report the results of a study to assess whether an A. annua extract was a safe and effective therapy for osteoarthritis (OA) over a six-month period. This builds on an initial randomised controlled study showing it reduced pain in OA. Sustained benefit over this follow-up period was noted, and A. annua shows promise as a potential alternative to current medicines used to manage OA symptoms. The results of this extension study are encouraging, and further investigation is warranted.

SUMMARY

Antimicrobial resistance in New Zealand: the evidence and a call for action

Humphrey W Pullon, John Gommans, Mark G Thomas, Sarah Metcalf, Rebecca Grainger, Harriet Wild

Microorganisms (eg bacteria) are developing resistance to a range of antimicrobial drugs, including antibiotics: this is known as antimicrobial resistance (AMR). Standard treatments are now becoming ineffective, which increases the risk of adverse outcomes (including death) and the spread of the infection. AMR is increasing globally where poor sanitation, close contact between humans and animals and unregulated prescribing are common. In New Zealand, there is increasing resistance in infections caused by Staphylococcus aureus, Enterobacteriaceae (eg E. Coli) and Neisseria gonorrhoeae. These bacteria are common causes of infection, and may occur in hospital and community settings. New Zealand must prioritise a plan to prevent increasing AMR, which includes prescribing guidelines, antimicrobial stewardship programmes to promote optimal use of antibiotics and public health campaigns.

SUMMARY

Medical students experiences of practising medical procedures on patients, other students and themselves

Michelle Bai, Helen Nicholson, Kelby Smith-Han

This study examined different ways medical students learn invasive clinical procedures, such as taking blood, and suturing. The majority of students indicated positive experiences for learning invasive clinical procedures, which included practising on peers and patients. A small proportion, 5%, reported practising procedures on themselves. To assist with safe practise of invasive clinical procedures, clearer guidelines for how students should practise clinical procedures may be helpful.

SUMMARY

A morbidity/mortality analysis of a tertiary level upper gastrointestinal/hepatopancreaticobiliary surgical unit

Susrutha K Wickremesekera, Ho Beom (Sean) Seo, Mary-Anne Trimber, Simon Bann, Katherine Tse

Wellington s two-specialist surgeon, upper gastrointestinal/hepatopancreatico-biliary unit was established in 2006. Wellington is a relatively small volume centre. However, with a team approach to every patient, morbidity and mortality rates of patients following surgery have shown to be at acceptable rates when viewed alongside international standards.

SUMMARY

Prevalence of contraceptive use in New Zealand women

Jacqueline Chesang, Ann Richardson, John Potter, Mary Jane Sneyd, Pat Coope

A study of contraceptive use among New Zealand women aged 35-69 found that 89% of women have used oral contraceptives at some stage. The next most commonly used types of contraception were condoms and vasectomy. Over the last 25-30 years, ever-use of the pill and condoms has become more common. There has also been an increase in the ever-use of vasectomy, but a decline in female sterilisation.

SUMMARY

Traditional Chinese medicine practitioners in New Zealand: differences associated with being a practitioner in New Zealand compared to China

Asmita Patel, Vahideh Toossi

There has been an increase in the use of Traditional Chinese Medicine (TCM) based acupuncture in New Zealand. TCM is viewed as an alternative from of treatment by the general New Zealand population. Acupuncture is predominately used for pain management purposes. Acupuncture appears to be utilised by individuals from a number of different ethnic groups, reflecting the ethnic diversity of those who seek this type of treatment in New Zealand.

SUMMARY

Combating antimicrobial resistance demands nation-wide action and global governance

Scott Metcalfe, Michael G Baker, Joshua Freeman, Nick Wilson, Peter Murray

Antimicrobial resistance is a growing threat to global health and health systems everywhere. Curbing this threat demands both nation-wide action and strong international governance. The Royal Australasian College of Physicians, New Zealand College of Public Health Medicine and New Zealand Medical Association call for comprehensive, well-funded measures across New Zealand s veterinary medicine, agriculture, human community and healthcare settings. International action is needed in parallel with effective governance structures, rules and targets.

SUMMARY

Comparison of documentation of patient reported adverse drug reactions on both paper-based medication charts and electronic medication charts at a New Zealand hospital

Wilson Shen, Bernice Wong, Jessica Yi Ping Chin, Michael Lee, Carolyn Coulter, Rhiannon Braund

Many patients report that they have drug allergies. These allergies can alter the choice of treatments for patients. Accurate documentation of the type of reaction can determine what therapy choice is appropriate. This study found that while many patients reported allergies, documentation of the types of reactions was limited irrespective of whether paper or electronic charts were used and so it is challenging for prescribers to make the most informed decision. Better documentation of drug reactions will improve this problem.

ALL ARTICLES
SUMMARY

Junior doctors: towards a solution?

John Scott Werry

Gynaecological cancer pathway for faster cancer treatment: a clinical audit

Catherine Askew, Anand Gangji

An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee

Sheena Hunt, Debra McNamara, Simon Stebbings

Antimicrobial resistance in New Zealand: the evidence and a call for action

Humphrey W Pullon, John Gommans, Mark G Thomas, Sarah Metcalf, Rebecca Grainger, Harriet Wild

Apixaban versus enoxaparin in the prevention of venous thromboembolism following total knee arthroplasty

A Case of Leprosy in a Trooper of the 1st (N.Z.) Expeditionary Force (ex Samoa)

By J. T. Bowie, M.B., D.P.H., D.T.M., Clinical Registrar Otago University Medical School.

Medical students experiences of practising medical procedures on patients, other students and themselves

Michelle Bai, Helen Nicholson, Kelby Smith-Han

Ciguatera fish poisoning

Patrick Armstrong, Peter Murray, Annette Nesdale, Brad Peckler

A morbidity/mortality analysis of a tertiary level upper gastrointestinal/hepatopancreaticobiliary surgical unit

Susrutha K Wickremesekera, Ho Beom (Sean) Seo, Mary-Anne Trimber, Simon Bann, Katherine Tse

Prevalence of contraceptive use in New Zealand women

Jacqueline Chesang, Ann Richardson, John Potter, Mary Jane Sneyd, Pat Coope

Traditional Chinese medicine practitioners in New Zealand: differences associated with being a practitioner in New Zealand compared to China

Asmita Patel, Vahideh Toossi

Combating antimicrobial resistance demands nation-wide action and global governance

Scott Metcalfe, Michael G Baker, Joshua Freeman, Nick Wilson, Peter Murray

Comparison of documentation of patient reported adverse drug reactions on both paper-based medication charts and electronic medication charts at a New Zealand hospital

Wilson Shen, Bernice Wong, Jessica Yi Ping Chin, Michael Lee, Carolyn Coulter, Rhiannon Braund

Living up to our own standards in the care of women with gynaecological cancer

Peter Sykes

SUMMARY

Gynaecological cancer pathway for faster cancer treatment: a clinical audit

Catherine Askew, Anand Gangji

Gynaecological cancers make up 10% of female cancer deaths in New Zealand. The Ministry of Health has set up a Faster Cancer Treatment programme to set about timelines for patients through the cancer pathway. This audit shows that Northland gynaecological cancer patients are meeting target of treatment within 62 days from first referral in only 39% of patient cases. Improvements that are needed include appropriate modernised tracking of cancer patients, increased frequency of meetings for treatment planning, prioritising operating lists for cancer diagnosis and standards of care that equate realistically to the targets set by the Ministry. With these improvements we can hope to provide more timely access to care for the women of New Zealand.

SUMMARY

An open-label six-month extension study to investigate the safety and efficacy of an extract of Artemisia annua for managing pain, stiffness and functional limitation associated with osteoarthritis of the hip and knee

Sheena Hunt, Debra McNamara, Simon Stebbings

Artemisia annua is medicinal plant used in Traditional Chinese Medicine. Extracts from this plant are used as the treatment of choice for resistant malaria and are supported by the World Health Organization. In TCM, extracts are also used to treat arthritis. In this study we report the results of a study to assess whether an A. annua extract was a safe and effective therapy for osteoarthritis (OA) over a six-month period. This builds on an initial randomised controlled study showing it reduced pain in OA. Sustained benefit over this follow-up period was noted, and A. annua shows promise as a potential alternative to current medicines used to manage OA symptoms. The results of this extension study are encouraging, and further investigation is warranted.

SUMMARY

Antimicrobial resistance in New Zealand: the evidence and a call for action

Humphrey W Pullon, John Gommans, Mark G Thomas, Sarah Metcalf, Rebecca Grainger, Harriet Wild

Microorganisms (eg bacteria) are developing resistance to a range of antimicrobial drugs, including antibiotics: this is known as antimicrobial resistance (AMR). Standard treatments are now becoming ineffective, which increases the risk of adverse outcomes (including death) and the spread of the infection. AMR is increasing globally where poor sanitation, close contact between humans and animals and unregulated prescribing are common. In New Zealand, there is increasing resistance in infections caused by Staphylococcus aureus, Enterobacteriaceae (eg E. Coli) and Neisseria gonorrhoeae. These bacteria are common causes of infection, and may occur in hospital and community settings. New Zealand must prioritise a plan to prevent increasing AMR, which includes prescribing guidelines, antimicrobial stewardship programmes to promote optimal use of antibiotics and public health campaigns.

SUMMARY

Medical students experiences of practising medical procedures on patients, other students and themselves

Michelle Bai, Helen Nicholson, Kelby Smith-Han

This study examined different ways medical students learn invasive clinical procedures, such as taking blood, and suturing. The majority of students indicated positive experiences for learning invasive clinical procedures, which included practising on peers and patients. A small proportion, 5%, reported practising procedures on themselves. To assist with safe practise of invasive clinical procedures, clearer guidelines for how students should practise clinical procedures may be helpful.

SUMMARY

A morbidity/mortality analysis of a tertiary level upper gastrointestinal/hepatopancreaticobiliary surgical unit

Susrutha K Wickremesekera, Ho Beom (Sean) Seo, Mary-Anne Trimber, Simon Bann, Katherine Tse

Wellington s two-specialist surgeon, upper gastrointestinal/hepatopancreatico-biliary unit was established in 2006. Wellington is a relatively small volume centre. However, with a team approach to every patient, morbidity and mortality rates of patients following surgery have shown to be at acceptable rates when viewed alongside international standards.

SUMMARY

Prevalence of contraceptive use in New Zealand women

Jacqueline Chesang, Ann Richardson, John Potter, Mary Jane Sneyd, Pat Coope

A study of contraceptive use among New Zealand women aged 35-69 found that 89% of women have used oral contraceptives at some stage. The next most commonly used types of contraception were condoms and vasectomy. Over the last 25-30 years, ever-use of the pill and condoms has become more common. There has also been an increase in the ever-use of vasectomy, but a decline in female sterilisation.

SUMMARY

Traditional Chinese medicine practitioners in New Zealand: differences associated with being a practitioner in New Zealand compared to China

Asmita Patel, Vahideh Toossi

There has been an increase in the use of Traditional Chinese Medicine (TCM) based acupuncture in New Zealand. TCM is viewed as an alternative from of treatment by the general New Zealand population. Acupuncture is predominately used for pain management purposes. Acupuncture appears to be utilised by individuals from a number of different ethnic groups, reflecting the ethnic diversity of those who seek this type of treatment in New Zealand.

SUMMARY

Combating antimicrobial resistance demands nation-wide action and global governance

Scott Metcalfe, Michael G Baker, Joshua Freeman, Nick Wilson, Peter Murray

Antimicrobial resistance is a growing threat to global health and health systems everywhere. Curbing this threat demands both nation-wide action and strong international governance. The Royal Australasian College of Physicians, New Zealand College of Public Health Medicine and New Zealand Medical Association call for comprehensive, well-funded measures across New Zealand s veterinary medicine, agriculture, human community and healthcare settings. International action is needed in parallel with effective governance structures, rules and targets.

SUMMARY

Comparison of documentation of patient reported adverse drug reactions on both paper-based medication charts and electronic medication charts at a New Zealand hospital

Wilson Shen, Bernice Wong, Jessica Yi Ping Chin, Michael Lee, Carolyn Coulter, Rhiannon Braund

Many patients report that they have drug allergies. These allergies can alter the choice of treatments for patients. Accurate documentation of the type of reaction can determine what therapy choice is appropriate. This study found that while many patients reported allergies, documentation of the types of reactions was limited irrespective of whether paper or electronic charts were used and so it is challenging for prescribers to make the most informed decision. Better documentation of drug reactions will improve this problem.

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