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Issue

Vol 129 No 1445: 18 November 2016

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Issue Summary

SUMMARY

Implementation of fracture liaison service in a New Zealand public hospital: Waitemata district health board experience

David Kim, Denise Mackenzie, Rick Cutfield

Fracture (broken bone) is a common and burdensome problem in our community, and doing appropriate tests and starting appropriate treatment, referred to as secondary fracture prevention, in those at high risk of more fractures can hugely reduce future fractures. Secondary prevention of fractures is poorly done in New Zealand and globally. Our study showed that highly effective secondary fracture prevention programme (Fracture Liaison Service) can be established in a New Zealand public hospital setting.

SUMMARY

A pioneer paediatrician in New Zealand Geoffrey Bruton Sweet

William J Sugrue, Patricia M Clarkson

An account of Dr Geoffrey Bruton Sweet, considered New Zealand's first specialist paediatrician. He was a powerful advocate for children, well read and interested in clinical research, and realised the need to communicate with those directly involved in the care of children. For New Zealand, he was a man ahead of his time.

SUMMARY

Improving accessibility to intravitreal anti-vascular endothelial growth factor treatment for ophthalmic patients in a peripheral centre

Verona Botha, John Ah-Chan, Nishan Ramachandran

There has been an exponential rise in patients requiring treatment with intravitreal injections for macular conditions. This includes conditions such as thewet form of age-related macular degeneration and diabetic macular oedema. A senior nurse-led clinic was established in Palmerston North to monitor these macular diseases. Analysis has shown that this has allowed the accessibility to treatment and follow up for macular conditions to remain stable, despite a large increase in the number of patients requiring these treatments and associated follow-up appointments.

SUMMARY

Detection of sudden death syndromes in New Zealand

Nikki Earle, Jackie Crawford, Kate Gibson, Donald Love, Ian Hayes, Katherine Neas, Martin Stiles, Mandy Graham, Tom Donoghue, Andrew Aitken, Jon Skinner

Sudden unexpected cardiac death in young people (aged 1-40) occurs at a rate of over 100 people per year in New Zealand. To date, we know that about one-third have a familial cause, and death can be prevented in these people, but they must first be detected in the community. This study shows that by screening family members of people who carry such a condition, with blood tests and heart tests, it is possible to detect large numbers of people at risk and offer them protection. It also shows that this is being done much better in the North Island than the South Island, because the South Island does not have anyone to coordinate the service and keep records. The authors argue that there is a pressing need for a South Island coordinator to address this inequity of service.

SUMMARY

Changes in high sensitivity troponin T in incident haemodialysis patients

Tze Liang Goh, Stefanie Honegger, Caroline Chembo, David Semple, Karishma Sidhu, Ralph Stewart, Helen Pilmore

Troponin is used as a marker of heart injury. Previous studies had shown that stable patients on long-term haemodialysis has chronically elevated and stabilised troponin levels. This paper shows that troponin levels decrease after the initiation of haemodialysis after a period of two to four months.

SUMMARY

Medicinal cannabis: moving the debate forward

Giles Newton-Howes, Sam McBride

There is an increase in the interest surrounding the application of cannabis for medical reasons, although doctors who would presumably prescribe are notably absent from this discussion to date. Cannabis has a long history of use by the medical fraternity and cannabis has clear psychoactive properties that could potentially be harnessed. The evidence of cannabis effectiveness are currently limited, however harms are well identified and this is a concern from a medical perspective. Doctors need to be engaged in the discussion of medical cannabis to move this debate forward.

SUMMARY

Hospital costs of Bordetella pertussis in New Zealand children

Anusha Ganeshalingham, Peter Reed, Cameron Grant, Brian Anderson, Emma Best, John Beca

Infants less than one year of age are more likely than older children to be admitted to hospital and the paediatric intensive care unit with whooping cough. This vulnerable group of children generate the bulk of hospitalisation costs. A revised focus on protecting this group of children include timely delivery of the primary immunisation schedule, booster doses of vaccination to adolescents and adults, maternal immunisation during pregnancy and providing a cocoon of protection around the baby by immunisation of immediate family and close relatives. This has the potential to reduce medical costs and improve health outcomes for infants with pertussis.

SUMMARY

Improving the use and timeliness of anticoagulation reversal for warfarin related intracranial haemorrhage

Carl Hanger, John Geddes, Tim Wilkinson, Michele Lee, Scott Pearson, Andrew Butler, Krishna Badami

Brain bleeds are a devastating form of stroke. If they occur while the person is taking anticoagulants, then this is a medical emergency. This paper reports the experience at Christchurch Hospital at changing the way, and the urgency that we reverse the bleeding tendency. The protocols developed have resulted in better (more complete) and faster reversal of the bleeding.

SUMMARY

Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide

Richard Beasley, Robert J Hancox, Matire Harwood, Kyle Perrin, Betty Poot, Janine Pilcher, Jim Reid, Api Talemaitoga, Darmiga Thayabaran

The New Zealand Adult Asthma Guidelines, published in the New Zealand Medical Journal, provide health professionals who deliver asthma care with simple, practical and evidence-based guidance for the diagnosis and treatment of asthma in adults. Prior to this project, New Zealand s asthma guidelines had not been updated since 2002. The new guidelines align the latest research with specific information for the New Zealand context including valuable medications and relevant content for treating Mori and Pacific adults with asthma. Implementing the guidelines nationwide will mean all asthma patients will have the opportunity to receive the same level of care and up-to-date information.

ALL ARTICLES
SUMMARY

Implementation of fracture liaison service in a New Zealand public hospital: Waitemata district health board experience

David Kim, Denise Mackenzie, Rick Cutfield

A pioneer paediatrician in New Zealand Geoffrey Bruton Sweet

William J Sugrue, Patricia M Clarkson

Improving accessibility to intravitreal anti-vascular endothelial growth factor treatment for ophthalmic patients in a peripheral centre

Verona Botha, John Ah-Chan, Nishan Ramachandran

Detection of sudden death syndromes in New Zealand

Nikki Earle, Jackie Crawford, Kate Gibson, Donald Love, Ian Hayes, Katherine Neas, Martin Stiles, Mandy Graham, Tom Donoghue, Andrew Aitken, Jon Skinner

A cure for asthma

Lutz Beckert, Ying-Tung Liu

Mitral stenosis with smoking mitral valve

Animesh Mishra, Manish Kapoor, Tony Ete, Gaurav Kavi, Pravin Jha, Rondeep Nath Sivam

Changes in high sensitivity troponin T in incident haemodialysis patients

Tze Liang Goh, Stefanie Honegger, Caroline Chembo, David Semple, Karishma Sidhu, Ralph Stewart, Helen Pilmore

New Zealand students at the front

By D. COLQUHOUN, M.D., Otago University.

Medicinal cannabis: moving the debate forward

Giles Newton-Howes, Sam McBride

Hospital costs of Bordetella pertussis in New Zealand children

Anusha Ganeshalingham, Peter Reed, Cameron Grant, Brian Anderson, Emma Best, John Beca

Improving the use and timeliness of anticoagulation reversal for warfarin related intracranial haemorrhage

Carl Hanger, John Geddes, Tim Wilkinson, Michele Lee, Scott Pearson, Andrew Butler, Krishna Badami

Life threatening torsades de pointes due to abiraterone-induced hypokaelemia in a patient with metastatic prostate cancer

Afrasyab Khan, Barry Kneale

Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide

Richard Beasley, Robert J Hancox, Matire Harwood, Kyle Perrin, Betty Poot, Janine Pilcher, Jim Reid, Api Talemaitoga, Darmiga Thayabaran

SUMMARY

Implementation of fracture liaison service in a New Zealand public hospital: Waitemata district health board experience

David Kim, Denise Mackenzie, Rick Cutfield

Fracture (broken bone) is a common and burdensome problem in our community, and doing appropriate tests and starting appropriate treatment, referred to as secondary fracture prevention, in those at high risk of more fractures can hugely reduce future fractures. Secondary prevention of fractures is poorly done in New Zealand and globally. Our study showed that highly effective secondary fracture prevention programme (Fracture Liaison Service) can be established in a New Zealand public hospital setting.

SUMMARY

A pioneer paediatrician in New Zealand Geoffrey Bruton Sweet

William J Sugrue, Patricia M Clarkson

An account of Dr Geoffrey Bruton Sweet, considered New Zealand's first specialist paediatrician. He was a powerful advocate for children, well read and interested in clinical research, and realised the need to communicate with those directly involved in the care of children. For New Zealand, he was a man ahead of his time.

SUMMARY

Improving accessibility to intravitreal anti-vascular endothelial growth factor treatment for ophthalmic patients in a peripheral centre

Verona Botha, John Ah-Chan, Nishan Ramachandran

There has been an exponential rise in patients requiring treatment with intravitreal injections for macular conditions. This includes conditions such as thewet form of age-related macular degeneration and diabetic macular oedema. A senior nurse-led clinic was established in Palmerston North to monitor these macular diseases. Analysis has shown that this has allowed the accessibility to treatment and follow up for macular conditions to remain stable, despite a large increase in the number of patients requiring these treatments and associated follow-up appointments.

SUMMARY

Detection of sudden death syndromes in New Zealand

Nikki Earle, Jackie Crawford, Kate Gibson, Donald Love, Ian Hayes, Katherine Neas, Martin Stiles, Mandy Graham, Tom Donoghue, Andrew Aitken, Jon Skinner

Sudden unexpected cardiac death in young people (aged 1-40) occurs at a rate of over 100 people per year in New Zealand. To date, we know that about one-third have a familial cause, and death can be prevented in these people, but they must first be detected in the community. This study shows that by screening family members of people who carry such a condition, with blood tests and heart tests, it is possible to detect large numbers of people at risk and offer them protection. It also shows that this is being done much better in the North Island than the South Island, because the South Island does not have anyone to coordinate the service and keep records. The authors argue that there is a pressing need for a South Island coordinator to address this inequity of service.

SUMMARY

Changes in high sensitivity troponin T in incident haemodialysis patients

Tze Liang Goh, Stefanie Honegger, Caroline Chembo, David Semple, Karishma Sidhu, Ralph Stewart, Helen Pilmore

Troponin is used as a marker of heart injury. Previous studies had shown that stable patients on long-term haemodialysis has chronically elevated and stabilised troponin levels. This paper shows that troponin levels decrease after the initiation of haemodialysis after a period of two to four months.

SUMMARY

Medicinal cannabis: moving the debate forward

Giles Newton-Howes, Sam McBride

There is an increase in the interest surrounding the application of cannabis for medical reasons, although doctors who would presumably prescribe are notably absent from this discussion to date. Cannabis has a long history of use by the medical fraternity and cannabis has clear psychoactive properties that could potentially be harnessed. The evidence of cannabis effectiveness are currently limited, however harms are well identified and this is a concern from a medical perspective. Doctors need to be engaged in the discussion of medical cannabis to move this debate forward.

SUMMARY

Hospital costs of Bordetella pertussis in New Zealand children

Anusha Ganeshalingham, Peter Reed, Cameron Grant, Brian Anderson, Emma Best, John Beca

Infants less than one year of age are more likely than older children to be admitted to hospital and the paediatric intensive care unit with whooping cough. This vulnerable group of children generate the bulk of hospitalisation costs. A revised focus on protecting this group of children include timely delivery of the primary immunisation schedule, booster doses of vaccination to adolescents and adults, maternal immunisation during pregnancy and providing a cocoon of protection around the baby by immunisation of immediate family and close relatives. This has the potential to reduce medical costs and improve health outcomes for infants with pertussis.

SUMMARY

Improving the use and timeliness of anticoagulation reversal for warfarin related intracranial haemorrhage

Carl Hanger, John Geddes, Tim Wilkinson, Michele Lee, Scott Pearson, Andrew Butler, Krishna Badami

Brain bleeds are a devastating form of stroke. If they occur while the person is taking anticoagulants, then this is a medical emergency. This paper reports the experience at Christchurch Hospital at changing the way, and the urgency that we reverse the bleeding tendency. The protocols developed have resulted in better (more complete) and faster reversal of the bleeding.

SUMMARY

Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide

Richard Beasley, Robert J Hancox, Matire Harwood, Kyle Perrin, Betty Poot, Janine Pilcher, Jim Reid, Api Talemaitoga, Darmiga Thayabaran

The New Zealand Adult Asthma Guidelines, published in the New Zealand Medical Journal, provide health professionals who deliver asthma care with simple, practical and evidence-based guidance for the diagnosis and treatment of asthma in adults. Prior to this project, New Zealand s asthma guidelines had not been updated since 2002. The new guidelines align the latest research with specific information for the New Zealand context including valuable medications and relevant content for treating Mori and Pacific adults with asthma. Implementing the guidelines nationwide will mean all asthma patients will have the opportunity to receive the same level of care and up-to-date information.

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