Issue

Vol 130 No 1463: 6 October 2017

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Issue Summary

SUMMARY

The New Zealand Major Trauma Registry: the foundation for a data-driven approach in a contemporary trauma system

Siobhan Isles, Grant Christey, Ian Civil, Peter Hicks

The establishment of the New Zealand Trauma Registry means that for the first time we have the capability to understand the patterns of trauma and the impact this has on individuals, their family/whanau, and the cost to society. The NZ-MTR is an important tool to support a data-driven approach to trauma. This paper explores how the NZ-MTR was established and its potential to bring us in line with formal systems internationally.

SUMMARY

Acute abdominal pain changes in the way we assess it over a decade

Kirsten de Burlet, Anna Lam, Peter Larsen, Elizabeth Dennett

In this study we have reviewed the number of acute admissions for the general surgery department in Wellington Hospital and have focused on patients presenting with abdominal pain. Overall we can state that the number of surgical admissions over the last decade has nearly doubled and more patients are admitted with non-urgent or self-limiting problems. Also, more CT scans are requested for this patient group and a greater proportion of these scans come back negative for acute pathology.

SUMMARY

Slavery in New Zealand: What is the role of the health sector?

Paula King, Alison Blaiklock, Christina Stringer, Jay Amaranathan, Margot McLean

Slavery and its adverse health consequences is a serious, complex, and often hidden problem in New Zealand. We have endeavored to raise awareness about this neglected issue and highlight the numerous opportunities for doctors and other health practitioners to be leading advocates for change at government, health system and organisational levels. Responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.

SUMMARY

Characteristics of older adults hospitalised following trauma in the Midland region of New Zealand

Katrina O Leary, Bridget Kool, Grant Christey

This paper was designed to document the incidence of trauma in older adults within the Midland region of New Zealand. The findings show how older adults are injured, where they are injured and what their outcomes are (mortality, hospital length of stay, discharge destination from hospital, surgical procedures).

SUMMARY

An observational study of how clinicians use cardiovascular risk assessment to inform statin prescribing decisions

Thomas Robinson, Rod Jackson, Susan Wells, Andrew Kerr, Roger Marshall

Ninety percent of New Zealanders who are in the NZ Guidelines target group have had a CVD risk assessment. There is little information on how this information is used by doctors and their patients. The decision to start cholesterol lowering medications (statins) might be driven mainly by cholesterol levels, or (as NZ Guidelines suggest) by a comprehensive assessment of the person s overall risk. This paper suggests that the latter approach is more likely, but that the decision process is complex and takes into account other factors.

SUMMARY

New Zealand s peak year for wartime mortality burden: the important role of the Battles of Messines and Third Ypres (Passchendaele) in 1917

Nick Wilson, Glyn Harper

At a total of 5,547 deaths among New Zealand s military personnel, the year 1917 was the worst year from a mortality perspective in the country s military history. This year had a third of the deaths in the whole of the First World War for this military population. Major drivers of this mortality burden were the battles of Messines and Third Ypres (Passchendaele) in June and October 1917 respectively. The contribution of disease deaths to the mortality burden was relatively small at 4.5%. Disease deaths were significantly more common in the Northern Hemisphere s winter months, and some may have been related to crowding.

SUMMARY

Mesh abdominal wall hernia surgery is safe and effective the harm New Zealand media has done

Steven Kelly

Patients in New Zealand have now developed a fear of mesh abdominal wall hernia repair due to inaccurate media reporting. This article outlines the extensive literature that confirms abdominal wall mesh hernia repair is safe and effective. The worsening confidence in the transvaginal mesh prolapse repair should not adversely affect the good results of mesh abdominal wall hernia repair. New Zealand general surgeons are well trained in providing modern hernia surgery.

ALL ARTICLES
SUMMARY

The New Zealand Major Trauma Registry: the foundation for a data-driven approach in a contemporary trauma system

Siobhan Isles, Grant Christey, Ian Civil, Peter Hicks

Heart Foundation grants awarded July 2017

Acute abdominal pain changes in the way we assess it over a decade

Kirsten de Burlet, Anna Lam, Peter Larsen, Elizabeth Dennett

Slavery in New Zealand: What is the role of the health sector?

Paula King, Alison Blaiklock, Christina Stringer, Jay Amaranathan, Margot McLean

A Case of Scurvy

By WM. YOUNG, M.D., F.R.C.S.E.

Characteristics of older adults hospitalised following trauma in the Midland region of New Zealand

Katrina O Leary, Bridget Kool, Grant Christey

Book Review
Vol 130 No 1463: 6 October 2017

Not Our Problem

Frank Frizelle

This soft-covered 250-page book (with 246 references) is the work of Ian Cowan, a radiologist in Christchurch.

An observational study of how clinicians use cardiovascular risk assessment to inform statin prescribing decisions

Thomas Robinson, Rod Jackson, Susan Wells, Andrew Kerr, Roger Marshall

Holiday headache

Nicole McGrath

Book Review
Vol 130 No 1463: 6 October 2017

Governor William Hobson: his health problems and final illness

Yee Chen Lau

Captain William Hobson, our first governor, had a tumultuous year before his untimely death in 1842

New Zealand s peak year for wartime mortality burden: the important role of the Battles of Messines and Third Ypres (Passchendaele) in 1917

Nick Wilson, Glyn Harper

Risk of serious infections associated with use of immunosuppressive agents in pregnant women with autoimmune inflammatory conditions

Mesh abdominal wall hernia surgery is safe and effective the harm New Zealand media has done

Steven Kelly

SUMMARY

The New Zealand Major Trauma Registry: the foundation for a data-driven approach in a contemporary trauma system

Siobhan Isles, Grant Christey, Ian Civil, Peter Hicks

The establishment of the New Zealand Trauma Registry means that for the first time we have the capability to understand the patterns of trauma and the impact this has on individuals, their family/whanau, and the cost to society. The NZ-MTR is an important tool to support a data-driven approach to trauma. This paper explores how the NZ-MTR was established and its potential to bring us in line with formal systems internationally.

SUMMARY

Acute abdominal pain changes in the way we assess it over a decade

Kirsten de Burlet, Anna Lam, Peter Larsen, Elizabeth Dennett

In this study we have reviewed the number of acute admissions for the general surgery department in Wellington Hospital and have focused on patients presenting with abdominal pain. Overall we can state that the number of surgical admissions over the last decade has nearly doubled and more patients are admitted with non-urgent or self-limiting problems. Also, more CT scans are requested for this patient group and a greater proportion of these scans come back negative for acute pathology.

SUMMARY

Slavery in New Zealand: What is the role of the health sector?

Paula King, Alison Blaiklock, Christina Stringer, Jay Amaranathan, Margot McLean

Slavery and its adverse health consequences is a serious, complex, and often hidden problem in New Zealand. We have endeavored to raise awareness about this neglected issue and highlight the numerous opportunities for doctors and other health practitioners to be leading advocates for change at government, health system and organisational levels. Responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.

SUMMARY

Characteristics of older adults hospitalised following trauma in the Midland region of New Zealand

Katrina O Leary, Bridget Kool, Grant Christey

This paper was designed to document the incidence of trauma in older adults within the Midland region of New Zealand. The findings show how older adults are injured, where they are injured and what their outcomes are (mortality, hospital length of stay, discharge destination from hospital, surgical procedures).

SUMMARY

An observational study of how clinicians use cardiovascular risk assessment to inform statin prescribing decisions

Thomas Robinson, Rod Jackson, Susan Wells, Andrew Kerr, Roger Marshall

Ninety percent of New Zealanders who are in the NZ Guidelines target group have had a CVD risk assessment. There is little information on how this information is used by doctors and their patients. The decision to start cholesterol lowering medications (statins) might be driven mainly by cholesterol levels, or (as NZ Guidelines suggest) by a comprehensive assessment of the person s overall risk. This paper suggests that the latter approach is more likely, but that the decision process is complex and takes into account other factors.

SUMMARY

New Zealand s peak year for wartime mortality burden: the important role of the Battles of Messines and Third Ypres (Passchendaele) in 1917

Nick Wilson, Glyn Harper

At a total of 5,547 deaths among New Zealand s military personnel, the year 1917 was the worst year from a mortality perspective in the country s military history. This year had a third of the deaths in the whole of the First World War for this military population. Major drivers of this mortality burden were the battles of Messines and Third Ypres (Passchendaele) in June and October 1917 respectively. The contribution of disease deaths to the mortality burden was relatively small at 4.5%. Disease deaths were significantly more common in the Northern Hemisphere s winter months, and some may have been related to crowding.

SUMMARY

Mesh abdominal wall hernia surgery is safe and effective the harm New Zealand media has done

Steven Kelly

Patients in New Zealand have now developed a fear of mesh abdominal wall hernia repair due to inaccurate media reporting. This article outlines the extensive literature that confirms abdominal wall mesh hernia repair is safe and effective. The worsening confidence in the transvaginal mesh prolapse repair should not adversely affect the good results of mesh abdominal wall hernia repair. New Zealand general surgeons are well trained in providing modern hernia surgery.

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