Vol 132 No 1503: 4 October 2019

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Issue Summary

Article

SUMMARY

The interaction between pre-operative anaemia and peri-operative blood transfusion on patient outcomes following general surgical procedure: a retrospective review

Leesa J Morton, Katy L Konrad, Teresa (Jibin) Xu, Nicholas J Lightfoot

Anaemia is common in patients undergoing surgery. In this study we found that patients who are anaemic when they have their operation need to stay in hospital longer and are more likely to have infectious complications. Anaemic patients are also more likely to need blood transfusions, which further increases these risks. This highlights the importance of diagnosing and if possible treating anaemia before surgery.

Article

SUMMARY

Urinary and faecal incontinence: psychological factors and management recommendations

Kenley LJ Kuoch, Geoffrey S Hebbard, Helen E O Connell, David W Austin, Simon R Knowles

Urinary and faecal incontinence substantially impacts upon physical health and is associated with significant psychological distress and reduced quality of life. Due to stigma and embarrassment, many patients do not see their general practitioner (GP) for management of incontinence. This article aims to summarise the forms and causes of incontinence, highlight the psychological mechanisms associated with incontinence, and provide management recommendations for GPs.

Article

SUMMARY

Availability of automated external defibrillators in Hamilton, New Zealand

Peter A O Callaghan, Janice Swampillai, Martin K Stiles

The aim of this study was to visit 50 publicly listed defibrillators in Hamilton, New Zealand, to assess their true availability and visibility to the public in the event of an out-of-hospital cardiac arrest (OHCA). During office hours there is a reasonable number of accessible defibrillators, however access is limited outside office hours, with only 7% available 24 hours seven days a week, and few available after 6pm and on weekends. There are no outdoor automated external defibrillators (AEDs) available, with none of the AEDs listed clearly visible from the outside. Combined with the lack of signposting, there would be an inevitable delay in obtaining an AED in an OHCA.

Article

SUMMARY

The projected burden of knee osteoarthritis in New Zealand: healthcare expenditure and total joint replacement provision

Ross Wilson, J Haxby Abbott

Treatment of knee osteoarthritis cost the New Zealand healthcare system $200 million in 2013, an amount projected to increase to $370 million by 2038. If current standards of treatment remain unchanged, an additional 4,000 knee replacement surgeries per year will be needed by 2038. Public health measures to address the growing obesity epidemic and better use of effective, low-cost, early interventions for knee osteoarthritis, such as exercise therapy, are required to alleviate the rising burden of osteoarthritis.

Article

SUMMARY

Patient-reported quality of life for cataract surgery: prospective validation of the ˜Impact on Life and Catquest-9SF questionnaires in New Zealand

Sunny S Li, Stuti L Misra, Henry B Wallace, Lyn Hunt, James McKelvie

With limited resources for publicly funded surgery, prioritising patients for cataract surgery is essential to enable equal access to surgery for all New Zealand residents and ensure those who are most likely to benefit from surgery are prioritised highest. Currently, the prioritisation system incorporates use of the Impact on Life questionnaire (IoL), which we have found to not accurately assess vision-related quality of life (VRQoL) for patients that require cataract surgery in New Zealand. On the other hand, the Catquest-9SF questionnaire has been shown to be a domain-specific assessment tool that can accurately measure VRQoL in New Zealand, and has also been validated internationally.

Viewpoint

SUMMARY

Pelvic mesh in colorectal pelvic floor surgery—implications of recent developments

Rowan J Collinson, Andrew R Moot

The use of prosthetic mesh products in pelvic prolapse surgery is under significant scrutiny, because of widely reported adverse outcomes. However, the reasons why patients are recommended this type of surgery, and the surgical techniques used, vary between different surgical specialty groups. In the bowel surgery subspeciality ( colorectal surgery ), a mesh repair is sometimes recommended for bowel prolapse problems, which can cause functional problems such as loss of bowel control. The emergence of bowel mesh procedures has provided an extra treatment option, in some cases where a satisfactory treatment did not exist before. The available evidence suggests that bowel prolapse surgery using the mesh technique is much safer than that of the gynaecological approach and should not necessarily be dismissed without due consideration. However, there are recommendations relating to improved reporting, training and patient education around this procedure.

Article

SUMMARY

Infectious pulmonary tuberculosis in a New Zealand cancer centre

James Chancellor, Julianna Lees, Kate Grimwade, Neil de Wet, Lynnette Borissenko

This report details the investigation of cancer patients, as well as cancer centre staff, friends and family who were exposed to a cancer patient with reactivated tuberculosis (TB) in a New Zealand cancer centre. A total of 67 patients, staff members, family and friends were identified as being exposed to the case of TB. These people were screened for TB infection by the use of a symptom questionnaire, a blood test and a chest x-ray. Of the people tested no one was found to have acquired TB, but surveillance for signs and symptoms of TB disease in those with significant risk is ongoing. In this article we discuss the public health response to TB in a cancer centre and potential preventative strategies for the future.

Viewpoint

SUMMARY

Tailoring a rapid autopsy protocol to explore cancer evolution: a patient collaboration

Cherie Blenkiron, Tamsin Robb, Kate Parker, Nicole Kramer, Simon Stables, Rexson Tse, Lucy Modahl, Esther Coats, Cris Print, Ben Lawrence

The donation of a patient s body, upon their natural death, for research purposes is an invaluable gift. In our study we have shown the value of that donation to further our understanding of how a tumour can change and develop in order to spread around the body. In the paper we have highlighted the scientific value of the gift but also carefully considered the ongoing engagement with the family and the significant efforts needed to coordinate the process.

Article

SUMMARY

Mate wareware: Understanding ‘dementia’ from a Māori perspective

Margaret Dudley, Oliver Menzies, Hinemoa Elder, Lisa Nathan, Nick Garrett, Denise Wilson

This paper explains an understanding of mate wareware (dementia) as obtained from interviews with over 200 elderly Mori and whnau from across Aotearoa New Zealand. The issues of wairua (spirituality) and whnau (family) were central to the findings thereby indicating a need for culturally appropriate services for Mori who live with this disease. It was found that the burden of caregiving may be greater for Mori whnau and must be factored in when providing services for Mori. Generally, there was found to be a lack of easily accessible knowledge available to Mori regarding mate wareware.

Editorial