Vol 134 No 1544: 22 October

Eliminating congenital syphilis from Aotearoa New Zealand

We all recognise the “aha” moment in the congenital syphilis case reported in this issue of the New Zealand Medical Journal, when “a subtle desquamating rash on the soles was noted and urgent treponemal serology requested,” which led to a successful clinical outcome for this whānau.

Non-traumatic dental presentations at emergency departments in New Zealand

Long patient stays and overcrowding at New Zealand emergency departments (EDs), a situation that appears to be worsening with time, may jeopardise timely access to quality care for acute conditions.

“Not a perfect situation, but...” A single-practice survey of patient experience of phone consultations during COVID-19 Alert Level 4 in New Zealand | OPEN ACCESS

Virtual consultations by telephone or video in general practice settings, enabled by smart-phone and video-conferencing technology, have become more common over recent years.

A survey of the smokefree status of pedestrian-only spaces in 10 New Zealand local government areas

One mechanism to make progress towards reducing the enormous health burden from tobacco smoking is to expand smokefree public areas.

The effect of perioperative sustained-release opioid use on long-term opioid dispensing following total knee arthroplasty: a retrospective cohort study

Opioid analgesics such as morphine or oxycodone are commonly prescribed for the treatment of acute postoperative pain. There is concern that inappropriate opioid prescribing following discharge can lead to prolonged opioid use in the community.

Effectiveness and risk assessment of non-contact respiratory radiology meeting

As awareness of lung cancer has increased, there has been an increasing trend in referrals to the respiratory specialist service for abnormal imaging reports by both primary care physicians and other healthcare professionals within secondary care.

Evaluating diabetes care quality improvement strategies used by clinical teams in five primary care practices in New Zealand

Despite the rapid growth of evidence on quality improvement (QI) strategies for improving diabetes care, much research has focused on single strategies, whereas, in typical practice, multiple strategies are used concurrently.

Using a randomised controlled trial to test the effectiveness of social norms feedback to reduce antibiotic prescribing without increasing inequities

In 2020, the World Health Organization (WHO) described antimicrobial resistance (AMR) accelerated by misuse and overuse of antibiotics as “one of the biggest threats to global health, food security, and development today.”

Celebrating a decade of the minor operations clinic: an approach at a regional New Zealand hospital

Minor surgical procedures place a significant cost burden on the New Zealand healthcare system because we are a country with one of the highest rates of skin cancer in the world.

Using REACH, a new modelling and forecasting tool, to understand the delay and backlog effects of COVID-19 on New Zealand’s health system | OPEN ACCESS

New Zealand’s 2020 response to the rise and spread of COVID-19 has rightly been widely praised. However, as in all countries, the unintended effects of measures to control the pandemic on the operation of our health system are potentially dramatic.

Whakarongorau Aotearoa: insight into the delivery of New Zealand’s national telehealth services

Whakarongorau Aotearoa/New Zealand Telehealth Services (Whakarongorau Aotearoa) responded to more than 1.2 million contacts during the 2020 calendar year (an increase of 41% on the previous year) and connected with more than 790,000 individual people across Aotearoa, approximately 1 in 6.5 New Zealanders.

Prevention is better than a cure: we can do better in skin cancer control in New Zealand!

Every day more than 250 New Zealanders are told that they have a skin cancer, and each week about ten die as a result. Urgent societal efforts are needed to curb this epidemic of the most prevalent cancer in Aotearoa New Zealand.

The End of Life Choice Act: a proposed implementation and research agenda

The purpose of this article is to examine the critical challenges for implementing the End of Life Choice Act 2019 (henceforth the EoLC Act or the Act) in New Zealand and to identify key future research needs.

Antimicrobial stewardship in human healthcare in Aotearoa New Zealand: urgent call for national leadership and co-ordinated efforts to preserve antimicrobial effectiveness | OPEN ACCESS

Antimicrobial resistance (AMR) is an immense threat to human health. Within 30 years, the global number of deaths from AMR-associated infections is predicted to increase from ~700,000 to ~10 million people annually, if we do not act now.

A case of congenital syphilis: the alarming and inequitable rise in congenital syphilis in Aotearoa and a call to action

A 2,400g male infant was born to a multiparous New Zealand Māori woman in the upper North Island following spontaneous onset of labour at approximately 36 weeks gestation. The pregnancy was not recognised until 24 weeks gestation, resulting in incomplete antenatal screening.

From left to right: an unusual presentation of Tolosa-Hunt syndrome with bilateral eye involvement

Tolosa-Hunt syndrome (THS) is an uncommon clinical syndrome characterised by painful ophthalmoplegia caused by an idiopathic granulomatous inflammatory process of the cavernous sinus.

Non-pharmaceutical interventions targeting COVID-19 were associated with large reductions in community antibiotic dispensing but no increase in severe morbidity from severe common bacterial infections

New Zealand’s public health response to the pandemic resulted in the elimination of COVID-19 and large reductions in the circulation of many common respiratory viruses and some bacterial pathogens, such as S. pneumoniae. We recently reported a large reduction in community antibiotic dispensing in New Zealand.

Anti-vax inactivity

As a retired GP, I am sad to realise that I am embarrassed by the apparent inability of our professional bodies to respond to the anti-vax doctors in our midst.

Response to: COVID-19: what comes after elimination?

The authors of the editorial COVID-19: what comes after elimination? deserve congratulations for writing a well-articulated, thoughtful and perhaps one of best “think pieces” from a multi-disciplinary perspective on what may happen as the country moves away from a strict COVID-19 elimination strategy to a strategy reliant on “zero tolerance for COVID-19 deaths.”

Two Cases of Laminectomy

These cases make an interesting comparison, because, though very similar in symptoms and subjected to the same treatment, they were paradoxical, both in morbid anatomy and results.

Abstracts for the 258th Otago Medical School Research Society Research Staff Speaker Awards, Wednesday 23 June 2021