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Issue

Vol 135 No 1560: 19 August 2022

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Issue Summary

Clinical Correspondence

SUMMARY

Multisystem inflammatory syndrome following mild COVID-19 in an unvaccinated Tongan adult

Tim Cutfield, Yousif Saeed, Amanda Taylor, Tim Askelund, Rob Bevan, Niels van Pelt

Multisystem inflammatory syndrome is a rare complication of COVID-19 that affects adults (MIS-A) less commonly than children (MIS-C), and can cause severe illness with high fevers and organ dysfunction, particularly of the heart. Thankfully, this rare illness is even less common in vaccinated people, and in people infected with the Omicron variant of the SARS-CoV-2 virus. This case report describes in detail the first case of MIS-A in New Zealand, and provides insight for clinicians caring for similar patients in the future.

Viewpoint

SUMMARY

The 2021 Global Health Security (GHS) Index: Aotearoa New Zealand’s improving capacity to manage biological threats must now be consolidated

Matt Boyd, Michael G Baker, Cassidy Nelson, Nick Wilson

The Global Health Security (GHS) Index measures how ready countries are to deal with biological threats such as pandemics. The 2021 iteration of the Index finds that the world remains highly vulnerable to these threats. However, the Index identifies New Zealand as one country that has improved its resilience in the last two years, and gains should now be consolidated. Ideally New Zealand would develop a World Health Organization National Action Plan for Health Security.

Article

SUMMARY

Psychiatric hospitalisation before and after commencing long-acting injectable antipsychotic medication: a mirror-image study

Marella Bedggood, Shirley Walton, Mayan Bedggood

Our study looked at a cohort of patients that had a diagnosis of a psychotic disorder (such as schizophrenia) or bipolar disorder and began treatment with a long-acting injectable antipsychotic medication. We compared the amount of time that these patients spent in psychiatric hospital before and after starting this form of treatment. We found that, on average, patients spent less time in hospital after they started treatment with the injectable medication. Long-acting medication could be a more effective treatment method for many patients, therefore reducing the amount of time that they spend hospitalised which is often an indicator of relapse of illness and is disruptive to their lives.

Article

SUMMARY

Trauma teams in Aotearoa New Zealand—a national survey

Rohan Lynham, Matthew McGuinness, Christopher Harmston

A multidisciplinary trauma team is common in regional and tertiary trauma hospitals across New Zealand. They are composed of approximately 10 health professionals, medical, nursing and allied health. They are activated using physiological, mechanism of injury and injury pattern criteria. There is potential for trauma team composition and activation criteria to be standardised in New Zealand.

Article

SUMMARY

Paediatric forearm fractures manipulated in the emergency department: incidence and risk factors for re-manipulation under general anaesthesia

Shaye Seefried, Kim Chin-Goh, Vahe Sahakian, Nicholas Lightfoot, Matthew Boyle

Re-manipulation of paediatric forearm fractures under general anaesthetic may be required following inadequate closed reduction under conscious sedation. Manipulation under general anaesthetic carries significant inherent risks and is preferably avoided. We assessed one institution’s experience with paediatric forearm fracture reduction and investigate the incidence of re-manipulation under general anaesthetic of fractures initially managed under conscious sedation without fluoroscopy (an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object.) In this study we identified that there are higher rates of re-manipulation under general anaesthetic in children presenting to the emergency department of our National Children’s Hospital with forearm fractures than seen in comparative international studies

Article

SUMMARY

2021 Assessment of New Zealand district health boards’ institutional healthy food and drink policies: the HealthY Policy Evaluation (HYPE) study

Sarah Gerritsen, Bruce Kidd, Magda Rosin, Stephanie Shen, Sally Mackay, Lisa Te Morenga, Cliona Ni Mhurchu

Hospital nutrition policies align with the institutional values and expectations of staff and visitors, while increasing availability and access to food and drinks recommended in the national dietary guidelines. In 2016, a national healthy food and drinks policy (NHFDP) was created for district health boards (DHBs), but by 2018 only five of the 20 DHBs had adopted or intended to adopt the policy. For this study, all DHBs and two central health agencies (Ministry of Health and the Health Promotion Agency) provided their policies to assess adoption and comparison with the national policy. Nine of the 20 DHBs had adopted the NHFDP. Using a standard policy scoring tool, we found individual DHB policies were not as comprehensive as the NHFDP, but some contained stricter or additional clauses that could be considered for future iterations of the NHFDP. There remains significant regional inconsistency in the food and drinks available to staff and visitors in health institutions across Aotearoa. An improved mandatory NHFDP should be implemented.

Viewpoint

SUMMARY

The unexpected benefits of sodium glucose co-transporter 2 (SGLT2) Inhibitors

Chok G Chan, Ralph Stewart

Empagliflozin, a Sodium Glucose Co-Transporter 2 (SGLT2) inhibitor is currently funded in New Zealand for patients with type 2 diabetes. We now know from large studies that this medication benefits people with heart failure, and reduces worsening of kidney disease. These studies suggest empagliflozin could benefit many more New Zealanders.

Article

SUMMARY

High prevalence of scabies in Auckland pre-schools

Simon Thornley, Gerhard Sundborn, Daniel Engelman, Rachel Roskvist, Maryann Heather, Cielo Pasay, Roger Marshall, James McCarthy

Evidence is increasing that scabies is linked to important diseases of childhood such as acute rheumatic fever. The condition is very common in Pacific Island nations. The prevalence of the condition in New Zealand, however, has not been well understood. In preliminary findings of three early childcare centres in socio-economically deprived areas of Auckland, 56% of surveyed children had lesions which were consistent with scabies. This indicates that scabies infestation is much more common than was previously appreciated.

Article

SUMMARY

Cruise ship patient presentation, admission, and intervention rates to the emergency department

Alice Alsweiler, Alice Rogan, Emma Carlin, Brad Peckler

Though large numbers of patients can be aboard a cruise ship this does not have a significant impact on our emergency healthcare resources in Wellington. There is room for improvement for education and system development to divert non-urgent medical needs to other resources rather than the emergency department.

Letter

SUMMARY

A quality improvement project to improve access to stroke clot retrieval from a regional stroke centre

Karim M Mahawish, Muir Wallace

Stroke clot retrieval is a procedure whereby a blood clot is removed from a blood vessel within the brain allowing blood flow to return. It should be performed urgently, within hours of the stroke. Only Wellington, Auckland, or Christchurch Hospitals have the expertise for this procedure. At Palmerston North Hospital, through a newly formed collaboration with the local Search and Rescue (Ltd) helicopter team, stroke patients can access this treatment two and a half hours earlier than previously, and twice as many patients can benefit. This means more stroke patients in our community making a recovery.

Letter

SUMMARY

Trends in the service provision and patient outcomes from 2013 to 2021 at a regional stroke centre

Karim M Mahawish

Stroke is the leading cause of disability worldwide. Data from the MidCentral region shows that there has been a 35% increase in the number of people affected by stroke over the last decade. Countering this, stroke care at MidCentral has improved, driven by national stroke improvement programs and Ministry of Health targets. Now more people are receiving effective clot-busting treatments and surviving their strokes. Both the public and health services are responsible for stemming the rising tide of stroke by adopting healthy lifestyles and optimising risk factor management.

Editorial