Oh my.
Authors: Crampton P PMID: 33119565 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Access to intrauterine contraceptives in the Southern District Health Board catchment.
CONCLUSIONS: Cost and travel time likely remain barriers to accessing intrauterine contraceptives for a significant population within this catchment. Increasing the capacity for all primary providers to offer insertion, funding the insertion process, minimising the number of appointments required and providing mobile services would improve access. PMID: 33119566 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Thyroid ultrasound and nodule malignancy risk: a "real world" assessment of ultrasound reporting and agreement of ultrasound-based malignancy risk estimates with cytology and histology findings.
CONCLUSIONS: Most ultrasound reports contained insufficient information about nodule malignancy risk to allow an independent assessment. Agreement between cytological/histological findings and malignancy risk estimates using ultrasound was not high. PMID: 33119567 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Detecting the re-emergent COVID-19 pandemic after elimination: modelling study of combined primary care and hospital surveillance.
CONCLUSIONS: This model-based analysis suggests that a surveillance system with a very high level of routine testing is probably required to detect an emerging or re-emerging SARS-CoV-2 outbreak within five weeks of a border control failure in a nation that had previously eliminated COVID-19. Nevertheless, there are plausible strategies to enhance testing yield and cost-effectiveness and potential supplementary surveillance systems such as the testing of town/city sewerage systems for the pandemic virus. PMID: 33119568 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Cataract surgery in New Zealand: access to surgery, surgical intervention rates and visual acuity.
CONCLUSIONS: New Zealand's cataract SIR is lower than most Organisation for Economic Co-operation and Development countries and patients have significantly worse BSCVA at prioritisation. Access to cataract surgery in New Zealand varies according to region. Māori and Pasifika present younger with worse BSCVA, suggesting potential barriers in accessing timely referral and prioritisation. PMID: 33119569 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Trends in the diagnosis of high-grade cervical abnormalities in young women in the post-vaccination era.
CONCLUSIONS: We observed a decreased number of CIN diagnoses in young women over time, with a particularly large drop in the number of CIN3/AIS/CGIN diagnoses. However, compared to non-Māori, Māori women having biopsies are more likely to have CIN3 or worse and there was a smaller reduction in the total number of Māori women diagnosed with CIN2 or worse. PMID: 33119570 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Outcomes after ST-elevation myocardial infarction presentation to hospitals with or without a routine primary percutaneous coronary intervention service (ANZACS-QI 46).
Authors: Lee S, Miller R, Lee M, White H, Kerr A Abstract AIM: Primary percutaneous coronary intervention (PCI) is the optimal reperfusion strategy to manage ST-elevation myocardial infarction (STEMI). Where timely primary PCI cannot be achieved, an initial pharmacological reperfusion strategy is recommended with subsequent transfer to a PCI-capable hospital. The study aim was to assess STEMI outcomes according to the interventional capability of the New Zealand hospital to which patients initially present. METHODS: Nine thousand four hundred and eighty-eight New Zealand patients, aged 20-79 years, admitted wit...
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Exploring Pasifika wellbeing: findings from a large cluster randomised controlled trial of a mobile health intervention programme.
CONCLUSION: Our study provides new insights on how Pasifika peoples' characteristics and behaviours align to wellbeing. Our findings point to 'family and community' as being the most important wellbeing factor for Pasifika peoples. PMID: 33119572 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

From gorse to ngahere: an emerging allegory for decolonising the New Zealand health system.
Authors: Came H, Warbrick I, McCreanor T, Baker M Abstract Prior to colonisation, Māori had a well-developed holistic health system based on maintaining balance between people, place and spirit. The colonial imposition of British economic, religious, educational, legal, health and governance, through warfare, immigration, legislation and social coercion had a devastating effect on Māori health outcomes. With the release of the WAI 2575 Waitangi Tribunal report exposing the failings of our health system in relation to Māori health, the need to decolonise our health system becomes more pressing. A key difficulty i...
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Nurse prescribing in New Zealand-the difference in levels of prescribing explained.
This article discusses the three types of nurse prescriber currently registered in New Zealand (nurse practitioners, registered nurse prescribers (RNP) in primary health and specialty teams and registered nurse prescribers (RNPCH) in community health). It also provides an overview of the evolution of each group, as well as a summary of the current legislation, prescribing restrictions and models of supervision required for each type of prescriber. PMID: 33119574 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

The case for a bicultural dementia prevalence study in Aotearoa New Zealand.
Authors: Cullum S, Dudley M, Kerse N PMID: 33119575 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

A rare presentation of Eagle syndrome.
Authors: Patel H, Phillips M, Mhuineachain AN, White J PMID: 33119576 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Multi-territory infarcts caused by intracranial giant cell arteritis.
Authors: Mahawish KM, Cariga P PMID: 33119577 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Physician heal thyself: observations on trigeminal neuralgia.
Authors: Friedlander D PMID: 33119578 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Uptake and outcome of a community-based healthy lifestyle intervention for preschoolers identified with obesity: an audit of the Wh ānau Pakari preschool programme.
Uptake and outcome of a community-based healthy lifestyle intervention for preschoolers identified with obesity: an audit of the Whānau Pakari preschool programme. N Z Med J. 2020 Oct 30;133(1524):135-139 Authors: Cave TL, Wynter LE, Wild CE, Derraik JG, Willing EJ, Hofman PL, Anderson YC PMID: 33119579 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 30, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

The Cannabis Referendum: why a yes vote offers a net gain for public health.
Authors: McBride S, Reid P, Signal L, Baker MG PMID: 33032298 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Healing or harming: the prostate cancer dichotomy.
Authors: Zarrabi A, Mark S PMID: 33032299 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

A three-way comparison of glycated haemoglobin: are results from the three platforms interchangeable?
CONCLUSION: HbA1c concentrations measured by Cobas c513, Capillarys 2 Flex-Piercing and the Bio-Rad D-100 were found to be comparable in the large majority of samples. While discordance was due to assay imprecision in some cases, in others no biological or analytical explanation could be found. PMID: 33032300 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

A survey of the NP workforce in primary healthcare settings in New Zealand.
CONCLUSION: The nurse practitioner workforce offers stability and flexibility in working across multiple clinical settings in primary healthcare. They provide the potential solution to the general practitioner workforce shortage by improving access to primary healthcare and reducing health inequalities. As authorised prescribers able to enrol patients, receive capitation payments and claim general medical services, it is timely to facilitate the expansion of the nurse practitioner workforce in New Zealand. PMID: 33032301 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Associations between childhood cancer treatment and tooth agenesis.
CONCLUSION: This study found that childhood cancer survivors in New Zealand had a high prevalence of developmental dental abnormalities and it identified potential risk factors related to their cancer treatment. Inequitable access to oral rehabilitation for this patient group argues for a mechanism for consistent improved access to publicly funded dental care across district health boards in New Zealand. PMID: 33032302 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Sexual assault experiences of university students and disclosure to health professionals and others.
CONCLUSIONS: Considering the low number of university students disclosing sexual assaults to health professionals or support services, the results of this survey suggest more work is needed to facilitate greater disclosures to health professionals enabling victims to access the services they need regardless of alcohol use. PMID: 33032303 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Turning on a dime-pre- and post-COVID-19 consultation patterns in an urban general practice.
CONCLUSIONS: This single practice study showed total patient contact was similar over both sample periods, but most contact in 2020 was virtual. Further longitudinal multi-practice studies to confirm these findings and describe future consultation patterns are needed to inform general practice service delivery post-COVID-19. PMID: 33032304 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

New Zealand may finally get funded access to diabetes drugs which reduce cardiovascular events and progression of kidney disease: an audit of proposed PHARMAC criteria compared with international guidelines.
CONCLUSION: The proposed PHARMAC criteria will give access to these important drugs to those people with T2DM who will likely benefit the most. PMID: 33032305 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Prostate cancer screening in New Zealand: lessons from the past to shape the future in the light of changing evidence.
Authors: Matti B, Zargar-Shoshtari K Abstract Prostate cancer represents a significant health burden worldwide. The cancer incidence had substantially increased since the introduction of prostate specific antigen (PSA) in cancer screening. This had led to considerable debates among health professionals and epidemiologists, since PSA as a screening tool seemed to be far from perfect. In New Zealand, the controversy was quite prominent in the last three decades, with some advocating the benefits of screening, while others concerned regarding the risk of harms. With the absence of an organised screening programme and ...
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

The clinical toxicology of cannabis.
Authors: Schep LJ, Slaughter RJ, Glue P, Gee P Abstract Cannabis is one of the most widely used recreational drugs in the world. Tetrahydrocannabinol (THC) is the psychoactive principal constituent of the cannabis plant (Cannabis sativa). It is taken either orally or by inhalation, resulting in sedation, euphoria, relaxation and loss of social inhibition. Adverse effects from higher doses can include fear, distrust and a profound state of unease, hallucinations, ataxia, stupor and seizures. Long-term use can result in respiratory and cardiovascular toxicity and has been associated with a range of psychiatric condit...
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Not the usual suspects: DRESS secondary to carvedilol.
Authors: Jones L, Isenmen H PMID: 33032308 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Oesophageal rupture presenting as upper gastrointestinal bleed.
Authors: Au M, Walcott J, Apostolov R, Lewis D, Hassen AS PMID: 33032309 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

The mental wellbeing of New Zealanders during and post-lockdown.
Authors: Nicolson MN, Flett JA PMID: 33032310 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Hospice/palliative care-entrenched attitudes against assisted dying.
Authors: Havill J, Smales L PMID: 33032311 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Reflections on EOLC Act Referendum.
Authors: Stephens R PMID: 33032312 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Reasons for stopping e-cigarette use among smokers: findings from the 2018 ITC New Zealand Survey.
Authors: White M, Edwards R, Stanley J, Hoek J, Waa AM, Ouimet J, Quah AC, Fong GT PMID: 33032313 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 10, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Alcohol is more harmful than cannabis.
Authors: Sellman D PMID: 32994588 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Time for a sea change in our COVID-19 management.
Authors: Gorman D, Horn M PMID: 32994589 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Evidence of inequitable use of chemotherapy in New Zealand colorectal cancer patients.
CONCLUSIONS: Although the uptake and timeliness of chemotherapy for colorectal cancer has been improving, Māori, Pacific, Asian and older patients were less likely to receive chemotherapy and less likely to receive chemotherapy in a timely manner. There is a variation in use of chemotherapy by Region with patients in the Southern Cancer region appearing to be the most likely to receive chemotherapy and to receive it within a timely period. PMID: 32994590 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Pneumocystis pneumonia in HIV-negative adults: missed opportunities for prevention.
CONCLUSION: There is a substantial incidence of potentially preventable PCP and PCP-related mortality in the Auckland region. This could be reduced by greater clinician familiarity with commonly proposed indications for PCP prophylaxis, particularly for clinicians prescribing prolonged corticosteroid courses to patients with malignancies. PMID: 32994591 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Evaluating the implementation and outcomes of a sepsis pathway in the emergency department.
Authors: Pouryahya P, Guiney N, Meyer A, Goldie N Abstract AIM: Early recognition and timely management, including prompt administration of antibiotics, has been fundamental in improving the mortality related to sepsis. We aimed to study the effect of the Sepsis Pathway Programme, a set of guidelines for sepsis, on the recognition, early investigation and management of septic patients in the emergency department. METHODS: We conducted a comparative prospective cohort study of patients who presented with suspected sepsis pre- and post-implementation of the Sepsis Pathway. Patients where the Sepsis Pathway was us...
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Quality measures in cervical lymphadenectomy for cutaneous malignancy by head and neck trained general surgeons.
CONCLUSION: Our data indicates that we are meeting quality measures, set by higher volume centres. We believe that any surgeon with subspecialty training in head and neck surgery can meet quality measures with regards to cervical lymphadenopathy for cutaneous malignancy. PMID: 32994593 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Combination budesonide/formoterol inhaler as sole reliever therapy in M āori and Pacific people with mild and moderate asthma.
CONCLUSION: The reduction in severe exacerbation risk with budesonide-formoterol reliever compared with maintenance budesonide was similar in Māori and Pacific adults compared with New Zealand European/Other. PMID: 32994594 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

A comparison of the clinical features and outcomes of Takotsubo syndrome across five metropolitan hospitals in New Zealand.
CONCLUSION: In this large New Zealand TS cohort, the clinical characteristics and presentation were similar among the five hospitals. A subset of patients had a complicated in-hospital course, but late deaths were almost all from non-cardiac causes and recurrence was infrequent. Mortality post-discharge and recurrence was similar between the hospitals. PMID: 32994595 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Assisted dying and evidence-based law-making: a critical analysis of an article's role in New Zealand's referendum.
CONCLUSION: The subject article is methodologically and factually flawed so is unreliable as evidence. It should not be considered in the assisted dying debates preceding the forthcoming referendum. PMID: 32994596 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

The transition to a "virtual practice" in primary care during the COVID-19 pandemic: experience from one medical centre in New Zealand.
The transition to a "virtual practice" in primary care during the COVID-19 pandemic: experience from one medical centre in New Zealand. N Z Med J. 2020 Aug 21;133(1520):91-98 Authors: Al-Busaidi IS, Martin M Abstract Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, driving radical transformation in the way patient care is delivered in primary and secondary care. As part of the response against COVID-19 across primary care in New Zealand, practices and medical centres have largely transitioned to telehealth over a short period of time while maintaining the traditional b...
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Smoke-free cars legislation: it works but New Zealand should still rigorously evaluate its upcoming law.
Authors: Wilson N, Thomson G, Edwards R Abstract In this viewpoint we briefly review the evidence for smoke-free car legislation. We find that this legislation has been consistently associated with reduced secondhand exposure in cars with children/youth in all nine jurisdictions studied. Despite this, there are various aspects of this intervention that warrant further study-especially determining its impact on reducing tobacco-related ethnic inequalities. So we argue that the New Zealand Ministry of Health should invest in a thorough evaluation of this important upcoming public health intervention. This could both ...
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Saying it don't make it so: a response to Winnington and MacLeod.
Authors: Mathison E PMID: 32994599 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Reflections on conducting research with healthcare users in a pandemic lockdown.
Authors: Imlach F Abstract The COVID-19 lockdown period created both challenges and opportunities to undertake research. Research was facilitated by flexibility from funders and team members, support from networks and stakeholders and the willingness of individuals to participate. We could learn from the experience of lockdown research by improving institutional support for research processes and dissemination, investing in a nationwide online panel for public good research and ensuring that a planned database of health research can collect and monitor research proposals in times of rapid change and uncertainty. ...
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Transparency in the year of COVID-19 means tracking and publishing performance in the whole health system: progress on the public reporting of acute coronary syndrome data in New Zealand.
Authors: Kerr A, Shuker C, Devlin G PMID: 32994601 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Spontaneous atraumatic lingual haematoma presenting with threatened airway obstruction.
We describe a case of an atraumatic lingual haematoma in an 88-year-old male presenting with threatened airway obstruction. The only risk factor our patient had was Aspirin use. Our patient was able to be managed conservatively with observation in the hospital's high dependency unit (HDU) and intravenous steroid (Dexamethasone) and antibiotic (Amoxicillin + Clavulanic acid) therapy. We discuss this case to highlight the importance of recognising an impending airway emergency in the setting of deep space bleeding or swelling. PMID: 32994602 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Necrotising fasciitis of the upper limb: an Auckland experience.
Authors: Patel D, Dekker A, Collocott S, Peat B, Canal A PMID: 32994603 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Leukaemia-in-ano.
We report an extremely unusual case of fistula-in-ano on an elderly man with chronic lymphocytic leukaemia (CLL). Histology from the fistula track demonstrated CLL infiltration. This case, not previously reported on PubMed search, illustrates a good example of joint specialist medical (a haematologist) and surgical effort in successfully treating this symptomatic fistula-in-ano. PMID: 32994604 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Time for a change.
Authors: Walls C, Dryson E, Gorman D, McBride D PMID: 32994605 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

On the epistemology of case studies of social phenomena in healthcare.
Authors: Mordaunt D PMID: 32994606 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - October 1, 2020 Category: General Medicine Tags: N Z Med J Source Type: research