NEW ZEALAND MEDICAL JOURNAL最新文献

{"title":"Expression of concern: \"Scurvy in a non-weight-bearing paediatric patient\".","authors":"","doi":"10.26635/6965.eoc1634","DOIUrl":"https://doi.org/10.26635/6965.eoc1634","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"112"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional and ethnic projections of gastric cancer incidence in Aotearoa New Zealand to 2045: identifying opportunities for targeted action.","authors":"Michael Walsh, Karen Bartholomew, Jonathan Koea, Clarence Kerrison, Nina Bevin, Maryann Heather","doi":"10.26635/6965.7460","DOIUrl":"https://doi.org/10.26635/6965.7460","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (stomach cancer) is an important contributor to morbidity and mortality in Aotearoa New Zealand, with marked ethnic inequities. Although national incidence rates are declining, Māori and Pacific peoples continue to experience higher rates than other groups. Demographic change and regional population growth are expected to influence future burden, yet no published projections provide estimates disaggregated by ethnicity and region.</p><p><strong>Methods: </strong>Gastric cancer registrations from 2001 to 2022 from the New Zealand Cancer Registry were linked to population estimates and projections stratified by age, sex, prioritised ethnicity and Health New Zealand - Te Whatu Ora region. Incidence was modelled using an age-period-cohort approach with time-based weighting to emphasise recent trends. Projections to 2045 were generated, and uncertainty was quantified using 1,000 non-parametric bootstrap iterations incorporating perturbation of population denominators.</p><p><strong>Results: </strong>Gastric cancer cases are projected to increase by 47.7% to approximately 725 per year by 2045, despite a decline in the age-standardised rate from 5.9 to 5.3 per 100,000. All regions show increasing absolute numbers, with the Northern Region experiencing the largest rise. Māori and Pacific peoples have the highest current incidence and a large proportional increase in projected cases, although incidence rates decline modestly for all ethnic groups. Future case growth is driven mainly by demographic expansion and an ageing population.</p><p><strong>Conclusion: </strong>Absolute gastric cancer cases are projected to increase, particularly among Māori and Pacific populations and in regions experiencing rapid population growth. This has implications for early diagnosis and specialist service delivery. These projections support equity-focussed prevention and service planning, including Helicobacter pylori control, timely diagnostic pathways, and regional planning for specialist cancer services.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"51-64"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision-threatening complications in herpes zoster ophthalmicus: lessons from two unvaccinated patients with orbital apex syndrome.","authors":"Christian P Pappas, Anna M M Waldie, Aditi Shukla, Derek Chan","doi":"10.26635/6965.7346","DOIUrl":"https://doi.org/10.26635/6965.7346","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"98-102"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement between self-reported fractures in a clinical trial with New Zealand Accident Compensation Corporation claims data.","authors":"Mark J Bolland, Zaynah Nisa, Anna Mellar, Chiara Gasteiger, Veronica Pinel, Borislav Mihov, Andrew Grey, Greg Gamble, Anne Horne","doi":"10.26635/6965.7279","DOIUrl":"https://doi.org/10.26635/6965.7279","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this article was to assess agreement between verified self-reported fractures in a clinical trial with Accident Compensation Corporation (ACC) claim data.</p><p><strong>Methods: </strong>In a 10-year randomised controlled trial of 1,054 women aged 50-60 years, participants self-reported fractures as they occurred or on routine 6-monthly questionnaires. Radiology imaging and reports were used to verify fractures, which were then compared with ACC claims data (ACC is the New Zealand no-fault accident claims organisation funded through levies). Initially, fracture claim data only were obtained, followed by all ACC claims for each participant for the study period.</p><p><strong>Results: </strong>Three hundred and fifty-six self-reported fractures in 248 women were verified in the trial, whereas there were 328 ACC fracture claims from 238 women for the study period. Out of 356 trial fractures, 211 (59%) had a matching ACC fracture claim, and out of 328 ACC fracture claims 211 (64%) had a matching trial fracture. After obtaining all ACC claims, we identified a matching ACC claim for 340/356 (96%) trial fractures: 59% were fracture claims and 31% soft-tissue injury claims.</p><p><strong>Conclusions: </strong>Repurposing ACC fracture claims data for clinical trials has significant limitations and is likely to introduce false negative and false positive events. When tolerance for misclassification is higher (e.g., large non-randomised studies), ACC claims data may be useful because 60% of claims had a verified fracture, with higher proportions for major fracture types.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"24-31"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity, regulation and Te Tiriti o Waitangi: a rapid review of Putting Patients First.","authors":"Heather Came, Clive Aspin, Alex Barnes, Maria Baker","doi":"10.26635/6965.7221","DOIUrl":"https://doi.org/10.26635/6965.7221","url":null,"abstract":"<p><p>The Crown's health workforce reforms, Putting Patients First: Modernising health workforce regulation (PPF),1 emerge in a political climate that is actively dismantling Māori health gains, undermining tino rangatiratanga and reframing equity as \"needs not race\". Using rapid Tiriti review-an adaptation of critical Tiriti analysis-we assessed the proposal's alignment with Te Tiriti o Waitangi. We found that PPF did not align well with the preamble or the articles of Te Tiriti. There was no equity analysis; no acknowledgement of hauora as taonga, limited Māori involvement in decision making, erasure of tino rangatiratanga and entrenched health inequities were disregarded. These findings highlight systemic silences and risk embedding monocultural practice, weakening accountability and further marginalising kaupapa Māori health models. We recommend that genuine patient-centred regulation must embed Te Tiriti, cultural safety and antiracism into regulatory standards and governance. Without these commitments, health workforce regulation perpetuates rather than remedies inequities, failing Māori and the wider population.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"79-85"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous gallstone: a case report.","authors":"Georgia Butt, Rana Alsadat, Universe Leung","doi":"10.26635/6965.7327","DOIUrl":"https://doi.org/10.26635/6965.7327","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"94-97"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric periorbital and orbital infections: a decade of experience at Christchurch Hospital.","authors":"Samuel Tomkins, Tony Walls, Hayleigh Miller","doi":"10.26635/6965.7068","DOIUrl":"https://doi.org/10.26635/6965.7068","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to describe the epidemiology, clinical features, microbiology and management of paediatric patients (<18 years) admitted to Christchurch Hospital with periorbital or orbital infections over a 10-year period.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients under 18 years admitted with periorbital and orbital infections between 2013 and 2023. Cases were identified using surgical theatre records and discharge coding, with data extracted from electronic medical records. Clinical, demographic, microbiological and management data were analysed descriptively.</p><p><strong>Results: </strong>A total of 495 paediatric cases were identified, with 93% presenting with periorbital cellulitis and 7% with orbital cellulitis. Sinusitis was the predominant predisposing factor for postseptal disease, present in 83% of those cases. Orbital signs such as proptosis, pain with eye movement, reduced visual acuity and ophthalmoplegia were more frequent in orbital cellulitis. Orbital cases had longer hospital stays with a median of 4.5 days (range 2-33 days) compared to periorbital disease with a median of 1 day (range 0-8 days). Orbital cases also had a higher rate of surgical intervention (47%), most commonly functional endoscopic sinus surgery. Staphylococcus aureus was the most frequently isolated organism in both groups (45% periorbital, 42% orbital). Māori and Pacific children were disproportionately affected (comprising 20% and 10% respectively of periorbital cases and 17% and 19% of orbital cases).</p><p><strong>Conclusions: </strong>The presence of orbital signs should prompt urgent imaging to exclude orbital disease. Sinusitis remains a key risk factor for orbital cellulitis, and Māori and Pacific children are disproportionately affected.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"32-37"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifungal susceptibility of genital yeast isolates, Auckland, 2016-2025.","authors":"Arthur J Morris, Wendy P McKinney, Sally A Roberts","doi":"10.26635/6965.7444","DOIUrl":"https://doi.org/10.26635/6965.7444","url":null,"abstract":"<p><strong>Aim: </strong>Our aim was to record current susceptibility results of genital yeast isolates and to compare the results to the previous report covering the period 2001-2015.</p><p><strong>Methods: </strong>Genital yeast isolates had their antifungal susceptibility determined by disc diffusion or minimum inhibitory concentration following standard methods. Sequential isolates from the same person had their initial and last susceptibility results compared.</p><p><strong>Results: </strong>Disc testing was performed on 1,307 initial isolates; 17 (1.3%) were from males. The most frequent isolates were Candida albicans (64%), Nakaseomyces glabratus complex (17%) and Candida parapsilosis complex (7%). While 94% of isolates were susceptible to clotrimazole, susceptibility for other azoles ranged from 62% to 84%. All isolates were susceptible to nystatin. Isolates non-susceptible to one topical azole were often resistant to all azoles tested. For fluconazole, itraconazole and miconazole fewer isolates were susceptible than in the previous time period. The susceptibility to clotrimazole did not change. One hundred and eight women had sequential isolates, range 2-5, collected 1 week to 75 months apart, median 6 months. Four pairs (4%) had a change from susceptible to resistant, all for miconazole, suggesting increased resistance. All latter isolates were susceptible to at least two other azoles and nystatin.</p><p><strong>Conclusions: </strong>There appears to have been an increase in antifungal resistance to several topical agents used for genital yeast infections. However, in a previously susceptible isolate, treatment failure seldom indicates a change to antifungal resistance. Women with recurrent vulvovaginal yeast infection can be reasonably treated empirically while identification and susceptibility results are awaited.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"103-110"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace violence casts a long shadow.","authors":"Michael Ardagh, Sandra Richardson","doi":"10.26635/6965.e1634","DOIUrl":"https://doi.org/10.26635/6965.e1634","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"9-11"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What legal protections are available to paramedics to prevent suicide? A review of case law concerning Section 41 of the Crimes Act 1961 (New Zealand).","authors":"Dylan A Mordaunt, Nicole Jones","doi":"10.26635/6965.6808","DOIUrl":"https://doi.org/10.26635/6965.6808","url":null,"abstract":"<p><strong>Aim: </strong>With the reduction in police involvement in front-line mental health responses in New Zealand (implemented November 2024), this study evaluates the primary legal justification supporting paramedics in using force to prevent suicide: Section 41 of the Crimes Act 1961.</p><p><strong>Methods: </strong>We conducted a qualitative analysis of 20 legal cases (1986-2023) identified through a systematic search. The analysis was structured thematically, focussing on the legal criteria for intervention, the role of de-escalation, the threshold for \"reasonable force\" and the unresolved conflict between intervention and patient autonomy. Cases were included if Section 41 was central to the legal reasoning or as a justification; cases where Section 41 was cited in passing without substantive discussion were excluded.</p><p><strong>Results: </strong>Case review suggests that while Section 41 can provide a legal justification, its application is highly context dependent. Courts have held that force is justifiable only to prevent immediate and unlawful harm and that it should be proportionate to the threat. Failing to attempt viable, less-restrictive alternatives can render even minimal force unreasonable. Cases involving excessive force demonstrate judicial focus on proportionality and the availability of other options. The analysis highlights a legal and ethical \"grey area\" concerning patient capacity and the limits of intervention.</p><p><strong>Conclusion: </strong>There is limited case law interpreting Section 41 (20 substantive cases identified between 1986 and 2023). To improve safety for patients and practitioners, we suggest clearer operational guidance, multidisciplinary education and consideration of legislative options that would better support healthcare-led responses to mental health emergencies.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1634","pages":"38-50"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}