NEW ZEALAND MEDICAL JOURNAL最新文献_第2页

Chest pain that is hard to swallow-a rare finding of Kommerell diverticulum. 难以吞咽的胸痛——Kommerell憩室的罕见症状。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-07-11 DOI: 10.26635/6965.6687

Michael Dick, Adam Bateman, Chethan Kasargod

引用次数: 0

Improving lung cancer survival outcomes for Māori. 改善Māori的肺癌生存结果。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-07-11 DOI: 10.26635/6965.6947

Jason Gurney, James Stanley, Anna Davies, Virginia Signal, Paul Dawkins, Laird Cameron, Shaun Costello, Christopher Gca Jackson, Kimiora Henare, Ross Lawrenson, Jesse Whitehead, Jonathan Koea

{"title":"Improving lung cancer survival outcomes for Māori.","authors":"Jason Gurney, James Stanley, Anna Davies, Virginia Signal, Paul Dawkins, Laird Cameron, Shaun Costello, Christopher Gca Jackson, Kimiora Henare, Ross Lawrenson, Jesse Whitehead, Jonathan Koea","doi":"10.26635/6965.6947","DOIUrl":"10.26635/6965.6947","url":null,"abstract":"Lung cancer is the most lethal cancer for Māori in Aotearoa New Zealand, with more Māori dying from lung cancer each year than the next five most common causes of cancer death combined. Māori have far poorer lung cancer survival outcomes than our majority European population, and access to timely, best-practice diagnosis and care could be an important driver of these disparities. We recently conducted a nationwide project to augment existing evidence and identify points along the clinical pathway where there are ethnic differences in access to this care. We found some cause for cautious celebration, including equitable access to bronchoscopy, pathological diagnosis, radiation therapy and systemic therapy, as well as minimal differences in the timing of treatment between ethnic groups. However, we identified a number of disparities along the treatment pathway that require intervention, including higher emergency presentation rates, poorer access to early detection, lower surgery rates and disparities in the distance required to travel to bronchoscopy, surgery and radiation therapy. Based on our observations from this project, along with the context provided by literature review and discussions with stakeholders, we have made five recommendations for areas of action to address these disparities, with a view to ultimately improving survival outcomes for Māori. Our results suggest that it is possible to achieve equitable outcomes for Māori in key areas; we must now push forward toward closing further gaps if we are to achieve equity in lung cancer survival for our Indigenous peoples.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"96-103"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609973","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}

引用次数: 0

The role of chelation for severe lead toxicity. 螯合对严重铅中毒的作用。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.6971

William Boroughf, Adam C Pomerleau

引用次数: 0

Outcomes in patients with rib fractures following implementation of the RIB-IMPROVE rib fracture guideline. 实施rib - improve肋骨骨折指南后肋骨骨折患者的结局。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.6926

Matthew J McGuinness, Lauren K Staveley, Eleanor F C Wilding, Olivia A Ray, Anita M Semmons, Cavaghn H Prosser, William Fleischl, Nejo Joseph, Wee Choen Ang, Christopher Harmston

{"title":"Outcomes in patients with rib fractures following implementation of the RIB-IMPROVE rib fracture guideline.","authors":"Matthew J McGuinness, Lauren K Staveley, Eleanor F C Wilding, Olivia A Ray, Anita M Semmons, Cavaghn H Prosser, William Fleischl, Nejo Joseph, Wee Choen Ang, Christopher Harmston","doi":"10.26635/6965.6926","DOIUrl":"10.26635/6965.6926","url":null,"abstract":"Aim: A rib fracture guideline was implemented at Whangārei Hospital with the aim of improving the care of patients and mitigating the risk of preventable additional morbidity. The aim of this study was to assess the impact of this guideline on the management and outcomes of patients.Methods: A single centre retrospective audit was performed comparing patients with rib fractures pre and post the implementation of the RIB-IMPROVE guideline. The primary outcome of interest was pneumonia. Patients with an abbreviated injury score (AIS) head or abdomen >2 were excluded. Binomial logistic regression was conducted for the primary outcome with adjustments for clinically plausible variables.Results: There were 418 patients identified, 241 in the pre-guideline and 177 in the post-guideline group. There was no difference in age, sex, ethnicity, number of rib fractures, injury severity score (ISS) or local anaesthetic block placement. The pneumonia rate was 13% vs 7% comparing the pre- and post-guideline groups, respectively. After adjustment for age, sex and ISS, the relative risk of developing pneumonia was 0.52 comparing the post- with the pre-guideline group (p=0.04). No statistical difference in secondary outcomes was seen, including the length of stay, 30-day readmission rate or 30-day mortality rate.Conclusion: This study found that the risk of pneumonia was decreased by almost half after implementation of the RIB-IMPROVE guideline at Whangārei Hospital. This study highlights the effectiveness of a multidisciplinary guideline in the management of patients with rib fractures.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1617","pages":"12-49"},"PeriodicalIF":1.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508880","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}

引用次数: 0

Evaluating the safety and effectiveness of bariatric surgery performed by a trainee or fellow in a low-volume New Zealand centre. 评估在新西兰一个小容量中心由实习生或研究员进行的减肥手术的安全性和有效性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.6788

Preekesh S Patel, James Jin, Rowan French

{"title":"Evaluating the safety and effectiveness of bariatric surgery performed by a trainee or fellow in a low-volume New Zealand centre.","authors":"Preekesh S Patel, James Jin, Rowan French","doi":"10.26635/6965.6788","DOIUrl":"10.26635/6965.6788","url":null,"abstract":"Background: Metabolic bariatric surgery (MBS) is an effective treatment for obesity and its related comorbidities.1 Publicly funded MBS in New Zealand is regionally limited with variable case volumes, potentially limiting surgical training.2 This retrospective study aims to evaluate if MBS safety and effectiveness are impacted by teaching within a low-volume unit.Methods: A retrospective outcomes analysis was carried out for all MBS cases of a single surgeon (public and private). Cases were compared based on primary operator status: consultant (COP) and trainee/fellow (TOF). Primary outcomes included multiple safety and effectiveness parameters including leaks, haemorrhage, 30-day morbidity and total weight loss (TWL).Results: Two-hundred and fifty patients satisfied inclusion criteria. Results are reported as COP and TOF. Primary operator: 87 (34.8%) and 163 (65.2%). There were no leaks, strictures or 30-day mortalities. Perioperative haemorrhage: 1 and 4. Thirty-day morbidity: 1 and 5. One-year TWL: 36.0% and 35.0%. Sleeve stenosis: 0 and 1. Thirty-day readmissions: 1 and 4. One-year readmissions: 4 and 9. Length of stay: 3 and 4 (p=<0.001).Conclusion: MBS safety and effectiveness outcomes in low-volume practice performed by TOF were no different to COP within our study setting.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1617","pages":"76-84"},"PeriodicalIF":1.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508879","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}

引用次数: 0

Urgency vs triage prioritisation: appropriateness of referrer-rated urgency of referrals to a public dermatology service. 急迫性vs分诊优先级：转诊到公共皮肤科服务的急迫性的适当性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.6909

Jessica Yi Han Aw, Israa Al-Manji, Amanda Oakley

{"title":"Urgency vs triage prioritisation: appropriateness of referrer-rated urgency of referrals to a public dermatology service.","authors":"Jessica Yi Han Aw, Israa Al-Manji, Amanda Oakley","doi":"10.26635/6965.6909","DOIUrl":"10.26635/6965.6909","url":null,"abstract":"Aim: To characterise the appropriateness of community referrer-rated urgency among dermatology referrals.Method: Using e-referral data from a month representative of volume and service provision in a tertiary dermatology service, referrer-rated urgency and triage priority assigned by two specialist dermatologists were compared to determine appropriateness. Descriptive analysis was conducted to quantify the proportion of appropriately and inappropriately assigned urgency in priority populations of women, Māori and Pacific peoples and paediatric patients.Results: One-third of general dermatology referrals, and nearly one in six referrals of suspected skin cancers, had an inappropriately assigned urgency. A quarter of general dermatology and most melanoma referrals had urgency lower than triage priority. Māori and Pacific patients were under-represented in the proportion of referrals received by ethnicity when comparing to national and provincial population estimates. However, no significant disparities in appropriateness of urgency across ethnicity were observed, and the same was seen for female and paediatric patients.Conclusion: Our study adds to the limited research on the appropriateness of referrer-rated urgency. We have pointed out that artificial intelligence (AI) has significant potential to improve the prioritisation of referrals by identifying melanoma and severe skin diseases.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1617","pages":"100-112"},"PeriodicalIF":1.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508886","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}

引用次数: 0

Emergency management in a regional setting of a paediatric patient with penetrating injury of the hard palate from a metal drinking straw. 一名儿童硬腭被金属吸管刺穿伤的急诊处理。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.6745

Jacob Arahill-Whitham, Hitesh Tailor, Dean Ruske

引用次数: 0

Review of the New Zealand Asthma and Respiratory Foundation's New Zealand Adolescent and Adult Asthma guidelines. 审查新西兰哮喘和呼吸基金会的新西兰青少年和成人哮喘指南。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.7061

Robert J Hancox, Richard Beasley, Lutz Beckert, Amy Chan, Nicola Corna, James Fingleton, Matire Harwood, Miriam Hurst, Susan Jones, Stuart L Jones, Zoe Manderson, David McNamara, Betty Poot, Jim Reid, Adrian Trenholme, Joanna Turner

引用次数: 0

Provision without vision: the need for a values-informed public health system. 没有远见的提供：需要一个了解价值观的公共卫生系统。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.7083

Harriet Wild, Lyndon Keene, Virginia Mills, Andrea Black

引用次数: 0

The bravado is not worth a brain injury: rethinking Run It Straight. 虚张声势是不值得脑损伤的：重新思考直行。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2025-06-27 DOI: 10.26635/6965.7055

Sarah Logan, Rachel Lauchlan, Christopher Wakeman

引用次数: 0