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Vol 118 No 1208: 28 January 2005

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Vol 118 No 1208: 28 January 2005 THE NEW ZEALAND MEDICAL JOURNAL Vol 118 No 1208 ISSN 1175 8716 CONTENTS This Issue in the Journal A summary of the original articles featured in this issue of the NZMJ Editorials Volunteer cord blood banking and transplantation Hilary Blacklock, Lochie Teague, Nigel Patton, Peter Browett Health expenditure and the ageing population Frank Frizelle Original Articles Bias measuring mortality gradients by occupational class in New Zealand Tony Blakely, Jackie Fawcett Heart failure hospitalisations and deaths in New Zealand: patterns by deprivation and ethnicity Tania Riddell Antithrombotic therapy in atrial fibrillation: an assessment of compliance with guidelines Anil Nair, Wayne Hazell, Timothy Sutton, Sandhya Pillai Avoiding and fixing medical errors in general practice: prevention strategies reported in the Linnaeus Collaboration’s Primary Care International Study of Medical Errors Murray Tilyard, Susan Dovey, Katherine Hall Quality use of medicines activities in New Zealand hospitals from 2000 to 2002 June Tordoff, Pauline Norris, Julia Kennedy, David Reith New Zealand Rural General Practitioners 1999 Survey Part 4: analysis of specific sub-groups Ron Janes, Donna Cormack, Anthony Dowell Accident and fatality characteristics in a population of mountain climbers in New Zealand Erik Monasterio Review Article A review of emerging flea-borne bacterial pathogens in New Zealand Patrick Kelly, Sally Roberts, Pierre-Edouard Fournier NZMJ 28 January 2005, Vol 118 No 1208 Page 1 URL: http://www.nzma.org.nz/journal/118-1208/1286/ © NZMA Case Reports Hyponatraemia, fever, vomiting, severe abdominal pain, and weight loss associated with omeprazole Barry Colls, Oliver Menzies Infective endocarditis with abdominal pain: just a coincidence? Calvin Ng, Ahmed Arifi, Song Wan, James Lau, Anthony Yim Viewpoints Predictors of persistent acute postoperative pain: an opportunity for preventative medicine to reduce the burden of chronic pain Edward Shipton Private umbilical cord blood banking: a biological insurance of dubious future benefit! Michael Sullivan, Peter Browett, Nigel Patton 100 Years Ago in the NZMJ Appendicitis: fifty consecutive and successful operations Medical Image Takotsubo cardiomyopathy (left ventricular apical ballooning) Constantin Marcu, Dragos Balf, Thomas Donohue Methuselah Selected excerpts from Methuselah Letters Regarding ‘Preventing diabetes—time is running out’; and Response Don Matheson, Colin Feek, Robert Scragg The potential health benefits of protecting marine biodiversity Nick Wilson, Cath Wallace, Barry Weeber Could exposure to methyl bromide cause motor neurone disease? Ian Shaw Vitamin D deficiency and chronic autoimmune disease Ronu Ghose Obituary William James Smith Notices Graham Aitken Nuffield Medical Postgraduate Travelling Scholarship NZMJ 28 January 2005, Vol 118 No 1208 Page 2 URL: http://www.nzma.org.nz/journal/118-1208/1286/ © NZMA New Zealand Evidence Based Practice Awards The Lloyd Morgan Lions Clubs Charitable Trust Fellowship Award Sport and Alcohol: Understanding the Mix (Conference) Grant announced for breast cancer drug resistance research project Book Reviews Succeeding as a hospital doctor (2nd edition; Roger Kirby, Tony Mundy) Angus Watson Electric universe: the true story of electricity (David Bodanis) Randall Allardyce Osteoporosis: Fast Facts Series (4th edition; Juliet Compston, Clifford Rosen) Nigel Gilchrist Headaches: Fast Facts Series (2nd edition; Richard Peatfield, David Dodick) Deborah Mason Textbook of Adult Emergency Medicine (2nd edition; Peter Cameron, George Jelinek, Anne-Maree Kelly, et al, eds) Michael Ardagh Evidence-based oncology (Chris Williams, ed) Mark Jeffery CD-ROM: Drug Identifier 2005—The premier drug identification tool Evan Begg Herbs and Natural Supplements: An evidence-based guide (Lesley Braun, Marc Cohen) Evan Begg Bailey & Love’s Short Practice of Surgery (24th edition; RCG Russell, Norman Williams, Christopher Bulstrode, eds) Frank Frizelle NZMJ 28 January 2005, Vol 118 No 1208 Page 3 URL: http://www.nzma.org.nz/journal/118-1208/1286/ © NZMA THE NEW ZEALAND MEDICAL JOURNAL Vol 118 No 1208 ISSN 1175 8716 This Issue in the Journal Bias measuring mortality gradients by occupational class in New Zealand T Blakely, J Fawcett Occupational class has been used extensively to monitor trends in socioeconomic mortality gradients. Using linked census and mortality data for New Zealand, Blakely and Fawcett find many likely biases that may impact on the measurement of occupational class differences in mortality. They conclude that whilst using occupational class to monitor socioeconomic trends over time in mortality in New Zealand is possible, it must be done very cautiously. Heart failure hospitalisations and deaths in New Zealand: patterns by deprivation and ethnicity T Riddell The focus of this research was to examine the association between socioeconomic deprivation and heart failure deaths and hospitalisations for Maori and non-Maori New Zealanders. This study found that deprivation was associated with an increased chance of death and hospitalisation from heart failure in New Zealand. However, within all socioeconomic strata, this risk was higher for Maori than non-Maori. Further studies are needed to explain the influence of other determinants such as lifecourse and lifestyle exposures, neighbourhood characteristics, access to medical care, and racism. Antithrombotic therapy in atrial fibrillation: an assessment of compliance with guidelines A Nair, W Hazell, T Sutton, S Pillai Atrial fibrillation is the most common arrhythmia and accounts for 15% of all strokes. This has resulted in the recommendation for commencement of prophylactic medications for prevention of strokes. The study showed a significant underuse of these medications (especially warfarin) in atrial fibrillation at our institution. NZMJ 28 January 2005, Vol 118 No 1208 Page 1 URL: http://www.nzma.org.nz/journal/118-1208/1248/ © NZMA Avoiding and fixing medical errors in general practice: prevention strategies reported in the Linnaeus Collaboration’s Primary Care International Study of Medical Errors M Tilyard, S Dovey, K Hall This international study reports strategies used by general practitioners in six countries to prevent medical errors seen in their everyday clinical practices. The default strategy in all countries, including New Zealand, reflected the unhelpful “name, shame, blame” medical culture. Other useful strategies were proposed and some had been implemented. These findings suggest that “insider” knowledge of the health system may be an important tool that health system planners should use to make healthcare safer for patients. Quality use of medicines activities in New Zealand hospitals from 2000 to 2002 J Tordoff, P Norris, J Kennedy, D Reith A recent study indicated a range of activities to promote the appropriate use of medicines were undertaken in New Zealand public hospitals in 2000 to 2002: Drug Utilisation Reviews and campaigns were undertaken; formularies, bulletins and drug expenditure data were distributed. Tertiary and secondary hospitals, where more clinical and specialist pharmacist staff-time was allocated, reported greater activity. Results suggest that staff resources may need consideration for activity to increase, and there may be resistance to central (rather than local) development of treatment guidelines. New Zealand Rural General Practitioners 1999 Survey Part 4: analysis of specific sub-groups R Janes, D Cormack, A Dowell This paper compares and contrasts sub-groups of rural general practitioners in New Zealand by age, rurality, training, country of graduation, and island location (North Island or South Island). It confirms the trend of younger doctors choosing to work part-time, in group practices, and to not own their practice. As older (predominantly male) rural general practitioners retire, finding their replacements may prove difficult, as it will require a greater number of these part-time younger (and increasingly female) doctors. Accident and fatality characteristics in a population of mountain climbers in New Zealand E Monasterio This is the first reported, systematic study that follows a group (49) of experienced climbers for 4 years. The purpose of the study was to determine the injury and death rate in this group. The results show that there was a significant rate of serious injury (involving 47% of climbers) and death (8.2%) related to climbing misadventure, and recommends urgent further investigation into the relationship between mountaineering, accidents, and fatal accidents. NZMJ 28 January 2005, Vol 118 No 1208 Page 2 URL: http://www.nzma.org.nz/journal/118-1208/1248/ © NZMA THE NEW ZEALAND MEDICAL JOURNAL Vol 118 No 1208 ISSN 1175 8716 Volunteer cord blood banking and transplantation Hilary Blacklock, Lochie Teague, Nigel Patton, Peter Browett Cord blood banking is a prerequisite for cord blood transplantation,1 which is used increasingly (mainly in children) to treat serious diseases of the bone marrow, blood, and immune system. Excellent outcomes are achieved using family or unrelated donations similar to allogeneic haemopoietic transplants from other sources (bone marrow or peripheral blood stem cells).2,3 Placental blood has advantages; these include easy and prompt access, the absence of risk in the donation procedure (mother and baby), the need for less rigorous HLA-matching (improving the odds of matching for minority populations under-represented on adult donor registries), and reduced risks from transmitted viruses and graft
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