Journal of the New Zealand Medical Association Vol 133 | No 1508 | 17 January 2020 Sudden unexpected death in epilepsy (SUDEP) in New Zealand; a retrospective review Disasters, policies and micronutrients: the intersect among ethics, evidence and e ective action Teeth or no teeth: exploring punitive measures for adults smoking in cars containing children in Aotearoa/New Zealand Media representation of Medical cannabis: knowledge Antenatal rubella serology is chronic pain in Aotearoa and expectations in a cohort useful for reassuring pregnant New Zealand—a content of North Island New Zealand women that they are likely to analysis of news media general practitioners be immune to measles Publication Information published by the New Zealand Medical Association NZMJ Editor NZMA Chair Professor Frank Frizelle Dr Kate Baddock NZMJ Production Editor NZMA Communications Manager Rory Stewart Diana Wolken Other enquiries to: NZMA To contribute to the NZMJ, fi rst read: PO Box 156 www.nzma.org.nz/journal/contribute The Terrace Wellington 6140 © NZMA 2020 Phone: (04) 472 4741 To subscribe to the NZMJ, email [email protected] Subscription to the New Zealand Medical Journal is free and automatic to NZMA members. 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Individual articles are available for purchase by emailing [email protected] NZMJ 17 January 2020, Vol 133 No 1508 ISSN 1175-8716 © NZMA 2 www.nzma.org.nz/journal CONTENTS EDITORIAL 72 8 Impact of human papillomavirus Disasters, policies and vaccination on rates of abnormal micronutrients: the intersect cervical cytology and histology in among ethics, evidence and young New Zealand women effective action Carrie RH Innes, Jonathan A Williman, Neville M Blampied, Roger T Mulder, Bryony J Simcock, Phil Hider, Usman Afzali, Oindrila Bhattacharya, Margaret Sage, Kieran Dempster-Rivett, Meredith Blampied, Julia J Rucklidge Beverley A Lawton, Peter H Sykes ARTICLES 85 Career outcomes of students of 12 an intercalated MBChB/PhD: Medical cannabis: knowledge experience from New Zealand and expectations in a cohort of Yassar Alamri, Tim J Wilkinson North Island New Zealand general practitioners 92 Karen Oldfield, Irene Braithwaite, Media representation of chronic Richard Beasley, Allie Eathorne, pain in Aotearoa New Zealand—a Giles Newton-Howes, Alex Semprini content analysis of news media Hemakumar Devan, Jessica Young, 29 Ceonne Avery, Liv Elder, Trends in length of stay following Yulia Khasyanova, Dominic Manning, acute coronary syndrome Morghan Scrimgeour, Rebecca Grainger hospitalisation in New Zealand 2006–2016: ANZACS-QI 32 study 111 Tom Kai Ming Wang, Corina Grey, New Zealand should introduce Yannan Jiang, Rod Jackson, nationwide pulse oximetry Andrew Kerr screening for the detection of critical congenital heart disease 43 and other hypoxaemic conditions Stage at diagnosis for Māori cancer in the newborn patients: disparities, similarities Elza Cloete, Thomas L Gentles, and data limitations Frank H Bloomfield, for the Pulse Jason Gurney, James Stanley, Oximetry Screening Steering Committee Chris Jackson, Diana Sarfati VIEWPOINT 65 Sudden unexpected death in 118 epilepsy (SUDEP) in New Zealand; Teeth or no teeth: exploring a retrospective review punitive measures for adults Mary Brennan, Shona Scott, smoking in cars containing Peter Bergin children in Aotearoa/New Zealand Frank Houghton, Diane O’Doherty, Ben Houghton NZMJ 17 January 2020, Vol 133 No 1508 ISSN 1175-8716 © NZMA 3 www.nzma.org.nz/journal CONTENTS CLINICAL CORRESPONDENCE LETTER 123 131 Murphy’s law in force: sequential Response to Ben Gray: Sun adverse events encountered during protection policy in New Zealand the treatment of Pneumocystis Bronwen McNoe, Anthony Reeder pneumonia (cotrimoxazole-induced 100 YEARS AGO acute peripheral neuropathy and primaquine-induced 134 methemoglobinemia) Unilateral Renal Haematuria Puneet Saxena, Valliappan Muthu, By ALFRED C. SANDSTON, F.R.C.S.E., Sahajal Dhooria, Inderpaul Singh Hon. Surgeon and Surgeon to the Genito- Sehgal, Kuruswamy Thurai Prasad, Urinary Clinique, Christchurch Hospital Ritesh Agarwal RESEARCH LETTER 127 Antenatal rubella serology is useful for reassuring pregnant women that they are likely to be immune to measles Timothy K Blackmore, Maxim Bloomfield, Sarah Burge, Kirsty Low, Marina Dzhelali, Annette Nesdale NZMJ 17 January 2020, Vol 133 No 1508 ISSN 1175-8716 © NZMA 4 www.nzma.org.nz/journal SUMMARIES Medical cannabis: knowledge and expectations in a cohort of North Island New Zealand general practitioners Karen Oldfield, Irene Braithwaite, Richard Beasley, Allie Eathorne, Giles Newton-Howes, Alex Semprini GPs are reporting that patients are asking them about medical cannabis prescriptions, mainly for symptoms relating to pain, cancer and palliative care, as well as reporting that patients are using illicit cannabis to self-manage conditions such as pain and anxiety/depression. Small numbers of GPs report that they have attempted to prescribe medical cannabis products, however the majority have concerns about the general use of cannabis as a medicine based on the lack of good evidence for use in the scientifi c literature and the confusing regulatory process currently in place for prescribing in New Zealand. GPs in the survey reported they would be likely to prescribe a cannabis product that is both regulated and has gone through clinical trials in specifi c medical conditions. With the upcoming implementation of the Medical Cannabis Scheme it is important that educational programmes emphasising evidence (both for and against use), medico-legal and practical elements of prescribing are in place to support the GPs to have informed discussions with their patients. Trends in length of stay following acute coronary syndrome hospitalisation in New Zealand 2006–2016: ANZACS-QI 32 study Tom Kai Ming Wang, Corina Grey, Yannan Jiang, Rod Jackson, Andrew Kerr This study reports on trend in the length of 185,962 hospitals stay for heart attacks in New Zealand from 2006–2016. The length of hospital stay has fallen gradually over time for all age-groups, gender, ethnic group and types of heart attack. The factors that are associated with longer hospital stay include older age, female sex, Māori or Pacifi c ethnicities, going to a rural hospital initially, not having heart procedures or having heart surgery. Stage at diagnosis for Māori cancer patients: disparities, similarities and data limitations Jason Gurney, James Stanley, Chris Jackson, Diana Sarfati In this study, we combined the best available data on stage of cancer at diagnosis for Māori and European/Other New Zealanders. We compared the two ethnic groups and found that while Māori are less likely to be diagnosed with early stage at diagnosis for several commonly-diag- nosed cancers, this is not the case for all cancers. In our paper we talk about the weaknesses of our national cancer registry in terms of allowing us to monitor stage at diagnosis for Māori (and non-Māori) patients. Sudden unexpected death in epilepsy (SUDEP) in New Zealand; a retrospective review Mary Brennan, Shona Scott, Peter Bergin Sudden unexpected death in epilepsy (SUDEP) has come to prominence in New Zealand over recent months because patients on lamotrigine have been required to change to the Logem brand, and several patients have apparently died shortly after changing brands. We have conducted a retrospective study of coroners’ reports of SUDEP, which occurred prior to this enforced brand change. We identifi ed 166 cases over a 10-year period (2007–2016), with a maximum of 26 cases occurring in 2013. Two-thirds of patients who died were aged between 15 and 45. We suspect that not all cases have been identifi ed, and we are now undertaking a prospective study to learn more about risk factors for SUDEP. NZMJ 17 January 2020, Vol 133 No 1508 ISSN 1175-8716 © NZMA 5 www.nzma.org.nz/journal SUMMARIES Impact of human papillomavirus vaccination on rates of abnormal cervical cytology and histology in young New Zealand women Carrie RH Innes, Jonathan A Williman, Bryony J Simcock, Phil Hider, Margaret Sage, Kieran Dempster-Rivett, Beverley A Lawton, Peter H Sykes Cervical cell abnormalities are caused by persistent human papillomavirus (HPV) infection. Our study investigated the rate of cervical cell abnormalities in young