New Zealand Medical Association

A summary of the original articles featured in this issue of the NZMJ

(For full articles, go to New Zealand Medical Journal)

Survey on the use of ototopical medications by New Zealand otolaryngologist/head and neck surgeons
Murali Mahadevan, David A M Wabnitz, David L McIntosh, Colin R S Brown
Antibiotic ear drops are prescribed for several conditions affecting the ear. Some of these antibiotic ear drops can cause permanent deafness or debilitating dizziness. It is important that doctors assess the ears properly when prescribing ear drops and give advice about when to stop ear drops, especially if using ear drops that can cause the above severe symptoms. The safer antibiotic ear drops are more expensive and some doctors believe that they should be subsidised so that they can be available to more patients.


The influence of steroid injections on the incidence of infection following total knee arthroplasty
Geoffrey Horne, Peter Devane, Andrew Davidson, Kathryn Adams, Gordon Purdie
Research shows a relationship between preoperative steroid injections into painful hip joints and postoperative wound healing in hip replacement surgery. This study investigates a similar relationship in total knee replacement surgery. This small study was undertaken to assess long-term outcomes of total knee joint surgery, and compares those who had prior injections into their knee joints, to those who did not. The outcome for patients who had injections into their knee joints prior to knee replacement surgery, is no less successful than for those who did not have injections. The findings indicate that if injections into the knee do have an effect, then it is much smaller than that seen in hip replacement surgery.

Clinical teaching capacity in New Zealand general practice
Susan Pullon, Ruth Lum
Effective training of all doctors needs to include good experience in primary care and general practice. The bulk of health care occurs in the community. New Zealand needs more fully trained (vocationally registered) general practitioners to work in primary care alongside other health professionals. Medical students and GPs-in-training alike need to work alongside experienced colleagues in general practices, but such placements are now limited by lack of physical space in practices, lack of dedicated time for teaching, and lack of co-ordination between different tertiary education providers. Primary care facilities and GPs are ready and willing to be involved in teaching, but structural and remuneration arrangements need to improve to increase their teaching capacity.

A single question reliably identifies physically inactive women in primary care
Sally B Rose, C Raina Elley, Beverley A Lawton, Anthony C Dowell
This paper set out to determine whether one question accurately identifies women who do not do the recommended amount of exercise. Participants were 51-74 year old women being screened for inclusion in the Women's Lifestyle Study, and were asked As a rule, do you do at least half an hour of moderate or vigorous exercise (such as walking or a sport) on five or more days of the week? Responses to this question were compared with responses to a longer exercise questionnaire and the level of agreement determined. The single question correctly identified 77% of those who were physically inactive according to the longer questionnaire. This question therefore provides a simple and practical way for GPs to identify women who would benefit from increasing their physical activity.