Review of acute symptomatic urolithiasis in Auckland
Decreasing incidence of symptomatic stones which could be attributed to a large influx of Asian immigrants. A male aged 40–49 with a past history of stones has the highest chance of stone formation.
Disease recurrence following surgery for colorectal cancer: five-year follow-up
In this article, the authors describe the patterns of disease recurrence in patients having curative surgery for colorectal cancer at a hospital in New Zealand over a three-year period. With five years of follow-up data, one in four patients experienced the cancer returning and this is in keeping with data reported in the worldwide literature. Recurrence most commonly occurred within the first two years, and the liver and lungs were the most common sites of recurrence.
Prevalence of hepatitis E virus antibodies and infection in New Zealand blood donors
Hepatitis E virus (HEV) can be transmitted by blood transfusion. This study measured the presence of HEV antibodies (evidence of past or present infection) in New Zealand blood donors. This was determined to be 8.1 to 9.7% using two different antibody tests. The rate in New Zealand is similar to that reported in other developed countries. HEV was not found in blood samples from 5,000 donations using a molecular test to detect viral nucleic acid. This indicated no evidence of current HEV infection. This study is the largest to date to assess past and current HEV infection in New Zealand blood donors.
Incidental findings during a surgical procedure—patient and public perspectives
When surgeons carrying out an operation incidentally find an unrelated problem, should they go ahead and treat this at the same surgery or wait for another time until having discussed it with the patient? This question was asked of patients awaiting surgery, and the public, to see what they thought were the important things to consider and what they would want to be done by their surgeon in different circumstances. These included whether it was an emergency or not, whether the extra surgery could lead to serious complications or if this might avoid another operation. The results showed that patients and public approached the options similarly although patients more often preferred to go on with the treatment of the IF at the same surgery. Both groups considered the opportunity to avoid another operation to be important. Generally, they preferred for surgeons to discuss the possibility of an incidental finding (IF) during the surgical consent process, although some were not so keen as it might confuse the situation. The preferences were very similar to the way surgeons approached an IF in the same situation as described in the previous paper.
Incidental findings during a surgical procedure—current practice and ethical implications
When surgeons carrying out an operation incidentally find an unrelated problem, should they go ahead and treat this too during the same surgery or wait for another time until having discussed it with the patient, and obtaining consent for further surgery if still required? This question was asked of New Zealand surgeons and those in training to see what they thought were the important things to consider and what they would do in different circumstances such as whether it was an emergency, whether the extra surgery could lead to serious complications or if it avoided another operation. The results showed that surgeons vary in what they emphasised but made decisions that reflected a sensible approach. It would be easier to make these decisions if there was a discussion between patient and surgeon beforehand prompted in the surgical consent process.
Treaty of Waitangi in New Zealand public health strategies and plans 2006–2016
This study examines how public health policy in New Zealand has represented te Tiriti o Waitangi and the Treaty of Waitangi between 2006 to 2016. Twelve of 49 public health strategies and plans reviewed from the Ministry of Health database referred to either treaty text. Crown discourses were categorised as i) rhetoric, ii) aspirational statements, iii) had elements of practical implementation and/or iv) substantive actions. The study confirms public health strategies rarely address Treaty obligations and this silence is inconsistent with legislative requirements to engage with the Treaty and health equity and is likely to inform health-related Waitangi Tribunal claims. Further work needs to be done to strengthen alignment of health policy to fulfil Crown Treaty obligations.
The American opioid death epidemic—lessons for New Zealand?
There has been an increase in opioid drug deaths world-wide and the US is currently in an epidemic of opioid-related deaths. Although so far New Zealand has not seen a significant rise in opioid drug deaths, there may be a risk. Medical surveillance for an increase of opioid abuse and deaths is warranted to take early action to prevent such an epidemic occurring in New Zealand.