The New Zealand medical journal
-
To eliminate Central Line Associated Bacteraemia (CLAB) in the Critical Care Complex (CCC)-Intensive Care Unit (ICU) and High Dependency Unit (HDU)-Middlemore Hospital. ⋯ Using an evidenced-based quality improvement approach, it is possible to significantly decrease Central Line Associated Bacteraemia in the Critical Care Complex. In doing so patient morbidity and mortality are reduced and money is saved for other healthcare needs.
-
Oral isotretinoin is a highly-effective treatment for severe acne. It is also highly teratogenic. Recently, funded access was widened (from vocationally registered dermatologists only) to include vocationally trained general practitioners and nurse practitioners acting within their scope of practice. This decision has caused some debate. While it is hoped that it will increase access to those living in more deprived areas, there are concerns that there will be an increase in the number of affected pregnancies. This study aims to report on terminations of pregnancy occurring while using isotretinoin in New Zealand. ⋯ While there are some limitations to this study, the results are consistent with recent international research suggesting previous pregnancy rates on isotretinoin have been underestimates. Widening funding of isotretinoin will likely increase the absolute numbers of pregnancies but also has the potential to increase relative numbers. As such, it will be vital that primary care is alert to the risks of isotretinoin use and gain experience in its day-to-day usage. Although access has been widened, all requests for funding will now be recorded on a national database (Special Authority database) to enable closer monitoring of isotretinoin usage.
-
A total smoking ban in prisons comes into effect from July 2011. The ban, introduced by the Corrections Minister, Judith Collins, aims to provide a healthier environment for prison staff and inmates through the elimination of secondhand smoke. Overseas experience has shown that simply banning smoking will not necessarily result in prisoners giving up, nor will it result in the maintenance of abstinence by those who do stop smoking during incarceration. In order to reap maximum health gains from the total smoking ban in prison policy, comprehensive cessation support for all inmates needs to be provided to ensure that they quit during incarceration and continue to abstain from smoking upon release.
-
Letter Case Reports
Constriction "Band-Aid" syndrome causing digital ischaemia.
A case report is presented in which the use of a "Band-Aid" adhesive dressing in a child for a trivial finger wound led to the development of full thickness necrosis requiring terminalisation of a digit.