The New Zealand medical journal
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Clinical Trial Controlled Clinical Trial
A prospective study of unexplained visible abdominal bloating.
To investigate the relationship between irritable bowel syndrome, constipation, obesity and abdominal muscle strength in patients whose primary complaint is visible abdominal bloating. ⋯ Patients whose primary complaint is visible abdominal bloating have greater increases in girth but not weight during bloating episodes than the normal daily fluctuations seen in healthy controls. They have weak abdominal muscles and frequently have recently gained weight. They are not more likely to have constipation, irritable bowel syndrome or obesity than patients whose primary complaint is something other than bloating.
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Comparative Study
An audit of the assessment and management of patients admitted to Christchurch Hospital with chronic obstructive pulmonary disease.
To audit the assessment and management of patients admitted to hospital with chronic obstructive pulmonary disease (COPD) during three months of the winter of 1992. ⋯ Standards of assessment and treatment were adequate. Several areas were identified where improvements are required, particularly in the prescribing and monitoring of oxygen therapy. Hospital-wide guidelines for the management of COPD are to be developed.
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To identify methods of treatment withdrawal, staff support and follow up of families with children dying in a paediatric intensive care unit (PICU). ⋯ Family members are willing to take an active part in the decision making process regarding management of the dying child. This process is multidisciplinary, time consuming and difficult. Valuable assistance for all ethnic groups was gained through the services of Te Whanau Atawhai. Consideration should be given to allowing parents to stay during acute resuscitation of a critically ill child. There were deficiencies of both parental and staff followups. As a consequence, we have introduced a grief education and support service through the, child and family psychiatric service for families and staff.
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Multicenter Study
Failed validation of a clinical decision rule for the use of radiography in acute ankle injury.
To validate the Ottawa clinical decision rule for the use of radiography in acute ankle injuries. ⋯ The Ottawa clinical decision rule for the use of radiography in acute ankle injuries is unacceptable for application in emergency departments in New Zealand due to a high false negative rate.
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Multicenter Study Clinical Trial
Respiratory distress syndrome in New Zealand: evidence from the OSIRIS trial of exogenous surfactant (Exosurf).
To assess the impact, mortality, morbidity and economic costs, of respiratory distress syndrome severe enough to warrant ventilation in one year in New Zealand. ⋯ In a full year (total births 60,000) approximately 350 New Zealand infants may require ventilation for respiratory distress syndrome. Increasing the percentage of infants who receive antenatal steroids is likely to be extremely cost effective. In the era of antenatal steroids and exogenous surfactant, 85% of infants with respiratory distress syndrome requiring ventilation survive to discharge home and over 90% of survivors are likely to be healthy normal adults.