The New Zealand medical journal
-
To investigate general medicine readmissions for risk factors and association with mortality. ⋯ Readmission to general medicine is strongly associated with older age, polypharmacy, and multiple comorbidities. Readmission is an independent strong risk factor for 1-year mortality, with this risk increasing after multiple readmissions. Readmissions can be a marker of deteriorating patient's condition, and a discussion in relation to prognosis, ceiling of treatment, resuscitation status documentation and advance directive may be warranted.
-
To decrease hospital-wide central line associated bacteraemia (CLAB) by spreading the prevention programme beyond the intensive care unit (ICU) in a secondary care hospital in Auckland, New Zealand. ⋯ We have demonstrated that the CLAB prevention work proven effective in the ICU can be successfully adapted and expanded to the rest of the hospital. As central lines are increasingly inserted in units outside the ICU, and maintained in general wards, this work provides some useful insights into tackling this larger problem.
-
Observational Study
Does seasonal level of serum 25-OH vitamin D correlate with the activity of Crohn's disease?
Vitamin D has immune modulating effects and normal to high levels might be correlated with less severe Crohn's disease (CD). We aimed to review seasonal vitamin D levels in CD patients in correlation with disease activity. ⋯ Suboptimal levels of serum 25(OH)D were found in the majority of our study participants particularly in winter and they would benefit from supplementation. Our study showed no statistically significant correlation between seasonal serum 25(OH)D levels and CD activity. Given the limitations of the study, the role of 25(OH)D as a predictor of disease activity could not be clearly concluded.
-
Metronidazole can produce neurological complications although it is not a common scenario. We present a case where a patient developed features of encephalopathy following prolonged metronidazole intake. Magnetic resonance imaging (MRI) brain showed abnormal signal intensity involving both dentate nuclei of cerebellum and splenium of corpus callosum. The diagnosis of metronidazole toxicity was made by the MRI findings and supported clinically.
-
Prior studies have reported higher rates of coronary revascularisation in European compared with Maori and Pacific patients. Our aim was to define the current variation by ethnicity in investigation, revascularisation and pharmacotherapy after admission with an acute coronary syndrome (ACS). ⋯ There is a small unexplained variation in angiography rates across ethnic groups. Much of the observed variation in revascularisation may be due to differences in the coronary artery disease phenotype.