The New Zealand medical journal
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Editorial Historical Article
Here we go again? A new pandemic of the 21st century.
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There has been a lot of speculation that patients with coronavirus disease 2019 (COVID-19) who are receiving angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may be at increased risk for adverse outcomes. We reviewed the available evidence, and have not found this to be the case. We recommend that patients on such medications should continue on them unless there is a clinical indication to stop their use.
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Admission of patients with likely fatal illness to ICU "solely for possible organ donation" has been a long-standing practice in New Zealand. This is advocated as a means of increasing the availability of organs for transplant. We sought to determine the extent and characteristics of current clinical practice. ⋯ There are already a small number of patients being admitted to ICUs in New Zealand "solely for possible organ donation", the majority following prior family discussion of donation. These patients occupy a small number of ICU bed-days and contribute ~15% of the deceased donation activity. Organ Donation New Zealand has developed and recently promulgated recommended best practice guidelines for clinicians in the ICU and emergency departments and is supporting expansion of the practice within the scope of these guidelines.
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Dental caries is the most common chronic childhood disease in New Zealand. Concurrently, obesity and related chronic metabolic diseases are the most challenging public health problems of modern times. There is considerable evidence that a common dietary behaviour-high frequency consumption of sugar- and starch-containing foods-is the principal aetiological factor for both dental caries, and presentation of children and young people with increased adiposity or obesity. ⋯ This advice also does not reflect evidence regarding observed associations between the consumption of full-fat dairy produce and reduced dental caries and obesity. We present evidence to support our contention that important elements of New Zealand's dietary guidelines have been established without due consideration of the entirety of the evidence, including that which is updated, recent or evolutionarily. Given the epidemics of dental caries and metabolic disease are ongoing public health challenges in New Zealand and share common dietary causes, guidelines for healthy eating should limit refined sugar- and starch-containing foods and encourage intake of full-fat dairy items.