Dalybradford7596

A pre-operative computerised tomography scan (CT) decreased the odds of false negative operative diagnoses, but it increased the odds of false positives.

Macroscopic assessment of the appendix lacks accuracy and may be challenging in certain groups of operators and patients.

Macroscopic assessment of the appendix lacks accuracy and may be challenging in certain groups of operators and patients.

A number of evidence-based medications are recommended following an acute coronary syndrome (ACS), including statins, antithrombotics (antiplatelet and/or anticoagulants), a beta-blocker and an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACE-I/ARB). This study aimed to describe the dispensing of the cardioprotective medications in the first year following an ACS hospitalisation in New Zealand and how this varies according to age, sex and type of coronary intervention.

National hospitalisation data was used to identify all New Zealand residents aged 35-79 years who were discharged from hospital in the years 2013/14 with a primary discharge diagnosis of ACS. Using anonymous linkage to national pharmaceutical dispensing and mortality datasets, the dispensing of each group of medications was examined in survivors of quarters one, two and four of the first year post discharge.

There were 14,496 patients; mean age was 63.4 years and 68.8% were male. Dispensing of medications in survivors steadily fell across quarters one, two and four 90.8%, 82.1% and 78.8% of patients were dispensed statins; 90.6%, 79.8% and 78.1% were dispensed aspirin; 82.7%, 72.6% and 70.0% were dispensed beta-blockers; 69.6%, 62.7% and 61.3% were dispensed ACE-I/ARB; 67.7%, 53.6% and 40.4% were dispensed a P2Y12 inhibitor; and 68.6%, 53.0% and 40.7% were dispensed a combination of two or more antithrombotics.

Cardioprotective medication dispensing was lower than would have been the case if the current ACS guidelines were followed. The greatest decrease in dispensing occurred between quarter one and quarter two, which highlights a potentially important period for targeted interventions to improve adherence.

Cardioprotective medication dispensing was lower than would have been the case if the current ACS guidelines were followed. The greatest decrease in dispensing occurred between quarter one and quarter two, which highlights a potentially important period for targeted interventions to improve adherence.

Regular physical activity (PA) is critical for children and young people's health and wellbeing. Schools are an important setting for promoting PA. This study aimed to examine prevalence of PA through physical education in New Zealand schools and the potential impact of increasing physical education on young people's PA levels.

We used data from the Active NZ Young People Survey of over 8,000 young people and modelled the impact of a hypothetical intervention that increased school-based physical education time to 2.5 hours (consistent with international best practice) on the distribution of PA.

At baseline, 61.3% (95%UI 60.2-62.5) of young people were classified as being sufficiently active (7+ hours/week), 19.8% (95%UI 18.9-20.8) were moderately active, and 18.8% (95%CI 17.9-19.7) were minimally active. The intervention scenario would more than halve the prevalence of minimal activity to 8.1% (95%UI 7.5-8.8) and increase the proportion of sufficiently active young people to 68.4% (95%UI 67.3-69.5).

Increasing time being active through physical education has the potential to reduce the prevalence of minimally active young people in New Zealand. Policies to support increased physical education time, such as time-based requirements, would increase PA levels.

Increasing time being active through physical education has the potential to reduce the prevalence of minimally active young people in New Zealand. Policies to support increased physical education time, such as time-based requirements, would increase PA levels.

To investigate regional variation in myeloma incidence in New Zealand in order to inform aetiological investigations.

All new registrations of myeloma (1991-2016) were extracted from the New Zealand Cancer Registry. Ethnic classifications used prioritised ethnicity. For geographical groupings, 74 Territorial Local Authority (TLA) categories for 2006 and population densities were used. Negative binomial regression was used to estimate incidence rate ratios, 95% confidence intervals and p-values.

Between 1 January 1991 and 31 December 2016, 7,083 myelomas were registered. The Clutha TLA had a significantly lower incidence than the New Zealand average. Compared to Clutha, many regions had a significantly higher incidence, but there was no clear spatial pattern. The highest incidence rate was for Māori men in the North Island. Women had significantly lower incidence than men of the same ethnic group and in the same area.

As both extremes of myeloma incidence occurred in rural areas, and as all TLAs (except one, Horowhenua) in the two lowest risk categories were rural, it seems unlikely that farming confers an increased risk. Results suggest that some other factor is driving the differences in myeloma incidence by ethnic group. We have provided a baseline of the geographical burden of myeloma in New Zealand.

As both extremes of myeloma incidence occurred in rural areas, and as all TLAs (except one, Horowhenua) in the two lowest risk categories were rural, it seems unlikely that farming confers an increased risk. Results suggest that some other factor is driving the differences in myeloma incidence by ethnic group. We have provided a baseline of the geographical burden of myeloma in New Zealand.We report the earliest known cluster of SARS-CoV-2 infection so far reported, which occurred in New Zealand in late February 2020. The cluster includes one confirmed and five probable cases. The cluster was identified while investigating a weak positive nasopharyngeal swab (NPS) polymerase chain reaction (PCR) test that was returned by a male in his 60s in September 2020. The PCR result, combined with a clear clinical and epidemiological history of a COVID-19 like illness in late February 2020, prompted serological testing. GLPG1690 SARS-CoV-2 IgG antibodies were detected and supported historical infection. Serology was also reactive for five close contacts who had also experienced a COVID-19 like illness in February 2020. Combined case histories and investigations suggest that this local cluster was import related, with the index case identified as a family member visiting from Italy in February. Case investigation also suggests this cluster was active in New Zealand prior to any previously documented local cases, indicating that SARS-CoV-2 was present and local transmission was occurring earlier than initially suspected.