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A recent UK study has found alcohol consumption had a negative linear association with global brain grey matter volume and widespread negative associations with white matter microstructure. Higher blood pressure and body mass index and binge-drinking increased the risk of alcohol-related harm to the brain. However, no safe level of alcohol consumption was found in terms of adverse effects to the brain structure.
The ABC approach to smoking cessation is well known and a similar approach is recommended at every opportunity to identify patients who may benefit from reducing their alcohol intake:
Current recommended upper limits of drinking in New Zealand are:
Use of the AUDIT-C screening tool is encouraged with risk stratification using the AUDIT tool if potentially hazardous drinking is identified on screening.
Comprehensive assessment and management advice is available from BPAC and there are resources for patients (self-assessment, self-management) on the alcohol.org.nz website.
The IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) can be a useful tool in screening for cognitive impairment and rate of cognitive decline in a patient with suspected cognitive impairment or dementia. It is recommended to use the tool in conjunction with other patient administered tools such as the Mini-ACE. It is available in written form on the Dementia Wellington website.
85% of people diagnosed with ovarian cancer are diagnosed in the later stages of disease when treatment options are limited.
Assess possible ovarian cancer if new abdominal or pelvic symptoms are present on a persistent or frequent basis – particularly more than 12 times per month.
The New Zealand Gynaecological Cancer Foundation has a downloadable patient diary available which may help clarify the nature and frequency of symptoms being experienced by your patient.
The Midland Region Community HealthPathways has succinct guidance on investigation and management of patients with possible ovarian cancer including the role of Ca-125 and the relevance of family history.
New Zealand is experiencing a surge in RSV infection in infants and young children. The infection may present as a mild respiratory infection, bronchiolitis or pneumonia. A high fever (> 39°C) and focal crackles on chest auscultation are consistent with the infant having pneumonia rather than bronchiolitis. Wheeze is less common in infants with pneumonia, however, the presence or absence of wheeze alone is insufficient to distinguish between bronchiolitis and pneumonia.
Midland Region Community HealthPathways gives clear guidance on management of bronchiolitis including red flags:
There is a useful grading tool to facilitate clinical decision-making.
There is no evidence for efficacy of the following interventions which are recommended against the following.
Printable patient information for parents of children being discharged home is available from KidsHealth and Health Navigator.
A more detailed discussion on diagnosis and management of bronchiolitis is available in a 2017 BPAC article.
A statement from the WHO Global Advisory Committee on Vaccine Safety on 9th July 2021 noted that clinicians need to be aware of the risks of myocarditis and pericarditis following mRNA vaccination (Moderna and Pfizer vaccines) and those most likely to be affected.
In response, Medsafe released information on 21 July 2021 including the following.
During the COVID-19 lockdown virtual consultations for POAC cases were funded. We are pleased to announce that this will be a permanent change.
Read moreRead updates about stock arriving in Aotearoa New Zealand, vaccines for the upcoming flu season, programme timing, training modules and more.
Read moreThis funding is available for a GP/NP consultation with patients eligible for an advance prescription for COVID-19 anti-viral medication, prior to them testing positive for COVID-19. There is no obligation for a clinician to issue an advance prescription.
View detailsBPAC traffic light system to predict risk of serious illness in children with fever.