Acceptability of electronic cigarettes as an option to replace tobacco smoking for alcoholics admitted to hospital for detoxification.

Aim: A feasibility/acceptability trial was undertaken at Ward 5, Kenepuru Hospital, Porirua, to ascertain whether electronic cigarettes (e-cigarettes) were a useful option to replace or reduce smoking in the detoxification ward.

Methods: Two groups of patients were studied. Tobacco use and dependency data were collected for each.

Patients in methadone maintenance treatment who inject methadone syrup: a preliminary study.

An increased awareness of the injection of methadone syrup has been appreciated by methadone treatment clinicians and Needle Exchange outlets which distribute large-volume syringes. This study aimed to identify patterns of use by methadone injectors, and the reasons and perceived risks of this behaviour. Nineteen of 36 attendees at a needle exchange who stated they had injected methadone over the previous 3 months completed a structured interview.

Thiamin concentration in geriatric hospitalized patients using frusemide.

Aim: To assess the association between thiamin concentration, frusemide use, and renal function in older adults.

Method: Thiamin concentration was measured in 73 consecutive admissions of patients aged over 65 years in a secondary care hospital. The patients were assigned to the study or control group based on frusemide use.

Beware of paracetamol use in alcohol abusers: a potential cause of acute liver injury.

There may be under-recognition of acute liver injury following reported therapeutic use of paracetamol in alcoholics. We present the case of an alcoholic patient who developed acute liver injury suspicious for chronic paracetamol toxicity on two occasions. The likely contribution of chronic paracetamol was not recognised at her second presentation, reflecting a need for increased awareness of this potential cause of acute liver injury.

Patterns of prescription drug misuse presenting to provincial drug clinics.

Aim: To survey new patients, presenting to three drug clinics, on the patterns, usage and costs of prescription pharmaceuticals.

Method: Consecutive patients seen by the medical staff for assessment had a 7-day history recorded for prescription drug (PD) usage, and the associated costs of these from street sources.

Results: There were 37 patients (26 males) with a mean age of 34 years (21-51).

Misuse of over-the-counter codeine-containing analgesics: dependence and other adverse effects.

Aim: To review cases of codeine dependency from over-the-counter (OTC) combination analgesics admitted to a hospital detoxification unit.

Method: Case records of all admissions following an index case were reviewed over a 2-year period.

Results: There were 7 cases reporting chronic excess of Nurofen Plus, of which 6 had prior or current histories of alcohol dependency.

Alcohol cardio-protection has been talked up.

Doctors have been promoting alcohol as a health tonic for a very long time. The last 30 years has seen the accumulation of a considerable medical literature investigating the potential role of alcohol use as a protection against coronary heart disease. When viewed through the lens of two major early reviews in the mid-1980s, Sir Richard Doll's contributions of the mid-1990s, two large meta-analyses of 10 years ago and two most recent overviews, the health-giving properties of alcohol use become increasingly debatable.

Recurrences determine the dynamics.

We show that under suitable assumptions, Poincare recurrences of a dynamical system determine its topology in phase space. Therefore, dynamical systems with the same recurrences are dynamically equivalent. This conclusion can be drawn from a theorem proved in this paper which states that the recurrence matrix determines the topology of closed sets.

Can beta agonists cause dilated cardiomyopathy?

We report a case of dilated cardiomyopathy that we believe is secondary to excessive use of inhaled beta agonists. Clinicians should be mindful of this possibility when using beta agonists to treat patients with obstructive airways disease; particularly if there is already recognised left ventricular dysfunction.

The New Zealand national junior doctors' strike: implications for the provision of acute hospital medical services.

The New Zealand junior doctors' strike provided an opportunity to consider strategies that might be employed to overcome the international shortage of junior doctors. This article reports the experience of the emergency department (ED) and internal medicine (IM) services at Wellington Hospital during the national strike, in which medical services were primarily provided by specialist consultants in addition to, or as part of, their routine work. During the strike, elective admissions and outpatient clinics were mostly cancelled.

Cannabis use and cancer of the head and neck: case-control study.

Objective: To investigate whether cannabis smoking increases the risk of head and neck cancer.

Design: Case-control study.

Subjects And Methods: Cases of head and neck cancer < or =55 years identified from hospital databases and the Cancer Registry, and controls randomly selected from the electoral roll completed interviewer-administered questionnaires.

Is it time to change the approach to oxygen therapy in the breathless patient?

The need to highlight the risks of high flow oxygen in clinical teaching

New hospital consultant: surviving a difficult period.

The first years of consultant practice are amongst the most stressful in a medical specialist's career. Recognising the likely difficulties is essential if measures are to be put in place to lessen their impact. In this article, recommendations are made on how to balance clinical and non-clinical duties and to obtain the support required for professional development.

Effects of cannabis on pulmonary structure, function and symptoms.

Background: Cannabis is the most widely used illegal drug worldwide. Long-term use of cannabis is known to cause chronic bronchitis and airflow obstruction, but the prevalence of macroscopic emphysema, the dose-response relationship and the dose equivalence of cannabis with tobacco has not been determined.

Methods: A convenience sample of adults from the Greater Wellington region was recruited into four smoking groups: cannabis only, tobacco only, combined cannabis and tobacco and non-smokers of either substance.

Hemochromatosis gene mutations, liver function tests and iron status in alcohol-dependent patients admitted for detoxification.

Background: Screening of target populations for hemochromatosis (HFE) gene allele status has been recommended. Alcoholic liver disease may be associated with iron overload and there is evidence of excessive alcohol consumption among patients with hereditary hemochromatosis. This study determined the HFE gene allele status in alcohol-dependent patients and explored the associations between iron status, liver enzymes, and HFE status.

Poppy seed tea and opiate abuse in New Zealand.

The opium poppy Papaver somniferum contains an array of opiates. There is a variety of methods of preparation that can be used by people with opiate dependence, with patterns of use determined by numerous factors including cost, safety, potency and legal status. The objective of this study was to determine the frequency and nature of poppy seed tea (PST) use by opiate-dependent patients in the form of a written questionnaire.

Streptococcus gallinaceus bacteraemia in an abattoir worker presenting with a febrile illness.

Streptococcus gallinaceus is a newly described species of viridans streptococci, previously only identified as causing disease in broiler chickens. This organism was recovered in pure culture from blood taken from a New Zealand abattoir worker presenting with a febrile illness. This first report of bacteraemia caused by S.

Raised plasma homocysteine levels in alcoholism: increasing the risk of heart disease and dementia?

Background: Raised plasma homocysteine levels, which may contribute to the increased risk of cardiovascular disease and dementia associated with alcoholism, have been observed in alcohol-dependent male subjects.

Methods: In this study, we measured plasma homocysteine levels in 20 female and 31 male alcoholic subjects admitted to hospital for detoxification. Nutritional status and clinical factors that might predict plasma homocysteine levels were assessed by measurement of red cell folate, vitamin B12, blood alcohol, and liver function tests.

The genetics of alcoholism in Polynesians: alcohol and aldehyde dehydrogenase genotypes in young men.

Background: The last 10 years have seen growing recognition of the significance of the genes encoding enzymes responsible for hepatic alcohol metabolism as protective factors in the development of alcoholism.

Methods: We have developed DNA sequencing assays for measuring genetic variation at the alcohol dehydrogenase 2 (ADH2), ADH3, and aldehyde dehydrogenase 2 (ALDH2) loci. These have been used to survey volunteer control subjects from three New Zealand ethnic groups (white, Asian, and Polynesian) and young male alcoholics recruited from white and New Zealand Maori patients in a local treatment program.