Preoperative comprehensive geriatric assessment and multidisciplinary team input in older people undergoing elective orthopaedic surgery: A feasibility trial.

Objective: To determine the feasibility of preoperative comprehensive geriatric assessment (CGA) and multidisciplinary team (MDT) input for older people undergoing elective orthopaedic surgery in a tertiary New Zealand setting.

Methods: This single-centre retrospective study included elective orthopaedic patients older than 65 years (and Māori/Pasifika aged greater than 55 years) with hyperpolypharmacy, frailty, neurocognitive disorders and poor functional status. Patients attended a preoperative clinic where they had a geriatrician-led CGA along with MDT input.

The training, experience, and confidence of junior doctors in performing pleural procedures.

Aim: Pleural procedures may cause patient discomfort and serious complications if performed inadequately. We surveyed junior doctors to provide information about training and experience.

Methods: We surveyed 493 junior doctors working in departments involved in pleural procedures in three teaching hospitals via postal questionnaires in 2002.

Occult nasal sinus tumours causing oncogenic osteomalacia.

Oncogenic osteomalacia (OOM) is a rare but curable cause of metabolic bone disease. We report 9 patients with OOM, including 2 patients with occult nasal sinus tumours and 1 in whom a progressive increase in the post-operative FGF23 level heralded the development of metastatic pulmonary disease. The median duration of symptoms before definitive surgical treatment was 6 years, and in one patient was more than 10 years.

Diving-related pulmonary oedema as an unusual presentation of alcoholic cardiomyopathy.

Diving-related pulmonary oedema (DRPO) is an uncommon and incompletely understood phenomenon. Pulmonary oedema has been rarely documented in shallow water. It is also associated with cold water and exertion and has been seen in swimmers as well as divers with no underlying heart disease.

Diabetes care: practice nurse roles, attitudes and concerns.

Background: Practice nurses (PNs) are the largest group of nurses providing primary care for patients with diabetes in New Zealand, and changes in the health system are likely to have a substantial effect on their roles. To inform the development of a new primary health care nursing structure and evaluate the new role associated with this, it will be important to have data on current practice nurse roles.

Aims: The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care.

Diabetes care by general practitioners in South Auckland: changes from 1990 to 1999.

Aim: To compare self-reported practices and preferences for diabetes care by general practitioners (GPs) in South Auckland between 1990 and 1999.

Methods: Mail questionnaires were sent to all GPs in South Auckland in 1990, and again in 1999.

Results: The response rate was 88% (163/185) in 1990 and 76% (186/245) in 1999 (p = 0.