High rates of the SDHB p.Arg46Gln pathogenic variant predisposes New Zealand Māori to phaeochromocytoma/paraganglioma.

Background: Phaeochromocytomas (PCC) and paragangliomas (PGL; together PPGL) are rare tumours of the adrenal medulla or extra-adrenal paraganglia. They may secrete catecholamines with significant cardiovascular effects. Management of PPGL is predominantly surgical, despite the anaesthetic risks related to potential haemodynamic instability.

Anaphylaxis is more common with rocuronium and succinylcholine than with atracurium.

Background: Intraoperative anaphylaxis is a rare but serious occurrence, often triggered by neuromuscular-blocking drugs (NMBDs). Previous reports suggest that the rates of anaphylaxis may be greater for rocuronium than for other NMBDs, but imprecise surrogate metrics for new patient exposures to NMBDs complicate interpretation.

Methods: This was a retrospective, observational cohort study of intraoperative anaphylaxis to NMBDs at two hospitals between 2006 and 2012.

Lead poisoning from Ayurvedic medicines.

A case of lead poisoning with established exposure to Ayurvedic medicines is presented. This patient migrated from India to New Zealand 8 years previously. He regularly visits India where he purchases "herbal remedies" for his wellbeing.

Pulmonary barotrauma and cerebral arterial gas embolism during hyperbaric oxygen therapy.

Hyperbaric oxygen therapy (HBOT) is used to treat a variety of disorders. It is a safe treatment modality, but rare catastrophic complications may occur. In this case report, we describe the occurrence of irreversible spastic quadriparesis in a patient who suffered a cerebral arterial gas embolism (CAGE) during decompression from HBOT.

The incidence of hypoxemia during surgery: evidence from two institutions.

Purpose: The incidence of hypoxemia in patients undergoing surgery is largely unknown and may have a clinical impact. The objective of this study was to determine the incidence of intraoperative hypoxemia in a large surgical population.

Methods: We performed a retrospective study of electronically recorded pulse oximetry data obtained from two large academic medical centres.

Lax sphygmomanometer standard causes overdetection and underdetection of hypertension: a computer simulation study.

Objective: To quantify overdetection and underdetection of hypertension caused by systematic sphygmomanometer errors permitted by the current European standard (EN 1060 'noninvasive sphygmomanometers').

Methods: We carried out Monte Carlo simulation of measurement of blood pressure (BP) of the adult Australian population using sphygmomanometers showing systematic errors compliant with the EN 1060 standard. We repeated the simulations limiting systematic sphygmomanometer errors to +/-1 mmHg.

Blood pressure variability causes spurious identification of hypertension in clinical studies: a computer simulation study.

Background: The blood pressure (BP) of an individual varies considerably from day to day. Hypertension is commonly identified based on the average of two BPs taken at each of two visits, a practice consistent with current guidelines. We hypothesized that (i) in the setting of high-normal BP ("prehypertension"), this practice results in frequent spurious detection of hypertension, and (ii) that random, spurious detection of hypertension and flawed study design together explain why in the Trial of Preventing Hypertension (TROPHY) study candesartan appeared to suppress the development of hypertension for 2 years after cessation of therapy.

Ayurvedic medicine: patients in peril from plumbism.

Heavy metals are commonly incorporated into Ayurvedic preparations as ashes or 'bhasmas'. A widely disseminated belief within Ayurvedic medicine is that these heavy metals can be valuable therapeutic components. Western toxicology refutes this contention.

The agreement between reaction-board measurements and kinematic estimation of adult male human whole body centre of mass location during running.

The segmental method for estimating the centre of mass (COM) location of the human body has been widely used since 1889. How closely this method agrees with direct measurements of the location and movement of COM during activity however, remains unclear. To test this, a novel reaction-board utilizing life sized projections of human subjects is designed for measuring COM location.