A prospective observational study on the effect of emboli exposure on cerebral autoregulation in cardiac surgery requiring cardiopulmonary bypass.

Objective: Cerebrovascular autoregulation impairment has been associated with stroke risk in cardiac surgery. We hypothesized that greater arterial emboli exposure in open-chamber surgery might promote dysautoreguation.

Methods: Forty patients underwent closed or open-chamber surgery.

A review of a regional primary percutaneous coronary intervention service, with a focus on door to reperfusion times: the 2012 Auckland/Northland experience.

Aims: Primary percutaneous coronary intervention (PCI) is the optimal management for ST segment elevation myocardial infarction (STEMI) patients. We reviewed the largest primary PCI regional service in New Zealand: the Auckland/Northland service based at Auckland City Hospital, to assess patient management, in particular the door to reperfusion times (DTRTs), and predictors of death in hospital.

Methods: We obtained patient details from a comprehensive prospective database of all primary PCI patients admitted with STEMI from 1/1/12 to 31/12/12 to the Auckland City Hospital cardiac catheterisation laboratory.

Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome. A retrospective observational study.

The prevalence of anaemia is increasing globally. It has a close association with perioperative blood transfusion which, in turn, results in an increased risk of postoperative complications. Undesirable effects are not only limited to short-term, but also have long-term implications.

Extracorporeal membrane oxygenation for cardiorespiratory failure in four patients with pandemic H1N1 2009 influenza virus and secondary bacterial infection.

We report four patients with pandemic H1N1 2009 influenza virus and secondary bacterial infection who were treated with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory failure. Three of the four patients had profound shock, necessitating support with venoarterial ECMO. Two patients died during ECMO support.

Pediatric experience with the VentrAssist LVAD.

Purpose: The purpose of this study is to describe the first experience of implanting a new left ventricular assist device in pediatric patients with end-stage heart failure.

Description: In two recent prospective, international, multicenter clinical trials, three children (aged
Evaluation: Despite the patients' disease severity (each child was in extremis at the time of implantation), VentrAssist (Ventracor Limited) implantation enabled each patient to be discharged home from the hospital.

Mental health in New Zealand.

New Zealand's healthcare system has undergone significant changes in recent times, among them being the establishment in 1993 of a purchaser/provider split and the specific attention given to the development of mental health services. Funding for mental health services (Fig. 1) increased from NZ$270 million in 1993/94 to NZ$866.

Cardiac transplantation and aortic coarctation repair in severe heart failure.

A 37-year-old man presented with severe dilated cardiomyopathy secondary to occult aortic coarctation. He was successfully managed with combined orthotopic heart transplantation and aortic coarctation repair.

New Zealand anaesthesia trainees and implications for the future workforce.

Attempting to ensure an adequate anaesthesia workforce for New Zealand requires many variables to be taken into consideration. The difficulty lies in trying to predict and match the future needs of the population and the future needs of the workforce itself. This paper examines variables that affect anaesthesia trainees' decisions in regard to future work plans which will affect anaesthesia distribution and manpower in New Zealand, particularly in smaller hospitals.

Further evidence for proinflammatory nature of perfluorohexyloctane in the eye.

Background: The authors present a clinicopathological report of their initial experience with perfluorohexyloctane (F6H8), a novel semifluorinated liquid fluorocarbon developed as a long-term vitreous substitute.

Methods: A retrospective observational review was performed of five patients in whom F6H8 had been used for management of rhegmatogenous retinal detachment. Surgical specimens taken from two patients at the time of F6H8 removal were also submitted for histopathological, immunohistochemical and electron microscopic analysis.

Loss of vision caused by expansion of intraocular perfluoropropane (C(3)F(8)) gas during nitrous oxide anesthesia.

Purpose: To report visual loss associated with nitrous oxide anesthesia in patients with intraocular perfluoropropane (C(3)F(8)) gas.

Design: Observational case series.

Methods: Three patients are described who lost vision in the eye with intraocular gas after subsequent nitrous oxide general anesthesia.

Teacher acquisition of functional analysis methodology.

The current study examined methods for training teachers to use functional analysis methods. Teachers first received written and verbal instructions detailing attention and demand conditions. They then received training that included modeling, rehearsal, and performance feedback.

Cicatricial pemphigoid: a diagnostic problem for the urologist.

We describe a case of cicatricial pemphigoid, which is a chronic bullous disorder that predominantly involves mucous membranes. It can sometimes present to the urologist, with erosions, blisters or ulcers on the male or female genitalia, and can pose a diagnostic problem. The response to medical therapy can be rewarding.

The use of medical audit for producing guidelines of medical practice.

To demonstrate that Medical Audit can be used to produce guidelines for medical practice in an endeavour to ensure quality of medical care. The North Western Urological Audit Group meet regularly six monthly to audit their urological practice. Guidelines are drawn up taking in to account the recent published literature.