Improving early detection of colorectal cancer in Aotearoa New Zealand; how do the direct access criteria perform?

Aim: Colorectal cancer (CRC) is a common malignancy in New Zealand, and there is increasing pressure on investigative resources for diagnosis. The national direct access referral guidelines from the Ministry of Health (MoH) guide who should be referred for investigation, but their performance in detecting CRC and other significant diseases has not been reported previously. This paper describes the yield, by direct access criterion, of all referrals through the direct access pathway to the Canterbury District Health Board (CDHB) during 2018.

Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?

Background: Colorectal cancer (CRC) may be reduced by healthy lifestyle behaviours. We determined the extent of self-reported lifestyle changes in people at increased risk of CRC, and the association of these reports with anxiety, risk and knowledge-based variables.

Methods: We randomly selected 250 participants who had undergone surveillance colonoscopy for family history of CRC.

Thyroid stimulating hormone and free thyroxine in pregnancy: expressing concentrations as multiples of the median (MoMs).

Background: Thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. Reference ranges are widely quoted but are arbitrary and do not allow for inter-laboratory differences or gestational age. We therefore explored using multiple of the median (MoM) values to overcome these limitations.

Perceived risks and benefits of surveillance colonoscopy in people undergoing surveillance for family history of colorectal cancer.

Aim: To determine perceived risks and benefits of colonoscopy surveillance among patients undergoing surveillance colonoscopy due to family history of colorectal cancer (CRC).

Method: We conducted a standardised phone interview of 250 randomly selected people who had undergone surveillance colonoscopy at Dunedin Hospital. We assessed perceptions of colonoscopy effectiveness, complication rates, and CRC risk.

Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer.

Background: It is not known whether low-dose radioiodine (1.1 GBq [30 mCi]) is as effective as high-dose radioiodine (3.7 GBq [100 mCi]) for treating patients with differentiated thyroid cancer or whether the effects of radioiodine (especially at a low dose) are influenced by using either recombinant human thyrotropin (thyrotropin alfa) or thyroid hormone withdrawal.

Antenatal thyroid screening and childhood cognitive function.

Background: Children born to women with low thyroid hormone levels have been reported to have decreased cognitive function.

Methods: We conducted a randomized trial in which pregnant women at a gestation of 15 weeks 6 days or less provided blood samples for measurement of thyrotropin and free thyroxine (T(4)). Women were assigned to a screening group (in which measurements were obtained immediately) or a control group (in which serum was stored and measurements were obtained shortly after delivery).

Transient congenital hypothyroidism due to thyroid-stimulating hormone receptor blocking antibodies: a case series.

We describe seven infants with transient congenital hypothyroidism (CH) due to maternal thyroid-stimulating hormone receptor (TSH-R) blocking antibodies (TRAb) identified over three decades of newborn screening for CH in Wales, UK that represents a minimum incidence of 1.6% of CH cases. Infants with transient CH due to maternal TRAb presented with a spectrum of clinical and biochemical hypothyroidism.

Measurement of urinary free cortisol by tandem mass spectrometry and comparison with results obtained by gas chromatography-mass spectrometry and two commercial immunoassays.

Background: Determination of urinary free cortisol (UFC) is an important adjunct for the assessment of adrenal function. In this study, we have analysed cortisol concentrations in urine samples by gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS/MS) and two immunoassays. The results were compared with GC-MS.

A cross-sectional and a prospective study of thyroid disorders in lithium-treated patients.

Background: The effects of lithium treatment on the thyroid gland have been demonstrated in a number of studies. Most of this research is based on cross-sectional studies and prospective studies are required to confirm these observations.

Method: During our genetic association studies, we recruited 115 males and 159 females suffering with affective disorders who had received lithium treatment.