Kotahitanga 9

We love a bit of deprescribing in the elderly and the primary care flavour of Nelsons contribution this issue. Anti-hypertensive medication reduction in some older patients is not associated with important change in BP control. In patients 80 years or older on at least two anti-hypertensive medications, stopping one...

Best Case Ever

This case comes from Dr Alex McLeod RHMS Taupō. ...

Kotahitanga 8

Impact of point of care testing on length of stay of patients in the Emergency Department. We were surprised by the non significant reduction in ED length of stay and curious about the possibility of entrenched clinical work patterns. Being a centre without CT we were also excited about...

empagliflozin

Great Goodfellow webinar tonight. Endocrinologist Dr Ryan Paul and RNZCGP Medical Director Dr Bryan Betty discussed the role of these medications. Key Messages  Empagliflozin is a preferred 2nd line agent in cardiovascular disease, especially heart failure, and renal disease. It reduces mortality from cardiovascular events and renal disease progression...

Of Art and Uncertainty

“In order to make progress, one must leave the door to the unknown ajar.” Richard Feynman...

Kotahitagna 7

Management of post-partum haemorrhage is encountered not infrequently in rural hospital medicine. Administration of TXA is part of local protocols, cheap, easy to use and widely available. Thanks for this appraisal of the evidence Kotahitagna!...

Salute to the Pōhutukawa and the West Coast.

It’s Christmas. I’m touring the north Island with family in tow.  Blooming pōhutukawa line the Coromandel coastline.  I’m curious about its evolution, uniquely suited to the landscape, shaped by millennia of slow and steady adaptations.  Courageously reaching for the coral sea. The New Zealand Christmas tree.  I wondered how many versions of the Christmas tree...

Time to surgery: Comparison between rural and metropolitan hospitals.

Another great read from Otago Universities LOFP. Researchers compared the length of time to receive surgery, the proportion that receive surgery within national guidelines and the corresponding mortality rates at 30 and 120 days for patients who present to the DHB’s rural hospitals vs Waikato hospital. Patients who presented...