The following are summaries of items appearing in the 10 February issue (Vol 125 No 1349) of the New Zealand Medical Journal, the journal of the New Zealand Medical Association

Editorial

A call for collaboration on inflammatory bowel disease in New Zealand
Russell Walmsley
In this edition of the Journal the first attempt at calculating the financial burden of inflammatory bowel disease (IBD) in either New Zealand or Australia is described.1 The Christchurch group of Tim Eglinton and his team-building on their reputation for sturdy epidemiological studies-have chosen just two categories of Crohn's disease (CD) patients where the burden to healthcare providers and patients and their families are perhaps the highest, namely paediatric and perineal disease.

Original Articles

The cost of paediatric and perianal Crohn's disease in Canterbury, New Zealand
Michaela Lion, Richard B Gearry, Andrew S Day, Tim Eglinton
The aim of this study was to determine the direct and indirect costs of Crohn's disease (CD) in paediatric and perianal patients in Canterbury in one year.

Screening for Mycobacterium tuberculosis infection among healthcare workers in New Zealand: prospective comparison between the tuberculin skin test and the QuantiFERON-TB Gold In-Tube® assay
Joshua T Freeman, Roger J Marshall, Sandie Newton, Paul Austin, Susan Taylor, Tony C Chew, Siobhan Gavaghan, Sally A Roberts
A cross-sectional study was used to compare the "QuantiFERON-TB Gold In-tube" assay® (QFT-GIT) to the Mantoux tuberculin skin test (TST) as a test for M. tuberculosis infection (TB) among healthcare workers in Auckland, New Zealand (NZ).

Audit of stroke thrombolysis in Wellington, New Zealand: disparity between in-hours and out-of-hours treatment time
Katie Thorne, Lai-Kin Wong, Gerard McGonigal
The aim of this study was to report on the safety and efficiency of a comprehensive stroke thrombolysis service and look for evidence of disparity between in-hours and out-of-hours treatment times

Training medical students in Pacific health through an immersion programme in New Zealand
Faafetai Sopoaga, Jennie L Connor, John D Dockerty, John Adams, Lynley Anderson
Medical schools are required to adequately prepare students to work in increasingly diverse and multi-ethnic societies. Students need to be able to integrate clinical knowledge with an understanding of the society they live in. Pacific peoples are a disadvantaged migrant minority ethnic group in New Zealand. This paper discusses the development of, and lessons learnt from a Pacific Immersion Programme for medical students at the University of Otago, New Zealand.

Insomnia treatment in New Zealand
Karyn M O'Keeffe, Philippa H Gander, W Guy Scott, Helen M Scott
The aim of this study was to describe insomnia treatment in New Zealand and estimate the annual societal costs of insomnia among New Zealanders aged 20-59 years.

Evaluation of New Zealand's bicycle helmet law
Colin Clarke
The New Zealand helmet law (all ages) came into effect from 1 January 1994. It followed after Australian helmet laws introduced in 1990-1992. Pre-law (in 1990) cyclist deaths were nearly a quarter of pedestrians in number, but by the 2006-09 period, the equivalent figure was near to 50% when adjusted for changes to hours cycled and walked. From 1988-91 to 2003-07, cyclists' overall injury rate per hour increased by 20%. Is a mandatory cycle helmet requirement the best approach to promoting health and safety for the nation?

Sun protection policies and practices in New Zealand primary schools
Anthony I Reeder, Janet A Jopson, Andrew Gray 
This study was for schools with primary age students, to report the percentages meeting specific requirements of the New Zealand SunSmart Schools Accreditation Programme (SSAP).

Viewpoint

Should measurement of vitamin D and treatment of vitamin D insufficiency be routine in New Zealand?
Mark J Bolland, Andrew Grey, James S Davidson, Tim Cundy, Ian R Reid
Epidemiological studies have reported associations between lower vitamin D levels and a great variety of diseases, prompting calls for widespread treatment of individuals with low vitamin D levels.

Clinical Correspondence

A case of yellow fever vaccine-associated disease
Heather Isenman, Andrew Burns
Yellow Fever is a mosquito borne flavi-virus  endemic and epidemic in South America, and Sub-Saharan Africa. Wild type disease  incidence  is between 100 to 1200 cases per annum worldwide, with mortality 20 to 50%. Whilst South America has instituted mass immunisation campaigns the highest incidence is reported in Africa, where vaccination coverage is poor.

An unusual cause of carotid sinus hypersensitivity/syndrome
Donny Wong, Joey Yeoh
Syncope is extremely common, especially in the elderly population. Although neurocardiogenic (vasovagal) syncope accounts for ≥35% of cases, carotid sinus hypersensitivity (CSH) is a notable, albeit rarer, cause of reflex syncope. We present an unusual case of CSH resulting from malignancy, representing a diagnostic and therapeutic challenge.
 
Medical image. Anterolateral diaphragmatic hernia presenting in the sixth decade
Emmanuel Bhaskar, Karthick Vishnu, Krishnan Vasanthan, Mani Rajkumar

Medical image. Bruising-unusual aetiology
Tilak de Almeida, Kewa Mascelle

Subscribers to the NZMJ can view these articles in full on the NZMJ website