The New Zealand medical journal
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Elderly are the most vulnerable population group owing to increased prevalence of chronic diseases and drug consumption. Several characteristics of aging and geriatrics medicine affect drug prescribing for elderly. Thus the selection of appropriate pharmacotherapy for elderly becomes a complex and challenging process. ⋯ The objective of this article is to understand the concept, causes and measurement of medication errors in elderly. Various interventions to improve drug prescribing such as educational approaches, geriatric medicine services, computerised prescribing and multifaceted approaches have also been highlighted. In conclusion there is an overwhelming need for optimising the prescribing in elderly through an integrated approach involving physician, pharmacologist, pharmacist and the patient himself.
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Review Case Reports
Bilateral plunging ranula: two case reports and a review of the literature.
Presentation of two bilateral plunging ranula cases and then review of the plunging ranula literature to understand current concepts on aetiology, imaging for diagnosis and management. ⋯ Plunging ranula are a rare cause of bilateral and unilateral neck swellings but more common in Maori, Polynesian and Asian people. Their cause is multifactorial and ultrasound scan (USS) is the current investigation of choice. Management relies on excision of the sublingual gland with the cystic contents via a trans-oral approach.
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After a spate of recent New Zealand cyclist deaths, cycle advocates and several policy makers have been pondering the issue of increased penalties aimed at drivers deemed at fault. A key question is whether vulnerable road users (VRUs), including pedestrians, workers, animal riders, stranded motorists, skateboarders, cyclists, and others, are likely to be protected through enhanced penalties for at fault drivers of motor vehicles. We explored current policy and the international literature to examine whether or not enhanced penalties would be likely to increase motor vehicle driver motivation to exercise greater caution around VRUs leading to improved road safety.
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New Zealand has a number of plants, both native and introduced, contact with which can lead to poisoning. The New Zealand National Poisons Centre (NZNPC) frequently receives enquiries regarding exposures to poisonous plants. Poisonous plants can cause harm following inadvertent ingestion, via skin contact, eye exposures or inhalation of sawdust or smoked plant matter. ⋯ Poisoning following ingestion or other forms of exposures to plants in New Zealand is relatively common, particularly among children. However, serious adverse reactions are comparatively rare. Accurate plant identification and details on the type of exposure can be important in assessing the likely risks. Effective medical management of these poisonings can be achieved by following the principles outlined in this review.