Paracetamol treatment for patent ductus arteriosus: practice and attitudes in Australia and New Zealand.

Aim: To describe the current clinical practices and attitudes of neonatologists towards paracetamol treatment of PDA in Australia (AU) and New Zealand (NZ). Method: A web-based survey of all neonatologists registered under the 2017 Australia New Zealand Neonatal Network (ANZNN) was conducted. Results: The response rate for the survey was 67%, (141/210). Of those respondents, 37% stated their unit had a written policy outlining how to treat patent ductus arteriosus (PDA). Of the written policies, 53% mentioned paracetamol treatment. The majority of the respondents (70%) have prescribed paracetamol for PDA closure. When comparing between countries, 79% of AU respondents had compared with 44% of NZ respondents. Successful ductal closure in the infants who received paracetamol was anecdotally reported by 61% of respondents. The main reasons for clinicians not prescribing paracetamol were due to preferential NSAID use (61%) and lack of evidence to indicate efficacy (49%). Conclusion: Many neonatologists in AU and NZ have prescribed paracetamol for PDA closure. However, considerable practice variations exist. The results from this study suggest there may be a role for paracetamol in the treatment of PDA, however, further research is required to clarify the optimal use and provide evidence of efficacy.

Small for gestational age and low birth weight term admissions to a tertiary perinatal centre in northern Queensland, Australia.

Northern Queensland is unique in that the proportion of Aboriginal and Torres Straits Islander (ATSI) communities is higher than the rest of Australia. The aim of this study was to describe the characteristics of term admissions of low birth weight (LBW; birth weight < 2,500 g) and small for gestational age (SGA; birth weight < 10th centile) infants to a neonatal unit. All term infants (>37 weeks of gestation) with LBW and/or SGA admitted to the neonatal unit over the last 10 years (2002-2011) were identified and the percentage calculated. Ethnicity was determined by the mother and that information was recorded in the patient's medical record. The average percentage of LBW ATSI infants was 20.2 ± 5.7%, which was significantly higher (almost double) compared with the percentage of LBW non-ATSI infants (10.2 ± 1.9%; p < 0.001). The average percentage of SGA ATSI infants was also significantly higher than the percentage of SGA non-ATSI infants (31.8 ± 6.0 vs. 18.6 ± 2.8%, respectively; p < 0.001). The mean percentage of LBW indigenous infants admitted to the neonatal unit was significantly higher than non-ATSI infants.

Trends in Maori mental health in Otago.

OBJECTIVE: This paper outlines the methods used, and preliminary descriptive data collected, in a study on a cohort of Maori and non-Maori patients admitted to the inpatient psychiatric services in Otago between 1990 and 1992. METHOD: The notes of 42 Maori and 217 non-Maori first admissions to psychiatric inpatients were reviewed. Information concerning this admission was entered onto a database and analysed. RESULTS: The Maori admission rate was 4 per 1000 compared with 1 per 1000 for non-Maori people. This was higher than expected based on Otago population figures. Rates of family psychiatric history did not differ between Maori and non-Maori. Although Maori were found to have higher rates of social welfare support and were more likely to have no academic qualifications the differences were not significant. The sources of referral for Maori admissions were more likely to be from the law, and Maori were more likely to have had prior psychiatric inpatient treatment. The most common diagnosis for Maori and non-Maori was depressive disorders, and suicidal behaviour was common. CONCLUSIONS: Maori are overrepresented among first psychiatric inpatient admissions in Otago. They appear to be a more disadvantaged group with respect to financial support, academic qualifications and other health problems. The most common diagnosis did not differ between Maori and non-Maori cohorts.

Familial bipolar disorder: preliminary results from the Otago Familial Bipolar Genetic Study.

OBJECTIVE: This paper outlines the methodologies used, and preliminary descriptive data collected, on a cohort of familial bipolar disorder (BPD) probands and first-degree relatives taking part in a descriptive and genetic study into familial BPD in New Zealand. METHOD: Fifty-five bipolar probands and 67 first-degree relatives were interviewed using the modified Diagnostic Interview for Genetic Studies (DIGS) and Family Interview for Genetic Studies (FIGS). Data was also collated from other sources. Blood samples were taken for DNA genomic analysis. RESULTS: New Zealand families in which BPD segregates proved willing participants in this familial based genetic research. The methodologies used were acceptable. High rates of comorbidity were found in probands (27.3% met DSM-IV criteria for panic disorder/sub-threshold panic disorder; 12.7% for phobic disorder; 1.8% for obsessive-compulsive disorder; 9.1% for alcohol-related disorders and 7.3% for an eating disorder) and relatives (major depression 34.3%; panic disorder/sub-threshold panic disorder 12.0%; phobias 11.9% and alcohol-related disorders 11.9%). The polarity of index BPD illness was related to age of onset and frequency of comorbidity. Suicidal behaviour was common. CONCLUSIONS: Psychiatric genetic research in New Zealand families is highly feasible. Emerging trends in the familial transmission of BPD include high rates of comorbidity, illness patterns based on polarity of index episode and frequent suicidal behaviour. Such trends will be delineated further as numbers accrue, perhaps enabling identification of more homogenous phenotypic subgroups than currently produced by diagnostic schemes.