Development of the International Classification of Functioning, Disability and Health as a brief head and neck cancer patient questionnaire.

WHO has adopted the International Classification of Functioning, Disability and Health (ICF) to assess functioning and disability. A Brief ICF Core Set for head and neck cancer comprises 19 items. This study developed a patient self-completed questionnaire from the items of the brief core set (BCSQ-H&N), compared the BCSQ-H&N questionnaire with the University of Washington v.4 (UW-QOLv4) and compared the BCSQ-H&N results with a clinician-rated evaluation. UW-QOL v4 and BCSQ-H&N were sent to 751 disease-free head and neck cancer patients in April 2008. 376 patients responded to the questionnaire and 25 were interviewed. The percentage reporting significant problems in BCSQ-H&N items ranged between 11% and 43%. The type of problem varied with tumour site. Patients with smaller tumours and patients without radiotherapy reported better outcomes. The BCSQ-H&N correlated well with appropriate items in the UW-QOLv4 especially for functional outcome. There were systematic differences between observer-rated scores and patient self-completed questionnaire responses. Patients suggested additional items for inclusion, namely taste, jaw opening, articulation function, structure of shoulder region, loss of function at the free flap donor site, and intimate relationships. Further validation is required but BCSQ-H&N shows promise as an outcome measure for global use.

Respiratory failure associated with human metapneumovirus infection in an infant posthepatic transplant.

This is the first reported case of respiratory failure associated with human metapneumovirus (hMPV) infection in a liver transplant recipient or in a pediatric solid transplant recipient. A 9-month-old female developed respiratory distress 8 days following a liver transplant. hMPV was detected and she required intubation followed by extracorporeal membrane oxygenation for 26 days. Immunosuppressive medications were stopped during the acute infection except for methylprednisolone as treatment for acute respiratory distress. Serial Doppler ultrasounds were used to monitor for hepatic vessel thromboses and serum liver function tests to assess for hepatic dysfunction and there was no evidence of allograft rejection. The patient recovered from the nosocomial hMPV infection with satisfactory pulmonary function and possible mild developmental delay.

A survey of wasp sting injuries in urban Auckland from December to April in 1991/2 and 1992/3.

AIM: To determine the numbers and the seasonal variations in patients seeking medical consultation for wasp sting injuries in urban Auckland. METHOD: A monthly record of the number of people seeking treatment for wasp stings was kept by 50 general practitioners from 18 medical centres and accident and emergency departments from three hospitals in urban Auckland. RESULTS: From December to April, 47 people in 1991/2 and 49 in 1992/3 received treatment for wasp sting injuries from the family practitioners surveyed. In addition, 27 people and 35 people received treatment at the three accident and emergency clinics over the same time period in 1991/2 and 1992/3 respectively. Paper wasps were found to be responsible for the majority of the sting injuries reported. CONCLUSION: Our data indicates that wasp stings have a significant impact on the health of the Auckland population and indicates the urgent need for more detailed studies in other parts of New Zealand.

Habitat preferences and carcase colonization by sheep blowflies in the northern North Island of New Zealand.

In urban Auckland, from September 1991 to May 1992, only six specimens of the Australian sheep blowfly, Lucilia cuprina, were collected in farmed parkland and in garden habitats. The common green blowfly, Lucilia sericata, was the most common calliphorid trapped in these habitats. Neither of the two Lucilia species were found in native bush remnants in urban or rural areas where Calliphora hilli was dominant. Similarly very few L.cuprina (0.3% of the total) were trapped in rural rubbish tips in January and February where the majority of blowflies were again L.sericata. These results are compared with data collected from pastoral habitats, where L.cuprina is the major cause of flystrike. Lucilia cuprina was reared from five out of ninety-nine carcases found in rural areas. Calliphora stygia and L.sericata were the most common blowflies colonizing carrion and were reared from 59% and 51% of the carcases respectively.