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We reviewed clinical records to determine whether the use of bronchial brushings improved diagnostic yield in a setting where bronchoscopy for suspected primary lung cancer is routinely guided by prior chest computed tomography but endobronchial ultrasound‐guided sampling is unavailable. For 29% of cases who had brushings and at least one other test taken (bronchial biopsies or washings), the histological diagnosis was made solely on the basis of samples obtained by brushings. [ABSTRACT FROM AUTHOR]

Background and objective: Clinical guidelines recommend the use of beta‐blockers and other cardiovascular prevention drugs in patients with acute coronary syndrome (ACS). Studies in several countries have found that beta‐blockers are underused in patients with chronic obstructive pulmonary disease (COPD) and co‐morbid heart disease, although most have only examined use in subgroups of patients. We undertook a nationwide follow‐up study in New Zealand to describe the use of beta‐blockers and other cardiovascular prevention drugs in patients with COPD and ACS. Methods: National health and pharmaceutical dispensing data were used to derive the study cohort, identify patients who were admitted to hospital with ACS and/or heart failure before cohort entry and during follow‐up, and ascertain drug use. Results: The study cohort included 83 435 patients aged ≥45 years, with 290 400 person‐years of follow‐up. Among 2637 patients with ≥1 ACS admission during follow‐up, only 56.6% received a beta‐blocker in the 6 months following the first admission, while 87.7% and 81%, respectively, received aspirin and a statin. Patients with higher COPD severity were less likely to receive a beta‐blocker than those with lower severity, as were those with no history of previous ACS and/or heart failure. Conclusion: Use of beta‐blockers following an ACS admission was much lower than expected based on the findings of general audits of ACS management in New Zealand. Along with the higher proportions using aspirin and statins, and the differences in beta‐blocker dispensing by COPD severity, this suggests a particular reluctance to prescribe beta‐blockers to patients with COPD. [ABSTRACT FROM AUTHOR]

Background and objective: While several studies have found that prescribing practices do not conform to chronic obstructive pulmonary disease (COPD) treatment guidelines, none have examined longitudinal patterns of use of long-acting beta2-agonist (LABA) and long-acting muscarinic antagonist (LAMA) therapy across an entire country. We undertook a nationwide follow-up study to describe treatment patterns in new users of long-acting bronchodilators. Methods: National health and pharmaceutical dispensing data were used to identify patients aged =45 years who initiated LABA and/or LAMA therapy for COPD between 1 February 2006 and 31 December 2013. Dispensings of LABAs, LAMAs and inhaled corticosteroids (ICSs) were aggregated into episodes of use of therapeutic regimens. Kaplan-Meier curves, sunburst plots and sequence index plots were generated to summarize, respectively, the duration of the first regimen, the sequences in which unique regimens were used and the patterns of use and non-use during follow-up. Results: The study cohort included 83 435 patients with 290 400 person-years of follow-up. The most commonly initiated regimen was a LABA with an ICS. ICS use was inconsistent with international guidelines: over- and under-treatment occurred in patients with infrequent and frequent exacerbations, respectively, and ICS monotherapy was common. The median duration of the first regimen was 46 days. Many patients used multiple regimens over time and periods of non-use were common. Conclusion: In this nationwide study, patterns of use of LABAs, LAMAs and ICSs were complex and often did not comply with treatment guidelines. Further work is required to address the discrepancy between guidelines and prescribing practices. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a New Zealand cluster of thyrotoxicosis with low uptake on scintiscan was associated with soy milk consumption. Method: A case-control study was conducted, with controls matched by age, sex, and region. Results: All cases (5/5) and one control (1/30) consumed soy milk before the index date. The cases all drank a brand of soy milk that had unexpectedly high levels of iodine. In a simple unmatched unadjusted analysis, the lower bound of the 95% confidence interval for the odds ratio was 19. Conclusion: This cluster was associated with consumption of a soy milk product. The thyrotoxicosis was probably due to iodine-induced thyrotexicosis. Implications: This investigation raises issues about quality control in manufacturing processes and the monitoring of food products for their safety. It also raises issues about public and health professional awareness of the potential health effects from food additives in some processed foods.