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J Neutze

Publications and source records attributed to J Neutze.

At least 19 recordsLinked to original sources
PubMed2006

[Salutogenesis and sexual medicine].

Salutogenesis means a paradigmatic change in medicine. While pathogenesis restricts itself to finding out what makes a man ill, salutogenesis tries to find out what keeps him or her healthy. The human being is seen as a biological, psychological, and social creature. There are many studies which show the importance of social relationships and the satisfaction of basic psychosocial needs as protection against psychological or psychosomatic disorders. The psychosocial basic needs for acceptance, intimacy, and security can be best fulfilled by sexual communication with the partner. Therefore a salutogenic approach to sexual medicine focuses mainly on the fulfillment of these needs and not only on the treatment of a sexual dysfunction. Unnecessarily frustrating experiences can thus be avoided, especially when the sexual possibilities of one or both partners are restricted by an illness or its medical treatment. A case report shows how sexual communication and sex therapy can help to cope with a tumor disease.

Delivery of Health Care↗
PubMed1997

The epidemiology of nontuberculous mycobacterial lymphadenitis affecting New Zealand children 1986-95.

AIMS: To study the epidemiological trends of nontuberculous mycobacterial lymphadenitis affecting New Zealand children from 1986-95. METHODS: Cases were identified from the records of the three regional reference laboratories in New Zealand. All children of less than 16 years with a positive culture of nontuberculous mycobacteria from a lymph node tissue sample were included. RESULTS: One hundred and sixty eight cases were identified, 43 in the first 5 years (no data available from Waikato) and 125 in the second 5 years of the study period. One hundred and fifty three (91%) of cases were in the 0-5 year age group and 101 (60%) were female. The head and neck was the most common site of infection accounting for 141 (84%) of all infection. In 161 (96%) of cases the causative organism was Mycobacterium avium intracellulare complex. CONCLUSION: Nontuberculous mycobacterial infections cause a subacute lymphadenitis in preschool children, usually affecting the lymph nodes of the head and neck. The annual number of microbiologically confirmed cases in New Zealand had increased substantially over recent years, most notably since 1992. The reason for the increase is unknown but possible explanations include increased awareness of mycobacterial disease, external factors causing either changes in the distribution or virulence of mycobacteria in the environment and alterations in the human immune response.

Adolescent↗
PubMed1994

Doppler echocardiography and the early diagnosis of carditis in acute rheumatic fever.

BACKGROUND: The incidence of acute rheumatic fever in New Zealand remains relatively high. Reliable early diagnosis of carditis is difficult and important in management. AIM: To determine if Doppler echocardiography contributed to the early diagnosis of carditis in acute rheumatic fever. METHODS: Forty-seven patients admitted to hospital with suspected acute rheumatic fever and 19 control patients, with a febrile illness due to a documented non-cardiac bacterial infection, were assessed two days and two weeks following admission. Presence or absence of clinical carditis was determined by a cardiologist unaware of the suspected diagnosis, from clinical examination, chest radiograph, electrocardiogram (ECG) and two dimensional echocardiogram. Doppler echocardiography was then performed and interpreted by a second cardiologist unaware of the diagnosis. After completion of the study the Jones criteria were applied, to categorise the patients with suspected acute rheumatic fever into four groups for the final diagnosis: no acute rheumatic fever, possible acute rheumatic fever, definite acute rheumatic fever without carditis, and definite acute rheumatic fever with carditis. RESULTS: In 19 patients with a final diagnosis of acute rheumatic fever and carditis at the baseline assessment carditis was detected by clinical assessment in 15 patients, compared with 19 patients with evidence of significant valve regurgitation by Doppler echocardiography. Following the two week assessment, all 19 patients had both clinical and Doppler evidence of carditis. Five patients with a final clinical diagnosis of possible acute rheumatic fever or definite acute rheumatic fever without carditis, had a Doppler abnormality detected. There was no clinical or Doppler abnormality in the febrile controls. CONCLUSIONS: Doppler echocardiography is more sensitive than clinical assessment in the detection of carditis in acute rheumatic fever, and can contribute to earlier diagnosis.

Acute Disease↗
PubMed1993

Analysis of costs of acute rheumatic fever and rheumatic heart disease in Auckland.

AIM: This analysis aims to identify the direct costs of rheumatic fever and its sequelae to the Auckland Area Health Board and to describe the indirect and intangible costs to patients. METHODS: The annual cost was estimated using primarily 1987 data costed in 1991 dollars. The cost analysis was undertaken in five sections: (1) acute rheumatic fever admissions; (2) surgical admissions; (3) rheumatic heart disease related admissions (nonsurgical); (4) outpatient clinic appointments; and (5) secondary prophylaxis programme. Non hospital board direct costs and indirect and intangible costs are described. Ethnic distribution and subsequent economic burden were analysed for each section. RESULTS: The total cost to the health board was estimated to be $3.60M. The management of chronic rheumatic heart disease accounts for 71% of the cost. Rheumatic heart disease related nonsurgical admissions cost $1,228,495 (34%), surgical admissions $846,235 (23%) and outpatient clinic appointments $490,060 (14%) respectively. Both Maori (30% of costs, $1.1M) and Pacific Island people (36% of costs, $1.3M) are disproportionately affected by this largely preventable disease. Of the total cost 13% is spent on coordinated secondary prevention programmes. CONCLUSION: An energetic secondary prevention programme over 10 years to prevent recurrences and the development of carditis has only partially reduced the rate of rheumatic heart disease. A targeted primary prevention pilot programme should be actively considered.

Acute Disease↗
PubMed1992

Health reforms.

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Hospitals, Public↗
PubMed1992

Health reforms.

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Efficiency↗
PubMed1992

Contribution of a risk factor clinic to lipid management in patients with coronary artery disease.

The progress of a cohort of 145 patients seen between June 1986 and June 1989 was reviewed. These patients had treatment prescribed by the clinic and had data recorded over serial visits; they allowed us to determine the contribution of the risk factor clinic. Eighty-six percent had coronary artery disease. Patients were given nutritional advice, partly in groups. In addition 61% were treated with drug therapy. Seventy-four percent had modified their diet before the clinic visit but only 32% received less than 30% of energy from fat; the number rose to 67% by discharge. Sixty-four percent had a body mass index of 25 or greater, falling to 53% at discharge. Mean total cholesterol of the 145 patients was 7.9, HDL cholesterol 1.06, and total:HDL cholesterol ratio 7.7 mmol/L. Changes with clinic management were: total cholesterol -19%, HDL cholesterol +11%, total:HDL cholesterol ratio -25%, LDL cholesterol -21%. Despite these changes, levels were less than optimal for patients with coronary arterial disease in at least 50% of patients at the time of discharge. Improved results can be achieved only with a more aggressive approach to drug therapy. Recent studies in patients with coronary disease provide strong support for such a change in management.

Body Mass Index↗
PubMed1990

Nasal radioiodine activity: a prospective study of frequency, intensity, and pattern.

The nose has been reported as a site of radioiodine accumulation on 131I whole-body scintigraphy. To determine the frequency, intensity, and pattern of nasal radioiodine accumulation, a prospective study was performed on 21 patients referred for 131I whole-body scintigraphy during a 26-mo interval. All patients were dosed with 5 mCi (18.5 MBq) of 131I p.o., and imaged 72 hr later. Ninety-five percent (20/21) of patients had nasal radioactivity greater than background, and in 75% (15/20) of positive patients the pattern of activity was round. Clinical follow-up of these patients has shown no evidence of tumor involvement in the nasal area. We conclude that nasal radioiodine activity is a normal finding. Radioiodine uptake in the nasal area, without clinical suspicion of metastatic disease, should not be considered a criterion for surgical intervention or radioiodine therapy.

Adult↗