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HealthMattersAn Update ofBarrett’s OesophagusHealth Group LimitedYour patients,our focusIssue 8 –Autumn 2014What’s insideAn Update of Barrett’s Oesophagus 1, 2 & 3Message from Acurity 2Managing Difficult Asthma 4 & 5New contact details for Rod Studd 6Wakefield HospitalArea: GastroenterologyArticle written by: Dr Rees Cameron,Gastroenterologist and TherapeuticEndoscopist, ph (04) 381 8110Group LimitedBarrett’s oesophagus (BO), metaplastic change in thedistal oesophagus due to chronic reflux of acid and bilesalts, remains a contentious topic in Gastroenterology.Interest in this condition is based on itbeing the primary source of oesophagealadenocarcinoma, the most rapidly increasinggastrointestinal malignancy, and the abilityof endoscopic biopsy to identify dysplasticchanges before they become malignant, orearly cancer at a curable stage. This has ledto the practice of screening patients withreflux symptoms for the presence of BO,and then performing surveillance at varyingintervals if it is discovered.Unfortunately, there are many problemswith such an approach. The populationprevalence is only one to two percent,screening and surveillance involve relativelycostly gastroscopy and biopsy, and screeningonly those patients with refluxsymptoms will miss as many as 50%who have BO in the absence of symptoms.We currently lack good biomarkers ofcancer risk apart from dysplasia, endoscopicbiopsy is inefficient at sampling the entireextent of Barrett’s, and interval cancers maystill occur in patients under surveillance.Most problematic, however, is that canceris an uncommon occurrence and is thecause of death in a small minority of patientswith BO, which impacts significantly onthe cost-effectiveness of any intervention.Acurity Health GPConference pull-outprogramme 7, 8, 9 & 10Page 4 Page 6 New Urology PracticeRITY HEALT HERENWe arepleasedPapa,Welling to announwe arecetondelighte on the 4th the 2014AcurityCHA- 5thLLENGE d to deliHealthAprilver an2014.S NEWGP ConPreDIRECT excitingferenceconfere sentedIONWe hopCEe youwill bediscoverlearnS: PROnce prog by Wakefihowheldwhat’seld andMOTINto enhrammeat TepositivenewanceG QUABowentodaarouyouroutcomey willLITYpracIN YOU nd the them Hospitals,becos fortice inme comyourentaR PRAthe faceepatientstionsmonCTICE. NEWhighand worpracand com of new chally skiltice inkshopsled speclengmunthe neaproges toitieswill berammeialistsr futu.ensureled byre, andin thehas beefor somsomecounn expe disctry, andof theandedussionmosthis yearto inclAcurityton subude atheHealthjectsHot Topiof intepracare pleatitioner,cs Sesrest.sedsionDr. Glento hostaccomplishehighn Singly respd adveleman,filmmectednturersakers.one ofmedHe willand awaAuson peaicalinspirek perfrd winn tralia’s mosormancewithing docutTo regiand succ a motivatmenstering prestarypleaessfulwwwentarisk.acurityg se visittionmanour webagemenprogpconsite,rammeference.t.pleaco.nzse contor forWe lookact Saraany queforwh Malard toriesyou twoaboonewelcut thedayson (04)omingof insp920 015youired8.learning and sharing with.Acurity Health‘AMI Round theBays‘ 11PaulNew Consultants 12 & 13QuaCOMyleMERCIALACURITY HEAL MANAGERTH GROUP LTDSarahMalBUSIoneNESSACURDEVEITY HEAL LOPMTH GROUENT MANP LTD AGER13844Acurity Conference2014HealthMatters Advertisement 13.0.indd1Hawke’s Bay Health Awards 14 & 15Contact Us 16Continued on page 2.Rod StuddACUPresEpidemiological studies provide some usefulinformation about who may benefit mostfrom screening and surveillance.Managing DifficultAsthmaGPCONFHawke’sBay HealthAwardsPage 14 12/03/141:38pm
Message fromAcurityAn Update of Barrett’sOesophagusContinued from page 1Continued from page 1Commercial Manager’s MessagePaul Quayle, Commercial Manager, ph (04) 920 0146It is my pleasure to bring you theHealth Group Limitedeighth edition of Health Matters.I sincerelyhope youare enjoyingreadingthis publication and mostimportantly are finding itof value. It’s certainly beenencouraging to hear positivefeedback from the doctorsI have had the opportunityto speak with to date.Once again I would like toextend my thanks to ourconsultants who take the timeto prepare educational andinformative articles aimed atkeeping the GP communityup to date with developmentsin their specialty areas.Business DevelopmentManagerI’m delighted to have welcomedSarah Malone to Acurity Healthin January. Sarah has joinedus in the capacity of BusinessDevelopment Manager, andwill be focusing her effortslargely on the GP communitywith a view to ensuring thatyou are provided with up todate information about ourspecialists and services.Right now, Sarah’s time islargely being taken up withthe final preparation for theupcoming GP Conference atTe Papa. Both Sarah and Ilook forward to meeting youat this event on Friday 4thand Saturday 5th April.Once the conference is concluded,Sarah will be spending sometime traveling around GPpractices to introduce herself,and explore how we canbetter meet your needs.2.GP ConferenceOur annual GP Conference isonly a few short weeks away,and we are greatly looking forwardto hosting you at this event.Following some changes atthe Goodfellow Unit ourpartner for the event is nowthe University of Otago,Wellington. We are workingclosely with the University teamto ensure that our event targetstopics which are of interestto GPs and will provoke boththought and discussion.In the centre of this publicationyou will find a pull-out conferenceprogramme together withspeaker information. To join yourcolleagues at this exciting event,please visit www.acurity.co.nzAMI Round the BaysOn Sunday 23rd FebruaryAcurity Health entered a teamof 55 staff, from Bowen andWakefield Hospitals, in one ofWellington’s major communitysporting events, AMI Round theBays. Wellington put on somesensational weather, and we allthoroughly enjoyed the event.Next year we’re hoping to exceedthe 100 mark for participants.FeedbackWe are always interested toreceive your feedback aboutwhat you would like to seein the magazine so please dosend us an email or phoneme directly on (04) 920 0146with your thoughts so wecan continue to bring you auseful publication.Paul Quayle,Commercial Manager,Acurity Health Group LimitedTable 1 contains a list ofidentified risk factors for Barrett’sand subsequent cancer, andthe more that a patient has willincrease the risk. Oesophagealadenocarcinoma is primarily adisease of older Caucasian males.Table 1:Risk Factors for Developmentof Oesophageal Adenocarcinomain GORD PatientsCaucasian ethnicityMale genderAge 50SmokingBarrett’s nodularity, ulcerationor strictureGreater area of Barrett’sPresence ever of dysplasiaFamily history of oesophagealadenocarcinomaSignificant recent advances havebeen made in the managementof Barrett’s dysplasia. Highdefinition and magnificationendoscopy increase the abilityto identify suspicious areas fortargeted biopsy, reducing falsenegative studies. What happenswhen dysplasia or intramucosalcancer is discovered, however,is where the greatest changeshave occurred. Whereas confirmedDr Rees Cameronhigh grade dysplasia (HGD)once led to a surgicalreferral for consideration ofoesophagectomy, managementis now entirely endoscopic.Endoscopic resection (ER) ofsuspected dysplasia (Figure 1)is important for providing highquality ‘surgical’ histology for thepathologist, and may eradicateshort segment BO. Oncenodular HGD has been resected,eradication of the remaining BO(completion ablation) if possiblereduces the risk of recurrence.Sequential ER is effective but canbe difficult to perform and has ahigh risk of stricture formation.Cryoablation (freezing) usingcarbon dioxide or liquid nitrogenhas the advantage of ease ofuse, though efficacy data isstill lacking and it is not yetavailable locally. Radiofrequencyablation (RFA) is currently thegold standard for eradicatingextensive Barrett’s though is anexpensive technology.Chemoprevention of Barrett’sdysplasia and cancer usingproton pump inhibitor (PPI) /aspirin is being investigated in alarge multinational trial reportingin 2019. It is currently consideredthat patients with Barrett’sshould receive effective 24 houracid suppression longterm.Summary points Consider screening in older overweight Caucasian maleswith GORD symptoms Patients with Barrett’s diagnosis should receive longterm PPI,and weigh the use of low dose aspirin. Smoking cessationadvice should be given Surveillance should be encouraged in patients who haveseveral of the risk factors in Table 1, and all with a historyof dysplasia Screening and surveillance should be carried out by an expertendoscopist, and the patient encouraged to take sedationfor the procedure to optimise views.Figure 1:Endoscopic resection ofdysplastic ––––––––––a nodular HGD within longsegment Barrett’sb a tip-mounted banding deviceabcdactuates a rubber band over somedysplastic tissue creatinga pseudopolypc the pseudopolyp is resected bysnare diathermyd hemicircumferential resection ofBarrett’s to level of deep submucosaFigure 2:Completion ablation techniquesfor dysplastic –––––––––a RFA balloon catheter in place in asegment of Barrett’sb inflated RFA balloon catheterc circumferential burn created by RFAd cryoablation using pressurised CO2(delivery catheter at left)abcdUseful ReferencesRex, D et al. Gastroenterology 2003;125:1670-77Sikkema, M et al. Clin Gastro Hepatol 2010;8:235-44Moss, A et al. Am J Gastro 2010;105:1276-83Winberg, H et al. Scand J Gastro 2012;47:397-406.3.
Managing Difficult AsthmaDr Justin TraversWakefield HospitalArea: RespiratoryArticle written by: Dr Justin Travers, Respiratory Physician, (04) 381 8120Asthma is usually fairly easy to control.Modern inhalers work well and patientscan enjoy a good quality of life. If asthmasymptoms remain a problem despite goodinhaled therapy, going through a quickchecklist can often sort things out (seechecklist). A minority of patients will haveongoing symptoms and asthma attacks despitethis. These patients with ‘difficult’ asthmapose a real clinical challenge. Some asthmaguidelines suggest using long term oralprednisone but nobody wants to turn theirpatient into a fat, doughy, osteoporotic wreck.Drug company studies haveshown SMART to be effective atreducing asthma symptoms andattacks compared to a standardasthma management plan.Over the last few years, therehas been interest in usingcombination inhalers for bothpreventive and rescue treatmentin asthma. This approach isknown as the SMART (Singleinhaler Maintenance andReliever Therapy) plan. It can beused with inhalers that containformoterol such as Symbicort orVannair but not with Seretidebecause salmeterol has a sloweronset of action.4.We conducted a clinical trial ofthe SMART plan in New Zealandin difficult asthma patients.The study was independent ofthe pharmaceutical industry.It confirmed the efficacy andimportantly the safety of theSMART approach in ‘real world’patients with difficult asthma.1The SMART management planprobably works well becausecompliance with inhaled steroidtherapy can be less than 60%in people with asthma. Whenthis poor compliance leads toincreased symptoms, the SMARTpatient gets an increased doseof inhaled steroid that halts theexacerbation before it becomesa big deal. For difficult asthma,the SMART management planis usually the first thing to try.Beyond SMART, there are afew other treatment optionsand a specialist opinion mightbe helpful. Some patients willrespond to the addition ofmontelukast (Singulair) tablets.This leukotriene blocker isusually well tolerated and isnow subsidised with a specialauthority for patients withexercise-induced bronchospasm.Unfortunately it only seemsto work in about one in fivecases. Another choice istheophylline (Nuelin). This drughas a complex mechanismof action but is essentially abronchodilator. Gastrointestinalside effects usually limittreatment and it can causearrhythmias so it needs to beused cautiously but it can workwell for a minority of patients.For difficultasthma, the SMARTmanagement plan isusually the firstthing to try.Some patients continue tohave significant symptomsdespite trying all theseapproaches. Many of thesepatients have a neutrophilicairway infiltrate rather thanthe usual eosinophilic infiltrateand current research intobiomarkers that could allowfor targeted or individualisedasthma treatment is promising.References1: Patel et al. Efficacy and safetyof maintenance and relievercombination budesonide-formoterolinhaler in patients with asthmaat risk of severe exacerbations: arandomised controlled trial. LancetRespir Med. 2013; 1(1):32-42.Checklist for Patients with Poor Asthma ControlConfirm diagnosisCheck inhaler techniqueCheck complianceReview an asthma management planAdvice and help to quit smokingRemove asthma triggers from environmentTreat comorbidities such as allergic rhinitis, GORD, OSA.It is also reasonable to have ago with prednisone. A fewweeks of high dose prednisonecan achieve good asthmacontrol. The dose can then betapered to identify the lowestdose that remains effective.The goal is to achieve bothan acceptable level of asthmacontrol and an acceptably lowprednisone dose for long termuse. Again this can work, butonly in a minority of cases.5.
New contact detailsfor Rod StuddGPCONFERENCEA C U R I T Y H E A LT HWakefiWakefieldeldHospitalHospitalDear GeneralPractitio ners,I have openeda new urology practice: Urolo gy Care Wellington.The practice will co ntinue tobe based at Wand I will co ntak ef ield Hospiinue to co nsultalt atincluding Bo wen Specialist Ce all other cu rrent lo catio nsntre, Bo ulco ttand ParaparaumHospital, Waikau and operatenaeat Wak ef ield HCross Hospital and Bo ulco ttospital, So utheHospitals.rnMy telephone,fax and Health-link details haFo r referrals plve changed.ease use the details listed below:Uro lo gy CareWellingtonHealth-Link address: wak especTelephone number: (04) 381 8120; 0800 27Practice fax nu7 646mber: (04) 381 8121Ro d’s mobile:027 280 2027Mailing address:Uro lo gy CareWellingtonWak ef ield Specialist MedicalCentre99 Rintou l StreetPO Bo x 16 116Wellington 6242Thank yo u for yo ur su pport.RegardsRo d StuddUro lo gist027 280 2027Pleup aseyo datrec ur eordsWe are pleased to announce the 2014 Acurity Health GP Conference will be held at TePapa, Wellington on the 4th - 5th April 2014. Presented by Wakefield and Bowen Hospitals,we are delighted to deliver an exciting conference programme around the theme NEWCHALLENGES NEW DIRECTIONS: PROMOTING QUALITY IN YOUR PRACTICE.We hope you discover what’s new today will become common practice in the near future, andlearn how to enhance your practice in the face of new challenges to ensurepositive outcomes for your patients and communities.Presentations and workshops will be led by some of the mosthighly skilled specialists in the country, and this year theprogramme has been expanded to include a Hot Topics Sessionfor some discussion on subjects of interest.Acurity Health are pleased to host highly respected medicalpractitioner, Dr. Glenn Singleman, one of Australia’s mostaccomplished adventurers and award winning documentaryfilmmakers. He will inspire with a motivating presentationon peak performance and successful risk management.To register please visit our website,www.acuritygpconference.co.nz or for any queries about theprogramme please contact Sarah Malone on (04) 920 0158.We look forward to welcoming you and sharing withyou two days of inspired learning.Paul QuayleWak ef ield Specialist MedicalCentre and BoBo ulco tt Hospiwen Specialistal in Lo wer Ht Centre in Welutt, WaikanaelingtonSpecialist Centre and ParapaAppo intmentsraumuand patient enqu iries can beWak ef ield Specmade thro ughialist MedicaltheCentreTelephone (04)381 8120 or 0800 277 646Fax (04) 381 8121COMMERCIAL MANAGERACURITY HEALTH GROUP LTDSarah MaloneBUSINESS DEVELOPMENT MANAGERACURITY HEALTH GROUP LTD6.7.
TE PAPAWELLINGTON4&5 APRIL 2014PROGRAMMEFRIDAY 4 APRIL0845Official Conference Opening RemarksMr Ian England, Chief Executive Acurity HealthGroup LtdDr Sue Pullon, Associate Professor and Head ofDepartment, Primary Health Care and GeneralPractice, University of Otago, WellingtonNew Challenges, New Directions. Promoting qualityin your practice0900Dr Tim Blackmore, Infectious Diseases Physician andMicrobiologistTravel Related Infection.more about UTI anddiarrhoea than dengue0935Mr Burton King, Breast and General SurgeonTBA1015MORNING TEA1045Dr Justine Cornwall, Deputy Children’s CommissionerThe Compass Project: A collaborative approach tochild and youth health outcomes1110Mr Fred Phillips, Orthopaedic Surgeon, Hip and KneeSurgeonPost Operative Infection Management: Meetingthe needs of patients with complications followingorthopaedic surgery1135Dr Robert Weinkove, Consultant Haematologist,CCDHB and Clinical Research Fellow, MalaghanInstitute of Medical ResearchImmune Therapies for Cancer Treatment:Explore the latest research and challenges1200Mr Simon Robinson, Otolaryngologist Head and NeckSurgeonChronic Sinusitis1225Chair concludes1230-1330 LUNCH1330 - 1415 Concurrent Workshop Sessions ADr David Abernethy, NeurologistWorkshop: Neurological Assessment:New Developments and quality of care inTIA, Stroke and EpilepsyDr Rees Cameron, Clinical Leader of the Departmentof Gastroenterology, CCDHBWorkshop: Underwater Colonoscopy – newtechnique to decrease patient risk and discomfortDr Cathy Fergusson, Otolaryngologist Head andNeck SurgeonWorkshop: Thyroid Assessment – what youneed to know1415Delegates transition to second workshop1430 - 1515 Concurrent Workshop Sessions B (repeat)Dr David Abernethy, NeurologistWorkshop: Neurological Assessment: NewDevelopments and quality of care in TIA, Stroke andEpilepsyDr Rees Cameron, Clinical Leader of the Departmentof Gastroenterology, CCDHBWorkshop: Underwater Colonoscopy – newtechnique to decrease patient risk and discomfortDr Cathy Fergusson, Otolaryngologist Head andNeck SurgeonWorkshop: Thyroid Assessment – what youneed to know1520AFTERNOON TEA8.1545Mini Symposium - The Atria, the ForgottenCardiac ChambersChair: Dr Malcolm Abernethy1545 – 1615 Dr Malcolm AbernethyIntroduction to Atrial Anatomy, Physiology andAnticoagulants1615 – 1645 Dr Alejandro Jimenez RestrepoIntroduction to Electrophysiology/Ablation and theManagement of Atrial Fibrillation/Flutter1645 – 1715 Dr Phil Matsis and Assoc Prof Alex Sasse“Plugs and Holes” PFO, ASD and Left AtrialAppendage Closure Devices1715Closing Remarks for Day One1730Networking Drinks hosted by Acurity HealthACURITYH E A LT HGP CONFERENCESPEAKERSWe are pleased to bring anoutstanding selection of speakersto the 2014 Conference, for moreinformation on our speakersplease visit our website.DR DAVID ABERNETHYNeurologistDR MALCOLM ABERNETHYInterventional CardiologistMR SIMON BANNConsultant Upper GI andLaparoscopic SurgeonMR NICK BEDFORDGynaecologist andObstetricianDR TIM BLACKMOREInfectious Diseases Physicianand MicrobiologistMR PETER BLAKEOtolaryngologist / Head andNeck SurgeonDR REES CAMERONClinical Leader of theDepartment ofGastroenterology, CCDHBDR JUSTINE CORNWALLDeputy Children’sCommissionerDR JOHN DENTONInterventional Neuroradiologist& General RadiologistDR CATHY FERGUSONOtolaryngologist - Head andNeck SurgeonMR JOHN GROOMGastrointestinal SurgeonMR CHRIS HOFFMANConsultant Spinal SurgeonDR ALEJANDRO JIMENEZRESTREPOCardiologist ElectrophysiologistMR JOHN KEATINGColorectal andGeneral SurgeonMR BURTON KINGBreast and General SurgeonDR PHIL MATSISCardiologistMR FRED PHILLIPSOrthopaedic Surgeon, Hipand Knee SurgeonMR SIMON ROBINSONOtolaryngologist,ENT SurgeonASSOCIATE PROFESSORALEX SASSECardiologistDR ROBERT WEINKOVEConsultant Haematologist,CCDHBMR S KUSAL WICKREMESEKERAConsultant Upper GI,Hepatopancreaticobiliaryand Laparoscopic Surgeonacuritygpconference.co.nzSATURDAY 5 APRIL0845Dr Glenn Singleman, Emergency and Critical CareDoctor and Adventure Filmmaker, SydneyManaging Risk and Reaching Peak Performance0930Mr Chris Hoffman, Consultant Spinal Surgeon,Capital and Coast Health; Medical Director,The Back Institute / TBI HealthThe Aging Spine – the process, the clinical conditionsand their treatments1015Dr John Denton, Interventional Neuroradiologist &General Radiologist Pacific RadiologyReview of Acute Subarachnoid Haemorrhage andCerebral Aneurysms1045Morning Tea1115 - 1200 Concurrent Workshop Sessions CMr John Keating, Colorectal and General SurgeonWorkshop: Hereditary aspects of Colorectal Cancer:an updateMr Nick Bedford, Gynaecologist and ObstetricianWorkshop: Assessment and Management ofProlapse and IncontinenceHot Topics1200LUNCH1250 - 1335 Workshop Sessions D (repeat)Mr John Keating, Colorectal and General SurgeonWorkshop: Hereditary aspects of Colorectal Cancer:an updateMr Nick Bedford, Gynaecologist and ObstetricianWorkshop: Assessment and Management ofProlapse and IncontinenceHot Topics1340Mini Symposium - Surgery and Cancer1350-1410 Mr S Kusal Wickremesekera, Upper GI,Hepatopancreaticobiliary and Laparoscopic Surgeonand Mr Simon Bann, Consultant Upper GI andLaparoscopic SurgeonUpper Gastrointestinal Cancers1410-1435 Mr John Groom, General SurgeonColorectal Cancer1435-1525 Mr Peter Blake, Otolaryngologist / Head and NeckSurgeonOropharyngeal Cancer – what to look for and whoare your at risk patients1525 - 1530 CLOSE OF CONFERENCE – FINAL REMARKS*The conference programme is subject to change at the discretion of the organising committee.DR GLENN SINGLEMANEmergency Room Doctor andProfessional Adventure FilmmakerGUEST SPEAKERDr Glenn Singleman is one of Australia’s mostrespected and accomplished professionaladventurers. He currently holds four worldrecords in extreme sport. He is also a practisingmedical doctor and an acclaimed documentaryfilmmaker.Glenn has spoken all around the world largelyabout the process of peak performanceand overcoming fear. He has made over700 professional presentations - many ofthem return visits to Top 100 companies.Dr Singleman continues to work as a medicalpractitioner, working in the Emergency andCritical Care Units at Sydney Adventist Hospitalin Sydney.As a medical doctor and professionaladventurer, Dr Singleman has travelled to themost remote and extreme locations on theplanet researching and testing his theories onpersonal peak performance and successfulrisk management, two things he believes areintrinsically linked and at the foundation ofhealth, happiness and success. His keynotespeaking presentation combines stories fromhis expeditions with valuable insights intowhat’s possible when we understand fear,successfully manage risk and diligently applyDr Singleman’s principals of peak performance.9.
NEWCHALLENGESAcurity Health Group at theAMI Round the BaysAcurity Health GroupDescription: Social eventLocation: Wellingtonladies:CentreMedicalstliiaceld SpWakefie and RoseJennyNEWDIRECTIONSPaul and NickMatt and RyanenjoyPROMOTING QUALITY IN YOUR PRACTICEACURITYH E A LT HGP CONFERENCETE PAPAWELLINGTON4&5 APRIL 2014Acurity Corporate:some BBQSharon andPaul, Deirdre and SarahWakefield’’s Rachael (centre)Wakefieldand Bowen ladiesfoodher boysPaul and NickCongratulating runnerswww.acuritygpconference.co.nzPresented by:The two Lynda ’s Linda ’sIn association with the Department of Primary Health Care and General Practice, University of Otago, WellingtonWe gratefully acknowledge the support of our sponsors:GOLDSILVER10.On Sunday23 February 2014,55 Acurity Healthemployees from Bowen andWakefield Hospital’s tookpart in the annual AMIRound the Bays 6.5kmfun run/walk, 10kmSnapper and Lencohalf marathon.Luke, Kathryn, Cathy and Fiona11.
New ConsultantsAcurity Health welcomesthe following consultantsto our Bowen, Roystonand Wakefield Hospitals.Please contact themdirectly if you would likemore informationabout their specialties.Mr Kenneth ChanMr Stephen ToyntonMr Simon McDowellDr Alejandro Jimenez RestrepoDr Ken RomerilMB ChB, FRANZCOMB BS, FRCS (Otol)(Eng), FRCS (ORL)MBChB PG Dip OMG FRANZCOGMBChB, FRACP, FRCPAOphthalmologistP: (04) 499 4940F: (04) 499 0242E: kenneth.chan@ccdhb.org.nzOtolaryngologistP: (06) 873 1162F: (06) 873 1163E: ent@airnet.net.nzGynaecologist, Fertility SpecialistP: (04) 384 8401F: (04) 384 8402E: smcdowell@fertilityassociates.co.nzMD, Am B Int Med (IM and CardiovascularDiseases, USA)Kenneth consults at the Thorndon EyeClinic, 230 Thorndon Quay, Wellingtonand operates at Bowen Hospital,98 Churchill Drive, Crofton Downs,Wellington.Stephen is an otolaryngologist whoconsults at the Royston Centre, 325Prospect Road, Hastings and operatesat Royston Hospital, in Hastings.Simon consults at Fertility Associates,Level 2, 205 Victoria Street, Wellingtonand operates at Wakefield Hospital,30 Florence Street, Newtown, Wellington.Alejandro is a Cardiologist/Electrophysiologist who consults at theWakefield Heart Centre, 99 Rintoul Street,Newtown and operates at WakefieldHospital also in Newtown, Wellington.SpecialtyOtolaryngology (ENT Surgery)SpecialtyGynaecology, FertilitySpecialtyCardiology, ElectrophysiologyTrainingStephen was the Senior Registrar atSt. Thomas’s and Guy’s Hospitals,London and advanced paediatrictraining at Great Ormond StreetHospital for Sick Children, London.General ENT Fellowship at ChristchurchPublic Hospital 1994/5.TrainingFellowship advanced lap surgery andreproductive endocrinology (Brisbane).Obstetrics and Gynaecology (General)training, Wellington, Hastings andPalmerston North.TrainingAlejandro has undertaken his initial trainingat Universidad CES School of Medicine,Colombia. Cardiovascular research trainingat Cardiovascular Centre, Medellin Clinic,Colombia. Internal Medicine residencyat the University of Texas Health ScienceCenter, USA. Cardiac ElectrophysiologyFellowship at the University of MarylandMedical Center, USA and his ResearchFellowship at Maryland Arrhythmia andCardiac Imaging Group (MACIG), USA.SpecialtyOphthalmologyTrainingKenneth’s vocational training inOphthalmology took place inWellington and Christchurch.Kenneth did his fellowship training inOculoplastic and Orbital Surgery inNewcastle upon Tyne, United Kingdom.Special interests Eyelid malposition Ptosis and dermatochalasis Dry/watery eyes Periocular skin tumours andreconstruction Thyroid eye disease Orbital surgery Socket reconstruction.BackgroundKenneth was born in Hong Kong andgrew up in Auckland where he obtainedhis medical degree. He has worked inthe Wellington/Hutt region since 2005and has returned to New Zealand afterfinishing his fellowship training in theUnited Kingdom in 2013.He is able to conduct his consultationin Cantonese and Mandarin if required.He has a Licentiate Diploma in pianoperformance and can frequently beseen attending local classical concerts.He is also keen on chasing freshpowder on the ski slopes whenopportunity beckons!12.Specialising inStephen specialises in ear surgery,in particular hearing reconstructionsurgery, stapes surgery, revisionsurgery and implantable hearing aids.Also in balance disorders, ear trauma,particularly in SCUBA divers andspecialist paediatric ENT.Career highlights prior to moving toHawke’s Bay in 2012 Otology advisor to Diving DiseasesResearch Centre, Plymouth, UK Former council member of BritishAssociation of Otorhinolaryngologyand British Association of PaediatricOtorhinolaryngology Contributor to major ENT text book Member Prosper Meniere Society Published on various aspects ofpaediatric ENT and presentedpapers at international meetings,including at the Royal Society ofMedicine, London Also invited expert atsymposia on stapes surgery atinternational meetings.Specialising inEndometriosis, menstrual disorder,infertility, reproductive endocrinology,clinical research.BackgroundSimon attended Otago Universitybetween 1997 – 2002. He has spenttime as a junior doctor in Masterton,Melbourne, UK, Hastings andPalmerston North. More recently asa consultant (Gynaecology, Fertility)in Brisbane and Wellington.Cardiologist, ElectrophysiologistP: (04) 381 8115, F: (04) 381 8116BackgroundAlejandro is a Consultant Cardiologist/Electrophysiologist at CCDHB/WellingtonHospital and Senior Clinical Lecturerat the University of Otago School ofMedicine since 2012. Prior appointmentsinclude Consultant Cardiologist/Electrophysiologist at the InternationalArrhythimia Centre, FundacionCardioInfantil in Colombia and ClinicalInstructor at the University of MarylandSchool of Medicine in Baltimore USA.HaematologistP: (04) 381 8120F: (04) 381 8121E: specialists@wakefield.co.nzW: www.likblood.co.nzKen is a specialist haematologist whoconsults from the Wakefield SpecialistMedical Centre, 99 Rintoul Street,Newtown, Wellington.SpecialtyHaematologySpecialising inKen specialises in specialist haematologyand has an interest in malignanthaematology, leukaemia, myelomaand lymphoma. Ken has run clinicaltrials in myeloma and immunethrombocytopenia.Other career highlights: Author of 26 peer reviewedjournal publications Recently chair of myelomasub-committee of AustralasianLeukaemia/Lymphoma Group New Zealand member ofInterventional MyelomaWorking Group.Special interestsDiagnosis and management in all areas ofcardiac electrophysiology, including deviceimplantation and electrophysiologicstudies/catheter ablation. Atrial fibrillation Ventricular tachycardia Supraventricular tachycardias Pacemakers and defibrillators Biventricular devices Syncope Sudden cardiac death Channelopathies Cardiac imaging.13.
Hawke’s Bay Health AwardsRoyston HospitalBy Denise PrimroseRoyston Hospital ManagerRecognising the importance of qualitywithin the healthcare environment,Royston Hospital has been delighted tosupport the Hawke’s Bay Health Awardsfor the past three years.The Royston Hospital SupremeAward Winner for 2013 waspresented by Royston HospitalManager Denise Primrose, toTai Ora Clinical Acting ChiefExecutive Marei Apatu andGeneral Manager Patrick LeGeyt, at a gala occasion atthe Hastings Opera House inNovember 2013.HB Health Awards attractedsignificant entries fromthroughout Hawke’s Bay’sprimary and secondary healthcare settings. Seven awardwinners were selected with al
in the magazine so please do send us an email or phone me directly on (04) 920 0146 with your thoughts so we can continue to bring you a useful publication. Paul Quayle, Commercial Manager, Acurity Health Group Limited Paul Quayle, Health Group Limited Commercial Manager's Message Paul Quayle, Commercial Manager, ph (04) 920 0146 Useful .
