John Pickering

Dr John Pickering is an Associate Professor in the Department of Medicine at the University of Otago, Christchurch and a Senior Research Fellow in Acute Care in the Emergency Department of Christchurch hospital. John aims to blog on science, health, and occasionally political issues. He believes publicly funded science should be made public - so publishes regular "cheesecake files" about his own research. John is on Twitter @kiwiskinz

Heart attacks in NZ – are women getting a raw deal? - Kidney Punch

Aug 31, 2016

This week the NZ Herald published an article saying doctors are failing to spot heart attacks in thousands of women.  This sounds alarming, could it be happening in NZ? Are women getting a raw deal? Important questions.  This post looks at the study behind the media and then at how heart attacks are being diagnosed in New Zealand. The Herald article is evidently based on press releases related to a study published to coincide with the European Society of Cardiologist’s conference currently underway in Rome and attended by some 30,000 cardiologists, other physicians, industry types, and the Pope (yep!). The study in question comes from the University of Leeds. Here’s the Leeds Uni press release. The US red-dress logo which is their national symbol for women and heart disease The study The study is based on an … Read More

Blood biomarker for heart attacks - Kidney Punch

Jun 02, 2016

Every now and again a Journal doesn’t want us to talk publicly about our own paper until it they publish it.  This is simply so they can make more of a splash with it.  This was the case of an article I have been involved with published today in the Cardiology journal of the American Medical Association*.  What’s it about? Ruling out a heart attack in the emergency department is difficult.  Readers of this blog would have read about various other ways we’ve developed to be part of it (eg here).  They depend on many things including the type of blood measurement used and the timing of that.  These markers – called troponins – detect damage to the heart muscle. In this study led by Ed Carlton of Southmead hospital in Bristol, UK, we evaluated whether … Read More

Cheesecake files: A little something for World Kidney Day - Kidney Punch

Mar 10, 2016

Today is World Kidney Day, so I shall let you in on a little secret. There is a new tool for predicting if a transplant is going to be problematic to get working properly. Nephrologist call a transplant a “graft” and when the new kidney is not really filtering as well as hoped after a week they call it “Delayed Graft Function.”  Rather than waiting a week, the nephrologist would like to know in the first few hours after the transplant if the new kidney is going to be one of these “problematic” transplants or not.  A lot of money has been spent on developing some fancy new biomarkers (urinary) and they may well have their place.  At this stage none are terribly good at predicting delayed graft function. A while ago I helped develop a new tool – simply … Read More

Cheesecake files: A world second for heart attacks - Kidney Punch

Mar 07, 2016

Going to the Emergency Department with chest pain no longer means an almost certain night in hospital.  Friday saw the publication online of our randomised controlled trial comparing two different strategies to rapidly rule-out heart attacks in people who present with chest pain to hospitals.  Here’s a précis: What’s the problem? Chest pain is common – 10% or so of presentations to ED are for chest pain. Heart attacks are not so common – only ~10-15% in NZ (and less overseas*) actually have a heart attack. It is devilishly difficult for most chest pain to rapidly rule out the possibility of a heart attack. Consequently, most people get admitted to hospital (in 2007 93% of those presenting with chest pain). But – led by Dr Martin Than in Christchurch and an international group including Dr Louise Cullen in … Read More

The effect of cannabis legalisation on Emergency Care  - Kidney Punch

Feb 27, 2016

Medical cannabis application guidelines are to be reviewed, announced Associate Health Minister Peter Dunne this week. Co-incidently a paper was published* in the Annals of Emergency Medicine on the effect on Emergency Care of legalising medical marijuana use in Colorado. Alas, this article is behind a paywall.  It does not have a lot of detail. However, it is relevant to the New Zealand debate.  Not so much as to any possible change in guidelines on applications made to the minister, but rather to the effect a broader legalisation of marijuana for medical purposes may  have an on our emergency departments. i.e. just one of the many factors which need to be taken into account in the debate. In 2009 the prosecution of marijuana users and suppliers was halted in the state of Colarado where the use of medical marijuana had been previously legalised and licensed.  … Read More

What’s going on at the UOC? - Kidney Punch

Feb 09, 2016

Q. What has Mars, Epidemics, Heart Disease, Infection, and Pacifika got in common? A. They are all central to research project at the University of Otago Christchurch (UOC). Here are some excerpts for the UOC summer newsletter (Written by UOC communications manager, Kim Thomas). Christchurch in NASA Mars project role University of Otago, Christchurch, researchers are playing a crucial role in research that will assist in NASA’s mission to Mars. Thee Christchurch researchers are scanning the brains of explorers who have wintered in Antarctica as part of a NASA /German Aerospace Center project to understand what impact living in extreme environments has on the human brain. The research will be relevant for NASA’s plans to send humans to Mars. The shortest possible return trip to the red planet would take two years. The international research team is led by the University … Read More

The physics of maiming a child (repost because of another close encounter) - Kidney Punch

Feb 03, 2016

Dear Driver, When you backed out of a driveway and did not even see how I swerved around behind your car to avoid T-boning you, how dare you have the temerity to tell me you were careful!  I was 7 feet tall, dressed in bright yellow and traveling at no more than 10 km/h.  Perhaps a simple lesson in physics will help you and your fellow “driveway backers” to realise how dangerous you are and to adopt safer driving practices. In the diagram you can see a car backing out of a driveway.  Typically when you are at the edge of your property and have a fence (see photo below) blocking your view of the footpath you are able to see about 1.7 metres along the footpath.  Let us imagine that there is a child on a trike riding at … Read More

Self plagiarism – a misnomer - Kidney Punch

Jan 10, 2016

The story so far… Dr Jaimie Whyte publishes in the NZ Herald an article that portions of which are substantially similar to an article he published in Britain in 2005.  This was picked up somehow by @LI_politico who posted: Jamie Whyte 2005 v 2016. He literally copied a previous thing he wrote about Britain. Really @nzherald? pic.twitter.com/hXDbITivX6 — Lamia (@LI_politico) January 7, 2016   The NZ Herald subsequently asked Dr Whyte for his reaction to the accusation of self-plagiarism & reported that he did not see anything wrong with submitting an article which was a variant of one he had already published and [besides] Dr Whyte added “There’s clearly no such thing as self-plagiarism.” I tweeted the article in reaction to the statement about self-plagiarism saying that I agree with Dr … Read More

Toms River - Kidney Punch

Nov 10, 2015

Toms River is a mystery. Not a mystery about the missing apostrophe, though that does warrant a thorough investigation. Rather, Toms River is a forensic mystery, an intrigue of science and health, of the marvels of chemical manufacturer and of the mischievousness of chemical pollution, and finally of that old conundrum of correlation verse causation. The writing flows like that of a well written novel – good enough that one forgets at times that it is not fiction, but a story about real people and real events. At the nub of the mystery is that so human of all questions, “why?” Why does my son have cancer? The answer provided in Toms River is neither sensational nor simplistic. To try and get near an answer the author must explore the histories of dye manufacture, cancer biology and epidemiology. In that … Read More

Christchurch Hospital’s latest study: IDENTAKIT-HF - Kidney Punch

Oct 13, 2015

If it weren’t for your kidney’s, where would you be? You’d be in the hospital or infirmary (with apologies to Fred Dagg). The heart and kidneys are not just linked by a pipe, but the health of one is very much dependent on the health of the other. Acute Kidney Injury (AKI) is a phenomenon whereby there is a sudden loss of all or some of the kidneys’ filtration ability. This can have dire immediate consequences with a greater increased risk of mortality & longer hospital stays. It can also increase the risk of developing a chronic kidney disease or even later cardiac problems. Unfortunately, AKI is devilishly difficult to detect, and therefore there are no early treatments. It is also very common – some 4-5% of all hospital patients. Those with heart failure are particularly vulnerable. IDENTAKIT-HF is … Read More