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November 2013

Best Tests

The New Zealand Laboratory Schedule and Test Guidelines: What does it mean for general practice?

In October, 2013, a new laboratory test schedule and accompanying referral guidelines were completed and are now available online. It is anticipated that clinicians will become more aware of these guidelines over time as District Health Boards (DHBs) begin to adopt the recommendations. View Article

Rural infections series: Leptospirosis

This article is the first in a series addressing the diagnosis and management of infections that predominantly occur in people who work or live in a rural environment. Most of these infections are caused by bacteria, viruses, fungi or parasites which infect animals but can also pass to humans (known as zoonoses). The first article in this series focuses on the diagnosis, laboratory investigation and management of patients with suspected leptospirosis. View Article

“Oh and while you are here...”: Fasting may be unnecessary for lipid testing

A growing body of evidence and expert opinion suggests that fasting is not necessary prior to a lipid test in most scenarios. The advantage of non-fasting testing is that it is likely to result in more patients being tested, including those who are “hard to reach”, and therefore greater identification of patients at high cardiovascular risk. Non-fasting lipid test results have been shown to have only small variations compared to fasting samples, and a non-fasting result can be used reliably to calculate cardiovascular risk. View Article

Laboratory investigation of exposure to metals or other hazardous substances in the environment

On occasion, General Practitioners will encounter a patient with a concern relating to possible exposure to a hazardous substance. These presentations can be very challenging – the symptoms may be non-specific, there may be no objective evidence of exposure, and the number of potential hazardous substances that the patient has been exposed to may be large. In this situation, laboratory investigation requires careful consideration. Testing is usually only useful if there is evidence of systemic toxicity, and a specific treatment option is available. View Article