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Irish Journal of Medical Science

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https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#1
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28616731/renal-nerve-stimulation-for-treatment-of-neurocardiogenic-syncope-a-review-from-perspective-of-commercialization-potential
#2
REVIEW
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28612197/the-value-of-multimodality-imaging-in-the-investigation-of-a-psa-recurrence-after-radical-prostatectomy-in-the-irish-hospital-setting
#3
L C McLoughlin, S Inder, D Moran, C O'Rourke, R P Manecksha, T H Lynch
INTRODUCTION: The diagnostic evaluation of a PSA recurrence after RP in the Irish hospital setting involves multimodality imaging with MRI, CT, and bone scanning, despite the low diagnostic yield from imaging at low PSA levels. We aim to investigate the value of multimodality imaging in PC patients after RP with a PSA recurrence. METHODS: Forty-eight patients with a PSA recurrence after RP who underwent multimodality imaging were evaluated. Demographic data, postoperative PSA levels, and imaging studies performed at those levels were evaluated...
June 13, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28597250/peer-teaching-as-a-means-of-enhancing-communications-skills-in-anaesthesia-training-trainee-perspectives
#4
S M O'Shaughnessy
PURPOSE: The purpose of this study is to introduce peer teaching of communication skills to first-year anaesthesia trainees in Ireland and to evaluate their perception of this teaching modality. METHODS: Seventy-nine first-year anaesthesia trainees participated in a novel peer-led communication skills programme over a 2-year period (Y1, Y2). A Likert scaling questionnaire was developed to explore trainee perception of the peer teaching programme. RESULTS: Of the 79 respondents (36 in Y1 and 43 in Y2), 99% either agreed or strongly agreed that the peer teachers were successful in their role...
June 8, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28593573/asthma-exacerbations-risk-factors-for-hospital-readmissions
#5
F-J Gonzalez-Barcala, U Calvo-Alvarez, M-T Garcia-Sanz, N Garcia-Couceiro, P Martin-Lancharro, A Pose, J-M Carreira, J-D Moure-Gonzalez, L Valdes-Cuadrado, X Muñoz
OBJECTIVE: The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase. STUDY DESIGN: We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010. METHODS: The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study...
June 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28580508/economics-of-early-warning-scores-for-identifying-clinical-deterioration-a-systematic-review
#6
A Murphy, J Cronin, R Whelan, F J Drummond, E Savage, J Hegarty
AIM: In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration. METHODS: A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings...
June 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28567561/measuring-healthcare-expenditure-different-methods-different-results
#7
C Keegan, S Connolly, M-A Wren
BACKGROUND: Accurate information on healthcare expenditure is essential; however, a number of issues arise when healthcare expenditure is being measured. Traditionally healthcare expenditure data in Ireland have been limited, especially data that facilitate comparable analysis through time and across particular programmes or services. Recently however, a major development in Irish healthcare expenditure estimates was the publication of Irish healthcare current expenditure estimates for 2013 according to the international standard of the OECD System of Health Accounts (SHA)...
May 31, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28560519/molecular-hydrogen-affects-body-composition-metabolic-profiles-and-mitochondrial-function-in-middle-aged-overweight-women
#8
D Korovljev, T Trivic, P Drid, S M Ostojic
BACKGROUND: Molecular hydrogen (H2) effectively treats obesity-related disorders in animal models, yet no studies have investigated the effectiveness and safety of H2 for improving biomarkers of obesity in humans. AIM: In this double blind, placebo-controlled, crossover pilot trial, we evaluated the effects of H2 intervention on body composition, hormonal status, and mitochondrial function in ten (n = 10) middle-aged overweight women. METHODS: Volunteers received either hydrogen-generating minerals (supplying ~6 ppm of H2 per day) or placebo by oral administration of caplets for 4 weeks...
May 30, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28560518/mir-210-expression-in-pbmcs-from-patients-with-systemic-lupus-erythematosus-and-rheumatoid-arthritis
#9
Q Huang, S-S Chen, J Li, S-S Tao, M Wang, R-X Leng, H-F Pan, D-Q Ye
BACKGROUND: In hypoxic conditions, miRNA-210 plays an important role in regulating the expression of hypoxia-inducing factor-1α (HIF-1α) and the differentiation of T helper 17 (Th17) cells, and this may be involved in the development and function of the immune system. AIMS: This study was to investigate the miR-210 expression levels in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and its association with the clinical and laboratory features of both diseases...
May 30, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28560517/a-contemporary-analysis-of-clinical-and-demographic-factors-of-chronic-rhinosinusitis-patients-and-their-association-with-disease-severity
#10
L P Hoehle, K M Phillips, D S Caradonna, S T Gray, A R Sedaghat
BACKGROUND: Chronic rhinosinusitis (CRS) is highly prevalent, significantly decreases quality of life and leads to tremendous health care costs every year. No recent study has characterised the prevalence of potentially CRS-modifying patient characteristics and simultaneously shown their impact on CRS severity. AIMS: We sought to determine the prevalence of potential clinical and demographic CRS-modifying characteristics and their associations with CRS symptom severity in a large contemporary cohort of CRS patients...
May 30, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28551720/effect-of-paricalcitol-on-pancreatic-oxidative-stress-inflammatory-markers-and-glycemic-status-in-diabetic-rats
#11
T M Ali, B El Esawy, A Elaskary
OBJECTIVES: This study is designed to explore the effect of paricalcitol (vitamin D receptor agonist) on pancreatic oxidative stress, inflammatory markers, and adiponectin and glycemic status in diabetic rats. MATERIALS AND METHODS: Forty Sprague-Dawley male rats aged 10-12 weeks (150-250 g) were used in this study. Type 2 diabetes was developed by providing 4 weeks of high-fat-diet feeding before one shot of streptozotocin injection (40 mg/kg i.p.). Four study groups were designed as normal control rats, diabetic control vehicle-treated, diabetic paricalcitol-treated (0...
May 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#12
REVIEW
C M McCarthy, J Unterscheider, C Burke, J Coulter
We describe a case of a 36-year-old woman presenting with vaginal bleeding and suboptimally rising serum human chorionic gonadotropin levels, who was investigated for a pregnancy of unknown location. Ultrasonography, laparoscopy and dilatation and curettage failed to reveal signs of an intra-uterine or intra-abdominal pregnancy. Following computed tomography imaging, a mediastinal mass was histologically determined to be a gestational choriocarcinoma. Following surgical resection and chemotherapy, the patient recovered and proceeded to have a successful intra-uterine pregnancy...
May 26, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28547682/adherence-to-clinical-guidelines-and-the-potential-economic-benefits-of-admission-avoidance-for-acute-uncomplicated-diverticulitis
#13
I S Reynolds, E O'Connell, R M Heaney, W Khan, I Z Khan, R Waldron, K Barry
BACKGROUND: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community. AIMS: The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis. METHODS: A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained...
May 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28540627/a-template-for-reducing-ophthalmology-outpatient-waiting-times-community-ophthalmic-care
#14
R K Goetz, F E Hughes, E S Duignan, E C O'Neill, P P Connell, T P Fulcher, M P Treacy
BACKGROUND: Through an Irish Health Service Executive (HSE) initiative to tackle excessive hospital outpatient waiting times, 996 patients referred to the Ophthalmology Outpatient Department (OPD) of the Mater Misericordiae University Hospital (MMUH), Eccles Street, Dublin 7, Ireland, were outsourced to a community medical eye clinic (CMEC) for consultation with specialist-registered ophthalmologists. AIMS: The study aims to determine if patients referred as routine to the OPD department could be managed in a community setting...
May 24, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28508956/doctors-attitudes-towards-the-introduction-and-clinical-operation-of-do-not-resuscitate-orders-dnrs-in-ireland
#15
M O'Reilly, C M P O'Tuathaigh, K Doran
BACKGROUND: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. AIMS: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. METHODS: A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals...
May 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28508191/investigations-of-severity-level-measurements-for-diabetic-macular-oedema-using-machine-learning-algorithms
#16
S Murugeswari, R Sukanesh
BACKGROUND: The macula is an important part of the human visual system and is responsible for clear and colour vision. Macular oedema happens when fluid and protein deposit on or below the macula of the eye and cause the macula to thicken and swell. Normally, it occurs due to diabetes called diabetic macular oedema. Diabetic macular oedema (DME) is one of the main causes of visual impairment in patients. AIM: The aims of the present study are to detect and localize abnormalities in blood vessels with respect to macula in order to prevent vision loss for the diabetic patients...
May 15, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28497412/improved-mortality-outcomes-over-time-for-weekend-emergency-medical-admissions
#17
R Conway, S Cournane, D Byrne, D O'Riordan, B Silke
BACKGROUND: Multiple studies have suggested an association between weekend hospital admissions and mortality. These have been limited by potential residual confounders and a lack of explanation of causation. AIM: We previously attributed adverse weekend outcomes to higher acuity; we have re-examined this question for all emergency medical admissions to our institution from 2002 to 2014. METHODS: We divided admissions by a weekday or weekend (Friday to Sunday) hospital arrival...
May 11, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28497411/research-amongst-irish-surgical-trainees-what-s-the-trend
#18
C K McDonald, S Flynn, M Kelly, I Feeley, E Sheehan
INTRODUCTION: A high publication rate for surgical trainees is considered a prerequisite for progression to Higher Specialist Training (HST). This rate has arguably been decreased by the formation of a new 'run-through' training pathway. We aim to quantify the number of publications that the 'new' pathway trainees have attained compared to the 'old' pathway trainees. We further aim to compare the H-index and average citations between General Surgery (GS) and Trauma and Orthopaedic (T&O) trainees...
May 11, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28493136/risk-factors-for-cardiovascular-disease-in-subclinical-hypothyroidism
#19
F Decandia
Subclinical hypothyroidism (SH), defined as an increased serum thyrotropin (TSH) level and normal plasma-free thyroid hormones' concentrations, is common in the general population, in particular, among elderly women. Its prevalence ranges from 4 to 15% and up to 20% among females aged > 60 year. Although SH has been associated with atherosclerotic cardiovascular disease (CVD), it is acknowledged that the high prevalence of dyslipidemia in elderly people is considered a common biochemical condition. Therefore, whether SH is associated with a higher risk for CVD is still controversial...
May 10, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28478610/advanced-practice-physiotherapy-in-paediatric-orthopaedics-innovation-and-collaboration-to-improve-service-delivery
#20
M Ó Mír, C O'Sullivan
INTRODUCTION: One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services...
May 6, 2017: Irish Journal of Medical Science
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