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Irish Journal of Medical Science

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https://www.readbyqxmd.com/read/28812226/in-light-of-recently-published-clinical-trials-and-their-implication-for-clinical-practice-does-a-large-catchment-area-acute-hospital-require-24%C3%A2-hour-ct-neck-and-head-angiography-and-or-neuro-interventional-services-in-the-setting-of-acute-ischaemic-stroke
#1
REVIEW
J Halpin, C Peters, J O'Brien, T Scanlon, M Shelly, N Cunningham, L Hickey
BACKGROUND: Recently published clinical trials have resulted in a significant change in the guidelines used to manage patients suffering an acute ischaemic stroke. New neuro-interventional techniques have revolutionised stroke outcomes. Currently, such services are only available in two specialist centres. AIMS: We attempted to evaluate the need for the provision of routine computed tomography (CT) angiography and neuro-interventional services at a university teaching hospital in Limerick...
August 15, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28812224/risk-factors-for-totally-implantable-venous-access-device-associated-complications-in-cystic-fibrosis
#2
C McCarthy, O O'Carroll, M E O'Brien, T McEnery, A Franciosi, C Gunaratnam, N G McElvaney
BACKGROUND: Candidaemia is an important nosocomial infection, seen frequently in immunocompromised and critically ill patients and increasingly recognised in cystic fibrosis (CF) patients with totally implantable venous access devices (TIVADs). This study aims to investigate the incidence and risk factors for the development of TIVAD-associated candidaemia and to assess the rate of TIVAD-related complications in CF patients. METHODS: A 10-year retrospective study was carried out on adult CF patients attending a single centre...
August 15, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28803271/brain-biopsies-requiring-creutzfeldt-jakob-disease-precautions-in-the-republic-of-ireland-2005-2016
#3
F M Brett, S Looby, A Chalissery, D Chen, C Heaney, J Heffernan, F Cunningham, R Howley, T Loftus, H Kearney, M A Farrell
AIMS: Creutzfeldt-Jakob disease (CJD) risk precautions are required when performing brain biopsies on patients with a dementing illness and in 'risk' groups. The impact on a diagnostic neuropathology service is considerable. We sought to determine if better case selection might reduce the necessity for application of CJD risk precautions. METHODS: We reviewed the clinical information, contributory investigations and final neuropathologic diagnosis in a cohort of patients (n = 21), referred to the National CJD Surveillance Centre between January 1, 2005, and December 31, 2016...
August 12, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28776128/in-recognition-of-ireland-s-medical-scientists-arnold-hill-mark-lawler-ian-young-and-kingston-mills
#4
EDITORIAL
W P Tormey
No abstract text is available yet for this article.
August 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28756541/accurate-and-dynamic-predictive-model-for-better-prediction-in-medicine-and-healthcare
#5
H O Alanazi, A H Abdullah, K N Qureshi, A S Ismail
INTRODUCTION: Information and communication technologies (ICTs) have changed the trend into new integrated operations and methods in all fields of life. The health sector has also adopted new technologies to improve the systems and provide better services to customers. Predictive models in health care are also influenced from new technologies to predict the different disease outcomes. However, still, existing predictive models have suffered from some limitations in terms of predictive outcomes performance...
July 29, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28756540/severe-ulcerative-colitis-predictors-of-response-and-algorithm-proposal-for-rescue-therapy
#6
D G Ribaldone, I Dileo, R Pellicano, A Resegotti, S Fagoonee, M Vernero, G Saracco, M Astegiano
BACKGROUND: There is no agreeing if rescue therapy can avoid short-term colectomy in patients treated for severe steroid-refractory ulcerative colitis. AIMS: The aim of our study was to identify predictors of response to infliximab and cyclosporine A. METHODS: In this cross-sectional study, 49 patients with severe ulcerative colitis were included. Response to therapy was defined as three or more point reductions in Mayo score after 6 months of treatment and avoidance of colectomy after 1 year...
July 29, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28752234/implementing-a-tobacco-free-hospital-campus-in-ireland-lessons-learned
#7
D McArdle, Z Kabir
BACKGROUND: The Irish Health Service Executive (HSE) had set a target that all HSE facilities should implement the HSE Tobacco Free Campus (TFC) policy by 2015. AIM: The aims of this study are to examine hospital staff awareness and to assess the progress of selected HSE health care facilities towards a TFC policy. METHODS: Three health care facilities that were conveniently located were self-selected in County Cork, namely, an acute hospital, a mental health service and an older person's facility...
July 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28752233/upper-limb-lymphedema-in-breast-cancer-patients-in-the-era-of-z0011-sentinel-lymph-node-biopsy-and-breast-conservation
#8
N R Bhatt, M R Boland, R McGovern, A Lal, S Tormey, A J Lowery, B A Merrigan
INTRODUCTION: Surgical techniques in breast cancer (BCa) have seen a dramatic change recently with breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). The ACOSOG-Z0011 trial reported equivalence in outcomes for certain patients with SLN metastases treated with axillary lymph node dissection (ALND) or SLNB alone. Our aim was to investigate changes in lymphedema referral patterns in BCa patients over the last 3 years in a specialist unit and to elucidate effects of SLNB, BCS, and Z0011 trial publication on such patterns...
July 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28744698/association-of-basal-serum-androgen-levels-with-ovarian-response-and-icsi-cycle-outcome
#9
C Abide Yayla, E Ozkaya, S Kayatas Eser, I Sanverdi, B Devranoglu, T Kutlu
BACKGROUND: The purpose of this study was to assess the predictive value of basal serum testosterone (T) and dehydroepiandrosterone sulfate (DHEAS) levels during follicular phase for ovarian response and outcome in intracytoplasmic sperm injection (ICSI) cycles of women with diminished ovarian reserve. METHODS: We prospectively gathered data of basal serum androgen levels and ICSI cycle characteristics of 120 women with diminished ovarian reserve. Association of basal serum T and DHEAS levels with ovarian response was analyzed...
July 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28744697/prospective-validation-of-neutrophil-to-lymphocyte-ratio-as-a-diagnostic-and-management-adjunct-in-acute-appendicitis
#10
A Khan, M Riaz, Michael E Kelly, W Khan, R Waldron, K Barry, I Z Khan
BACKGROUND: No optimal biomarker exists that accurately diagnoses appendicitis or predicts severity, estimates post-operative complications or total length of hospital stay (LOS). AIM: To prospectively validate the utility of neutrophil-to-lymphocyte (NLR) ratio in predicting the severity of appendicitis, LOS, and 30-day complication rates. METHODS: Patients who were admitted with a provisional diagnosis of acute appendicitis over a period of 18 months (Oct 2014-April 2016) were included...
July 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28744696/a-letter-of-reply-to-salehmohamed-m-r-griffin-m-branigan-t-et-al-patients-treated-with-immunosuppressive-steroids-are-less-aware-of-sick-day-rules-than-those-on-endocrine-replacement-therapy-and-may-be-at-greater-risk-of-adrenal-crisis-ir-j-med-sci-2017-doi
#11
LETTER
https://www.readbyqxmd.com/read/28735501/step-by-step-guide-to-do-a-systematic-review-and-meta-analysis-for-medical-professionals
#12
Y Bashir, K C Conlon
INTRODUCTION: Systematic review and meta-analysis are statistical tools used to review researches performed on a same topic. They extract the collective effect of the studies performed on the topic of interest after statistically analysing the data of all the studies included. AIMS AND OBJECTIVES: Systematic reviews and meta-analysis are getting more and more popular in the medical field. Statistics is never the strong aspect of medical professionals, and facing a large number of statistical tests and values could be quite confusing for them...
July 22, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28735500/adherence-to-copd-management-guidelines-in-general-practice-a-review-of-the-literature
#13
REVIEW
J Sehl, J O'Doherty, R O'Connor, B O'Sullivan, A O'Regan
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive illness that is mostly managed in the general practice setting. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are the international gold standard, and it is important to understand how these are being applied in general practice. AIMS: This review aimed to assess the current level of adherence to international best practice guidelines among general practitioners in relation to COPD...
July 22, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28733940/pituitary-tuberculoma-a-rare-cause-of-sellar-mass
#14
REVIEW
H M Zia-Ul-Hussnain, M Farrell, S Looby, W Tormey, M Javadpour, S Mcconkey, C J Thompson
INTRODUCTION: Pituitary tuberculosis is an uncommon cause of sellar mass [1]; the estimated prevalence worldwide is not known, and there have been no reports of the condition occurring in Ireland. Tuberculosis of the pituitary gland may present as a sellar mass or with symptoms of hypopituitarism. CASE PRESENTATION: A 41-year-old woman, with a short prodromal history without endocrine symptoms, was found to have pituitary tuberculosis after the demonstration of a sellar mass on MRI, and lumbar puncture findings consistent with lymphocytic meningitis...
July 21, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28730460/impact-of-safety-warnings-on-domperidone-prescribing-in-ireland
#15
M Teeling, M J MacAvin, K Bennett
AIM: This study aimed to investigate the impact of the 2014 safety warnings on use of domperidone, on subsequent prescribing patterns in Ireland. METHODS: The Irish HSE-PCRS pharmacy claims database was used to identify the study cohort (aged 18+), prescribed domperidone from Jan 2014 to Oct 2015. Dosage was available for each claim; concomitant prescription with the following drug classes was identified and calculated as a percentage of the total number of claims: anti-arrhythmics, macrolide antimicrobials and the selective serotonin receptor inhibitors (SSRIs) citalopram and escitalopram...
July 20, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28726032/comparison-of-abdominal-vaginal-and-laparoscopic-hysterectomies-in-a-tertiary-care-hospital-in-turkey
#16
Z O Inal, H A Inal
AIM: The aim of this retrospective study was to assess and compare the clinical results of three hysterectomy techniques: abdominal hysterectomy (AH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (LH). METHODS: A total of 2163 patients having undergone AH (n = 1226), VH (n = 426), and LH (n = 511) procedures were analyzed. The mean age, body mass index (BMI), parity, uterus weight, operation time, blood loss, duration of hospitalization, analgesic needs, intra- and postoperative complications, and indications for hysterectomy were analyzed and compared...
July 19, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28726031/the-natural-history-of-leydig-cell-testicular-tumours-an-analysis-of-the-national-cancer-registry
#17
G J Nason, E J Redmond, S W Considine, S I Omer, D Power, P Sweeney
BACKGROUND: Leydig cell tumour (LCT) of the testis is a rare histological subtype of stromal tumours, accounting for 1 to 3% of testicular neoplasms. The natural history of LCT is poorly understood. AIMS: The aim of this study was to assess the incidence and natural history of Leydig cell tumours (LCT) of the testes. METHODS: A search of the National Cancer Registry of Ireland database was performed regarding Leydig cell testicular tumours...
July 19, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28726030/intravascular-large-b-cell-lymphoma-presenting-clinically-as-rapidly-progressive-dementia
#18
REVIEW
F M Brett, D Chen, T Loftus, Y Langan, S Looby, S Hutchinson
BACKGROUND: In patients presenting with rapidly progressive dementia, prion disease may enter the differential diagnosis. The commonest malignancies masquerading as prion disease are primary CNS lymphoma and intravascular large B-cell lymphoma, both rare and difficult to diagnose without brain biopsy. CASE PRESENTATION: This 82-year-old lady with a past history of hypertension, presented with rapidly progressive cognitive impairment and ataxia. The possibility of sCJD was raised...
July 19, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28717986/thrombolysis-for-stroke-in-ireland-increasing-access-and-maintaining-safety-in-a-challenging-environment
#19
P McElwaine, J McCormack, C Brennan, H Coetzee, P Cotter, R Doyle, A Hickey, F Horgan, C Loughnane, C Macey, P Marsden, D McCabe, R Mulcahy, I Noone, E Shelley, T Stapleton, D Williams, P Kelly, J Harbison
BACKGROUND: In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. METHOD: Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study...
July 17, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28702828/evaluating-the-perioperative-safety-of-laparoscopic-radical-nephrectomy-for-large-non-metastatic-renal-tumours-a-comparative-analysis-of-t1-t2-with-t3a-tumours
#20
E M Bolton, D Hennessy, P E Lonergan, F T Darcy, R P Manecksha, T H Lynch
OBJECTIVE: With increasing surgeon experience, the use of laparoscopic radical nephrectomy (LRN) in large and locally advanced renal tumours (T3a) is gaining favour in urological practice. There are limited studies reporting surgical outcomes in such groups. The aim of this study was to review our experience with LRN in these patients. METHODS: Data was retrospectively collected on 201 consecutive patients who underwent LRN for renal cancer by a single surgeon. Perioperative parameters assessed were age, gender, American Society of Anaesthesiologists score (ASA), waist circumference, tumour size, specimen size, histological subtypes, anaesthetic duration, operative approach and technique, surgery duration, blood loss, pre and postoperative renal function, complication rate and duration of hospital stay...
July 13, 2017: Irish Journal of Medical Science
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