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Irish Journal of Medical Science

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https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28478609/comparison-of-nomograms-predicting-lymph-node-invasion-in-patients-undergoing-radical-prostatectomy-for-prostate-cancer
#10
G J Nason, E M O'Connor, D MacMahon, B Moss, S W Considine, A Cahill, C O'Rourke, F M O'Brien
INTRODUCTION: The aim of this study was to compare the performance of preoperative risk nomograms or detecting lymph node invasion in a cohort of men undergoing radical prostatectomy (RP). METHODS: A retrospective analysis was performed on all men (n = 145) who underwent RP between 2012 and 2015. Preoperative data was inputted to the Memorial Sloan-Kettering Cancer Centre (MSKCC), Partin 2011 and Briganti nomograms and the University of California San Francisco- Centre of the Prostate Risk Assessment tool (UCSF-CAPRA)...
May 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28478608/reply-the-significance-of-regression-in-thin-melanoma-of-the-skin
#11
LETTER
K M Joyce, P J Regan
No abstract text is available yet for this article.
May 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28478607/trends-in-corneal-transplant-surgery-in-ireland-indications-and-outcomes-of-corneal-transplant-surgery-and-intraocular-lens-opacification-following-descemet-s-stripping-automated-endothelial-keratoplasty
#12
C Quigley, E McElnea, G Fahy
PURPOSE: To evaluate the indications for corneal transplantation, the procedures carried out, and the postoperative outcomes and to compare these with previous Irish corneal transplant studies. METHODS: A retrospective review of the case notes of all patients who underwent corneal transplantation under the care of a single surgeon, from 2008 to 2015, was performed. The risk factors for postoperative complications including transplant failure were examined. RESULTS: During the period studied, 42 corneal transplant surgeries were carried out on 40 eyes of 38 patients, 24 of whom were male (63%), median age at surgery was 62 years (range 23-96 years)...
May 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28478606/margins-of-viability
#13
Roy K Philip
A poem reflecting the compassion, conflicts, dilemmas and outcome in the management of an extremely premature 22(+4)-week gestation baby girl. Challenges faced by neonatologists in offering optimal care to extremely low birth weight (ELBW) newborn infants and their families is summarised in this poem as an emotional transaction between the clinician and the periviable baby.
May 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28477329/is-chemotherapy-always-required-for-cancer-in-pregnancy-an-observational-study
#14
E M Walsh, G M O'Kane, K A Cadoo, D M Graham, G J Korpanty, D G Power, D N Carney
BACKGROUND: Cancer in pregnancy is relatively rare, but the incidence is increasing. Several studies show that cytotoxic agents are safe to use in pregnancy from the second trimester onwards. AIMS: This study assesses the maternal and foetal outcomes of cancers diagnosed during pregnancy. In particular, it focuses on a subset of women who elected to defer systemic chemotherapy until after delivery. This study examines if all cancers need to be treated during pregnancy or if, in certain cases, treatment can be safely deferred until after full-term delivery...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28477328/can-chronic-disease-be-managed-through-integrated-care-cost-effectively-evidence-from-a-systematic-review
#15
J Cronin, A Murphy, E Savage
BACKGROUND: The increase in demand for integrated care models to manage chronic disease is a challenge for the Irish health system, which is traditionally organised around the acute hospital services. Implementing integrated care programmes requires significant investment, and thus, their economic impact requires consideration. AIMS: This paper updates the previous evidence on the cost-effectiveness of integrated care programmes to support the development of a cost-effective integrated care programme for chronic disease management...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28477327/circulating-rotavirus-genotypes-in-the-irish-paediatric-population-prior-to-the-introduction-of-the-vaccination-programme
#16
Z Yandle, S Coughlan, R J Drew, N O'Flaherty, J O'Gorman, C De Gascun
BACKGROUND: Rotavirus is the leading cause of viral gastroenteritis in children, and it is anticipated that the introduction of the Rotarix™ vaccine (GlaxoSmithKline Biologicals S.A., Rixensart, Belgium) into the Irish immunisation schedule will result in a significant reduction of rotavirus-associated disease. In the pre- and post-vaccination eras, it is important to determine circulating strains of rotavirus to assess vaccine effectiveness, to monitor vaccine failures, and to detect potential emerging strains...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28477326/assessment-of-the-effectiveness-of-group-education-on-knowledge-for-women-with-newly-diagnosed-gestational-diabetes
#17
H Alayoub, S Curran, M Coffey, M Hatunic, M Higgins
BACKGROUND: Gestational diabetes mellitus (GDM) is identified in pregnancy and resolves following delivery. It increases maternal and foetal morbidity and may increase risk of future type 2 diabetes. Women diagnosed with GDM need high-quality multidisciplinary education in order to apply necessary changes to their diet and lifestyle. There is a paucity of information on the effectiveness of group education for women with GDM. AIMS: The aim of this study was to assess the effect of a multidisciplinary group intervention delivered by a specialist midwife and dietitian on women's knowledge of GDM...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28474238/pragmatic-considerations-for-medical-imaging-of-the-obese-patient
#18
LETTER
T É Murray, D C O'Neill, A McErlean
No abstract text is available yet for this article.
May 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28474237/tinzaparin-thromboprophylaxis-prescribing-practice-after-caesarean-delivery-2009-2014
#19
P J Maguire, M McGuire, K A Power, M McNicholl, S R Sheehan, M J Turner
BACKGROUND: National guidelines have been developed to ensure correct dosing of tinzaparin for women delivered by caesarean delivery (CD) to reduce the risk of venous thromboembolism. AIMS: The aim of this study is to examine the impact of implementation of national guidelines on thromboprophylaxis prescribing practice for women undergoing CD in a university maternity hospital. METHODS: Details of tinzaparin usage were obtained from the Hospital pharmacy for the years 2009-2014...
May 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28474236/the-impact-of-a-structured-clinical-training-course-on-interns-self-reported-confidence-with-core-clinical-urology-skills
#20
C Browne, S Norton, J M Nolan, C Whelan, J F Sullivan, M Quinlan, M Sheikh, T E D Mc Dermott, T H Lynch, R P Manecksha
BACKGROUND: Undergraduate training in core urology skills is lacking in many Irish training programmes. AIMS: Our aim was to assess newly qualified doctors' experience and confidence with core urological competencies. METHODS: A questionnaire survey covering exposure to urology and confidence with core clinical skills was circulated to all candidates. The group then attended a skills course covering male/female catheterisation, insertion of three-way catheters, bladder irrigation and management of long-term suprapubic catheters...
May 4, 2017: Irish Journal of Medical Science
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