World Patient Safety Day
PMID: 31651127 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Murphy JFA Tags: Ir Med J Source Type: research

Psychiatry in Ireland: A Lot Done, More to Do
PMID: 31651128 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Kelly BD Tags: Ir Med J Source Type: research

Development of an Insulin-Prescribing Chart for Paediatric Diabetes
Conclusion The new paediatric insulin prescribing chart has improved safety and ease of prescribing insulin. The colour coded quasi graph and ALERT system has made it easier to appreciate capillary blood glucose trends and manage them safely. PMID: 31651129 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Finn BP, O’Neill T, Bradfield A, O’Sullivan T, Beattie S, O’Connell SM Tags: Ir Med J Source Type: research

Cannabis use and Associated Health Problems – What’s the Harm?
Conclusion A concerted public health response is required to address escalating cannabis related health harms which have coincided with the arrival of more potent cannabis. PMID: 31651130 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Smyth BP, O’Farrell A, Daly A Tags: Ir Med J Source Type: research

How Much Greater is Obstetric Intervention in Women with Medical Disorders in Pregnancy When Compared to the General Population?
Abstract Introduction The purpose of this study was to compare obstetric and neonatal outcomes between women attending a specialised maternal medicine service and the general obstetric population. Methods Women attending from January 2011 to December 2016 were identified from the clinic database. Medical diagnosis, demographics, obstetric and neonatal outcomes were compared with data from hospital annual report 2014. Results 1873 women were compared with 8632 women who delivered at the hospital in 2014. Delivery before 34 weeks [82 (4.5%) vs 189 (2.2%)], induction of labour [761 (40.6%) vs 2664 (30.9%)] and del...
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Keane R, Manning C, Lynch C, Regan C, Byrne B Tags: Ir Med J Source Type: research

The Prevalence and Management of Metabolic Acidosis of Chronic Kidney Disease
Abstract Aim Emerging evidence supports initiating oral sodium bicarbonate (OSB) at a serum bicarbonate (HCO3) level of less than 22mmol/L. We look to identify the prevalence of metabolic acidosis of chronic kidney disease (MA-CKD) and its management with OSB at a regional university hospital. Methods Retrospective data was collected using the national electronic renal database (eMED) to identify chronic kidney disease (CKD) patients with MA-CKD over a one-year period. Results One-hundred and forty-four patients were identified with CKD, of which 131 (89%) were tested for HCO3. MA-CKD was present in 44 patient...
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Ahmed AR, Satti MM, Abdalla AE, Giblin L, Lappin D Tags: Ir Med J Source Type: research

A Temporal Comparative Study of Women ’s Rugby Injuries Presenting to an Emergency Department
Discussion Women’s rugby injury presentations are increasing. We have seen a rise in significant injuries. Patients now require first level diagnostics and specialist follow up care. PMID: 31651133 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Gilmartin S, Ryan J Tags: Ir Med J Source Type: research

Factors Contributing to Non-Exclusive Breastfeeding in Primigravid Mothers
Abstract Aims We aimed to examine the factors contributing to non-exclusive breastfeeding in primigravid mothers in a large Irish tertiary maternity hospital. Methods This was a retrospective cohort study carried out at the Rotunda Hospital, Dublin, Ireland. Maternal demographics, antenatal, perinatal, delivery-related information and neonatal outcomes were collected and analysed. Results 569 eligible mothers were delivered during the study period. Out of the 416 mothers intending to breastfeed, 278 (67%) mothers were exclusively breastfeeding at discharge. On univariate analysis, a higher body mass index, une...
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Panaviene J, Zakharchenko L, Olteanu D, Cullen M, EL-Khuffash A Tags: Ir Med J Source Type: research

Changing Trends in Life Expectancy in Intellectual Disability over Time
Abstract Decreased life expectancy (LE) has historically been found among people with intellectual disability (ID) compared to the general population. Several recent studies have looked into ageing and cause of death in ID. Results of many of these studies suggest that, although LE in ID remains lower than the general population, it has increased across many Western societies in recent decades. Increases in LE in the general and ID populations appear to follow similar trends. Some major causes of mortality in ID are similar to the general population, and therefore may be amenable to similar preventative healthcare...
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Dolan E, Lane J, Hillis G, Delanty N Tags: Ir Med J Source Type: research

Measles and Eye Complications
Conclusion Measles cases have increased by 244% in Ireland1 remaining an important public health concern. This case illustrates the difficulty in diagnosis, ocular manifestations and serves to remind health care professionals that this potentially devastating disease has not gone away. PMID: 31651136 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: O’ Mahony AM, McSwiney TJ, Cosgrave E Tags: Ir Med J Source Type: research

Near Peer Teaching in a Paediatric Healthcare Setting
PMID: 31651137 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Jenkinson A, Smith A, Doyle S, Gorman K, Murphy S Tags: Ir Med J Source Type: research

Major Oncological Surgery (Radical Cystectomy) in Octogenarians- is it Safe?
PMID: 31651215 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Izzeldin S, Nason GJ, Elamin M, Brady CM, Power D, Sweeney P Tags: Ir Med J Source Type: research

An Integrated Vaccine Clinic; a Novel Model of Care to Improve Vaccine Uptake in At-Risk Patient Groups
n C PMID: 31651915 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: Sadlier C, O’Rourke A, Carr A, Bergin C Tags: Ir Med J Source Type: research

Flu Flying in August
s S PMID: 31652033 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - October 15, 2019 Category: General Medicine Authors: O’ Sullivan S, Kelly E, Collins O, McGrath E, Waqas S Tags: Ir Med J Source Type: research

High-flow Nasal Cannulae, Bronchopulmonary Dysplasia and Retinopathy of Prematurity
Abstract Aims To determine if HFNC use was associated with changes in incidence of BPD and ROP. Methods This retrospective study examined premature infants (
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Healy LI, Corcoran P, Murphy BP Tags: Ir Med J Source Type: research

What Stops Doctors Switching from Intravenous to Oral Antibiotics?
Conclusion Results will assist in implementing quality improvement initiatives to increase the rate of guideline compliance. PMID: 31650816 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Hogan-Murphy D, Waqas S, Tuite H, Ni Riain U Tags: Ir Med J Source Type: research

Risks for Surgical Site Infection after Infra-inguinal Bypass
Conclusion Pre-operative co-morbidity (e.g., BMI reduction), and MRSA screening optimization and SAP are areas identified for improvement. PMID: 31650818 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: AlMushcab N, Connolly R, Naughton P, Moneley D, McHugh S, Fitzpatrick F Tags: Ir Med J Source Type: research

PC/DC: Police Contact with Distressed Children
PMID: 31650819 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: McNicholas F, Rooney L, Holme I Tags: Ir Med J Source Type: research

Benefit of Sequential Audit Cycles in Improving Management of Vitamin D Deficiency in the HIV Infected Paediatric Population
Conclusions Sequential audits along with a shift to nurse led management were the most likely reasons for sustained improvement. Similar projects in all medical departments could improve clinical outcomes. PMID: 31650823 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Geoghegan AR, Walsh O, O’Connor M, Goode M, McDonagh S, Rochford A, Gavin P, Butler K Tags: Ir Med J Source Type: research

Status Cataplecticus Following Abrupt Withdrawal of Clomipramine
Discussion There have been a total of 4 case reports of status cataplecticus following withdrawal of antidepressant therapy. In all cases, reintroduction of anti-cataplectic therapy led to resolution of attacks. The abrupt discontinuation of an SSRI is believed to precipitate cataplexy attacks due to reduction in noradrenergic tone. PMID: 31650824 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Fullam S, Scott A, Garvey JF Tags: Ir Med J Source Type: research

Laboratory-Confirmed Metformin-Associated Lactic Acidosis
We report three cases of prospectively identified laboratory confirmed metformin-associated lactic acidosis admitted to our intensive care unit. Case 1 72-year-old female presented with lactic acidosis; pH 6.7, lactate 22.6mmol/L with elevated Metformin levels of 4.9mg/L. Case 2 56-year-old female presented with lactic acidosis; pH 7.2 and lactate 14.8mmol/L. Metformin levels elevated at 3.9mg/L. Case 3 72-year-old female presented with lactic acidosis, pH 6.95 and lactate of 27.6mmol/L with elevated Metformin levels of 48.7mg/L. Results All three cases were admitted to the intensive care unit to receive supportive car...
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Nestor C, Nasim S, Coyle N, Canavan C Tags: Ir Med J Source Type: research

Improving Patient Care with Patient Centred Reports
MK PMID: 31650827 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Nason GJ, O’Reilly MK Tags: Ir Med J Source Type: research

The Lone Night Medical Registrar on Call : “Juggling on a Skyfall Rope”
The Lone Night Medical Registrar on Call : “Juggling on a Skyfall Rope” Ir Med J. 2019 Sep 12;112(8):994 Authors: Kooblall M, Cody L, O’Callaghan M PMID: 31651109 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Kooblall M, Cody L, O’Callaghan M Tags: Ir Med J Source Type: research

The Addition of MCADD to the Newborn Blood Spot Screening Programme
PMID: 31651112 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Ryan H, Crushell E, Boyle MA Tags: Ir Med J Source Type: research

Can ’t Acopia, Won’t Acopia
Can’t Acopia, Won’t Acopia Ir Med J. 2019 Sep 12;112(8):996 Authors: Nolan R, Byrne C, Duggan J PMID: 31651115 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Nolan R, Byrne C, Duggan J Tags: Ir Med J Source Type: research

The Medical CV: Getting it Right
PMID: 31647209 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Murphy JFA Tags: Ir Med J Source Type: research

The Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration
PMID: 31647210 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - September 12, 2019 Category: General Medicine Authors: Broderick D Tags: Ir Med J Source Type: research

Recruitment of New Consultants
illy MK PMID: 31646841 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Nason GJ, O’Kelly F, Daly MF, O’Reilly MK Tags: Ir Med J Source Type: research

Complex Regional Pain Syndrome; a Visible Pain Disease
PMID: 31646846 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Khan A, Murphy P Tags: Ir Med J Source Type: research

Opt-Out Organ Donation - a Patient Organisation ’s Perspective
Opt-Out Organ Donation - a Patient Organisation’s Perspective Ir Med J. 2019 Aug 01;112(7):979 Authors: Cassidy N, Fox L, Sheridan M, Galvin L, Geoghegan M, Cassidy E, The committee of the Irish Lung Fibrosis Association PMID: 31646847 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Cassidy N, Fox L, Sheridan M, Galvin L, Geoghegan M, Cassidy E, The committee of the Irish Lung Fibrosis Association Tags: Ir Med J Source Type: research

Fatal Propionic Acidemia: A Challenging Diagnosis
PMID: 31646848 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Fulmali A, Goggin N Tags: Ir Med J Source Type: research

The Role of Interventional Radiology in the Management of Obstetric and Gynaecological Haemorrhage
Conclusion Arterial embolization is a highly successful treatment of obstetric and gynaecological haemorrhage in unstable patients. PMID: 31642642 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: O’Brien C, Healy GM, Anglim BC, O’Brien A, Duignan J, Patel A, Cheung M, Cantwell CP Tags: Ir Med J Source Type: research

Exploring the Interface of Oncology and Palliative Care in Ireland
Conclusion The gulf between positive attitudes and limited implementation suggests the need for interdisciplinary changes to facilitate integration of PC in clinical practice in Ireland. PMID: 31642643 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Coleman K, Brady C, O’Reilly S, O’ Brien T Tags: Ir Med J Source Type: research

The Emergence of New Psychoactive Substance (NPS) Benzodiazepines. A Survey of their Prevalence in Opioid Substitution Patients using LC-MS
Abstract Benzodiazepines have a wide range of clinical uses being among the most commonly prescribed medicines globally. The EU Early Warning System on new psychoactive substances (NPS) has over recent years detected new illicit benzodiazepines in Europe’s drug market1. Additional reference standards were obtained and a multi-residue LCMS method was developed to test for 31 benzodiazepines or metabolites in urine including some new benzodiazepines which have been classified as New Psychoactive Substances (NPS) which comprise a range of substances, including synthetic cannabinoids, opioids, cathinones and ben...
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Mc Namara S, Stokes S, Nolan J Tags: Ir Med J Source Type: research

A Prospective Audit of Inappropriately Occupied Hospital Beds in Patients with Newly Acquired Traumatic Spinal Cord Injury
Conclusion Valuable health-care resources are being wasted because TSCI patients cannot move seamlessly from one phase of care to the next. This impacts negatively on the quality of care being delivered to this patient cohort. PMID: 31642645 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Smith E, Synnott K Tags: Ir Med J Source Type: research

Incidence of Asymptomatic Chiari Malformation
Conclusion This study shows an asymptomatic Chiari Malformation rate of 2%. This study supports the idea that in asymptomatic patients, a tonsil herniation of up to 5 millimeters may be an incidental and inconsequent finding. PMID: 31642646 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: O’Reilly EM, Torreggiani W Tags: Ir Med J Source Type: research

A Classic Case of Panton-Valentine Leucocidin MethicillinResistant Staphylococcus Aureus (PVL-MRSA)
Abstract Strains of Staphylococcus aureus capable of producing Panton-Valentine leucocidin (PVL-SA) are increasingly implicated in commnity acquired infection. The key principles of preventing and controlling the spread of infection in the community setting centre on early suspicion, rapid diagnosis and appropriate treatment. PMID: 31642655 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Fitzgerald L, Sheeran Purcell E, Sheeran Purcell P Tags: Ir Med J Source Type: research

The Administration of Naloxone: Social Care Worker Perspectives and Experiences
PMID: 31642658 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Deacy JJP, Houghton F Tags: Ir Med J Source Type: research

The Modified Sarnat Score in the Assessment of Neonatal Encephalopathy: A Quality Improvement Initiative
PMID: 31643175 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Power BD, McGinley J, Sweetman D, Murphy JFA Tags: Ir Med J Source Type: research

On Call Medical Rosters: New Approaches Should be Explored
PMID: 31553143 [PubMed - as supplied by publisher] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Murphy JFA Tags: Ir Med J Source Type: research

Moving Away from Slapping and Promoting Effective Discipline to Raise Healthy Children in Ireland
PMID: 31553144 [PubMed - as supplied by publisher] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Nicholson A Tags: Ir Med J Source Type: research

Predicting Spontaneous Preterm Birth
r V PMID: 31553145 [PubMed - as supplied by publisher] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Kennedy C, O’Dwyer V Tags: Ir Med J Source Type: research

Circumcision Rates after the Release of Preputial Adhesions
Conclusion RPA is an effective alternative to circumcision where either reassurance on the benign and self-limiting nature of physiologic phimosis or steroid treatment are unsuccessful in managing symptoms. PMID: 31553146 [PubMed - as supplied by publisher] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: Aworanti OM, Rasheed F, Aldiab A, Mortell A Tags: Ir Med J Source Type: research

Varicella Related Hospital Admissions in Ireland
Conclusion Chickenpox places a consistent burden on Irish healthcare, accounting for in excess of 1100 acute and 160 intensivecare bed days annually. This study adds weight to the argument that universal varicella vaccine should be considered and provides baseline epidemiology to determine vaccine effectiveness in the future. PMID: 31553147 [PubMed - as supplied by publisher] (Source: Ir Med J)
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: McCarthy KN, Ó Maoldomhnaigh C, Butler KM, Gavin PJ Tags: Ir Med J Source Type: research

Dietitians ’ Attitudes and Experiences of Blended Tube Feeding in Paediatrics
Dietitians’ Attitudes and Experiences of Blended Tube Feeding in Paediatrics Ir Med J. 2019 Aug 01;112(7):967 Authors: O’Sullivan K, O’Sullivan M, Quigley S, Delahunt A, Sugrue S Abstract Aims To examine; (a) the number of registered dietitians (RDs) with blended tube fed (BTF) patients, work setting and caseload; (b) attitudes and experiences towards BTF; (c) current BTF supports and future resources required. Methods An online survey collected information from Irish RDs over one month. Data was examined using cross-tabulations and Mann-Whitney U tests. Free-text was categorized int...
Source: Ir Med J - August 1, 2019 Category: General Medicine Authors: O’Sullivan K, O’Sullivan M, Quigley S, Delahunt A, Sugrue S Tags: Ir Med J Source Type: research

Caring for Caregivers: An Evaluation of Schwartz Rounds in a Paediatric Setting
Conclusion The results showed that there was a positive perception of Schwartz rounds in TSCUH. PMID: 31537055 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - June 17, 2019 Category: General Medicine Authors: Silke A, Rushe H, Keating K, Thurstan R, Barrett E Tags: Ir Med J Source Type: research

Impact of Introduction of a Clinical Pathway for the Management of Pyelonephritis on Obstetric Patients: a Quality Improvement Project
This study has shown that the introduction of a pathway for the treatment of pyelonephritis in pregnancy had a positive impact on several important clinical outcomes. PMID: 31538439 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - June 17, 2019 Category: General Medicine Authors: Clooney L, Ronayne A, Glennon K, Brennan M, Hickey N, Magee C, Cooley S, Eogan M, Drew RJ Tags: Ir Med J Source Type: research

Solitary Plasmacytoma Management and Outcomes
PMID: 31538440 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - June 17, 2019 Category: General Medicine Authors: Comerford C, McKey S, Wallace N, McArdle O, Faul C, Glavey S, Sargent J, Thornton P, Murphy PT, Quinn J Tags: Ir Med J Source Type: research

Hypercalcaemia due to Hypervitaminosis D in a Self-Supplementing Multiple Sclerosis Patient: A Case Report
We report the case of a 45 year-old male with MS who presented with symptomatic hypercalcaemia secondary to self-supplementation of vitamin D3 purchased online. Treatment was with IV hydration, glucocorticoids, calcitonin and bisphosphonates. This case highlights a lack of consensus guidance regarding safe vitamin D supplementation dosages and the importance of a thorough history with regard to non-prescribed supplements, particularly those easily available online. PMID: 31538442 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - June 17, 2019 Category: General Medicine Authors: Duffy E, Brassill MJ Tags: Ir Med J Source Type: research

Metastatic Solitary Fibrous Tumour of the Kidney Presenting more than a Decade Later with Pulmonary Disease
We present a case of metastatic pulmonary Solitary Fibrous Tumour presenting 11 years post resection of renal primary Solitary Fibrous Tumour. The patient underwent apical segmentectomy of the right lower lobe extending to wedge excision of right upper lobe due to fissure involvement with lymphadenectomy. The patient was discharged day 12 post surgery. Discussion Robust guidance regarding long-term management of solitary fibrous tumours is lacking. Salvage resection offers favourable long-term prognosis. This case demonstrates the importance of long-term surveillance. PMID: 31538443 [PubMed - in process] (Source: Ir Med J)
Source: Ir Med J - June 17, 2019 Category: General Medicine Authors: Daly A, Dorman AM, Hinchion J Tags: Ir Med J Source Type: research