The purpose of ward rounds
AbstractWard rounds are a highly important forum for collaborative medical reasoning. Despite being prevalent for over a century, they are under-researched. In particular, no clear and comprehensive statement of the purpose of ward rounds exists in the literature. This letter provides such a statement. Having the purpose of ward rounds clearly described helps to provide a foundation for evaluating the effectiveness of rounds and suggesting ways in which rounds can be improved. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 13, 2018 Category: General Medicine Source Type: research

A growing problem: cycling referrals to the National Centre for Pelvic and Acetabular Fracture Management in Ireland
ConclusionsThe rise in popularity of cycling has been mirrored by an increase in PA injuries and deaths. These injuries are associated with significant costs to the patient, hospital and society. Greater investment in safety and awareness is needed to protect this vulnerable group. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 11, 2018 Category: General Medicine Source Type: research

Nutritional deficiency among vulnerable elderly patients on acute wards in hospitals
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - November 6, 2018 Category: General Medicine Source Type: research

The inclusion health awareness month at University College Hospital Galway (UCHG)
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 16, 2018 Category: General Medicine Source Type: research

Characteristics and in-hospital outcomes of hospitalisations with heart failure with reduced or preserved ejection fraction undergoing percutaneous coronary intervention
AbstractBackgroundStudies comparing characteristics and in-hospital outcomes for heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) for hospitalisations undergoing percutaneous coronary intervention (PCI) for ST-segment elevated myocardial infarction (STEMI) remain limited.AimThis sought to investigate characteristics and in-hospital outcomes for HFpEF and HFpEF hospitalisations undergoing STEMI-PCI.MethodsThe National inpatient sample database from years 2012 to 2014 was queried and appropriateInternational Classification of Disease, Ninth Revision, Clinical Mod...
Source: Irish Journal of Medical Science - October 16, 2018 Category: General Medicine Source Type: research

Implementation of day of surgery admission for rectal cancer surgery in Ireland following a national centralisation programme
ConclusionsDespite an increase in caseload of 54%, an estimated 272 bed days were saved. This demonstrated that DOSA is sustainable and highly effective in tackling the increased inpatient bed demands associated with the growing requirement for elective surgery. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 6, 2018 Category: General Medicine Source Type: research

Critical biochemistry values and patient safety in primary care
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 2, 2018 Category: General Medicine Source Type: research

Migration to aphakia and contact lens treatment is the trend in the management of unilateral congenital cataract in Britain and Ireland
ConclusionAphakia with CL rehabilitation was the most common approach to the treatment of unilateral congenital cataract in infants less than 6 months in this study. The results of the IATS appear to have influenced a change in practice from primary IOL implantation to aphakia and CL visual rehabilitation in approximately one quarter of those surveyed. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 29, 2018 Category: General Medicine Source Type: research

Ethnic and racial blindness in EU anti-smoking campaigns, slogans and images
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 26, 2018 Category: General Medicine Source Type: research

An audit of healthcare professionals ’ knowledge regarding perinatal autopsy
ConclusionsThe results of this audit highlight the need for further education among all healthcare professionals working with bereaved families. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 25, 2018 Category: General Medicine Source Type: research

Differences in clinical manifestations and prognosis of Chinese giant cell arteritis patients with or without polymyalgia rheumatica
ConclusionsGCA patients with or without PMR have different clinical characteristics. Patients with PMR present myalgia or arthralgia more frequently, while those without PMR have higher inflammatory markers, lower lymphocyte counts, and wider involvement of arteries under aortic arch. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 24, 2018 Category: General Medicine Source Type: research

Dr Eveleen O ’Brien (1901–1981)
AbstractDr Eveleen O ’Brien (1901–1981) was a leading figure in Irish asylum medicine, with a particular interest in the care of patients suffering from epilepsy and the crossover between neurology and psychiatry. From 1933 to 1966, O’Brien worked in Grangegorman Mental Hospital. She was appointed Governor of the Central Mental Hospital, Dundrum in January 1968 and remained in this position until 1971. An enthusiastic researcher, O’Brien published several papers in theJournal of Mental Science, including Ireland ’s first systematic review of insulin therapy (1939). In 1942, O’Brien obtai...
Source: Irish Journal of Medical Science - September 24, 2018 Category: General Medicine Source Type: research

Differences in clinical manifestations and prognosis of Chinese giant cell arteritis patients with or without polymyalgia rheumatica
ConclusionsGCA patients with or without PMR have different clinical characteristics. Patients with PMR present myalgia or arthralgia more frequently, while those without PMR have higher inflammatory markers, lower lymphocyte counts, and wider involvement of arteries under aortic arch. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 24, 2018 Category: General Medicine Source Type: research

Dr Eveleen O ’Brien (1901–1981)
AbstractDr Eveleen O ’Brien (1901–1981) was a leading figure in Irish asylum medicine, with a particular interest in the care of patients suffering from epilepsy and the crossover between neurology and psychiatry. From 1933 to 1966, O’Brien worked in Grangegorman Mental Hospital. She was appointed Governor of the Central Mental Hospital, Dundrum in January 1968 and remained in this position until 1971. An enthusiastic researcher, O’Brien published several papers in theJournal of Mental Science, including Ireland ’s first systematic review of insulin therapy (1939). In 1942, O’Brien obtai...
Source: Irish Journal of Medical Science - September 24, 2018 Category: General Medicine Source Type: research

YouTube as a source of information in retinopathy of prematurity
ConclusionYouTube could be used as an important tool for patient information in ROP. However, one third of the YouTube videos regarding ROP are misleading and may present a risk of harmful consequences. In this aspect, authoritative videos by healthcare professionals should be uploaded for dissemination of reliable information on ROP. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 20, 2018 Category: General Medicine Source Type: research

Electronic referrals for virtual fracture clinic service using the National Integrated Medical Imaging System (NIMIS)
ConclusionVirtual review of orthopaedic trauma patients results in satisfactory patient outcomes. Clinical outcomes were acceptable with minimal additional medical attention required following injury. Electronic transfer of information allows for the virtual service to operate from sites long distances from the primary orthopaedic centre. The NIMIS is a safe and confidential means of collaborating with other institutions and has huge potential in the areas of trauma care delivery, clinical conferencing and other image-based disciplines. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 18, 2018 Category: General Medicine Source Type: research

A systematic review of the clinical effectiveness of emergency endovascular therapy using mechanical thrombectomy in acute ischaemic stroke: implications for service delivery
AbstractBackgroundTwelve randomised controlled trials (RCTs) comparing mechanical thrombectomy against traditional treatment options for patients experiencing acute ischaemic stroke (AIS) have been published.AimsTo evaluate whether this technology is more effective and/or safer than traditional treatment options and to assess the potential for implementation of this technology as a treatment strategy for acute ischaemic stroke in Ireland.MethodsRCTs published up to February 2017 were included. Meta-analysis was performed for two primary (mortality at 90  days, mRS at 90 days) and four secondary outcomes. Cumulati...
Source: Irish Journal of Medical Science - September 15, 2018 Category: General Medicine Source Type: research

The “National Integrated Medical Imaging System” [NIMIS]—friend, not nimesis!
ConclusionNIMIS allows the safe and confidential flow of patient images and clinical information in the Irish health system. It could provide definite potential in the areas of clinical conferencing, multidisciplinary meetings and remote patient assessment along with collaborative research and education. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 15, 2018 Category: General Medicine Source Type: research

A systematic review of the clinical effectiveness of emergency endovascular therapy using mechanical thrombectomy in acute ischaemic stroke: implications for service delivery
AbstractBackgroundTwelve randomised controlled trials (RCTs) comparing mechanical thrombectomy against traditional treatment options for patients experiencing acute ischaemic stroke (AIS) have been published.AimsTo evaluate whether this technology is more effective and/or safer than traditional treatment options and to assess the potential for implementation of this technology as a treatment strategy for acute ischaemic stroke in Ireland.MethodsRCTs published up to February 2017 were included. Meta-analysis was performed for two primary (mortality at 90  days, mRS at 90 days) and four secondary outcomes. Cumulati...
Source: Irish Journal of Medical Science - September 15, 2018 Category: General Medicine Source Type: research

The “National Integrated Medical Imaging System” [NIMIS]—friend, not nimesis!
ConclusionNIMIS allows the safe and confidential flow of patient images and clinical information in the Irish health system. It could provide definite potential in the areas of clinical conferencing, multidisciplinary meetings and remote patient assessment along with collaborative research and education. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 15, 2018 Category: General Medicine Source Type: research

Trans-catheter paravalvular leak closure: a single-centre experience
ConclusionsPatients with PVL represent a high-risk patient cohort. Percutaneous PVL offers a safe alternative to surgical PVL repair and appears particularly effective in those patients who present primarily with HF. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 12, 2018 Category: General Medicine Source Type: research

Axillary ultrasound-guided core biopsy in breast cancer: identifying higher nodal burden and more aggressive clinicopathological characteristics
AbstractBackgroundPatients with sentinel lymph node (SLN) metastases may not require axillary lymph node dissection (ALND) but it remains unclear if patients with a positive ultrasound-guided axillary core biopsy (ACB) would satisfy such criteria.AimsThe aim of this study was to assess if breast cancer patients with a positive pre-operative ACB have more aggressive tumour characteristics/higher axillary nodal burden compared to those with a positive SLN.MethodsData was extracted from a prospectively maintained breast cancer database between 2012 and 2015. Patients who underwent ALND after either positive ACB or SLN were in...
Source: Irish Journal of Medical Science - September 5, 2018 Category: General Medicine Source Type: research

Health status of the homeless in Dublin: does the mobile health clinic improve access to primary healthcare for its users?
ConclusionWhile the findings of this study are limited by the small sample size, they nevertheless indicate that the MHC promotes access to primary care service. Results also highlight the need to expand the healthcare approaches on the MHC to adequately meet the health needs of its target population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 3, 2018 Category: General Medicine Source Type: research

Oral antiplatelets in primary and secondary prevention of myocardial infarction: a review
AbstractThere are a number of guidelines and articles available for the use of oral antiplatelets for primary and secondary prevention of myocardial infarction (MI). Antiplatelet medications inhibit platelet activation, aggregation, and other pathways eventually inhibiting clot formation. Aspirin and clopidogrel have been the mainstay in the management of acute coronary syndrome for about a decade. We have discussed the role of aspirin, clopidogrel, ticagrelor, and prasugrel which are the most commonly used oral antiplatelet medications in the current era. We have also considered the role of newer thrombin inhibitor vorapa...
Source: Irish Journal of Medical Science - September 3, 2018 Category: General Medicine Source Type: research

Health status of the homeless in Dublin: does the mobile health clinic improve access to primary healthcare for its users?
ConclusionWhile the findings of this study are limited by the small sample size, they nevertheless indicate that the MHC promotes access to primary care service. Results also highlight the need to expand the healthcare approaches on the MHC to adequately meet the health needs of its target population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - September 3, 2018 Category: General Medicine Source Type: research

Spiritual care in neonatology: analysis of emergency baptisms in an Irish neonatal unit over 15  years
ConclusionEmergency baptism remains an important element in the spiritual care of the critically ill newborn infants and their families. Maternity hospitals and neonatal units should have access to emergency baptism service or other equivalent ‘spiritual blessings’ as appropriate to the faiths followed by the family, especially in an emerging multi-faith population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 27, 2018 Category: General Medicine Source Type: research

Disturbing and distressing: a mixed methods study on the psychological impact of end of life care on junior doctors
ConclusionsJunior doctors are regularly carrying out tasks related to end of life care, resulting in high levels of psychological distress. Further training and a change in culture are required. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 24, 2018 Category: General Medicine Source Type: research

CT cervico-cerebral angiography in acute stroke. Can we justify aortic arch imaging?
ConclusionsRoutine inclusion of the upper chest on CTCCA is currently difficult to justify in the evaluation of a suspected acute anterior circulation stroke, contributing significantly to total radiation dose without demonstrating significant extra-cranial vascular findings. Prospective studies adopting narrower fields of view excluding the upper chest are necessary. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 24, 2018 Category: General Medicine Source Type: research

Disturbing and distressing: a mixed methods study on the psychological impact of end of life care on junior doctors
ConclusionsJunior doctors are regularly carrying out tasks related to end of life care, resulting in high levels of psychological distress. Further training and a change in culture are required. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 24, 2018 Category: General Medicine Source Type: research

CT cervico-cerebral angiography in acute stroke. Can we justify aortic arch imaging?
ConclusionsRoutine inclusion of the upper chest on CTCCA is currently difficult to justify in the evaluation of a suspected acute anterior circulation stroke, contributing significantly to total radiation dose without demonstrating significant extra-cranial vascular findings. Prospective studies adopting narrower fields of view excluding the upper chest are necessary. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 24, 2018 Category: General Medicine Source Type: research

Large loop excision of the transformation zone and preterm delivery over a decade in a major women ’s hospital
ConclusionsDespite having a lower mean depth of excision, women with CIN 3 comprised the majority of those who experienced PTD, suggesting that factors other than mechanical weakness are implicated in PTD for these women. This is in keeping with recent suggestions that the common denominator in high grade CIN and PTD is an altered vaginal microbiome. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 23, 2018 Category: General Medicine Source Type: research

Non-pharmacological management of hypertension: in the light of current research
AbstractHypertension is a major risk factor for a number of cardiovascular diseases. Proper management of hypertension may require both pharmacological and non-pharmacological interventions. Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption. Nutritional requirements of hypertensive individuals can be addressed through adopting either the DASH diet or through t...
Source: Irish Journal of Medical Science - August 22, 2018 Category: General Medicine Source Type: research

Irrational use of proton pump inhibitors in general practise
ConclusionIrrational prescribing of PPIs continues both in hospital and in general practise. It is imperative that the side-effects of these medicines are weighed against the benefit and cost effectiveness, especially in the elderly population where polypharmacy remains a substantial concern. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 22, 2018 Category: General Medicine Source Type: research

Non-pharmacological management of hypertension: in the light of current research
AbstractHypertension is a major risk factor for a number of cardiovascular diseases. Proper management of hypertension may require both pharmacological and non-pharmacological interventions. Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption. Nutritional requirements of hypertensive individuals can be addressed through adopting either the DASH diet or through t...
Source: Irish Journal of Medical Science - August 22, 2018 Category: General Medicine Source Type: research

Irrational use of proton pump inhibitors in general practise
ConclusionIrrational prescribing of PPIs continues both in hospital and in general practise. It is imperative that the side-effects of these medicines are weighed against the benefit and cost effectiveness, especially in the elderly population where polypharmacy remains a substantial concern. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 22, 2018 Category: General Medicine Source Type: research

Antenatal breastfeeding self-efficacy and breastfeeding outcomes among mothers participating in a feasibility breastfeeding-support intervention
ConclusionsBreastfeeding outcomes differed by maternal education. Future interventions should target mothers with lower education and possibly also overweight and obese mothers. Increasing breastfeeding self-efficacy, particularly among older and Irish-born mothers, may be a mechanism for improving breastfeeding outcomes. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 21, 2018 Category: General Medicine Source Type: research

Prevalence and co-variates of burnout in consultant hospital doctors: burnout in consultants in Ireland Study (BICDIS)
ConclusionsThis study demonstrated that over 40% of the consultants studied are affected by burnout. This finding raises concerns for patient safety and standard of care as well as doctors well-being. Interventions to address and minimise burnout are important to guarantee high patient outcomes and retain medical staff. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - August 20, 2018 Category: General Medicine Source Type: research

Ethical implications of population ageing in the intensive care unit
AbstractPopulation ageing has significant ethical implications in the management of elderly patients in the intensive care unit (ICU). In the aspects of beneficence and non-maleficence, conflicting evidence has long existed regarding an association of older age with poorer prognosis, but elderly patients who have poor prognosis in the ICU may have a worse outcome if not admitted. More randomised controlled studies are needed to study the benefits of ICU admission to different subgroups of critically ill elderly patients. The acute care for the elderly unit could be developed to provide more comprehensive care to the elderl...
Source: Irish Journal of Medical Science - August 18, 2018 Category: General Medicine Source Type: research

Does an elective induction policy negatively impact on vaginal delivery rates? A 30-month review of an elective induction policy
AbstractBackgroundThe rate of induction of labour varies across Health Service Executive hospital regions in Ireland averaging at 23.3 per 100 deliveries in 2005 –2009. The increasing rate of elective induction of labour in Ireland calls for more studies looking into associated maternal and/or neonatal outcomes.Study aimThe aim of this study is to show that an elective induction policy with management by a sole consultant obstetrician can decrease caesarean section rates as well as positively impact maternal and neonatal complications.MethodsWe conducted a retrospective review of women attending a named obstetrician ...
Source: Irish Journal of Medical Science - August 18, 2018 Category: General Medicine Source Type: research