Nursing home patients and Emergency Department attendance in a single urban Irish catchment area: an observational study surrounding the introduction of a community medicine for older person service
ConclusionThis is the first Irish study of NH ED utilization over an extended period. ED attendances PBC have not decreased since the introduction of the CMOP. Discharges PBC, however, have decreased and may represent a decrease in potentially preventable attendance/improvement in appropriateness of ED transfers, following the introduction of this intervention. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 29, 2020 Category: General Medicine Source Type: research

Ileal pouch-anal anastomosis for ulcerative colitis: long-term outcomes and trends over time in a low-volume institution
ConclusionsOverall outcomes and practice in this study are consistent with previously published studies on IPAA nationally and internationally. While acceptable, the opportunity from surgical centre collaboration outside of the National Cancer and Acute Surgery Strategies is to offer still better outcomes for our patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 29, 2020 Category: General Medicine Source Type: research

Virtualised care and COVID-19
AbstractFollowing the declaration by the World Health Organization (WHO) of the Covid-19 pandemic on March 11, 2020, health organisations and staff have had to adapt and restructure services in order to respond to this global health emergency. Numerous containment strategies have been, and continue to be, introduced in this rapidly evolving and fluid situation with a significant shift towards virtual or remote patient assessment. The concept of virtual patient evaluation has previously been adopted across a range of medical and surgical specialities yielding safe and efficient pathways associated with good Patient Reported...
Source: Irish Journal of Medical Science - May 28, 2020 Category: General Medicine Source Type: research

The utility of MRI scans for a painful knee in the elderly patient
AbstractIntroductionWe assess the requesting patterns and overall utility of MRI scans in our institution over a 6-month period for knee pain in an elderly population.MethodsWe performed a retrospective cohort study analysing patients undergoing a knee MRI between June 2018 and January 2019. Clinical notes were reviewed to determine the nature of any surgical intervention that was performed as a result of the MRI findings. A simple economic analysis was then performed using local pricing information.ResultsOne hundred and nine MRI scans were performed. The majority of scans were ordered by primary care physicians with no p...
Source: Irish Journal of Medical Science - May 28, 2020 Category: General Medicine Source Type: research

The COVID-19 pandemic: is our medicine still evidence-based?
AbstractThere is no randomized controlled trial that demonstrated the efficacy of antiviral therapy against COVID-19 yet. However, physicians are prescribing different drugs to a large part of COVID-19 population in the hope they will cure them. This does not reflect the evidence-based medicine approach. What we need is more evidence-based knowledge about what routine care practices we should to apply to ameliorate symptoms of patients and fight COVID-19 pathology. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 28, 2020 Category: General Medicine Source Type: research

General practice nursing: the views and experience of practice nurses and GPs in one county
ConclusionPractice nursing contributes extensively to general practice, and an expansion of the role is advocated by PNs and practices. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 28, 2020 Category: General Medicine Source Type: research

Career destinations of graduates from a medical school with an 18-week longitudinal integrated clerkship in general practice: a survey of alumni 6 to 8  years after graduation
ConclusionThe reform of the delivery of general practice within medical school curricula should be considered by medical schools, curriculum designers and policy-makers as part of an overall strategy to address the recruitment and retention of general practitioners as part of the global healthcare workforce. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 27, 2020 Category: General Medicine Source Type: research

Annexin A10 is a novel prognostic biomarker of papillary thyroid cancer
ConclusionsANXA10 expression was upregulated in PTC, and it was an independent prognostic biomarker of PTC, suggesting that ANXA10 may be a promising target for individual treatment of ANXA10. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 25, 2020 Category: General Medicine Source Type: research

Hope and chronic pain —a systematic review
ConclusionsThe findings of this review demonstrate that hope is influenced by several patient factors and has a positive impact on patients with chronic pain. The current literature supports the usefulness of hope as a therapeutic intervention for not only chronic pain but many chronic illnesses. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 25, 2020 Category: General Medicine Source Type: research

Patient ’s perceptions of physical examination in the setting of chronic pain
ConclusionPatients with chronic pain indicate that the physical examination is a highly positive aspect of their care. There are some negative aspects of been examined which physicians should be aware of. This study adds to our knowledge regarding the physical exam in chronic pain patients. It will inform practice and training. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 25, 2020 Category: General Medicine Source Type: research

Intradialytic hypotension prevalence, influencing factors, and nursing interventions: prospective results of 744 hemodialysis sessions
ConclusionNursing staff awareness regarding the frequency of IDH in hemodialysis patients and the related symptoms needs to be increased. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 23, 2020 Category: General Medicine Source Type: research

Permanent pacemaker implantation rates following cardiac surgery in the modern era
ConclusionAs clinicians, it can be challenging to provide our patients with accurate information on the risk of PPM implantation relative to their operation. A unit-specific data may be a more accurate method of informing our patients on this risk. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 22, 2020 Category: General Medicine Source Type: research

Follow-up study on transphyseal ACL reconstruction in Irish adolescents with no cases of leg length discrepancy or angular deformity
ConclusionsMidterm results at an average follow-up of 3  years after the surgery showed good functional outcomes using the transphyseal ACL reconstruction technique with good return to activity. There were no cases of leg length discrepancy or angular deformity. Transphyseal ACL reconstruction is a viable method of treatment for adolescent ACL tears. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 22, 2020 Category: General Medicine Source Type: research

Evaluation of biochemical and clinical effects of hyaluronic acid on non-surgical periodontal treatment: a randomized controlled trial
This study aimed to evaluate the early term effects of HA as an adjunct to scaling and root planing (SRP) on clinical parameters, periodontal inflamed surface area (PISA), and adenosine deaminase (ADA), catalase (CAT), and glutathione (GSH) levels in gingival crevicular fluid (GCF) in periodontitis.MethodsA total of 24 periodontitis patients per group were included in this randomized-controlled study. The study population was divided into four groups: in Group 1: SRP+ saline; in Group 2: SRP  + HA gel; in Group 3: SRP+ HA mouth rinse; and in Group 4: SRP + HA mouth rinse + HA gingival gel were a...
Source: Irish Journal of Medical Science - May 21, 2020 Category: General Medicine Source Type: research

Structural changes in the brain of patients with relapsing-remitting multiple sclerosis compared to controls: a MRI-based stereological study
ConclusionThe findings showed that quantitative assessments based on stereological method on brain MRIs facilitate clarifying neuropathology of the disease. Also, it can be helpful as a simple index for following up the clinical situation and assessing therapeutic efficiency in MS patients. It may provide a precise treatment approach and justification of symptoms in patients with MS. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 20, 2020 Category: General Medicine Source Type: research

Patient demographics and management challenges in an Irish symptomatic breast cancer unit
ConclusionPatients attending the symptomatic breast cancer unit Beaumont Hospital have different demographics compared with the national registry data. This presents particular challenges for management. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 20, 2020 Category: General Medicine Source Type: research

The use of 3D printing technology in the creation of patient-specific facial prostheses
Conclusions3D printing is a valuable tool which can provide significant savings in time and improve patient outcomes by offering a tailored approach to each individual ’s treatment. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 18, 2020 Category: General Medicine Source Type: research

Survival of childhood and adolescent/young adult (AYA) cancer patients in Ireland during 1994 –2013: comparisons by age
ConclusionsReasons for age-related survival differences, and differences in time-trend by age group, are not clear. The significant narrowing of survival differences by age in more recent years for lymphoid leukaemias reflects a more marked recent increase in survival among AYA. More work is required to explain and improve other age-related survival differences. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 18, 2020 Category: General Medicine Source Type: research

COVID-19 in adults: test menu for hospital blood science laboratories
ConclusionGiven the rapidity with which patients with COVID-19 disease can deteriorate, we recommend regular testing with vigilance paid to the rate and trajectory of change in each of these parameters. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 18, 2020 Category: General Medicine Source Type: research

Medicine and heuristics: cognitive biases and medical decision-making
ConclusionIt remains unknown if heuristics are primarily positive or negative for clinical decision-making. Future efforts should assess heuristics in real-time and controlled trials should be applied to assess the potential impact of mitigating factors in reducing the negative impact of heuristics and optimizing their efficiency for positive outcomes. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 14, 2020 Category: General Medicine Source Type: research

Antibacterial and antifungal impacts of combined silver, zinc oxide, and chitosan nanoparticles within tissue conditioners of complete dentures in vitro
ConclusionsThe combination of Ag, ZnO, and chitosan nanoparticles inhibited the growth of fungi and bacteria in tissue conditioners. These nanoparticles inhibited the growth of fungi more effectively than bacteria. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 14, 2020 Category: General Medicine Source Type: research

Inferolateral T wave inversion in athletes: phenotype-genotype correlation
ConclusionsThe absence of mutations in target genes and heterogeneous sequence variations identified in this study suggest that inferolateral T wave inversion in athletes without a phenotype may potentially represent a benign repolarization syndrome related to athletic adaptation. This was the first study to assess a phenotype-genotype correlation in this population. Further genetic studies need to be undertaken in this area. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 14, 2020 Category: General Medicine Source Type: research

A cloth mask for under-resourced healthcare settings in the COVID19 pandemic
ConclusionThis article describes a simple way to make a cloth mask, suitable if medical masks are not available. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 12, 2020 Category: General Medicine Source Type: research

Predictors of in-hospital mortality in patients with left ventricular assist device
ConclusionsCF-LVADs have not reduced mortality, possibly due to utilization in patients with comorbid conditions. Future trials are necessary for improved patient selection and reduced post-procedural complications. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 9, 2020 Category: General Medicine Source Type: research

Physical illnesses associated with childhood homelessness: a literature review
ConclusionThis literature review summarized the physical illnesses prevalent among homeless children and the contributing factors leading to them. Gaps in the literature were also identified and included a dearth of studies focusing on younger children compared with adolescents.Further research into prevention and intervention programs for this vulnerable population is urgently needed. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 8, 2020 Category: General Medicine Source Type: research

Cancer incidence in Beh çet’s disease
In this study, we aimed to assess cancer incidence in a large cohort of BD patients and to compare with the data of the same age and gender groups.MethodsThe study cohort consisted of BD patients of>  18 years of age who were prospectively recorded in the Hacettepe University Vasculitis Center. Data on any cancer was collected from the patient files. Cancer incidence was compared with age- and gender-specific cancer incidence rates of the normal population retrieved from the 2014 Turkish Nati onal Cancer Registry (TNCR) data using standardized incidence rates (SIR).ResultsTotally, 451 adult cases with BD wer...
Source: Irish Journal of Medical Science - May 8, 2020 Category: General Medicine Source Type: research

A prospective feasibility study of MammoSite accelerated partial breast irradiation for early breast Cancer
ConclusionThe use of the MammoSite technique, as an alternative to standard whole breast irradiation, is feasible in a typical Irish clinical setting with integrated multidisciplinary team input. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2020 Category: General Medicine Source Type: research

Predictive value of CRP/albumin ratio in major abdominal surgery
This study sought to examine the relationship between the CRP/albumin ratio in the prediction of SSI in patients undergoing emergency major abdominal surgery.MethodsA retrospective study of all patients who underwent emergency major abdominal surgery in our institution over 2  years was performed. Patients were identified from a prospectively maintained database of SSI’s and cross-referenced with hospital records. Patient demographics including age, gender, ASA grade, and wound classification (clean, clean/contaminated, contaminated, and dirty) were collated.ResultsCRP preoperatively of greater than 5 was statis...
Source: Irish Journal of Medical Science - May 2, 2020 Category: General Medicine Source Type: research

Obituary: Dr S éamus Mac Suibhne (Sweeney) (1978–2019)
AbstractDr S éamus Mac Suibhne (Sweeney) (1978–2019) was a widely admired psychiatrist, writer and scholar whose contributions ranged from psychiatric care to Greek philosophy, and from medical education to the application of new technologies in educational and clinical settings. Séamus wrote extensively on these and many other themes in the professional and popular literature. In his clinical work, Séamus was a compassionate doctor, effective team-worker and skilled manager. He served as a representative of graduates on the Governing Authority of University College Dublin (2008–2013), secr...
Source: Irish Journal of Medical Science - April 21, 2020 Category: General Medicine Source Type: research

Response to: an audit of discharge summaries from secondary to primary care
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 21, 2020 Category: General Medicine Source Type: research

A survey of general practitioner ’s opinion on the proposal to introduce ‘treat and referral’ into the Irish emergency medical service
ConclusionsGPs are in the main supportive of the introduction of treat and referral; however, they have identified several barriers that may inhibit successful introduction. Importantly, a GP appointment within 48  h does not appear to be a barrier. The adequacy of the working relationships between GPs and the ambulance service and its practitioners appears to have reduced since 2006, which is concerning. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 19, 2020 Category: General Medicine Source Type: research

Therapeutic and prophylactic potential of anti-microbial peptides against coronaviruses
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 18, 2020 Category: General Medicine Source Type: research

The ICMJE recommendations: challenges in fortifying publishing integrity
AbstractIn December of 2019, the International Committee of Medical Journal Editors (ICMJE) updated its recommendations. As occurs regularly with the ICMJE recommendations, this document was edited and tweaked, and thus fortified and verified. At least one new fortifying positive element was introduced, namely that peer reviewers who relied on the assistance of others during peer review need to declare this to editors. This fortifies publishing integrity, via transparency, in the peer review process in biomedical science. However, a new clause was introduced: “Authors should avoid citing articles in predatory or pseu...
Source: Irish Journal of Medical Science - April 15, 2020 Category: General Medicine Source Type: research

Evaluation of physician burnout at a major trauma centre using the Copenhagen burnout inventory: cross-sectional observational study
This study aimed to assess the degree of burnout among physicians of different grades and specialties in a major trauma centre.MethodsThis study was performed in a UK tertiary trauma centre (Brighton and Sussex University Hospitals) in which 165 doctors from four medical specialties working with acute admissions were given the Copenhagen burnout inventory questionnaire via email and responses were received anonymously. Mean scores were calculated, and a two-tailedP test was performed to assess for statistically significant difference between patient- and work-related factors.ResultsThe response rate was 77.57% (n =&...
Source: Irish Journal of Medical Science - April 14, 2020 Category: General Medicine Source Type: research

Defining clinicopathological and radiological features of breast cancer in women under the age of 35: an epidemiological study
AbstractIntroductionBreast cancer is the most commonly diagnosed female cancer. Diagnosis in younger women (under 35  years) is different to their older counterparts, and mammography is not considered as sensitive in this cohort. Consequentially, younger patients may present later with more advanced disease.MethodsThis is a retrospective analysis of a prospectively updated database containing consecutive patients who presented to the symptomatic breast unit of Galway University Hospital between 2009 and 2015. Patient clinicopathologic factors, clinical examination features, diagnostic radiological modalities and Bi-RA...
Source: Irish Journal of Medical Science - April 13, 2020 Category: General Medicine Source Type: research

The levels of advanced oxidation protein products in patients with obstructive sleep apnea syndrome
ConclusionsAOPP, which is an oxidative stress marker, was found to be high in OSAS patients. Especially, high levels in moderate and severe OSAS patients may be an indicator of increased morbidity. After 6  months of PAP treatment, there was no statistically significant change in these levels. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 11, 2020 Category: General Medicine Source Type: research

Safety culture in a major accredited Irish university teaching hospital: a mixed methods study using the safety attitudes questionnaire
ConclusionsIn this study, a mixed methods approach was successfully used to investigate the safety culture in a large Irish hospital. Although the SAQ results indicated a positive safety culture, the qualitative data revealed a number of issues that the hospital staff felt impacted negatively on patient safety. The results of this study will inform future work on the design of an intervention to improve patient safety in the hospital. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 10, 2020 Category: General Medicine Source Type: research

Research on promoting liver fibrosis injury by the targeted regulation of miR-202 for HGF to activate HSC
ConclusionsmiR-202 could negatively regulate the expression of target gene HGF, activated HSC, and increased the expression levels of various fibrosis factors, and the pathological process of liver fibrosis injury was promoted. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 9, 2020 Category: General Medicine Source Type: research

Tinnitus management in Ireland: a pilot study of general practitioners
ConclusionsThis study demonstrates there is wide variation in how tinnitus is evaluated and managed by GPs, which represents a gap in clinical care. We recommend further research, implementation of a service model for tinnitus, national clinical guidelines, training pathways for primary care staff and establishment of regional direct-access tinnitus clinics throughout Ireland. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 8, 2020 Category: General Medicine Source Type: research

Moving beyond the technical skills and promoting professionalism —the experience of the College of Anaesthesiologists of Ireland with incorporating the Medical Council Eight Domains of Good Professional Practice into Entrustable Professional Activities
ConclusionsWe advocate and make recommendations for more effective incorporation of the non-technical domains of professional practice in the processes of curriculum development, teaching, learning, feedback and assessment. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 5, 2020 Category: General Medicine Source Type: research

Establishment of a national surveillance system to monitor community HIV testing, Ireland, 2018
ConclusionsSustained national monitoring in community settings will help inform HIV testing guidelines and will enable assessment of the impact of local and regional community HIV testing strategies. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 2, 2020 Category: General Medicine Source Type: research

Predictors of emergency department attendance following ureterorenoscopy for urolithiasis
AbstractBackgroundWe sought to determine the rate of emergency department (ED) attendance for complications after ureterorenoscopy (URS) for stone disease and to identify risk factors for ED attendance after URS.MethodsAn analysis of all patients undergoing URS over 12  months at a single institution was performed. Patient demographics, preoperative and intraoperative variables associated with postoperative complications and subsequent ED attendance were collected. Logistic regression analyses were performed to determine predictors of URS complications presenting to ED.ResultsIn total, 202 ureteroscopies were performe...
Source: Irish Journal of Medical Science - April 1, 2020 Category: General Medicine Source Type: research

Therapeutic effect of N-acetylcysteine on chemotherapy-induced liver injury
AbstractBackgroundN-acetylcysteine (NAC) may be useful in the management of chemotherapy-induced liver injury.AimsThe present study evaluates the possible therapeutic effects of NAC on chemotherapy-induced hepatotoxicity.MethodsA total of 102 patients ’ files who were diagnosed with cancer between 2015 and 2019 were evaluated retrospectively. Two patient groups with and without NAC were selected. NAC was administered in a 3-μg/kg IV dose in a 24-h infusion to 70 patients when any alanine aminotransferase (ALT) or gamma-glutamyl transferase (GG T) values reached three times the normal levels. The other group consis...
Source: Irish Journal of Medical Science - April 1, 2020 Category: General Medicine Source Type: research

Application of personal-oriented digital technology in preventing transmission of COVID-19, China
We reported several personal-oriented and mobile phone-based information technologies which were recently developed and widely used during the outbreak of COVID-19 in China. These technologies help reduce the transmission of COVID-19 and maintain normal social order. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2020 Category: General Medicine Source Type: research

COVID-19 may transmit through aerosol
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 24, 2020 Category: General Medicine Source Type: research

Cardioprotective properties of leptin in patients with excessive body mass
AbstractBackgroundAdipose tissue is producing adipokines that play different roles in the pathophysiology of cardiovascular disease.AimsThe study aimed to assess the role of selected biomarkers in hypertensive patients with overweight and obesity compared with those with normal body-mass index (BMI).MethodsA total of 62 patients with BMI  
Source: Irish Journal of Medical Science - March 20, 2020 Category: General Medicine Source Type: research

Complications and pitfalls of central venous port catheters: experience with 782 patients with cancer
ConclusionsDespite these benefits, port catheters are associated with various complications. However, most of these complications can be effectively prevented by proper techniques and easily applied precautions. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 19, 2020 Category: General Medicine Source Type: research

A clinical audit and cost analysis of latent TB management at a tertiary referral centre in Ireland
ConclusionOur TB clinic is effective in the assessment and safe management of latent TB in accordance with national guidelines. Interventions for improvement are the creation of referral guidelines and a referral proforma and exploring alternative clinic models. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 18, 2020 Category: General Medicine Source Type: research

Investigation of the relationship between disease severity, caregiver burden and emotional expression in caregivers of children with cerebral palsy
AbstractPurposeThe aim of this study was to investigate the relation between the physical problems of children with CP and caregiving burden and the emotional expression characteristics of caregivers.MethodsThe study included 144 caregivers of child with cerebral palsy and Zarit Burden Interview (ZBI) and Expressed Emotion Scale (EES) will be applied to the caregivers who will participate in the study. Disease severity of children with cerebral palsy will be evaluated by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) in children with cerebral palsy. Communication Func...
Source: Irish Journal of Medical Science - March 17, 2020 Category: General Medicine Source Type: research

Radial artery spasm: reviews and updates
AbstractElective and emergent coronary interventions via transradial access (TRA) are been used increasingly as they carry a reduced risk of complications. Percutaneous coronary intervention via TRA may lead to radial artery spasms (RAS) that may result in prolonged procedure time, cross-over of access site, and other complications. This review article discusses the recent definitions, incidences, pathophysiology, predictive score calculator, efficacy, the safety of the radial cocktails, and treatment of the RAS. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 17, 2020 Category: General Medicine Source Type: research