Where youth matters —clinicopathologic characteristics and emerging trends in treatment and outcomes in young Irish women with breast cancer
AbstractBackgroundYoung women with breast cancer (YWBC) represent 7 –12% of breast cancer diagnoses and ostensibly have more biologically aggressive subtypes with higher relapse and mortality rates. We studied the clinical and pathological characteristics in YWBC and examined how outcomes and treatment have evolved.MethodsYWBC were identified from pathology databases at two tertiary centers. Patients were divided into two cohorts: those diagnosed from 2000 to 2005 (C1) and from 2006 to 2015 (C2). Data were retrieved from clinical, radiology, and histology databases. Statistical analysis was performed using R ® (V...
Source: Irish Journal of Medical Science - May 15, 2018 Category: General Medicine Source Type: research

Levels of evidence in pelvic trauma: a bibliometric analysis of the top 50 cited papers
ConclusionWe have identified and analysed the publications that have contributed most to the assessment and management of pelvic trauma over the past 50  years. We have also identified the researchers and institutions which have most influenced the evidence-based approach currently employed in the management of pelvic trauma. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 12, 2018 Category: General Medicine Source Type: research

Updated pharmacological management of rheumatoid arthritis for women before, during, and after pregnancy, reflecting recent guidelines
ConclusionsRA tends to improve during pregnancy and flare postpartum. Several anti-rheumatic medication options during pregnancy and breastfeeding are now available including anti-tumor necrosis factor (anti-TNF) agents. Good disease control at all stages of reproduction is important to ensure best outcome for both mother and baby. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 10, 2018 Category: General Medicine Source Type: research

Femoral offset found not to affect metal ion levels in metal-on-metal total hip arthroplasty
ConclusionIt is known that failure to restore femoral offset during THA can lead to high rates of wear in metal-on-polyethylene articulations. In our study, no statistically significant relationship was found between femoral offset and serum cobalt or chromium ions. This study adds to the information available to surgeons regarding factors that increase wear in metal-on-metal total hip arthroplasty. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 7, 2018 Category: General Medicine Source Type: research

Microvascular diabetes complications in a specialist young adult diabetes service
ConclusionsDiabetic retinopathy is prevalent in young adults with type 1 diabetes attending specialist secondary care diabetes services. Duration of diabetes was the strongest determinant of retinopathy risk. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 7, 2018 Category: General Medicine Source Type: research

Obesity, diet and lifestyle in 9-year-old children with parentally reported chronic diseases: findings from the Growing Up in Ireland longitudinal child cohort study
This study aims to establish the prevalence of parentally reported chronic disease in children in Ireland and to describe their diet and lifestyle.MethodsThis study analyzed data from the Growing Up in Ireland longitudinal child cohort study and compared the diet, lifestyle and prevalence of obesity in children with and without a parentally reported chronic disease.ResultsOverall, 954 parents in the sample (11.1%) reported that their child had a chronic illness and 43.4% of these children are hampered by it in their daily activities. Respiratory disorders were the commonest type of chronic disease (46%) reported. Children ...
Source: Irish Journal of Medical Science - May 5, 2018 Category: General Medicine Source Type: research

The changing tides of Irish orthopaedic research
ConclusionsThere has been a significant decrease in publication rates by T&O trainees in high-quality journals. There has also been a notable decline in Irish representation at the BOA and a drop in the number of abstract submissions to the IOA. We suggest these findings coincide with the streamlining of surgical training in Ireland, which does not provide for the pursuit in research that is crucial to our practice as clinicians, to the future of our specialty and to the Irish orthopaedic representation internationally. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 4, 2018 Category: General Medicine Source Type: research

How to establish a successful bowel management programme in children: a tertiary paediatric centre experience
AbstractBackgroundBowel management is a term used to describe a medical approach to the management of faecal incontinence.AimsTo present the outcomes of an individualised bowel management programme developed by a tertiary paediatric centre and evaluate contributory factors for successful bowel management in children.MethodsA retrospective review of children attending a bowel management clinic in a tertiary centre in Dublin, Ireland, over 5  years (2010–2015). The main outcome measure was the ability to achieve a regular bowel pattern and remain socially clean. Multiple linear regression analyses were used to det...
Source: Irish Journal of Medical Science - May 3, 2018 Category: General Medicine Source Type: research

Breast cancers missed by screening radiologists can be detected by reading mammograms at a distance
ConclusionSome malignant tumours missed by an individual screening radiologist can be detected from 1.5  m distance. Therefore, we recommend that screening radiologists consciously take a distant view before closely evaluating the mammogram in detail. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 3, 2018 Category: General Medicine Source Type: research

Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit
ConclusionsWeaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - May 2, 2018 Category: General Medicine Source Type: research

Variations in biochemical values for common laboratory tests: a comparison among multi-ethnic Israeli women cohort
ConclusionsEthnic subpopulations have distinct distributions in biochemical laboratory test values, which should be taken into consideration in medical practice enabling precision medicine. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 28, 2018 Category: General Medicine Source Type: research

Trends in the treatment of chronic kidney disease-associated anaemia in a cohort of haemodialysis patients: the Irish experience
AbstractBackgroundAnaemia among haemodialysis patients is treated with iron and erythropoietin-stimulating agents (ESAs). ESAs reduce requirements for blood transfusions but are also expensive and overzealous use may be associated with adverse outcomes. Recent international trends have been characterised by reduced ESA doses and a greater reliance on intravenous (IV) iron. We determined trends in prescribing patterns of ESAs and IV iron for the treatment of anaemia in two representative Irish dialysis centres and correlated with current guidelines and international trends.MethodsPatient data was accessed from the Kidney Di...
Source: Irish Journal of Medical Science - April 27, 2018 Category: General Medicine Source Type: research

The surgical management of severe dentofacial infections (DFI) —a prospective study
AbstractDentofacial infections (DFI) lead to morbidity and rarely, mortality. We hypothesised that certain clinical and laboratory parameter factors may be associated with a more severe course and an increased length of stay. We designed a prospective study that included all patients admitted with a DFI to the Oral and Maxillofacial Department between July 2014 and July 2015. A total of 125 were enrolled. We found that serum concentration of CRP on admission and increasing number of fascial spaces involved by the infection were significant predictors of hospital stay (p = 0.02 andp = 0.01, respe...
Source: Irish Journal of Medical Science - April 27, 2018 Category: General Medicine Source Type: research

To tube or not to tube? Utilising a tubeless antegrade ureteric stenting system in a tertiary referral hospital
ConclusionSingle-stage primary ureteric stenting is a safe practice to employ and has universal benefits for both the patient and the health service. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 26, 2018 Category: General Medicine Source Type: research

Correction to: A meta-analysis of consanguinity and breast cancer
The original version of this article contained an author name error. Gabiella Jones has been corrected to Gabriela Jones. The original article has been corrected. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 25, 2018 Category: General Medicine Source Type: research

Festschrift for Professor Ronan O ’Connell
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 25, 2018 Category: General Medicine Source Type: research

In recognition of Ireland ’s doctor scientists: Richard Costello, Christopher Thompson, Fidelma Dunne and Douglas Veale
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 25, 2018 Category: General Medicine Source Type: research

A retrospective analysis comparing the use of ProCore ® with standard fine needle aspiration in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)
AbstractEndobronchial ultrasound has become first line in the investigation of mediastinal lesions suspicious for malignancy in keeping with National Institute for Health and Care Excellence (NICE) guidelines; however, needle size and type required to maximise diagnostic sensitivity remains unclear. Previous meta-analyses have compared the use of ProCore with standard fine needle aspiration in the assessment of pancreatic masses with differences noted only in the number of passes required. We aim to assess whether a ProCore needle improves diagnostic sensitivity in EBUS-TBNA. Complete follow-up data regarding all 235 patie...
Source: Irish Journal of Medical Science - April 24, 2018 Category: General Medicine Source Type: research

Admission and readmission rate incidences from deprived areas —impact of a classical or multi-dimensional model
ConclusionDeprivation influences hospital incidence rates for emergency medical admissions and readmissions; instruments focusing at the very small area (individual or street level) have a utility but appear inferior in terms of representing the population risk of environmental/socio-economic factors which seem best approximated at a larger scale. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 24, 2018 Category: General Medicine Source Type: research

Management of optic neuritis in Ireland: a survey comparing the management practices of acute demyelinating optic neuritis amongst ophthalmologists and neurologists in Ireland
ConclusionsOverall, most respondents would follow the ONTT guidelines regarding IV methylprednisolone. There was a significant difference in responses between the ophthalmologists and neurologists regarding who to treat, duration of treatment and appropriate investigations. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 24, 2018 Category: General Medicine Source Type: research

Evaluation of factors affecting time to achieve dry weight among hemodialysis patients using bioimpedance spectroscopy
ConclusionThis suggests that assessing the hydration status at 45  min postdialysis in all patients or in those with identified risk factors for not achieving a euvolemic state at 30 min will provide a relatively accurate assessment for most patients. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 22, 2018 Category: General Medicine Source Type: research

General practitioners ’ (GP) attitudes and knowledge about attention deficit hyperactivity disorder (ADHD) in Ireland
ConclusionsDespite the high rates of ADHD among children, a slim majority of Irish GPs have positive attitudes towards ADHD. This could lead to undiagnosed or misdiagnosed cases. Strategies need to be considered to address this. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 13, 2018 Category: General Medicine Source Type: research

A profile of physiotherapy supply in Ireland
ConclusionThe supply of physiotherapists in Ireland is 30% lower than the EU-28 average. Substantial inequality in the distribution of physiotherapists across counties is observed. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 13, 2018 Category: General Medicine Source Type: research

How accurate is the data provided to the Irish hip fracture database?
AbstractNational databases, such as the Irish Hip Fracture Database (IHFD), are known to contain inaccuracies. The coordination of services, national funding and future research rely on the integrity of the IHFD so as to avoid policy and budget planning being based on misrepresentative data. An audit was performed to assess the accuracy of the 2016 IHFD data collected in our trauma unit. The Hospital In-Patient Enquiry (HIPE)-recorded fracture classification, IHFD-recorded fracture classification and IHFD-recorded operation performed for each hip fracture patient was identified. Each variable was compared with the classifi...
Source: Irish Journal of Medical Science - April 11, 2018 Category: General Medicine Source Type: research

Identifying risk factors associated with acquiring measles in an outbreak among age-appropriately vaccinated school children: a cohort analysis
ConclusionsThe reason for intense measles activity in one class was not established. Although a concurrent investigation into cold chain and vaccine stock management did not identify a cause for the high relative risk of measles in children vaccinated, recommendations were made for improving cold chain and vaccine stock management in General Practices. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 10, 2018 Category: General Medicine Source Type: research

Festschrift for Patrick Ronan (PR) O ’Connell (also known as ROCON): reconciling surgery and science
AbstractRonan O Connell ’s clinical activities were fundamentally based on accurate data. His scientific outputs were based on similarly high quality data. Anybody who trained with him and in particular those who trained with him on more than occasion base their clinical and scientific activities on a similar approach. H is many clinical, scientific and political achievements and accolades will be detailed in the articles in this Festschrift. There is an advancement that is important to me personally and that I would like to attribute to his influence. Exceptional and highly reproducible technique underpinned his su ...
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

Caffeine, CYP1A2 genotype, and sports performance: is timing important?
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

Have bailouts shifted the burden of paying for healthcare from the state onto individuals?
AbstractBackground/aimsThe financial crisis that enveloped Europe in 2009 created financial pressure for governments and required a number of countries to obtain a financial bailout from the IMF. The purpose of this paper is to examine the effect of the financial crisis on public health expenditure in bailout countries and if bailouts shift the burden of paying for healthcare from the state onto individuals.MethodsQuantitative health expenditure data were collected from the WHO and OECD for the period 2004 –2015 and evaluated using a comparison of means Welch’st test.ResultsThe majority of bailout countries rec...
Source: Irish Journal of Medical Science - April 9, 2018 Category: General Medicine Source Type: research

An animal model of faecal incontinence and sacral neuromodulation
AbstractThe pudendal nerves can be injured during traumatic vaginal childbirth and result in faecal incontinence. Some of these incontinent patients benefit from chronic sacral neuromodulation and the mechanism of action of this therapy has been a focus of many studies. In 2008, a rodent model of neuropathic faecal incontinence was introduced and subsequently validated through a series of investigations. This review summarizes the decade-long contribution of Professor Ronan O ’Connell to the inception and application of this rodent model of faecal incontinence and sacral neuromodulation. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 8, 2018 Category: General Medicine Source Type: research

Clinical presentation of cashew nut allergy in a paediatric cohort attending an allergy clinic in the West of Ireland
ConclusionChildren are ingesting CN at a young age with more than half of allergic reactions reportedly severe in nature. The specific CN IgE value was not helpful in predicting severity of reactions. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 5, 2018 Category: General Medicine Source Type: research

Glucose sensing technology —current practice?
(Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - April 4, 2018 Category: General Medicine Source Type: research

Difference in intraocular pressure measurements between non-contact tonometry and Goldmann applanation tonometry and the role of central corneal thickness in affecting glaucoma referrals
AbstractBackgroundPatients at glaucoma risk are commonly identified by optometrists and subsequently referred to glaucoma specialists. Optometrists mainly use non-contact tonometry (NCT) for intraocular pressure (IOP) measurement.AimsTo investigate the role of differences in IOP measurement between NCT and Goldmann applanation tonometry (GAT) and the effect of central corneal thickness (CCT) on these differences in optometrist referralsMethodsDetails of the initial clinical visit of patients referred with IOP>  21 mmHg in either eye as measured by NCT to a consultant glaucoma specialist were retrospectively ...
Source: Irish Journal of Medical Science - April 4, 2018 Category: General Medicine Source Type: research

Child Art Psychotherapy in CAMHS in Ireland —a parent satisfaction study
ConclusionParents are satisfied with the Vasarhelyi method of Child Art Psychotherapy. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 29, 2018 Category: General Medicine Source Type: research

Quality of information on the Internet —has a decade made a difference?
ConclusionsDue to the reduced completeness of information available to patients online, it is important that health professionals direct patients to appropriate websites if they wish to do their own research. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 28, 2018 Category: General Medicine Source Type: research

Cardiovascular disease risk factor profile of male Gaelic Athletic Association sports referees
ConclusionsThe findings from this study demonstrate the presence of hypertension and negative lifestyle behaviours within this male population. This justifies the need to implement a policy on the pre-participation screening and risk reduction of CVD for male G.A.A. referees in Ireland. This health promotion intervention would assist in reducing the CVD epidemic within this specific population. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Future career intentions of higher specialist trainees in general Paediatrics
ConclusionThere appears to be a mismatch between the career goals of the future paediatric consultant workforce and the requirements for staffing paediatric units nationally. This has the potential to complicate the proposed expansion of general paediatricians in regional centres and result in a significant proportion of current trainees failing to secure a post in their desired location. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Acute hospital reconfiguration and self-harm presentations: a before-and-after study
ConclusionsThere is evidence to suggest that acute hospital reconfiguration of hospital services impacts on patterns of patient flow. Findings have implications for those implementing reconfiguration of acute services. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 27, 2018 Category: General Medicine Source Type: research

Breast screening in symptomatic women over 35  years of age: improvements in service efficiency
ConclusionImage first patients, who represent a cohort of “symptomatic” non-urgent women, have a greater rate of breast cancer detection than an asymptomatic screening population. This may have an impact on the appropriate triaging of symptomatic women in a national cancer center. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 26, 2018 Category: General Medicine Source Type: research

Evaluation of regulatory T lymphocytes and IL2Ra and FOXP3 gene expression in peripheral mononuclear cells from patients with amyotrophic lateral sclerosis
AbstractBackgroundLoss of neuroprotective role of CD4+ helper T cells, regulatory T cells, and M2 microglia constitutively results in the rapid neural death in the “rapidly progressive phase” of amyotrophic lateral sclerosis (ALS).AimWe aimed to investigate relative count of CD4+ and regulatory T lymphocytes and expression level of IL2Ra and FOXP3 genes in peripheral blood mononuclear cells (PBMCs) from patients with ALS.MethodWe performed a flow cytometric analysis on PBMC from 38 patients with ALS and 32 controls to determine the count of CD4+ and CD4+CD25+ cells. Quantitative real-time PCR analyses were impl...
Source: Irish Journal of Medical Science - March 25, 2018 Category: General Medicine Source Type: research

A meta-analysis of consanguinity and breast cancer
ConclusionThough there is limited literature published on the effects of parental consanguinity, the available data does not demonstrate that it is a risk factor for breast cancer. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 24, 2018 Category: General Medicine Source Type: research

Coloproctology procedure clinic: a novel service developed to reduce suffering of patients with bleeding per rectum
AbstractAimsEvaluation of the role and impact of introducing a dedicated coloproctology procedure clinic in tertiary referral colorectal unit.MethodsA retrospective analysis of 126 consecutive patients managed in the coloproctology clinic between March2015 and September 2016 was carried out. All patients were preselected for attendance based on symptom-based protocol.ResultsBased on the information available in GP referrals, 126 patients with bleeding per rectum with low risk of cancer were re-triaged from the general outpatient to dedicated coloproctology procedure clinic. Those patients accounted for 14% of waiting list....
Source: Irish Journal of Medical Science - March 22, 2018 Category: General Medicine Source Type: research

Evaluation of the effect of the accordion suturing technique on wound lengths in breast cancer surgery: a randomised clinical trial
ConclusionThe accordion suturing technique was associated with a significant reduction in surgical wound lengths in breast conserving surgery at 6  weeks without compromising the cosmetic result. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 21, 2018 Category: General Medicine Source Type: research

The College of Anaesthetists of Ireland Simulation Training programme: a descriptive report and analysis of course participants ’ feedback
AbstractBackgroundSimulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date.AimsDescribe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants ’ feedback.MethodsA retrospective r...
Source: Irish Journal of Medical Science - March 20, 2018 Category: General Medicine Source Type: research

Fifteen-year outcomes of an acute medical admission unit
We report on the 15-year outcomes of an AMAU in our institution.MethodsAll emergency medical admissions between 2002 and 2016 were examined and 30-day in-hospital mortality, admission rates, readmission rates and length of stay (LOS) assessed. We used logistic and Poisson regression and margin statistics to evaluate outcomes.ResultsThere were 96,305 admissions in 50,612 patients. By admission, the 30-day in-hospital mortality averaged 5.6% (95% CI 5.4 to 5.7%); there was a relative risk reduction (RRR) of 33.9% between 2002 and 2016, from 7.0 to 4.6% (p = 0.001), number need to treat (NNT) 41.9. By unique pat...
Source: Irish Journal of Medical Science - March 17, 2018 Category: General Medicine Source Type: research

A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis
AbstractBackgroundCore needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM).AimsIt is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method.MethodsArticles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were ...
Source: Irish Journal of Medical Science - March 16, 2018 Category: General Medicine Source Type: research

Clinical characteristics of Black patients with hypertensive urgency
ConclusionThe large proportion of newly diagnosed hypertensive patients presenting with end organ signs of prolonged uncontrolled hypertension suggests that there are significant numbers of undiagnosed Black patients in the community, suggesting that we should more actively conduct test for hypertension and its complications when we encounter these patients, who constitute a growing part of the populations in Europe. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 14, 2018 Category: General Medicine Source Type: research

Dedicated general practitioner education sessions can improve diagnostic capabilities and may have a positive effect on referral patterns for common skin lesions
ConclusionDedicated education sessions on skin lesions can improve the diagnostic accuracy of GP trainees, and we suggest that they are incorporated into the GP training curriculum. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 14, 2018 Category: General Medicine Source Type: research

Antibiotic use for acute respiratory tract infections (ARTI) in primary care; what factors affect prescribing and why is it important? A narrative review
ConclusionThere is an emerging consensus in the literature regarding strategies proven to reduce antibiotic consumption for acute respiratory tract infections. The widespread adoption of these strategies in primary care is imperative. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 12, 2018 Category: General Medicine Source Type: research

The effect of CYP1A2 genotype on the ergogenic properties of caffeine during resistance exercise: a randomized, double-blind, placebo-controlled, crossover study
ConclusionIn conclusion, acute ingestion of CAF significantly enhanced RE performance in resistance-trained men who were homozygous for the A allele, but not for C allele carriers. Further studies are needed to replicate the potential role of theCYP1A2 -163C>A polymorphism on the ergogenic effects of CAF in other modes of exercise and in other populations. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 12, 2018 Category: General Medicine Source Type: research

Festschrift for Ronan O ’Connell: pouchitis, ulcerative colitis and the microbiome
This article, part of a festschrift, summarises the contributions of the O ’Connell lab to the field of host-microbial interactions in inflammatory bowel disease. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - March 9, 2018 Category: General Medicine Source Type: research