Irish Journal of Medical Science最新文献

{"title":"Macrophage migration inhibitory factor (rs755622) gene polymorphism in vitiligo.","authors":"Doaa Falih Hadi, Abdel-Aziz Ibrahim El-Taweel, Amany Ibrahim Mustafa, Ola Samir El-Shimi, Mahmoud A Rageh","doi":"10.1007/s11845-025-03966-9","DOIUrl":"https://doi.org/10.1007/s11845-025-03966-9","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo is a cutaneous disease caused by the destruction of functioning melanocytes. Cellular immunity is known to have a role in the pathogenesis of vitiligo. Macrophage migration inhibitory factor (MIF) is a potent activator of macrophages and is considered to play an important role in cell-mediated immunity.</p><p><strong>Aims: </strong>We tried to investigate the association between MIF (rs755622) gene polymorphism and vitiligo susceptibility and its relationship to severity and clinical types of the disease.</p><p><strong>Methods: </strong>Fifty patients with vitiligo and 50 healthy controls were included. Determination of MIF gene (rs755622) single nucleotide polymorphism was conducted using polymerase chain reaction (PCR).</p><p><strong>Results: </strong>There were 18 males and 32 females who had vitiligo, together with 50 control participants of matched age and gender. Taking GG genotype and G allele as references, MIF GC, CC, (GC + CC) genotypes, and C allele demonstrated a substantially higher occurrence in all patients when compared to controls, with a higher risk of developing vitiligo within healthy control subjects.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the third study worldwide and the first from Egypt to investigate the association between MIF gene polymorphism (rs755622) with vitiligo susceptibility and severity, and it showed that MIF gene polymorphism (rs755622) may be considered a risk factor for vitiligo susceptibility. Moreover, it may be associated with higher disease extent.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with ST-segment elevation myocardial infarctions among young patients treated in the Mid-West of Ireland: a case series report using secondary data.","authors":"Sandra N Nantumbwe, Roisin Gardiner, Thomas J Kiernan, Niamh M Cummins","doi":"10.1007/s11845-025-03965-w","DOIUrl":"https://doi.org/10.1007/s11845-025-03965-w","url":null,"abstract":"<p><strong>Background: </strong>ST-segment elevation myocardial infarction (STEMI) occurs when the myocardium has been damaged due to an acute occlusion of a coronary artery. STEMI commonly presents in older populations; however, little is known about the prevalence and risk factors among young patients. This is the first study on STEMI in young patients in Ireland.</p><p><strong>Aims: </strong>To determine the prevalence of STEMI and explore the associated risk factors in a cohort of young adults aged 45 years and below in the Mid-West of Ireland.</p><p><strong>Methods: </strong>This is a case series report using secondary data analysis of data collected from patients aged 45 years or below, hospitalized at University Hospital Limerick between January 2012 and December 2019. All patients who had a primary diagnosis of STEMI during this time period were eligible for inclusion. Clinical data were collected via electronic records and included demographic, clinical, and biomarker variables.</p><p><strong>Results: </strong>The sociodemographic characteristics of the STEMI patients revealed that a majority were male (90%), overweight or obese (63%), smokers (69%) and lived in urban areas (74%). Over half of the patients (53%) were diagnosed with hypertension, 69% had a family history of cardiovascular disease (CVD) and 40% had diabetes diagnosis. After initial hospitalization, 64% were readmitted for another procedure.</p><p><strong>Conclusions: </strong>This study identified cardiovascular risk factors among STEMI patients in Ireland as male, smoking, family history of cardiovascular disease, and being overweight or obese. This study hopes to increase awareness of young STEMI patients and inform health promotion initiatives within this cohort.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between socioeconomic deprivation and maxillofacial trauma in Midwest Ireland.","authors":"Saoirse Kilgarriff, Louise Barry, Francesca Lee, Akinsola Ogunbowale, Michael Gilbride, Mark Wilson","doi":"10.1007/s11845-025-03964-x","DOIUrl":"https://doi.org/10.1007/s11845-025-03964-x","url":null,"abstract":"<p><strong>Aim: </strong>The primary objective of this study was to assess the potential association between social deprivation and maxillofacial trauma in Midwest Ireland.</p><p><strong>Method: </strong>A retrospective cohort study of patients undergoing surgical management of maxillofacial fractures, between January 2014 and December 2023, was undertaken. The Pobal 2022 Index utilises recent census data to determine relative deprivation of each electoral region. This database was utilised to assign patients a socioeconomic quartile ranging from Q1 (most deprived) to Q4 (most affluent) and a numerical Deprivation Index Score (DIS).</p><p><strong>Results: </strong>A total of 529 patients were included, of which nine had sustained repeated facial fractures during the predetermined period. The majority of patients were male (86.43%), with a median age was 26.5 (Inter Quartile Range 20 - 36). Whilst the relative frequency of facial fractures was unaffected by area-level deprivation, fracture aetiology varied considerably across the social gradient. The incidence of assault-related fractures was significantly greater in low-income settings (Q1 versus Q3 + Q4, 66.07% versus 40.32%, p = 0.00046). Conversely, sport-related injuries were significantly more prevalent amongst affluent communities (Q3 + Q4 versus Q1 + Q2, 28.06% versus 17.89%, p = 0.0049).</p><p><strong>Conclusion: </strong>The increased incidence of assault-related fractures amongst deprived communities may be secondary to poor social cohesion and higher background levels of community violence. Furthermore, known risk factors for physical violence - namely drug and alcohol misuse - are more prevalent in low-income settings. Public policy should be directed at tackling endemic healthcare disparities that contribute to the unequal distribution of maxillofacial trauma.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A long-term experience of day-case pelvic osteotomy for developmental dysplasia of the hip.","authors":"Dave M Moore, Catherine Howells, Olga Gallagher, David P Moore, Pat O'Toole","doi":"10.1007/s11845-025-03963-y","DOIUrl":"https://doi.org/10.1007/s11845-025-03963-y","url":null,"abstract":"<p><strong>Objective: </strong>Developmental hip dysplasia has an incidence of 6.73 per 1000 live births and leads to a significant number of orthopaedic referrals annually. This high demand has encouraged the drive to optimize the efficiency of service provision in the paediatric orthopaedic setting. Here we describe our long-term experience with a novel day-case pelvic osteotomy initiative. We also describe any potential complications one can expect when performing day-case pelvic osteotomies.</p><p><strong>Methods: </strong>This was a non-randomized prospective cohort study conducted to compare conventional in-patient pelvic osteotomies with day-case osteotomies performed between January 2017 and November 2023. All surgeries took place at an urban tertiary national referral centre by four paediatric orthopaedic surgeons with a specialist interest in DDH.</p><p><strong>Results: </strong>164 Salter and Pemberton osteotomies were performed of which 115 met the day-case criteria. Based on the HSE 'Specialty Costing Report' and 'Annual Report and Financial Statements', the total discharge cost for patients undergoing an in-patient osteotomy was €6619 in contrast to €2670 per day-case patient. For the 110 day-cases, the cost to treat amounted to €293,700; hence, there was a total saving of €434,390 made by the hospital for the 110 day-cases performed. This amounts to €3949 saved for every day-case.</p><p><strong>Conclusion: </strong>Review at 7 years has demonstrated that day-case pelvic osteotomy surgery for DDH remains a safe and cost-effective initiative that significantly reduces the demand on in-patient hospital bed resources.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: 11 Abstracts from UL Hospitals NCHD Conference.","authors":"","doi":"10.1007/s11845-025-03959-8","DOIUrl":"https://doi.org/10.1007/s11845-025-03959-8","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valid consent in the acute hospital setting: perspectives of nursing and medical professionals from a survey-based study.","authors":"Charmaine Zahra, Motheo Kobua, Živa Kovic, Mary Fogarty, Catherine Buckley, Jane Murphy, Julie Walshe, Paul Zambra, Declan Byrne, Una Geary, Marie E Ward","doi":"10.1007/s11845-025-03952-1","DOIUrl":"https://doi.org/10.1007/s11845-025-03952-1","url":null,"abstract":"<p><strong>Background: </strong>In healthcare, consent refers to the act of granting permission or agreement for treatment and care, investigation, receiving or utilising a service, or participating in research or teaching. Consent should be an ongoing process that involves clear communication about the proposed intervention, including its nature, benefits, and potential risks.</p><p><strong>Aim: </strong>This survey-based study gathered experiences from junior doctors and nurses in a large acute teaching hospital about current consent practices and suggestions for improvement.</p><p><strong>Method: </strong>Two surveys were developed and distributed to junior doctors in 2022 and nurses in 2023.</p><p><strong>Results: </strong>The response rate for junior doctors (n = 58) was 21% (interns) and 57% (senior house officers) and 10% of the total nursing population responded (n = 184). Descriptive statistics and content analysis were used to analyse the results. Both junior doctors and nursing professionals believed there were areas for improvement in terms of consent processes and practices including in relation to better information for patients and more education and training for healthcare professionals.</p><p><strong>Conclusions: </strong>The process of informed consent is central in the planning and provision of safe, effective person-centred healthcare as it encompasses healthcare professionals and patients communicating about and together deciding on and agreeing to medical interventions. This survey-based study looked at the experiences, attitudes, and perceived needs of junior doctors and nursing professionals in relation to the informed consent process in clinical practice at an acute hospital and informed the development of recommendations for improvement.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus between healthcare professionals on the \"appropriateness\" of attendances in an Irish emergency department.","authors":"Conor Prendergast, John Ryan, Louise A Barry, Rose Galvin, Niamh M Cummins","doi":"10.1007/s11845-025-03961-0","DOIUrl":"https://doi.org/10.1007/s11845-025-03961-0","url":null,"abstract":"<p><strong>Background: </strong>Non-urgent care attendances to the emergency department (ED) increase the strain on this sector. Identification of patients who may benefit from appropriate alternative care pathways may serve to lessen ED crowding. However, healthcare professionals from different specialties may differ in their opinion of what is an appropriate use of ED services.</p><p><strong>Aim: </strong>The study aims to establish the consensus between healthcare professionals, from different specialties, on the appropriateness of attendances to an Irish ED.</p><p><strong>Methods: </strong>This was a single centre, cross-sectional study. Data were compiled in anonymised patient summary files (n = 77) from adults attending the ED over 24 h period. These summary files were reviewed by five different healthcare professionals; an emergency medicine consultant (EMC), an emergency medicine specialist registrar (EM SpR), an ED clinical nurse manager (CMN), an advanced paramedic (AP) and a general practitioner (GP). The clinicians were asked if the patient could have been managed by GP the same day or next day, if the patient's ED visit was an inappropriate use of ED resources and to rank on a scale of 0-10 how appropriate the ED visit was.</p><p><strong>Results: </strong>Inter-rater agreement on management by GP in 24-48 h was 56% and ranged from 30% (CMN) to 40% (EMC). For inappropriate use of ED resources, consensus was 58% and ranged from 12% (GP) to 35% (EMC). Median \"appropriateness\" rating ranged from 6 (EM SpR) to 8 (AP and CMN). When the \"appropriateness\" scale was trichotomized, the \"inappropriate\" attendances ranged from 1% (CMN) to 21% (EM SpR), whilst \"appropriate\" attendances ranged from 47% (EM SpR) to CMN (78%).</p><p><strong>Conclusion: </strong>Despite agreement that there was \"inappropriate\" use of ED services, healthcare professionals from different backgrounds did not reach a general consensus on which attendances were inappropriate. Therefore, expectations regarding patients' ability to self-assess illness or injury severity related to ED attendances may not be reasonable.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency anaesthesia drug preparation in Irish training hospitals; a national survey.","authors":"Seán Boyd, Jack Collins","doi":"10.1007/s11845-025-03962-z","DOIUrl":"https://doi.org/10.1007/s11845-025-03962-z","url":null,"abstract":"<p><strong>Introduction: </strong>Anaesthetic and intensive care (ICU) non-consultant hospital doctors (NCHDs) cover critical care areas along with theatre anaesthesia and maternity care during on call hours. NCHDs often prepare emergency drugs so that they are available for immediate use. The nature of this is not standardised nationally and may be department driven or at the discretion of the NCHD.</p><p><strong>Aims: </strong>The aim of this survey was to ascertain the practice in Irish acute hospitals in relation to drug preparation, transport, storage, specific protocols, and the availability of prefilled syringes.</p><p><strong>Methods: </strong>A telephone survey of each department was undertaken between 15th February to 2nd July 2024. With consent, 17 anaesthetic NCHDs were contacted to complete a phone survey.</p><p><strong>Results: </strong>The rate of use of each drug was ascertained for each tier of call. The storage and transport methods were recorded. The availability of prefilled syringes at each site was ascertained. Differences were reported between model 3 and model 4 hospitals.</p><p><strong>Conclusion: </strong>Guidance on essential anaesthetic drugs exists. However, we are not aware of any specific guidelines relating to drug preparation for on call service. Each hospital may provide different services and treat a different cohort of patients. Therefore, the need for standardised protocols would need to be assessed on a hospital-specific basis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elbow arthroplasty: an Irish perspective.","authors":"Nicolaas Leon Kotze, Diarmuid Molony, Olivia Flannery","doi":"10.1007/s11845-025-03960-1","DOIUrl":"https://doi.org/10.1007/s11845-025-03960-1","url":null,"abstract":"<p><strong>Background: </strong>Elbow arthroplasty (EA) aims to restore function and alleviate pain in the elbow joint. Research shows that a higher volume of EAs performed by surgeons and surgical centres correlates with decreased complications, reduced revision rates, and lower healthcare costs.</p><p><strong>Aims: </strong>This study aims to determine the current landscape of elbow arthroplasty in Ireland.</p><p><strong>Method: </strong>A retrospective cross-sectional study was conducted through surveys distributed to upper limb surgeons in Ireland who performed EAs from October 2022 to October 2024. The survey sought to gather data on the number of procedures completed in the 2-year window. Additionally, it probed surgeons' intentions to continue performing these surgeries and their views on the necessary number of surgeons for adequate service provision in Ireland.</p><p><strong>Results: </strong>Nineteen surgeons participated, performing a total of 97 elbow arthroplasties over 2 years, which translates to a median of 4 procedures per surgeon (approximately 2 annually). The cohort included 32% distal humerus hemiarthroplasties (DHHs) and 68% total elbow arthroplasties (TEAs), with 60% classified as elective and 40% as trauma-related. All participants indicated a desire to continue performing these procedures.</p><p><strong>Conclusion: </strong>The low volume of elbow arthroplasty procedures in Ireland underscores the necessity for a national policy focused on enhancing surgical quality and patient outcomes. The insights gained from this data aim to stimulate discussions among elbow surgeons in Ireland, paving the way for effective policy implementation.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation and management of urethral erosion caused by mid-urethral sling.","authors":"Olwyn E Lynch, Eabhann M O'Connor, Bianca Barea, James C Forde","doi":"10.1007/s11845-025-03949-w","DOIUrl":"https://doi.org/10.1007/s11845-025-03949-w","url":null,"abstract":"<p><strong>Background: </strong>Mid-urethral slings (MUS) have been the standard of care in surgical management of female stress urinary incontinence (SUI) internationally. Complications including pain and erosion has led to a temporary \"pause\" of their use in the UK and Ireland. We report on our experience to date on patient presentation, operative management, and post-operative outcomes in management of MUS erosion.</p><p><strong>Methods: </strong>Review of female patients who had partial MUS removal due to urethral erosion over a 7-year period. Data on patient presentation, operative technique, and post-operative outcomes were collected and collated.</p><p><strong>Results: </strong>A total of 21 patients were identified. Overall, 66% of patients presented with symptoms of urinary tract infection (UTI). Other presentations include overactive bladder symptoms (52%), recurrent incontinence (42%), or dyspareunia (9%). Some patients presented with a combination of these symptoms. Overall, 9 patients had a trans-obturator tape (TOT), 6 had a trans-vaginal tape (TVT), and 4 had unspecified type of MUS. Two patients had 2 previous MUS insertions. Initial operative management with urethroscopy and laser fragmentation in cases with significant MUS calcification was required in 18% (n = 4) of patients. A total of 86% (n = 18) of patients had urethral erosion that required formal urethral repair and a short period with an indwelling catheter. All patients had resolution of their UTI symptoms post procedure. Fifteen patients required further surgical intervention to manage recurrent incontinence after MUS removal.</p><p><strong>Conclusion: </strong>Partial removal of MUS due to urethral erosion improves patient symptoms. However, the majority have recurrence of SUI and require further intervention.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}