Irish Journal of Medical Science最新文献

{"title":"Attitudes and knowledge relating to advance healthcare directives among psychiatry staff in Ireland.","authors":"Maria Redahan, Catherine Rock, Michal Grudzien, Brendan D Kelly","doi":"10.1007/s11845-025-03943-2","DOIUrl":"https://doi.org/10.1007/s11845-025-03943-2","url":null,"abstract":"<p><strong>Background: </strong>Advance healthcare directives are the subject of increased interest in psychiatry. A new legislative framework for advance healthcare directives came into effect in Ireland in 2023 in the Assisted Decision Making (Capacity) Act, 2015.</p><p><strong>Aim: </strong>To investigate levels of knowledge about, and attitudes towards, advance healthcare directives among multidisciplinary psychiatry inpatient staff in Ireland one year after commencement of the new legislation.</p><p><strong>Methods: </strong>A survey was completed among psychiatry inpatient staff (n = 51) in Tallaght University Hospital, Dublin, Ireland between June and August 2024.</p><p><strong>Results: </strong>Majorities of psychiatry inpatient staff have heard of advance healthcare directives (84.3%), think they are a good idea (90.2%), and recommend involving medical staff (84.3%) and/or family and friends (68.6%) in writing them. There are high levels of confidence that staff would respect and be able to access advance healthcare directives when needed, but divided opinions on whether patients understand enough about advance healthcare directives. A majority of staff members (74.5%) would prefer an advance care plan that was not legally binding but still included the patient's will and preferences.</p><p><strong>Conclusions: </strong>Psychiatry inpatient staff are largely supportive of advance healthcare directives but identify needs for more patient education and an explicit option for non-binding, rather than binding, advance healthcare directives.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719298","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 comprehensive study of laser use in dermatology: assessing the safety, innovations, and effectiveness of laser technology for skin treatment.","authors":"Zahra Al Timimi, Abeer Fauzi Al-Rubaye, Donia Mohsen Diwan","doi":"10.1007/s11845-025-03942-3","DOIUrl":"https://doi.org/10.1007/s11845-025-03942-3","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this review article is to provide a general overview of the development of laser technology and its applications in dermatology. It will describe the mechanism, effectiveness, and hazardous characteristics of different laser modalities used for the treatment of skin diseases, such as disorders of pigmentation, vascular malformations, acne scarring, and photoaging.</p><p><strong>Methods: </strong>There was a thorough literature review through databases such as Scopus and PubMed, along with Google Scholar. Articles from 2000 to 2023 that were peer-reviewed were included. In addition to pulsed dye lasers, the search terms used in the literature review involved \"laser dermatology,\" \"skin treatment,\" and names of specific lasers such as carbon dioxide (CO₂), Er: YAG, and Nd: YAG. Information on adverse effects, long-term effects, clinical outcomes, and patient satisfaction ratings was gathered.</p><p><strong>Results: </strong>The results show that, in the past 20 years, laser treatment has evolved significantly. Relative to historical approaches, innovations like fractional lasers have been more effective with reduced downtime. For conditions like melasma, as much as acne scars, evaluations show high levels of patient satisfaction from diverse populations. Darker skin types continue to be susceptible to adverse effects like post-inflammatory hyperpigmentation.</p><p><strong>Conclusions: </strong>The efficacy and versatility of laser therapy have made it an anchor of dermatologic practice. Laser technology is continually evolving, with the hope of enhanced results at lower risk. To optimize benefit and minimize side effects, future research should aim to design therapy regimens specific to each skin type.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730030","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 effect of COVID-19 during pregnancy on postpartum depression and mother-infant attachment.","authors":"Canan Satır Özel, Reyhan Ayaz Bilir, Evrim Şenkal, Tahsin Gökhan Telatar, Abdulkadir Turgut","doi":"10.1007/s11845-025-03928-1","DOIUrl":"https://doi.org/10.1007/s11845-025-03928-1","url":null,"abstract":"<p><strong>Background: </strong>The psychiatric impacts of the COVID-19 pandemic are well-documented; however, its effects during the postnatal period have been less explored.</p><p><strong>Aims: </strong>We aimed to investigate the effect of COVID-19 on mother-infant attachment and postnatal depression in pregnant women during the pandemic.</p><p><strong>Methods: </strong>The study group consisted of women with the diagnosis of 'pregnancy and COVID-19' after the 20th gestational week (n = 55). The control group included women who did not have a history of COVID-19 in their pregnancy or until the study date (n = 52). Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Attachment Scale (PPAS) were administered to the participants. COVID-19 patients were grouped according to the WHO classification.</p><p><strong>Results: </strong>The mean EPDS score was higher in the study group than in the control group (9.55 (7.17) vs. 6.65 (6.72) (P = 0.006)). There was no difference between the groups in the number of individuals with depression (EPDS score > 13) and PPAS factors. The mean EPDS score was found to be higher in the hospitalized group (P = 0.025). The mean EPDS score in the group with moderate or severe disease was higher than mild disease group (16 (8.49) vs. 8.67 (6.57) (P = 0.039)), there was no difference in terms of PPAS.</p><p><strong>Conclusion: </strong>While the presence of COVID-19 during pregnancy has been associated with elevated postpartum depression scores in pandemic pregnant women, hospitalization of women who had COVID-19 during pregnancy and had at least one family member with moderate or more severe illness resulted in higher depression scores. The presence of COVID-19 during pregnancy does not affect mother-infant attachment. It is recommended that women with a history of COVID-19 during pregnancy be evaluated more carefully for postpartum depression.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700489","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":"Retraction Note: Presentations to eye emergency departments with flashes and floaters differ dependent on incident solar radiation.","authors":"Sarah K Powell, Darragh Garrahy, Daire J Hurley, Syed Bilal Hassan Zaidi, Brian McEllistrem, Kirk A J Stephenson","doi":"10.1007/s11845-025-03934-3","DOIUrl":"https://doi.org/10.1007/s11845-025-03934-3","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700488","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":"An analysis of compassionate access programmes for novel oncology drugs.","authors":"Sarah A Kelly, Karine E Ronan, Mohammed Zameer, Jennifer Brown, Grainne Johnston, Ruth Adams, Dearbhla Murphy, Deirdre Kelly, Waseem Darwish, John McCaffery, Geraldine O'Sullivan Coyne, Emily Harrold, Shahid Iqbal, Darren Cowzer, Austin G Duffy","doi":"10.1007/s11845-025-03930-7","DOIUrl":"https://doi.org/10.1007/s11845-025-03930-7","url":null,"abstract":"<p><strong>Background: </strong>Despite the rise in the number of approved novel oncology drugs, just over half of all new cancer medicines approved by the EMA between 2017 and 2021 were granted reimbursement in Ireland by the HSE. Compassionate access programmes (CAPs) are a means of providing managed access to drugs which are of proven benefit but have not yet received full approval for reimbursement by the state, or where the requested indication has not been yet been authorised/licensed.</p><p><strong>Methods: </strong>A retrospective review was performed of patients attending The Mater hospital for treatment of advanced malignancy who availed of a CAP between August 2012 and July 2022. Clinical data collected included disease type, treatment received, duration of treatment received, and best response to treatment. To categorize outcome \"Clinical Benefit\" was defined as a radiological complete, partial, or stable disease response to treatment.</p><p><strong>Results: </strong>One hundred and thirteen patients were included in the study. Ninety-three received at least one dose of CAP treatment. Treatment duration ranged from 0 to 112 months, with 12 patients on treatment for ≥ 2 years. N = 47 (42%) experienced a Clinical Benefit. Of these, N = 7 experienced a complete response [CR]. Thirty patients (27%) did not receive a planned treatment or died within 3 months of treatment.</p><p><strong>Conclusions: </strong>In this review of a decade of CAPs at our institution we observed that a significant proportion of patients derived a clinical benefit from CAP treatment. Unfortunately, however, a significant proportion of patients did not receive a planned treatment due to disease progression or died within 3 months of treatment suggesting availability came too late. While CAPs can provide meaningful benefit, they are not a substitute for timely approval of novel agents.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673793","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":"Connected health in cancer survivorship: Evaluating the usability and utility of the cancer thriving and surviving programme in Ireland.","authors":"Isaiah Gitonga, Deirdre Desmond, Louise Mullen, Dorothy Thomas, Cathleen Osborne, Bernie O'Loughlin, Rebecca Maguire","doi":"10.1007/s11845-025-03931-6","DOIUrl":"https://doi.org/10.1007/s11845-025-03931-6","url":null,"abstract":"<p><strong>Background: </strong>Cancer survivorship care has become increasingly complex, with a growing population of people living with and beyond the disease requiring holistic support and follow-up. Connected health (CH) offer a promising solution to enhance care delivery.</p><p><strong>Aim: </strong>This study evaluated the usability and effectiveness of CH, and motivations of participants in the Cancer Thriving and Surviving (CTS) programme in Ireland.</p><p><strong>Methods: </strong>A cross-sectional survey of persons living with and beyond cancer (PLWBC) who completed the CH-delivered CTS was conducted between December 2022 and April 2023. Closed and open-ended questions captured participants experiences and motivations. Telehealth Usability Questionnaire (TUQ) assessed the CH usability. Qualitative content analysis examined recurring themes in participant responses.</p><p><strong>Results: </strong>Forty-four participants who engaged in CTS completed the survey. Participants were predominantly female (88%), diagnosed with breast cancer (76%), and had third-level education or higher (86%). Slightly over one third (36%) were in full time employment. Motivations for engaging in CTS included seeking peer support, psychosocial assistance, and practical self-management tools. Most respondents agreed that the programme improved their psychological wellbeing (90%), quality of life (76%) and helped them take more control of their health (83%). TUQ scores indicated high usability of the CH systems.</p><p><strong>Conclusion: </strong>Findings suggest that the CH-delivered CTS programme effectively benefits PLWBC, improving psychological well-being and quality of life. The high CH system usability and positive user experiences highlight its potential to complement in-person care, supporting the continued development and evaluation of CH systems to enhance cancer survivorship, particularly within Irish digital health initiatives.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673794","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":"Prognostic value of progesterone receptor expression in non-small cell lung cancer tissue.","authors":"Romanov I P, Bogush T A, Scherbakov A M, Grishanina A N, Bogush E A, Ravcheeva A B, Kosorukov V S","doi":"10.1007/s11845-025-03917-4","DOIUrl":"https://doi.org/10.1007/s11845-025-03917-4","url":null,"abstract":"<p><strong>Background: </strong>Progesterone receptors (PRs) play a role in the regulation of cell proliferation and are expressed in non-small cell lung cancer (NSCLC) tissue. Therefore, they represent a potential target for novel antitumor therapies. A survival analysis of NSCLC patients based on PR expression in tumor tissue may help assess the feasibility of using PR modulators in the treatment of this disease.</p><p><strong>Aim: </strong>This study aims to evaluate the prognostic significance of PR expression in NSCLC to determine the potential utility of PR modulators as a therapeutic strategy.</p><p><strong>Methods: </strong>PR expression was assessed in 130 surgically resected NSCLC samples using immunofluorescence analysis combined with flow cytometry. Primary antibodies against PR (NBP2-4638, Novus Biologicals, USA) and secondary antibodies conjugated with DyLight650 (ab98729, Abcam, UK) were used. The percentage of PR-expressing cells was quantified using FlowJo software. Statistical analyses were conducted in GraphPad Prism and RStudio using the \"survival\" package. The prognostic impact of PR expression in NSCLC tissue was evaluated in the overall patient cohort and after excluding censored events (n = 56) to minimize the influence of confounding factors on survival analysis.</p><p><strong>Results: </strong>After excluding censored events and stratifying patients based on the median PR expression level (57%), survival analysis revealed that high PR expression in NSCLC tissue is associated with a poorer prognosis (p = 0.05). Patients with high PR expression (≥ 57%) had a median survival of 12.8 months, whereas those with low PR expression (< 57%) had a median survival of 25.8 months (HR = 1.7).</p><p><strong>Conclusions: </strong>Elevated PR expression in NSCLC tumors is associated with reduced patient survival. These findings suggest that PR modulators may have potential therapeutic value for NSCLC patients with PR-positive tumors.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673854","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 1-year review of anti-Ro/La autoantibody testing in an obstetric population.","authors":"Elizabeth Tunney, Clare M Crowley, Claire M McCarthy, Etaoin Kent","doi":"10.1007/s11845-025-03935-2","DOIUrl":"https://doi.org/10.1007/s11845-025-03935-2","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate current anti-Ro and anti-La autoantibody ordering patterns, clinical indications for performing these tests, and potential cost-benefit analysis.</p><p><strong>Methods: </strong>In this retrospective cohort study, patients who underwent autoantibody testing over 1 year were included. Necessary information was obtained from patient electronic records.</p><p><strong>Results: </strong>In total 47 patients underwent anti-Ro/La autoantibody testing. Of those tested, 11/47 (2%) had positive results and testing was clinically indicated in 26/47 (55%) patients, indicating minimal cost-benefits. The total rate of the cost prescription was €1644.96. The mean time to process tests was 5 days. In those with positive autoantibodies, two infants were diagnosed with congenital heart block and had pacemakers inserted after delivery.</p><p><strong>Conclusion: </strong>This study found anti-Ro/La autoantibody tests were appropriately ordered in accordance with clinical guidelines. By identifying patients who were autoantibody negative, economic benefits were gained, in terms of antenatal management including reduced frequency of antenatal visits and fetal heart surveillance.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673765","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":"How can physical activity promotion be optimised in general practice: a narrative review of the literature.","authors":"Stephen Dolan, Andrew O'Regan","doi":"10.1007/s11845-025-03932-5","DOIUrl":"https://doi.org/10.1007/s11845-025-03932-5","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity is a significant contributor to preventable chronic health conditions worldwide. General practice has been identified as a setting to improve physical activity levels through exercise promotion during consultations. However, physical activity promotion in general practice is unstructured and suboptimal.</p><p><strong>Aims: </strong>The aim of this study is to review the literature pertaining to factors that influence physical activity promotion in general practice and to answer the research question: what are the experiences of patients and GPs with physical activity promotion in consultations?</p><p><strong>Methods: </strong>Online databases were searched for relevant papers using predetermined inclusion and exclusion criteria. Papers retrieved were original research only, involving patients, general practitioners or practice nurses. A PRISMA approach to study selection was followed.</p><p><strong>Results: </strong>Of 464 papers retrieved, 20 were included in the review. Physical activity promotion is acceptable to patients but some do not appreciate its health benefits. A personalised approach is important to patients, including tailored advice and setting meaningful goals. Studies involving general practitioners and practice nurses report that they are aware of the importance of physical activity and their role in its promotion, but time is the primary barrier. Strategies identified include demedicalisation of physical activity, resources such as patient handouts as well as signposting to community initiatives, social prescribers and collaboration with exercise professionals.</p><p><strong>Conclusion: </strong>General practice has the potential to effectively promote physical activity but system- and practitioner-level changes are necessary to achieve meaningful change.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673853","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":"International surgical fellowships in the USA: the pathway to success.","authors":"Ian S Reynolds, Nicholas P McKenna, Kellie L Mathis, William R Perry","doi":"10.1007/s11845-025-03936-1","DOIUrl":"https://doi.org/10.1007/s11845-025-03936-1","url":null,"abstract":"<p><p>International surgical fellowships offer senior trainees the opportunity to experience alternative health systems and learn novel cutting-edge techniques. They might also offer trainees exposure to a job market that they had not considered before. Obtaining a surgical fellowship in a reputable North American institution has been the chosen pathway for generations of Irish surgical trainees, yet it is not always a straightforward pathway. The following manuscript highlights the necessary preparation and key steps required to be a successful candidate in the search for a fellowship. It details some key pieces of advice surrounding the application and interview process and provides some guidance on how to choose a programme that will best suit your needs and meet your expectations.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648473","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}