Irish Journal of Medical Science最新文献_第2页

Referral patterns and patient characteristics observed during the first year of Ireland's inaugural community hub diabetes service: a retrospective analysis. 转诊模式和患者特征观察在爱尔兰的首年社区中心糖尿病服务：回顾性分析。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-19 DOI: 10.1007/s11845-025-03975-8

Katie De Jong, Tommy Kyaw-Tun, John H McDermott, Seamus Sreenan, Colin Davenport

{"title":"Referral patterns and patient characteristics observed during the first year of Ireland's inaugural community hub diabetes service: a retrospective analysis.","authors":"Katie De Jong, Tommy Kyaw-Tun, John H McDermott, Seamus Sreenan, Colin Davenport","doi":"10.1007/s11845-025-03975-8","DOIUrl":"https://doi.org/10.1007/s11845-025-03975-8","url":null,"abstract":"Background: Enhanced Community Care (ECC) for type 2 diabetes mellitus (T2DM) in Ireland introduces episodic, community-based, consultant-led multidisciplinary care of diabetes that in turn supports the general practitioner (GP)-delivered chronic disease management programme (CDMP). The Dublin North West (DNW) hub, Ireland's first fully operational ECC hub, began providing its diabetes service in March 2023.Aims: This study reviewed the first year of the DNW hub's diabetes operations, focusing on referral patterns, patient demographics, clinical characteristics, and CDMP eligibility (only those people living with T2DM with a medical card or a GP visit card are eligible for CDMP for T2DM; otherwise, people living with T2DM must self-pay for GP-provided T2DM care).Methods: A retrospective analysis was conducted on patient charts and hospital databases for all referrals to the DNW hub from March 2023 to March 2024.Results: Out of 204 referrals, 67% were redirected from hospital waiting lists, 22% were direct GP referrals, and 11% were internal from other hub services. The average wait time from referral to first appointment was 8.6 weeks. Attendees were 44% female and 56% male, with an average age of 56.2 years. Notably, only 46% were eligible for CDMP. During the study period, the number of people living with T2DM waiting for diabetes appointments at Connolly Hospital decreased by 61%, with the average waiting time reduced from 11 to 5 months.Conclusions: The first year of activity in the DNW hub illustrates the potential of the ECC model to positively impact hospital waiting lists. Our data also suggests that eligibility to access the CDMP may merit expansion as part of the ongoing implementation of ECC in Ireland.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667658","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}

引用次数: 0

Identification of CT features and laboratory indicators to aid in the management of patients with portal venous gas identified on imaging. 识别CT特征和实验室指标，以帮助处理门静脉气体在影像学上识别的患者。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-18 DOI: 10.1007/s11845-025-03998-1

Marion Hanley, Munir Saeed, Ronan Lee, Damien C O'Neill, Taranum Naz, Paula Loughlin, Michael J Lee, Martina M Morrin

{"title":"Identification of CT features and laboratory indicators to aid in the management of patients with portal venous gas identified on imaging.","authors":"Marion Hanley, Munir Saeed, Ronan Lee, Damien C O'Neill, Taranum Naz, Paula Loughlin, Michael J Lee, Martina M Morrin","doi":"10.1007/s11845-025-03998-1","DOIUrl":"https://doi.org/10.1007/s11845-025-03998-1","url":null,"abstract":"Background: It can be difficult to distinguish cases of benign portal venous gas (PVG) that can be managed conservatively from forms associated with ischaemic bowel.Purpose: To identify CT, clinical and laboratory factors that may be assist in the decision-making regarding patient management.Methods: All patients in whom PVG was demonstrated on CT imaging were identified over an 8-year period. CT imaging was reviewed for 19 CT features. Clinical findings and laboratory values also retrospectively reviewed. Patients were divided into four groups based on management and outcomes; Group 1, conservatively managed and died, Group 2, conservatively managed and survived, Group 3, operative management and died and Group 4, operative managed and survived.Results: Fifty-six patients had PVG. Overall mortality rate was 54%. Thirty-four percent of patients underwent surgical exploration. Sixty-six percent of patients were managed conservatively. Serum lactate values were found to be highest in Group 1 and lowest in Group 2 (p < 0.001). Neutrophil/lymphocyte ratios significantly differed across the groups. High serum lactate was associated with significantly increased inpatient hospital mortality. CT features of a stenosed or occluded coeliac artery, stenosed or occluded superior mesenteric artery, bowel obstruction, non-obstructed small bowel dilatation and the presence of ascites were associated with significantly increased inpatient hospital mortality.Conclusion: Management of patients with PVG should be determined by assessing the combination of clinical assessment, laboratory values in addition to CT features. Attention may be given to elevated serum lactate levels and specific CT features associated with higher mortality rates.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659228","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}

引用次数: 0

A comparison of objective structured clinical examinations (OSCEs) for medical students, modified during the COVID-19 pandemic. 在COVID-19大流行期间修改的医学生客观结构化临床检查（oses）的比较

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-18 DOI: 10.1007/s11845-025-03976-7

Andrew O'Malley, Nóirín Fitzgerald, Edina Moylett, Geraldine Gaffney, Geraldine McCarthy, Andrew W Murphy, Rosemary Geoghegan, Brian Hallahan

{"title":"A comparison of objective structured clinical examinations (OSCEs) for medical students, modified during the COVID-19 pandemic.","authors":"Andrew O'Malley, Nóirín Fitzgerald, Edina Moylett, Geraldine Gaffney, Geraldine McCarthy, Andrew W Murphy, Rosemary Geoghegan, Brian Hallahan","doi":"10.1007/s11845-025-03976-7","DOIUrl":"https://doi.org/10.1007/s11845-025-03976-7","url":null,"abstract":"Introduction and aims: Objective structured clinical examinations (OSCEs) are an integral part of medical education assessment. The advanced clinical skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics for fourth-year medical students at the University of Galway. This study compares results between the 2019 OSCE, and two subsequent OSCEs (2020 and 2021) modified to varying degrees secondary to the COVID-19 pandemic. We also examined student's satisfaction and perspectives regarding both modified OSCEs.Materials and methods: Anonymised results between the 2019 (128 min), 2020 (56 min) and 2021 (96 min) ACS OSCEs were compared, and student feedback pertaining to the 2020 and 2021 OSCEs was analysed.Results: A higher total mean mark OSCE result was achieved at the 2020 OSCE (62.95%) compared to the 2019 (59.35%) and 2021 (58.89%) OSCEs (F = 31.83, p < 0.001), with significantly more first-class honours marks attained in 2020 (11.5%) compared to 2019 and 2021 (both 1%) (p < 0.001). Measures of reliability were consistent across all years. A majority of students in both 2020 and 2021 reported the OSCE to be safe, well-coordinated, and fair, but similar numbers of students from both 2020 and 2021 expressed concern that face masks impeded their communication skills.Conclusion: This study demonstrates the feasibility of conducting a modified reliable OSCE during a pandemic. Conducting a 96-min OSCE demonstrated similar results to the pre-COVID-19 pandemic 128-min OSCE, in contrast to a 56-min OSCE where potentially inflated marks were attained.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659227","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}

引用次数: 0

BDNF-TrkB signalling: a neurotrophic pathway to cardiovascular protection. BDNF-TrkB信号传导：心血管保护的神经营养途径。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-16 DOI: 10.1007/s11845-025-03996-3

Amita Joshi Rana, Md Sadique Hussain, Vikas Jakhmola, Ayesha Sultana, Sreeshma Ravindran Kammarambath, Rajesh Raju, Inamul Hasan Madar

{"title":"BDNF-TrkB signalling: a neurotrophic pathway to cardiovascular protection.","authors":"Amita Joshi Rana, Md Sadique Hussain, Vikas Jakhmola, Ayesha Sultana, Sreeshma Ravindran Kammarambath, Rajesh Raju, Inamul Hasan Madar","doi":"10.1007/s11845-025-03996-3","DOIUrl":"https://doi.org/10.1007/s11845-025-03996-3","url":null,"abstract":"The brain-derived neurotrophic factor (BDNF)-tropomyosin receptor kinase B (TrkB) signaling axis has emerged as a promising frontier in cardiovascular research, particularly in the context of myocardial ischemia/reperfusion (I/R) injury. Originally recognized for its neuroprotective functions, BDNF is now gaining recognition for its cardioprotective properties, including anti-apoptotic effects, improved cardiomyocyte survival, and enhanced contractile function. Acting predominantly through TrkB, BDNF attenuates ischemia-induced apoptosis by downregulating caspase-3 and cleaved caspase-9, while simultaneously promoting cardiomyocyte differentiation and proliferation. Intriguingly, under hypoxic conditions, a shift from p75NTR to TrkB receptor activity amplifies these protective effects. Moreover, BDNF modulates intracellular calcium handling by activating Ca2⁺/calmodulin-dependent protein kinase II (CaMKII), contributing to efficient cardiac muscle contraction and relaxation. Paralleling its role in neurons, BDNF-TrkB signaling may also influence mitochondrial dynamics, energy metabolism, and ATP synthesis, potentially aiding in myocardial recovery. Activation of downstream pathways such as PI3K/Akt/mTOR further suggests a role in metabolic reprogramming, though these effects in cardiac tissue require further validation. Despite growing preclinical evidence, the precise molecular interplay between BDNF's anti-apoptotic, metabolic, and calcium-regulatory roles in the heart remains incompletely understood. Future research should focus on elucidating these mechanisms across cardiac cell types and disease contexts to fully harness the therapeutic potential of BDNF-TrkB modulation. Such strategies may pave the way for personalized, neurotrophin-based interventions in the treatment of ischemic heart disease.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642506","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}

引用次数: 0

Indwelling pleural catheter for malignant pleural effusion: a real-life experience in a tertiary centre with a dedicated pleural service in the Republic of Ireland. 恶性胸腔积液留置胸膜导管：在爱尔兰共和国一个专门的胸膜服务三级中心的现实生活经验。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-15 DOI: 10.1007/s11845-025-03999-0

Lorraine Thong, Mohammed Mitha, Donna Langan, Helen Mulryan, David Breen

{"title":"Indwelling pleural catheter for malignant pleural effusion: a real-life experience in a tertiary centre with a dedicated pleural service in the Republic of Ireland.","authors":"Lorraine Thong, Mohammed Mitha, Donna Langan, Helen Mulryan, David Breen","doi":"10.1007/s11845-025-03999-0","DOIUrl":"https://doi.org/10.1007/s11845-025-03999-0","url":null,"abstract":"Background: Malignant pleural effusion (MPE) is a significant cost of burden and carries a poor prognosis with a median survival of 3-12 months. Indwelling pleural catheters (IPC) have been shown to be effective in improving symptoms in patients with MPE. This study reports our 5-year real-life experience with IPC in patients with MPE from a hospital with a dedicated pleural service in the Republic of Ireland.Methodology: This is a retrospective, single-centre study based in a tertiary hospital. All patients who had IPC inserted by the pleural service in a 5-year period (1st of January 2019 until 31 December 2023) were included in this study. Patients' clinical details and histology results were acquired via the hospital's electronic medical records.Results: During the 5-year period, there were 55 patients who had IPC inserted. Symptom improvement was achieved in almost all patients (n = 54, 98.2%). Our total complication rate was low at 14.5% (n = 8), with the majority being catheter-associated skin infection. Pleurodesis was achieved in 21 (47.8%) patients with the mean and median time to pleurodesis were 115.5 days and 94 days, respectively.Conclusion: IPC is a relatively safe procedure with low complication rates when performed by trained physicians. The additional support of a dedicated pleural service will maximize the benefits of IPC while reducing the complication rates.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637035","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}

引用次数: 0

Ultrasound evaluation of muscles in older patients with metabolıc syndrome. 老年metabolıc综合征患者肌肉超声评价。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-14 DOI: 10.1007/s11845-025-04004-4

Ibrahim Ileri, Merve Hafizoglu, Didem Karaduman, Cansu Atbas, Zeynep Sahiner, Ayse Dikmeer, Yelda Ozturk, Merve Guner, Arzu Okyar Bas, Cafer Balci, Mustafa Cankurtaran, Burcu Balam Dogu, Meltem Gülhan Halil

{"title":"Ultrasound evaluation of muscles in older patients with metabolıc syndrome.","authors":"Ibrahim Ileri, Merve Hafizoglu, Didem Karaduman, Cansu Atbas, Zeynep Sahiner, Ayse Dikmeer, Yelda Ozturk, Merve Guner, Arzu Okyar Bas, Cafer Balci, Mustafa Cankurtaran, Burcu Balam Dogu, Meltem Gülhan Halil","doi":"10.1007/s11845-025-04004-4","DOIUrl":"https://doi.org/10.1007/s11845-025-04004-4","url":null,"abstract":"Background: Metabolic syndrome (MetS) is a disease characterized by various metabolic disorders and increases the risk of cardiovascular events. Osteosarcopenia (OS) is the name given to conditions where osteopenia/osteoporosis (OP) and sarcopenia coexist. In this study, the relationship between MetS and bones assessed by dual-energy X-ray absorptiometry (DXA) and muscles assessed by muscle ultrasonography (USG) was investigated.Methods: The study conducted among patients aged 65 and over who applied to the geriatric outpatient clinic between January 2022 and June 2022. This study was a cross-sectional study. There were 161 patients.Results: In the study, 77 (73%) of the patients with MetS were female and the median age of the patients with MetS was 72(9) interquartile range (IQR) years. While OP was present in 18% of patients with MetS, this rate was 41% in those without MetS, and this difference was significant (p = 0.002). There was no difference in OS and sarcopenia rates between the two groups (respectively; p = 0.14, p = 0.09). Gastrocnemius medialis (GM) and transversus abdominis (TA) muscles were significantly thicker in patients with MetS (respectively; p = 0.002, p = 0.003).","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626356","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}

引用次数: 0

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-12 DOI: 10.1007/s11845-025-03995-4

Brian Maloney, Min Seo Jung, Gerard Kearns, Conor Bowe

{"title":"Equestrian-related maxillofacial injuries-a five-year retrospective review.","authors":"Brian Maloney, Min Seo Jung, Gerard Kearns, Conor Bowe","doi":"10.1007/s11845-025-03995-4","DOIUrl":"https://doi.org/10.1007/s11845-025-03995-4","url":null,"abstract":"Background: Equestrian-related activities inherently involve the risk of serious injury. There are few reports of maxillofacial injury patterns and management arising from equestrian activities in the literature.Aims: To investigate maxillofacial fracture presentations at a tertiary trauma centre to identify injury profiles of patients who have sustained equine-based injuries over 5 years.Methods: This work involved a retrospective review of all trauma presentations to our unit over 5 years. The data collected included patient demographics, injury mechanisms and patterns, and management of fractures.Results: The study identified 73 patients with facial fractures resulting from activity with horses between 2020 and 2025. A total of facial fractures were recorded. The mean age was 39.5 (11-86) years. There were 40 (55%) males and 33 (45%) females. Mounted riders accounted for 41% of cases, with 59% being unmounted. The incidence of head injury was 5%. A further 5% had an associated spinal injury. The most common specific mechanism of maxillofacial injury was a direct kick, in 55% of cases. The most commonly affected facial region was the middle third (81%), with zygomaticomaxillary complex fractures most commonly recorded (39%). There was a statistically significant increase in the risk of head injury associated with frontal bone fracture in this group.Conclusion: Activities involving horses pose a high risk of maxillofacial injury. Education should be promoted to increase the usage of helmets with a particular design to protect the facial skeleton, whether mounted or unmounted.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618094","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}

引用次数: 0

A qualitative analysis of head and neck cancer patient's lived experience on their treatment journey in a single Irish institution. 定性分析头颈癌患者的生活经验，在他们的治疗旅程在一个单一的爱尔兰机构。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-11 DOI: 10.1007/s11845-025-04002-6

Seamus Boyle, Michael Fitzsimons, Shauna Hurley, Tom Moran, Fergal O'Duffy

{"title":"A qualitative analysis of head and neck cancer patient's lived experience on their treatment journey in a single Irish institution.","authors":"Seamus Boyle, Michael Fitzsimons, Shauna Hurley, Tom Moran, Fergal O'Duffy","doi":"10.1007/s11845-025-04002-6","DOIUrl":"https://doi.org/10.1007/s11845-025-04002-6","url":null,"abstract":"Introduction: Head and neck cancer can have a dramatic impact on the lives of patients. We wish to determine patients subjective preparedness for their treatment and to assess their service satisfaction provided by a Head and Neck Cancer Unit.Methods: An observational cohort study of patients with a diagnosis of head and neck cancer was performed. This consisted of a 22-question survey of post-treatment patients. Patients prior to their clinic appointment were offered a feedback form for completion. The patients were aware that the clinician was blinded to completion of the form and advised that their feedback would not alter their future management.Results: In total, 40 patients completed the questionnaire. Patients felt physically, mentally, nutritionally ready pre-treatment in 94%, 84.2% and 89% respectively. Forty per cent of respondents felt they would have benefited from the support of a psychologist. Regarding speech and swallow, 96% and 93% of patients felt they had adequate education of voice and swallow. 96% felt they had adequate post op support.Conclusion: Patient-reported outcomes and feedback are essential to assess service provision and determine areas of insufficiency. One area of deficiency identified is regarding psychological support and we wish to highlight this insufficiency within our unit.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608366","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}

引用次数: 0

Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre. TAVI结果的时间趋势：来自爱尔兰三级转诊中心的经验。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-10 DOI: 10.1007/s11845-025-04001-7

Zaran Butt, Stefan Elekes, Lara Harrington, Laoise Geoghegan, Zsombor Mathe, Julia Rodighiero, Andrew Maree, Mark Hensey, Stephen O'Connor

{"title":"Temporal trends in TAVI outcomes: experience from an Irish tertiary referral centre.","authors":"Zaran Butt, Stefan Elekes, Lara Harrington, Laoise Geoghegan, Zsombor Mathe, Julia Rodighiero, Andrew Maree, Mark Hensey, Stephen O'Connor","doi":"10.1007/s11845-025-04001-7","DOIUrl":"https://doi.org/10.1007/s11845-025-04001-7","url":null,"abstract":"Background: Transcatheter aortic valve implantation (TAVI) has become a well-established therapeutic option for severe aortic stenosis in recent decades. There is limited data published about Irish experiences with TAVI.Aims: To characterize contemporary TAVI outcomes from an Irish tertiary referral centre.Methods: A retrospective registry was created which included data on consecutive patients who underwent TAVI in our centre over a 3-year period. The Valve Academic Research Consortium 3 guideline was used to define endpoint definitions.Results: A total of 230 TAVI procedures were performed; 62 (2019), 57 (2020) and 111 (2021). Cumulative mean age was 81 years, with a male majority (65%). Median hospital length-of-stay was lower in 2021 versus 2019 [3 days (IQR 2 to 10) versus 9 days (IQR 4-22), p = 0.008]. Of patients with at least 30-day follow-up data (95.3%), none experienced procedural or 30-day mortality. Cumulative all-cause mortality was 22% over a median follow-up of 491 days (IQR 323 to 780). The incidence of in-hospital cerebro-vascular accidents was higher in 2019 versus 2021 (9.7% versus 1.8%, p = 0.02). A pacemaker was implanted in 20 (9%) cases, while 28 (12%) patients experienced an acute kidney injury. There was a general trend towards temporal improvements in complication rates across the years.Conclusions: The TAVI caseload has risen significantly in our centre in recent years. Overall, peri-procedural complication rates have been low and device success rates high, consistent with international registry data. There have been temporal improvements in the majority of TAVI-related complications and length of hospital stay with increasing operator experience.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600392","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}

引用次数: 0

3-year revision rates of left vs right cephalomedullary nails with a helical blade design. 螺旋刀片设计的左、右头髓钉3年翻修率。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2025-07-09 DOI: 10.1007/s11845-025-04000-8

Linda Kelly, Darren Moloney, Denis Collins

{"title":"3-year revision rates of left vs right cephalomedullary nails with a helical blade design.","authors":"Linda Kelly, Darren Moloney, Denis Collins","doi":"10.1007/s11845-025-04000-8","DOIUrl":"https://doi.org/10.1007/s11845-025-04000-8","url":null,"abstract":"Introduction: Intramedullary (IM) femoral nailing in the form of cephalomedullary (CM) nailing is a common treatment of intertrochanteric femoral fractures. Previous literature has demonstrated higher revision rates of left intertrochanteric fractures. Helical blade constructs offer a theoretical advantage over a screw design.Objectives: The objective of this study is to examine 3 year revision rates for right vs left CM nails with helical blade head screw. No current studies exist which compare revision rates in left versus right IM nails over this defined time period.Study design and methods: Patients who sustained intertrochanteric femoral fracture subsequently treated by CM nailing between July 2021 and December 2022 were retrospectively identified from a database of orthopaedic patients. Patients were stratified based on left-sided or right-sided fracture. Criteria for inclusion were anterograde femoral nails, performed for Intertrochanteric hip fractures. Exclusion criteria included revision nails, retrograde nails, diaphyseal and subtrochanteric fractures, reverse oblique fracture patterns and prophylactic nails. The primary outcome was 3 year revision rate. Relevant frequency statistics were generated for each cohort with odds ratios comparing revision rates between the two groups.Results: n = 104 patients were included in the final sample, comprising n = 48 left and n = 56 right sided intertrochanteric fractures who underwent CM nailing. n = 4 (3.8%) TFNAs underwent subsequent surgical revision. Incidence of revision was higher in patients undergoing left IM nailing Left: 3/48, 0.063, Right: 1/56, 0.018, Odds Ratio: 3.667, 95% Confidence Interval: 0.37 - 36.47, p = 0.268).Conclusion: A greater proportion of patients who sustained a left sided intertrochanteric fracture and were surgically treated with CM nailing underwent revision surgery within 3 years of initial surgery compared to right sided CM nails.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591254","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}

引用次数: 0