Irish Journal of Medical Science最新文献

{"title":"Palatal sweating is a marker of anaesthetic depth.","authors":"Niall James McInerney, Eric Farrell, Liam Skinner","doi":"10.1007/s11845-025-03896-6","DOIUrl":"https://doi.org/10.1007/s11845-025-03896-6","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038904","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":"Efficacy of Ozurdex implants as second-line therapy for non-responders to anti-VEGF in retinal vein occlusion-associated macular edema: a retrospective cohort study.","authors":"Mahmoud Eissa, Dimitrios Kalogeropoulos, William Evans, Rashi Arora, Andrew John Lotery","doi":"10.1007/s11845-025-03881-z","DOIUrl":"https://doi.org/10.1007/s11845-025-03881-z","url":null,"abstract":"<p><strong>Purpose: </strong>Retinal vein occlusion (RVO) is a prevalent retinal vascular disorder characterized by retinal haemorrhage, neovascularization, and macular edema This study aimed to assess the structural and functional effects of intravitreal implant (Ozurdex) treatment as a second-line for RVO-associated macular edema in patients who did not respond to first-line anti-VEGF therapy.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational cohort study using electronic health records of RVO patients at Salisbury District Hospital between January 2014 and December 2019. Inclusion criteria included patients diagnosed with central or branch RVO. Patients underwent ophthalmic evaluations at baseline, including central retinal thickness (CRT) and best-corrected visual acuity (BCVA) assessments. Statistical analysis was performed using IBM SPSS Statistics, employing various tests to determine significance.</p><p><strong>Results: </strong>Sixteen eyes of 16 White British patients were evaluated. Most patients had branch RVO (52.95%), and 47.05% had central RVO. While anti-VEGF treatment significantly improved BCVA (p = 0.0061), Ozurdex did not result in additional gain (p = 0.747). Both treatments significantly reduced CRT (p = 0.0055 for anti-VEGF; p = 0.0079 for Ozurdex). No significant differences were observed between diabetic and non-diabetic BCVA patients receiving either treatment.</p><p><strong>Conclusion: </strong>Ozurdex emerges as a safe and effective option for persistent macular edema in RVO patients unresponsive to anti-VEGF therapy. Although structural improvements in CRT were observed following Ozurdex treatment, they did not correlate with additional gain in BCVA. Despite this, the reduced treatment frequency of Ozurdex compared to anti-VEGF injections may be advantageous, particularly for frail non-responding patients minimizing treatment burden.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032596","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":"Mortality trends for colorectal cancer during the COVID-19 pandemic in the US.","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1007/s11845-025-03883-x","DOIUrl":"https://doi.org/10.1007/s11845-025-03883-x","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032597","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":"Community prevalence of blood-borne viruses (hepatitis B and HIV) in Ireland.","authors":"P Aiden McCormick, Marie O'Grady, Paul Holder, Cillian F De Gascun, John S Lambert, Orla Crosbie, Susan McKiernan, Maeve Skelly, Garry Courtney, Brian Hennessy, Kevin Walsh, Roisin Twohig, Kate Browne, Tessa O'Gorman, Vivion Crowley, Seán J Costelloe, Roz O'Byrne, Orla Gildea, Noreen Montgomery","doi":"10.1007/s11845-025-03869-9","DOIUrl":"https://doi.org/10.1007/s11845-025-03869-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic infection with hepatitis B virus and HIV causes significant morbidity and mortality. Effective antiviral treatment is available for both. Ireland has historically been considered a low prevalence country. However, with increasing inward migration and diversity, this may be changing.</p><p><strong>Aims: </strong>The aim of this study was to measure the community prevalence of hepatitis B virus and HIV infections in Irish residents born between the years 1965 and 1985.</p><p><strong>Methods: </strong>Anonymised residual serum samples from blood tests ordered by community general practitioners and tested in eight general hospital laboratories, spread across Ireland, were analysed for the presence of Hepatitis B surface antigen and antibodies to HIV.</p><p><strong>Results: </strong>A total of 6080 samples were analysed for hepatitis B surface antigen including 2993 males, 2807 females and 280 samples for which gender was not recorded. HBsAg was detected in 28/6067 samples giving an estimated prevalence of 0.46% (95% CI 0.32-0.67%). Antibodies to HIV were identified in 18/6064 giving an estimated prevalence of 0.33% (95% CI 0.19-0.47%). The prevalence of both hepatitis B and HIV was significantly higher in Cork (Southwest Ireland) than other centres: hepatitis B (12/1050 vs 16/5017, p = 0.014) and HIV (11/1049 vs 7/5015, p < 0.001).</p><p><strong>Conclusions: </strong>The prevalence of hepatitis B virus and HIV infections in this cohort appear to be higher than previously estimated. In addition, their prevalence in the Cork area appears particularly high. Whether this represents a true prevalence or a chance finding will require confirmatory studies.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023469","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":"Challenges and effectiveness of remote neurological follow-up of children with concussion following TBI using telemedicine.","authors":"Türker Demirtakan, Semra Işık, Tugay Usta, Ahmed Edizer, Serkan Doğan","doi":"10.1007/s11845-024-03862-8","DOIUrl":"https://doi.org/10.1007/s11845-024-03862-8","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) in children, including concussion, is one of the major causes of emergency department (ED) registration and a significant burden on the health system.</p><p><strong>Objectives: </strong>The primary goal of this study was to evaluate the outcomes of a telemedicine strategy for remotely monitoring the children with traumatic brain concussions, focusing on their neurological symptoms and signs. The secondary goal was to explore socioeconomic and educational differences among the participating families.</p><p><strong>Methods: </strong>This study was conducted in a prospective and observational fashion. It included children aged between 6 and 18 years who presented in the ED with head trauma and were subsequently diagnosed with a brain concussion. Enrolled patients split into telemedicine-only and telemedicine + readmission groups according to their concussion symptoms during video-call visits.</p><p><strong>Results: </strong>We recruited 29 children and performed 75 telehealth visits. Four children were called for readmission, and they comprised the telemedicine + readmission group. The telemedicine-only group included 25 children whose follow-ups were completed remotely. The median PECARN score was 1 (IQR = 0.75), and the most common reason for head trauma was simple falls from the same level (n = 18, 62%); 22 (76%) children were suffering from headaches; 55% of the families were in very low-income status. During the video-call visit sessions, three children stated worse headaches, and one child's parents reported consistent sleepiness.</p><p><strong>Conclusion: </strong>This study demonstrates the potential effectiveness of telemedicine in monitoring children with concussions, especially in regions with diverse socioeconomic backgrounds and overcrowded metropolitan hospitals.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005292","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":"Weekend effect on patient care.","authors":"Adem Az, Nihat Mujdat Hokenek","doi":"10.1007/s11845-025-03870-2","DOIUrl":"https://doi.org/10.1007/s11845-025-03870-2","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005344","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":"Utility of systemic staging in breast cancer patients with a positive sentinel lymph node biopsy.","authors":"Tim Harding, Patrick James O'Donoghue, Michael Boland, Denis Evoy, Damien McCartan, Claire Rutherford, Ruth Prichard","doi":"10.1007/s11845-025-03867-x","DOIUrl":"https://doi.org/10.1007/s11845-025-03867-x","url":null,"abstract":"<p><strong>Background: </strong>CT thorax, abdomen and pelvis (CT-TAP) remains the standard in the identification of metastatic disease in patients with newly diagnosed breast cancer. In patients with proven micro and macro axillary nodal metastasis, the optimal radiological technique remains controversial. A consensus on which patients with axillary nodal disease should receive radiological staging for distant disease and how this should be performed is not currently available. The aim of this study was to evaluate the yield from CT staging of the thorax, abdomen and pelvis (CT-TAP) in patients with proven nodal disease.</p><p><strong>Methods: </strong>Patients diagnosed with invasive breast cancer with a positive sentinel lymph node biopsy (SLNB) and subsequent staging CT-TAP between 2013 and 2017 were identified. Patient demographics, clinicopathological characteristics, CT-TAP findings and further imaging requirements were documented.</p><p><strong>Results: </strong>A total of 234 patients were identified. Of these, 164 (70%) were found to have macrometastasis and 70 (30%) to have micrometastasis or isolated tumour cells on SLNB. Within the macrometastasis cohort, abnormalities were noted on staging CT-TAP for 100 (61%) patients. Eighty of the 100 received follow-up assessment of abnormalities with 3 (2%) patients being diagnosed with distant metastatic disease. Within the micrometastasis group, abnormalities on CT-TAP staging were noted in 36 (52.1%) patients. Twenty-eight (40%) patients required further investigation and follow-up. No patient was found to have metastatic disease within this group.</p><p><strong>Conclusion: </strong>Patients diagnosed with micrometastatic disease of the axilla following a sentinel lymph node biopsy do not require systemic staging as it fails to detect metastatic disease.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005336","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":"Exploring patient perspectives of barriers and facilitators to participating in hospital-based pulmonary rehabilitation in patients diagnosed with non-small-cell lung cancer treated with curative intent.","authors":"Denise Doyle, Matthew O'Brien, Rosemary Murphy, Aidan O'Brien, Deirdre McGrath, Dervla Kelly","doi":"10.1007/s11845-024-03855-7","DOIUrl":"https://doi.org/10.1007/s11845-024-03855-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary rehabilitation (PR) is increasingly offered to patients who have undergone lung resection for non-small-cell lung carcinoma (NSCLC) as it can improve exercise tolerance and quality of life. However, designing and implementing such a complex multidisciplinary programme has its challenges.</p><p><strong>Objective: </strong>This study aims to explore perspectives of patients offered PR services post-lung resection for NSCLC to gain an understanding of the potential barriers and facilitators behind implementing and designing PR programmes.</p><p><strong>Methods: </strong>The PR programmes were offered in an outpatient rehabilitation gym at University Hospital Limerick, Ireland. Patients attending routine follow-up appointments post-lung cancer resection during the period of the study were identified and based on inclusion criteria were invited to participate in semi-structured interviews (focus groups). Interviews with patients who participated in the PR programme (n = 8) and those who declined (n = 4) were transcribed and major themes identified using normalisation process theory (NPT analysis) before interpretation of the themes in context.</p><p><strong>Results: </strong>Across 4 focus groups that were conducted, the important barriers identified were the presence of comorbidities, location, perceived lack of benefit, and a fear of causing harm. Relevant facilitators included the prospect of acquiring new knowledge, optional access to psychological support, peer interaction/social support, individualised, tailored programmes, and a holistic approach to recovery as well as goal setting and accomplishment.</p><p><strong>Conclusions: </strong>Patient participation in PR has been shown to be influenced by both external and intrapersonal variables. The barriers and facilitators experienced by the patients in this study contribute to the existing knowledge of the patient experience of pulmonary rehabilitation and can help to inform clinical practice and future research.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005299","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":"Insights into VTE risk in trauma patients: an observational study in an Irish trauma patient population.","authors":"Bibi Ayesha Bassa, Elizabeth Little, Francis O Keefe, Fionnuala Ní Áinle, Tomás Breslin, Valeria Lima Passos","doi":"10.1007/s11845-024-03866-4","DOIUrl":"https://doi.org/10.1007/s11845-024-03866-4","url":null,"abstract":"<p><strong>Background: </strong>The rate of VTE in trauma patients varies significantly in the reported literature. We aimed to determine the incidence of VTE in trauma patients in a trauma-receiving hospital over a 7-year period. We sought to evaluate the timing and nature of VTE events and explore the patterns of co-occurrence between PE and DVT, while factoring in clinical care and death outcome.</p><p><strong>Methods: </strong>Retrospective review of consecutive trauma patients ≥ 18 years admitted between January 2014 and December 2020. Data were extracted from the TARN database, picture archiving and communication system, and hospital records. The primary outcome was VTE incidence. Latent class analysis was used to uncover cross combinations of clinical management and VTE outcomes, yielding subgroups of trauma patients. Subgroups were compared for demographic and clinical characteristics.</p><p><strong>Findings: </strong>Seventy-three VTE were observed-incidence of 0.0036 cases/people-year (95% CI 0.0 to 3.69). VTE ( +) group consisted mostly of males (75%), had an advanced age, had higher injury severity scores, and had increased length of stay. Most patients (64%) developed a PE only. Most DVT (64%) were proximal. Two subgroups had a high probability of PE/low probability of DVT and two a high probability of DVT/low-to-moderate probability of PE. Subgroup comparisons showed differences in the clinical characteristics which were statistically inconclusive.</p><p><strong>Conclusion: </strong>This is the largest study of VTE incidence in Irish trauma patients and the first to delineate VTE risk in a trauma population. These findings urge reconsideration of VTE risk in trauma patients and implementation of prevention strategies.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005312","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":"Cannabis use in Crohn's disease: a systematic review and meta-analysis of randomized controlled trials (RCTs).","authors":"Rayyan Vaid, Areeba Fareed, Rabia Qader, Aariz Hussain, Wajiha Shaikh, Ushna Zameer, Sidhant Ochani","doi":"10.1007/s11845-024-03844-w","DOIUrl":"https://doi.org/10.1007/s11845-024-03844-w","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to systematically evaluate the efficacy and safety of cannabis in the management of Crohn's disease (CD) by synthesizing evidence from randomized controlled trials (RCTs). By adhering to the 2020 PRISMA guidelines and registering the study protocol with PROSPERO, this research intends to offer robust, evidence-based recommendations for healthcare practitioners on the therapeutic potential and clinical implications of cannabis use in CD management.</p><p><strong>Methods: </strong>A literature search encompassing PubMed, Google Scholar, and the Cochrane Library was conducted to identify relevant RCTs comparing cannabis to placebo or standard therapy in CD patients. Inclusion criteria focused on outcomes such as remission rates, C-reactive protein (CRP) levels, quality of life (QoL), and adverse events (AEs). Statistical analysis using RevMan 5.3 involved weighted mean differences (MD) and 95% confidence intervals to compare outcomes between the cannabis and control groups.</p><p><strong>Results: </strong>The meta-analysis revealed significant findings regarding the impact of cannabis on CD management. The cannabis group exhibited significantly higher clinical remission rates at 8 weeks compared to the control group, with low heterogeneity [MD = - 67.98; 95% CI: (- 100.68, - 35.29)]. However, a statistically significant improvement in QoL was observed in the placebo group compared to the cannabis-treated group [MD = 19.62; 95% CI (14.24 to 25.00)]. There was a non-significant lowering in serum CRP levels compared to the placebo group [MD: - 0.51; 95% CI: (- 1.05, 0.02)].</p><p><strong>Conclusion: </strong>The study concludes that cannabis shows promise as a therapeutic option for CD, demonstrating higher remission rates and potential benefits for disease management. However, it also highlights the need for larger, standardized research studies to solidify conclusions regarding efficacy, safety, and biomarker responses in CD patients.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005277","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}