Irish Journal of Medical Science最新文献_第6页

The clinical significance and burden of thyroid nodules discovered incidentally. 偶然发现的甲状腺结节的临床意义和负担。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-26 DOI: 10.1007/s11845-024-03858-4

Rohil F Dureja, Caoimhe Casey, Josephine Barry, Antoinette Tuthill

{"title":"The clinical significance and burden of thyroid nodules discovered incidentally.","authors":"Rohil F Dureja, Caoimhe Casey, Josephine Barry, Antoinette Tuthill","doi":"10.1007/s11845-024-03858-4","DOIUrl":"https://doi.org/10.1007/s11845-024-03858-4","url":null,"abstract":"Background: The majority of thyroid nodules are benign; however current guidelines suggest that thyroid incidentalomas should be appropriately evaluated to rule out malignancy.Aims: This study aims to determine the incidence of thyroid incidentalomas and the likelihood that they harbour sinister pathology in the largest Irish cohort studied to-date.Methods: A retrospective observational chart review was conducted using data from July 2018 to December 2018 using the Radiology Database in use at Cork University Hospital. The text of 1000 imaging reports (500 carotid Doppler and 500 computed tomography thorax) was manually screened for phrases such as \"thyroid mass\" or \"thyroid nodule\".Results: On 1000 scans, 14 (1.4%) thyroid incidentalomas were discovered. The occurrence of incidentalomas by imaging was 2/500 (0.4%) for ultrasound and 12/500 (2.4%) for computed tomography. Three of these nodules (21.4%) were further evaluated with a subsequent ultrasound and due to a size of more than 1 cm underwent fine needle aspiration. Using the Thy classification, all three were given a Thy 2 (non-neoplastic) grading.Conclusion: This study found that there was no clinical benefit to reporting the presence of thyroid incidentalomas incidentally noted on radiology investigations. Although the overall percentage of thyroid incidentalomas is low, this number may be enough to cause unnecessary strain on the healthcare system and burden patients with invasive investigations in addition to causing unnecessary anxiety.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894690","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

Predictive value of NT-proBNP for major adverse cardiovascular events within a 6-month period in patients with acute coronary syndrome. NT-proBNP对急性冠脉综合征患者6个月内主要不良心血管事件的预测价值

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-23 DOI: 10.1007/s11845-024-03849-5

Ozlem Canan Ozbaltan, Sumeyye Cakmak, Ozgur Sogut, Adem Az, Hasan Ogur

{"title":"Predictive value of NT-proBNP for major adverse cardiovascular events within a 6-month period in patients with acute coronary syndrome.","authors":"Ozlem Canan Ozbaltan, Sumeyye Cakmak, Ozgur Sogut, Adem Az, Hasan Ogur","doi":"10.1007/s11845-024-03849-5","DOIUrl":"https://doi.org/10.1007/s11845-024-03849-5","url":null,"abstract":"Background: The role of NT-proBNP as a cardiac biomarker for predicting short-term major adverse cardiovascular events (MACEs) in acute coronary syndrome (ACS) remains unclear.Aims: This study investigated the utility of the NT-proBNP level for predicting MACEs within a 6-month period in patients with ACS.Methods: This prospective study included 241 consecutively enrolled adults with ACS between September 2023 and February 2024. Demographic data, clinical characteristics, GRACE score, and high-sensitivity cardiac troponin T (hs-cTnT) and NT-proBNP levels were compared between patients who were MACE-positive vs. MACE-negative within a 6-month period.Results: The overall mortality rate was 8.7%, and the incidence of MACEs was 43.2%. The mean serum levels of hs-cTnT and NT-proBNP were significantly higher in the MACE-positive than in the MACE-negative group. Age, concomitant coronary artery disease, NT-proBNP, and GRACE score were independent predictors of MACEs in patients with ACS. An NT-proBNP level of 250 pg/mL had a sensitivity of 73.1% and a specificity of 88.3% for predicting MACEs, with an area under the curve of 0.847. The estimated risk of MACEs was 70% and 90% for NT-proBNP values of 600 pg/mL and 900 pg/mL, respectively.Conclusion: The NT-proBNP level measured at ED admission was strongly associated with short-term MACEs in patients with all ACS subtypes and was an important prognostic biomarker. Therefore, combining the NT-proBNP level with the GRACE score in ACS patients may provide significant benefits in terms of predicting MACEs and obtaining a more accurate risk stratification.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876402","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

Does FDG PETCT have a predictive value for neoadjuvant chemotherapy response in nonmetastatic breast cancer? FDG PETCT对非转移性乳腺癌的新辅助化疗反应有预测价值吗？

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-18 DOI: 10.1007/s11845-024-03856-6

Ender Dogan, Safak Yildirim Disli, Esra Asik, Seyhan Karacavus, Feyyaz Ozdemir

{"title":"Does FDG PETCT have a predictive value for neoadjuvant chemotherapy response in nonmetastatic breast cancer?","authors":"Ender Dogan, Safak Yildirim Disli, Esra Asik, Seyhan Karacavus, Feyyaz Ozdemir","doi":"10.1007/s11845-024-03856-6","DOIUrl":"https://doi.org/10.1007/s11845-024-03856-6","url":null,"abstract":"Background: A pathological complete response (pCR) rate after neoadjuvant chemotherapy (NAC) is important for the prognosis of early-stage breast cancer. The prediction of an NAC response plays a key role in managing neoadjuvant treatment.Aims: The aim of this study is to investigate the predictive value of the baseline PETCT FDG (F-18 fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography) SUVmax (the maximum standardized uptake value) for pCR after NAC in early-stage breast cancer.Methods: The patients who performed PETCT before NAC were included in this retrospective study. The basal PETCT SUVmax values were divided into two categories based on the cutoff points of ≥ 8.77 or < 8.77, namely the low SUV max group and the high SUV max group. These two groups were compared according to the general characteristics. The impact of the PETCT SUVmax values on pCR was determined with logistic regression analyses.Results: One hundred forty-eight patients who performed PETCT before NAC were included in this retrospective study. Eighty-one patients were in the low SUV max group and 67 patients were in the high SUVmax group. The pCR trended toward a higher rate in the high SUVmax group than in low SUVmax group but it was not statistically significant (p = 0.052). The baseline PETCT SUVmax value was an independent predictive factor for pCR. (p = 0.025).Conclusion: PETCT SUVmax may be a factor for the predicting complete response to neoadjuvant treatment in early-stage breast cancer.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846461","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

Challenges for neurodiverse children in acute medical hospitals and opportunities for the new National Children's Hospital to be 'neurodiversity-friendly'. 急症医院神经多样性儿童面临的挑战和新国家儿童医院“神经多样性友好”的机遇。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-17 DOI: 10.1007/s11845-024-03850-y

Laura Bond, Timothy Frawley, Kieran Moore, Blánaid Gavin, Fiona McNicholas

引用次数: 0

Five-year follow-up of idiopathic granulomatous mastitis. 特发性肉芽肿性乳腺炎5年随访。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-17 DOI: 10.1007/s11845-024-03857-5

Mehmet Nur Kaya, Emre Tekgöz, Seda Çolak, Özlem Kılıç, Muhammet Çınar, Sedat Yılmaz

{"title":"Five-year follow-up of idiopathic granulomatous mastitis.","authors":"Mehmet Nur Kaya, Emre Tekgöz, Seda Çolak, Özlem Kılıç, Muhammet Çınar, Sedat Yılmaz","doi":"10.1007/s11845-024-03857-5","DOIUrl":"https://doi.org/10.1007/s11845-024-03857-5","url":null,"abstract":"Background: Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast. Although there are various treatment modalities, an ideal treatment algorithm has not been defined.Aims: We designed this study to evaluate the clinical status, duration of remission, remission rates, and treatment algorithm in patients with IGM during a 5-year follow-up period after immunosuppressive therapy.Methods: This study was planned retrospectively in the rheumatology outpatient clinic including 63 patients with biopsy-proven IGM. Demographic characteristics, clinical findings, treatment options, and drug-free remission periods after treatment were obtained from the patient's records.Results: The mean age of female patients with IGM was 36.4 ± 6.1 years. Remission was achieved in all patients receiving immunosuppressive treatment and the median remission period was 13.9 months. After 5 years of follow-up, the median remission time without medication was 46.1 months. There was a significant improvement in the laboratory parameters and clinical findings of the patients. The most preferred immunosuppressive agent in all patients was methotrexate, and the second was azathioprine.Conclusion: During the 5-year follow-up period, no recurrence after immunosuppressive therapy was detected in IGM patients. As seen in the treatment management chart, methotrexate provided remission in the majority of patients.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836672","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

Evaluation of lower urinary tract symptoms and sexual functions after holmium laser prostate enucleation. 钬激光前列腺摘除后下尿路症状及性功能的评价。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-12 DOI: 10.1007/s11845-024-03854-8

Guclu Gurlen, Mubariz Aydamirov, Ediz Vuruskan, Bugra Aksay, Kadir Karkin

{"title":"Evaluation of lower urinary tract symptoms and sexual functions after holmium laser prostate enucleation.","authors":"Guclu Gurlen, Mubariz Aydamirov, Ediz Vuruskan, Bugra Aksay, Kadir Karkin","doi":"10.1007/s11845-024-03854-8","DOIUrl":"https://doi.org/10.1007/s11845-024-03854-8","url":null,"abstract":"Background: Studies evaluating lower urinary tract symptoms (LUTS) and sexual functions after holmium laser enucleation of prostate (HoLEP) are very limited.Aims: To evaluate both the LUTS voiding and storage functions of patients after HoLEP operation and to examine its effect on postoperative sexual functions.Methods: The data of male patients who underwent HoLEP for benign prostatic hyperplasia (BPH) between May 2019 and February 2022 were evaluated. The International Prostate Symptom Index (IPSS) was used for questioning LUTS. The International Erectile Function Index-Erectile Function (IIEF-EF) section was completed to evaluate erectile functions and Male Sexual Health Questionnaire-Ejaculation function (MSHQ-EjD) was completed to evaluate ejaculation functions.Results: A total of 427 patients were included in the study. A significant improvement was found in IPSS total, storage, and voiding scores at the 3rd month follow-ups of the patients after HoLEP. While improvement was detected in the erectile functions of the patients (p < 0.001), a significant decrease was found in MSHQ-EjD scores (15.97 ± 2.26 vs. 11.02 ± 3.69; p = 0.002). More than 50% reduction in IPSS scores was found in 85.48% (365/427) of the patients. It was determined that the patients who did not benefit from the treatment had higher preoperative IPSS-storage symptoms (p = 0.001), lower IIEF-EF scores (p < 0.001), and higher PVRs (p = 0.001).Conclusions: HoLEP is an effective method that can be used safely and effectively in the treatment of LUTS due to BPH. While both storage and voiding functions of the patients improve, there is no worsening in erectile functions, but deterioration in ejaculation functions can be observed.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812493","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

Meta-analysis: the prophylactic use of tranexamic acid to reduce blood loss during caesarean delivery. 荟萃分析：预防使用氨甲环酸减少剖宫产时的出血量。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-09 DOI: 10.1007/s11845-024-03834-y

Frederick Guinness, Ciara Hanley, Aidan Spring

{"title":"Meta-analysis: the prophylactic use of tranexamic acid to reduce blood loss during caesarean delivery.","authors":"Frederick Guinness, Ciara Hanley, Aidan Spring","doi":"10.1007/s11845-024-03834-y","DOIUrl":"https://doi.org/10.1007/s11845-024-03834-y","url":null,"abstract":"Introduction: The 2022 national guideline on The Prevention and Management of Primary Postpartum Haemorrhage (PPH) recommended consideration of prophylactic tranexamic acid (TXA) for women who are at high PPH risk undergoing caesarean section (CS). This meta-analysis reviews the basis for this recommendation.Method: PubMed, OVID Medline, EMBASE, Science Citation Index, Scopus, CENTRAL, and ClinicalTrials.gov were searched (from inception to January 2024) for randomised controlled trials comparing prophylactic intravenous TXA with placebo or no treatment in women undergoing CS who received a uterotonic. Our main outcome was PPH > 1L. Secondary outcomes included estimated mean blood loss, blood transfusion, drop in haemoglobin, the need for additional uterotonics, or surgical intervention. Adverse effects of TXA were also assessed.Results: Sixty-one studies including 25,098 women were identified, and 12,446 received prophylactic TXA. Patients who received prophylactic TXA had significantly reduced likelihood of PPH > 1L (RR, 0.47; 95% CI, 0.38 to 0.59), reduced estimated mean blood loss (MD 185.86 ml, 95% CI 159.14-212.59), and reduced drop in Hb (MD 0.84g/dl, 95% CI 0.72, 0.95). There was a significant reduction in need for additional uterotonics (RR 0.47, 95% CI 0.39-0.57) or surgical intervention (RR 0.54, 95% CI 0.30-0.95).Conclusion: The reduced risk of PPH > 1L was greatest in patients at higher risk of bleeding. The greatest risk reduction was seen in smaller studies and in studies undertaken in developing economies. Prophylactic TXA administration is effective at reducing the incidence of PPH > 1L at CS. The clinical benefit of universal prophylaxis is questionable; women who are high risk of PPH are more likely to derive benefit.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800862","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

An analysis of e-scooter-related trauma in Ireland: an update. 对爱尔兰电动滑板车相关创伤的分析：最新进展。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-06 DOI: 10.1007/s11845-024-03843-x

Aoife O'Halloran, Oisin Tyrell, Pedro Correia, Ciara Fox

{"title":"An analysis of e-scooter-related trauma in Ireland: an update.","authors":"Aoife O'Halloran, Oisin Tyrell, Pedro Correia, Ciara Fox","doi":"10.1007/s11845-024-03843-x","DOIUrl":"https://doi.org/10.1007/s11845-024-03843-x","url":null,"abstract":"Aims: Electronic (E)-scooters have become increasingly common in Ireland. Our group was the first to publish an analysis of injuries related to these devices in Ireland in 2021. Since then, the use of e-scooters has increased significantly. The primary aim of this study was to re-analyse the trend in scooter-related trauma 4 years later.Methods: We conducted a retrospective analysis over the same time period as our previous study (13 months). Seventy-six patients with e-scooter-related trauma in our emergency department (ED) were identified between June 2023 and July 2024. Medical records and patient imaging were reviewed. Injury severity score (ISS) was calculated, and results were compared to our previous study.Results: There was an increase from 22 to 76 patients presenting to our ED with an e-scooter-related injury over a 13-month period. The number of patients presenting with fractures has risen from 15 to 34 (45%). Twenty-four per cent of ED attendees required hospital admission, and 13 patients underwent surgical intervention. The average ISS was 4.3, and helmet use has decreased significantly from 40% to 8%.Conclusions: E-scooters remain to be a key contributor to emergency department presentations and complex orthopaedic injuries. The majority of patients require radiological investigation and specialist follow-up, with many needing surgical fixation. The effects of such injuries can have severe long-term consequences for patients and place financial constraints on our health system. With the rollout of e-scooter rental schemes and infrequent helmet use, one can expect the resulting trauma will continue to rise.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785466","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

Nintedanib and its combination with immunosuppressives in connective tissue disease-related interstitial lung diseases. 尼达尼布及其联合免疫抑制剂治疗结缔组织病相关间质性肺疾病

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-05 DOI: 10.1007/s11845-024-03848-6

Emre Tekgoz, Seda Yurumez Colak, Ezgi Cimen Gunes, Nesrin Ocal, Muhammet Cinar, Sedat Yilmaz

{"title":"Nintedanib and its combination with immunosuppressives in connective tissue disease-related interstitial lung diseases.","authors":"Emre Tekgoz, Seda Yurumez Colak, Ezgi Cimen Gunes, Nesrin Ocal, Muhammet Cinar, Sedat Yilmaz","doi":"10.1007/s11845-024-03848-6","DOIUrl":"https://doi.org/10.1007/s11845-024-03848-6","url":null,"abstract":"Background: Nintedanib reduces the decline of pulmonary function in patients with advancing lung fibrosis.Aim: To assess the characteristics of the patients with connective tissue diseases (CTDs) related to interstitial lung disease (ILD) under nintedanib treatment.Methods: The CTD-related ILD patients under nintedanib treatment who were followed up between 2020 and 2023 were included in the study. The clinical data of the patients before and after nintedanib were evaluated retrospectively.Results: There were 36 patients (19 female) with a mean age of 65.2 ± 8.5 years who were treated with nintedanib. The median duration for nintedanib treatment was 19 months. The most common CTD was Sjogren's syndrome (36.1%), followed by systemic sclerosis (27.8%), rheumatoid arthritis (25%), undifferentiated CTD (8.3%), and inflammatory myositis (2.8%). Fifteen (41.7%) patients had impaired pulmonary function tests (FVC < 70 ml and/or DLco < 80 ml), and 23 (63.9%) patients had ≥ 20% involvement of parenchyma in high-resolution computed tomography (HRCT) before nintedanib. According to HRCT findings, 25 (69.4%) patients had the usual interstitial pneumonia pattern. All patients had 300 mg/day of nintedanib and received at least one immunosuppressive treatment during the study period. The mean %predicted value of FVC was 82.8 ± 17.6, and DLco was 65.3 ± 19.2 before nintedanib treatment. Following the 6-month follow-up, FVC showed an increase to 92.3 ± 15.8 (with an R correlation coefficient of 0.54, p = 0.025), and 22 (61.1%) patients exhibited either stabilization or regression of findings on HRCT.Conclusions: Nintedanib emerges as a promising therapeutic agent compatible with immunosuppressives for treating progressive lung fibrosis in patients with CTD-related ILD.","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785467","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

Complications in interventional radiology: early detection and effective intervention strategies. 介入放射学并发症：早期发现及有效干预策略。

IF 1.7 4区医学

Irish Journal of Medical Science Pub Date : 2024-12-04 DOI: 10.1007/s11845-024-03845-9

Hugo C Temperley, Annabel Hylands, Niall J O'Sullivan, Benjamin M Mac Curtain, Tatiana S Temperley, Caitlin Waters, Niall McEniff, Ian Brennan, Kevin Sheahan

引用次数: 0