Irish Journal of Medical Science最新文献

{"title":"Analyzing quality of life after low anterior resection for rectal cancer.","authors":"Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati","doi":"10.1007/s11845-024-03757-8","DOIUrl":"10.1007/s11845-024-03757-8","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer is one of the most common cancers worldwide that imposes high costs on patients and the healthcare system while also having a significant impact on the patient's quality of life (QoL).</p><p><strong>Aim: </strong>We aimed to assess the QoL of rectal cancer patients undergoing lower anterior resection (LAR) and evaluate potential confounding factors.</p><p><strong>Methods: </strong>In this cross-sectional study, we included patients undergoing neo-adjuvant chemotherapy followed by LAR, diverting ileostomy, and adjuvant chemotherapy. Six months after stoma reversal, QoL was assessed using a cancer-specific core questionnaire EORTC QLQ-C30 and also a colorectal cancer module EORTC QLQ-CR29. Linear and quantile regression models were used to examine associations of QoL and patients' demographical and clinical features.</p><p><strong>Results: </strong>The study population comprised 210 patients with an average age of 61.9 ± 11.0 (range: 37-85) and 112 (53.3%) male patients. The higher tumor stage increases the QoL of patients by reducing diarrhea, loss of appetite, defecation problems, and stool frequency. Based on the linear regression analysis, a farther distance of the anastomosis from the anal verge (AV) was correlated with lower symptom scores and higher QoL. Also, at the 75th percentile cut-off of the QLQ-CR29 scores, a higher N stage of the tumor was correlated with higher QoL based on functional subscale (coefficient = 3.032, P = 0.016).</p><p><strong>Conclusions: </strong>QoL of patients after LAR for rectal cancer is significantly associated with the distance of the anastomosis site from the AV.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2643-2652"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889197","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":"Asprosin: the potential player in combined double diabetes and hypothyroidism.","authors":"Hussein Jawad Hassan, Ekhlas Khalid Hameed, Taghreed Uloom Mohammad","doi":"10.1007/s11845-024-03758-7","DOIUrl":"10.1007/s11845-024-03758-7","url":null,"abstract":"<p><strong>Background: </strong>Double diabetes is a term used to describe people with type 1 diabetes who are overweight, show signs of insulin resistance, or have a family history of type 2 diabetes. Asprosin is a novel glucogenic adipokine; Asprosin regulates appetite and glucose metabolism. The study aimed to investigate the level of asprosin in people with double diabetes with and without hypothyroidism and its association with markers of insulin resistance.</p><p><strong>Subjects and methods: </strong>This case-control study was conducted in Iraq between March 2022 and January 2023. One hundred sixty participants were enrolled; the selected participants were classified into three age and sex-matched groups. The first group consisted of eighty healthy controls served as the control group. Of eighty participants with newly discovered DD, half (40) have DD alone, and 40 have both DD and hypothyroidism. Serum asprosin, insulin, thyroid, lipid profile, glucose, and glycated hemoglobin were measured. The estimated glucose disposal rate, triglyceride-glucose index, and HOMA-IR were calculated.</p><p><strong>Results: </strong>Participants with double diabetes had significantly (p ≤ 0.001) greater circulation asprosin levels than subjects in the control group. Comparatively, to double diabetes participants without hypothyroidism, asprosin levels were also higher in double diabetes subjects with hypothyroidism (p ≤ 0.001), and the insulin resistance markers increased in a stepwise way across the asprosin quartiles (p ≤ 0.001). Asprosin significantly correlated with insulin resistance markers, eGDR, plasma glucose, HbA1C, triglycerides, HDL-C, and LDL-C.</p><p><strong>Conclusion: </strong>Elevated asprosin levels might be a potential biomarker for the alteration in glucose metabolism, insulin resistance, and double diabetes. It may be the missing link between metabolic and endocrine disorders.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2915-2921"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633474","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":"Metformin administration during pregnancy tends to reduce the risk of gestational diabetes mellitus and improve pregnancy outcomes in previously infertile women with polycystic ovary syndrome who become pregnant.","authors":"Huamei Liu, Yajia Liu, Changhe Wei, Shoujiu Zhang, Yanjie Xu","doi":"10.1007/s11845-024-03760-z","DOIUrl":"10.1007/s11845-024-03760-z","url":null,"abstract":"<p><strong>Objective: </strong>Metformin reduces incidences of miscarriage and preterm delivery in polycystic ovary syndrome (PCOS) women, but its impact on gestational diabetes mellitus (GDM) is conflicting. Hence, this study set up selection criteria to include previously infertile women with PCOS but without pre-existing DM who became pregnant, aiming to minimize confounders and investigate the influence of metformin on GDM, miscarriage, and preterm delivery.</p><p><strong>Methods: </strong>This study included 195 previously infertile women with PCOS who became pregnant. They were divided into metformin (receiving metformin during pregnancy) and control (not receiving metformin) groups without intervention.</p><p><strong>Results: </strong>Metformin group tended to have a lower incidence of GDM versus control group (13.3% versus 23.3%, P = 0.070). A logistic regression model adjusted for all baseline characteristics (demographics, infertile duration, and diabetes mellitus-related features) showed that metformin was associated with a decreased probability of GDM (odds ratio (OR): 0.426, P = 0.037). Metformin group showed a similar incidence of miscarriage (6.7% versus 11.1%, P = 0.273), but decreased incidences of preterm delivery (not statistically significant) (6.7% versus 13.3%, P = 0.091) and miscarriage or preterm delivery (13.3% versus 24.4%, P = 0.046) versus control group. A logistic regression model adjusted for all the aforementioned features revealed that metformin was related to a lower risk of miscarriage or preterm delivery (OR: 0.417, P = 0.040). Fetal outcomes, including birth weight (P = 0.245) and the incidence of 5 min-Apgar score ≤ 7 (P = 0.702), were similar between groups.</p><p><strong>Conclusion: </strong>Metformin administration during pregnancy may reduce GDM, miscarriage, and preterm delivery risks without adverse effects on fetal outcomes in previously infertile women with PCOS.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2843-2849"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727199","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 incidence of incidental neoplasia in pathology samples of patient who underwent appendectomy due to acute appendicitis. A single center experience: 6446 cases.","authors":"Nurettin Sahin, Ferman Tevfik Ozyalvac, Turgut Donmez, Ahmet Surek, Emine Ayca Sahin, Goker Calis, Sezer Bulut, Husnu Aydin, Hamit Ahmet Kabuli, Alpen Yahya Gumusoglu","doi":"10.1007/s11845-024-03793-4","DOIUrl":"10.1007/s11845-024-03793-4","url":null,"abstract":"<p><strong>Purpose: </strong>Appendectomy is the standard treatment of acute appendicitis. However, recent advancements have introduced medical treatment as a potential alternative. Within this context, it's important to recognize the rare occurrence of appendiceal tumors, often incidentally discovered during histopathological examination following appendectomy. Consequently, there's a concern about the possibility of overlooking appendiceal neoplasms, particularly in cases where conservative treatment for acute appendicitis is considered.</p><p><strong>Methods: </strong>The files of patients who underwent surgery for acute appendicitis between January 2015 and December 2023 and were diagnosed with neoplasia in their pathology reports were retrospectively registered. Demographic characteristics of the patients, laboratory and imaging features, details of the surgery performed, preoperative and intraoperative suspicion of neoplasm and data from pathology reports were collected and analyzed.</p><p><strong>Results: </strong>A total of 6446 patients were operated for acute appendicitis. Neoplasia was detected in the histopathological examination of 93 patients (1.44%). Acute appendicitis was diagnosed in 51.6% of the patients by computed tomography. Neoplasm suspicion was present in 9.7% of patients in preoperative imaging methods and in 6.5% of patients intraoperatively. Only appendectomy was performed in 94.5% of patients. The most common appendiceal neoplasm is neuroendocrine tumors (40.9%), followed by appendiceal mucinous neoplasm (29%), sessile serrated adenoma (15%), and adenocarcinoma (6.5%).</p><p><strong>Conclusion: </strong>Although appendiceal neoplasms are relatively rare in proportion, they represent a significant numerical value due to the density of cases. Therefore, this information should be taken into consideration when evaluating treatment options for acute appendicitis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2669-2679"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125710","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":"Correlation between clinical and MRI findings in disc herniation in the lumbosacral region.","authors":"Mustafa Saad Ghanim, Mohammed Shihab Al-Edanni, Laith Thamer Al-Ameri","doi":"10.1007/s11845-024-03788-1","DOIUrl":"10.1007/s11845-024-03788-1","url":null,"abstract":"<p><strong>Aim of the study: </strong>To compare clinical findings with MRI findings and evaluate the role of physical examination in the diagnosis, localization of the level, site, size, and type of lumbosacral disc herniation.</p><p><strong>Materials and methods: </strong>A prospective study of 104 patients with low back pain and/or sciatica was conducted et al.-Kindy Teaching Hospital between January to December 2022. All Participants were evaluated via history, clinical examination, and MRI. One hundred patients had a disc herniation in the lumbosacral region, which was confirmed by MRI assessment after clinical presentation and physical examination. The data were collected and analyzed by the chi-square test.</p><p><strong>Results: </strong>Most of the patients (84%) experienced pain in the lower back that radiated to the lower limb or limbs, and nearly half of the patients experienced paresthesia (48%). Sixty-six percent of the patients had a scoliotic list; limitation of lumbar spine movements was common in 96%, and a decrease in the straight leg raising test (SLR) was detected in 98%. Cross SLR \"Well test\" was positive in 64% of patients. The femoral nerve stretch test was positive in 40% of patients. Sixty-four percent were presented with neurological deficits, 42% with affected L5 nerve roots, 22% with affected S1 nerve roots, and no patients with L4 affected. Twenty-two percent showed a positive SLR test with an angle between 41 and 70°.</p><p><strong>Conclusion: </strong>Proper correlation between clinical and MRI will help determine the lesion's level, horizontal location, herniation type, and herniated disc size in the lumbosacral region and achieve a more accurate diagnosis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2995-3000"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287369","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":"D-dimer/high sensitive troponin I ratio is useful in predicting in-hospital mortality in pulmonary embolism patients.","authors":"Ahmet Burak Urfalioglu, Ertugrul Altug, Hayri Cinar, Erdem Aksay, Onder Yesiloglu, Adem Cakir, Mustafa Avsar, Ozlem Ercen Diken, Ramazan Guven, Akkan Avci","doi":"10.1007/s11845-024-03766-7","DOIUrl":"10.1007/s11845-024-03766-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism requires careful differential diagnosis as it is associated with a wide range of symptoms that may suggest different diseases such as chest pain, shortness of breath and syncope. Since the disease can be fatal, especially in cases where right ventricular failure and hemodynamic instability develop, prognostic markers are great importance in terms of monitoring the patient during the treatment process.</p><p><strong>Aim: </strong>We aimed in our study to compare the relationship between the ratio of D-dimer and High Sensitive Troponin T (HsTnT) values ​​with short-term mortality and to compare this relationship with Pulmonary Embolism Severity Index (PESI) scoring.</p><p><strong>Method: </strong>Our study was conducted with patients who applied to the emergency department of our hospital between 01/01/2022 and 01/01/2023 and were definitively diagnosed with Pulmonary thromboembolism after their evaluation.</p><p><strong>Findings: </strong>The success of D-dimer/HsTroponin, D-dimer/CK-MB and troponin/D-dimer indices calculated from the laboratory test results of the cases in predicting mortality was examined, and a comparison was made with the success of the PESI score in predicting mortality. Among these indices, D-dimer/CK-MB was found to be the most successful index in predicting 7-day mortality (AUC: 0.734; 95% CI: 0.653-0.815; p < 0.001). Additionally, the D-dimer/HsTroponin ratio was found to be statistically significant as a successful index in predicting 7-day mortality (AUC: 0.697; 95% CI: 0.621-0.774; p < 0.001).</p><p><strong>Conclusion: </strong>FD-dimer/HsTroponin ratio, which is a powerful, fast, low-cost, easy and simple test, can be used especially in emergency services instead of the PESI score as a mortality marker in pulmonary embolism, which has a high mortality rate.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2695-2703"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucometrics utilisation in an urban teaching hospital in ireland: current practice and future aims.","authors":"Joseph McGauran, Arianna Dart, Phyllis Reilly, Matthew Widdowson, Gerard Boran","doi":"10.1007/s11845-024-03768-5","DOIUrl":"10.1007/s11845-024-03768-5","url":null,"abstract":"<p><strong>Background: </strong>Dysglycaemia in hospitalised patients is associated with poorer clinical outcomes, including cardiovascular events, longer hospital stays, and increased risk of mortality. Therefore, glucose monitoring is necessary to achieve best outcomes.</p><p><strong>Aims: </strong>This audit assesses use of point-of-care (POC) blood glucose (BG) testing in Tallaght University Hospital (TUH) over an 8-day period. It evaluates compliance with international and TUH glucose monitoring protocols and determines frequency of diabetes team consultations for inpatient adults.</p><p><strong>Methods: </strong>Data from an 8-day period (12/03/2023-19/03/2023) were extracted from the TUH COBAS-IT system and analysed. Invalid tests were excluded. Hyperglycaemia was defined as ≥ 10 mmol/L and hypoglycaemia as ≤ 3.9 mmol/L. Persistent hyperglycaemia was defined as two BG results of ≥ 10 mmol/L. A chart review was conducted on adult patients with persistent hyperglycaemia to assess for HbA1C results, diabetes diagnosis, and diabetes consult.</p><p><strong>Results: </strong>3,530 valid tests were included and analysed. 674 individual patients had tests done. 1,165 tests (33.00%) were hyperglycaemic and 75 (2.12%) were hypoglycaemic. 68.25% of adults with persistent hyperglycaemia had an HbA1C test performed or documented within three months. 42.71% of inpatient adults with persistent hyperglycaemia and a known diabetes diagnosis received a consult from the diabetes team.</p><p><strong>Conclusion: </strong>Increased adherence to hospital protocols for testing HbA1C in adults with persistent hyperglycaemia could improve treatment and clinical outcomes. Increased diabetes team consultation could facilitate appropriate treatment and improve patient outcomes in persistently hyperglycaemic adult patient populations.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2773-2779"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided growth surgery for angular deformity of the knee: one centres experience.","authors":"Dave M Moore, Henry Turner, Oliver Boughton, Maria Noonan, Jacques Noel, Pat Kiely, Pat O'Toole, Paula M Kelly, David P Moore","doi":"10.1007/s11845-024-03794-3","DOIUrl":"10.1007/s11845-024-03794-3","url":null,"abstract":"<p><strong>Background: </strong>Angular deformity in the lower extremity can result in pain, gait disturbance, cosmetic deformity and joint degeneration. Up until the introduction of guided growth, which has since become the widely accepted treatment for frontal plane angular angular deformity around the knee in skeletally immature patients, treatment consisted of staples, corrective osteotomy or an angular epiphysiodesis. Guided growth modulation uses the tension band principle with the goal of treatment being to normalise the lower limb mechanical axis resulting in lower morbidity than previous treatments. In order to assess the success of this procedure we reviewed our results in an attempt to identify patients who may not benefit from this elegant procedure.</p><p><strong>Methods: </strong>We performed a retrospective review of prospectively collected surgical records and diagnostic imaging in our paediatric tertiary national referral centre to identify all patients who had guided growth surgery for coronal plane angular deformity of the knee from 2007 to 2023. We noted the patient demographics, diagnosis, peri-operative experience and outcome. All patients were followed until skeletal maturity, until their hardware was removed or at least 2 years.</p><p><strong>Results: </strong>Two hundred thirty-six patients were assessed for eligibility. Of the 282 treated knees which met the criteria for final assessment 55 (19.5%) were unsuccessful. Complications were few but included infection and metal-work prominence. Procedures that were less likely to be successfully included growth disturbances following trauma (18.8% failure) or infection (40%), tumour (66.6%), mucopolysaccharidoses type I (15.7%), spondyloepiphyseal dysplasia (25%) or Blount's disease (60%). Idiopathic angular deformity showed an 89.5% success rate with guided growth.</p><p><strong>Conclusion: </strong>In our hands, guided growth had an 80.5% success rate when all diagnoses were considered. We continue to advocate the use of guided growth as a successful treatment option for skeletally immature patients with limb deformity however caution should be employed when considering its use in certain patient groups.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2825-2833"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craic, Ceoil agus COVID-19: the impact of 'Fleadh Cheoil na hÉireann' on presentations to the local emergency department.","authors":"Freya Guinness, Aoife Corcoran, Michael J O'Grady, Jennifer Finnegan","doi":"10.1007/s11845-024-03786-3","DOIUrl":"10.1007/s11845-024-03786-3","url":null,"abstract":"<p><strong>Aims: </strong>Fleadh Cheoil Na hÉireann, the world's largest Irish music festival, was held in Mullingar in August 2023, gathering a crowd of nearly 600,000 people. Our aim was to assess the impact on presentations to the local emergency department (ED).</p><p><strong>Methods: </strong>We performed a retrospective case analysis on all presentations to the ED at Regional Hospital Mullingar (RHM) from 23/7/2023 to 02/09/2023. We also collected data on COVID-19 swab results processed in our laboratory.</p><p><strong>Results: </strong>There was a 10% increase in ED attendances during the 2 weeks of the Fleadh. There was a statistically significant increase in COVID-19 presentations when compared to national positivity rates.</p><p><strong>Discussion/conclusion: </strong>Our study shows that the Fleadh led to an increase in all-cause ED visits as well as an increase in COVID-19 cases. Our study plays an important role in informing health service preparation for future host towns of the Fleadh.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3025-3027"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107509","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":"Chaperone in breast examination: a comprehensive systematic review of patient and clinician perspectives, and documentation.","authors":"Kai Qi Ou, Zhen Ning Wong, Zhen Yu Wong","doi":"10.1007/s11845-024-03803-5","DOIUrl":"10.1007/s11845-024-03803-5","url":null,"abstract":"<p><strong>Background: </strong>The General Medical Council (GMC) has made it mandatory to have a chaperone present during intimate examinations, including breast exams, highlighting the importance of medicolegal protection for both patients and clinicians.</p><p><strong>Aims: </strong>The use of chaperones during breast examinations is logical, especially in an increasingly litigious society. This review aims to summarize current information regarding patients' and clinicians' perspectives on chaperone use in breast examination.</p><p><strong>Methods: </strong>A PRISMA-compliant search was conducted in electronic databases from inception until April 2023 for qualitative literature on patients' and clinicians' perspectives on chaperone use in breast examination. The inclusion criteria focused on studies related to breast examinations, excluding other intimate examinations. An inductive thematic analysis was performed in three domains: physician-associated factors, patient-associated factors, and chaperone documentation.</p><p><strong>Results: </strong>Ten studies were included after screening 939 articles. For breast examination, the presence of male and older surgeons, nurse availability, rural settings, and patients' psychiatric comorbidities increased the likelihood of chaperone use during consultations. Medico-legal concerns were prominent for male physicians, while female physicians highlighted the need for technical support. Logistical issues were a common hindrance. The gender of physicians was important for patients, but there was conflicting evidence regarding patient preferences for chaperones and their purpose. Poor documentation was generally observed despite quality improvement projects.</p><p><strong>Conclusion: </strong>This study emphasizes the vital role of chaperones in clinical practice, urging a precise definition and targeted resolution for implementation challenges. Patient preferences highlight the need for a personalized approach, and increased awareness among healthcare professionals is essential.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2955-2963"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287367","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}