Irish Journal of Medical Science最新文献

{"title":"Complications in interventional radiology: early detection and effective intervention strategies.","authors":"Hugo C Temperley, Annabel Hylands, Niall J O'Sullivan, Benjamin M Mac Curtain, Tatiana S Temperley, Caitlin Waters, Niall McEniff, Ian Brennan, Kevin Sheahan","doi":"10.1007/s11845-024-03845-9","DOIUrl":"10.1007/s11845-024-03845-9","url":null,"abstract":"<p><p>This narrative review provides a comprehensive overview of complications in interventional radiology (IR), focusing on their aetiology, recognition, and management. As IR procedures continue to evolve and expand, understanding potential adverse events is crucial for improving patient safety and outcomes. The review will summarise various common complications associated with IR-based procedures, including their presentation, aetiology, and management. By consolidating current knowledge on these issues, the review offers valuable insights into minimising risks and enhancing procedural success. This synthesis will aid practitioners' knowledge and ultimately try and ensure safer IR practices and aftercare of patients.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"19-29"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768865","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":"Knee pain and function in retired male intercounty GAA players: an exploratory study.","authors":"Sean Carmody, Ronan Kearney, Chantelle Doran, Gurneet Brar, Vincent Gouttebarge","doi":"10.1007/s11845-024-03853-9","DOIUrl":"10.1007/s11845-024-03853-9","url":null,"abstract":"<p><strong>Background: </strong>Knee injuries are common among elite intercounty Gaelic games players (collectively GAA players).</p><p><strong>Aims: </strong>The primary aim was to examine knee pain, function, and quality of life in retired elite male GAA players. Secondary objectives were to (i) report the incidence of previous knee surgery and total knee replacement, (ii) assess medication usage, and (iii) investigate any associations between a history of knee injury and/or knee surgery and knee pain, function, and quality of life among retired elite male GAA players.</p><p><strong>Methods: </strong>One hundred retired male senior intercounty GAA players were surveyed on their history of severe knee injury and previous knee surgery (68 completed survey; 47 Gaelic football, 20 hurling, 1 dual player). The Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS) and the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) were used to assess level of function and pain.</p><p><strong>Results: </strong>Forty-seven (69%) of the retired players described experiencing at least one severe knee injury during their intercounty career. Fourteen (21%) participants retired due to a significant knee injury. Mean KOOS-SP score was 75.5 (SD 17). The Global Physical Health and Global Mental Health mean scores were 44 and 51. There was a low negative correlation between KOOS-SP scores and a history of severe knee injury (r = -0.35, p = 0.001). Moderate negative correlation between Global Mental Health scores and a history of severe knee injuries (r = -0.36, p = 0.386) and a very weak negative correlation between the number of surgeries during a participant's intercounty career and Global Mental Health score (r = -0.089, p = 0.234).</p><p><strong>Discussion: </strong>Severe knee injuries and knee surgery are common among male intercounty GAA players. These injuries lead to self-reported reduced performance and retirement and are potentially associated with worse health-related outcomes post-intercounty career. Further well-designed studies, including among retired women GAA players, are required to assess the relationship between knee injuries and long-term athlete outcomes. Improved injury prevention efforts, enhanced rehabilitation of knee injuries, and post-retirement care may mitigate the adverse effects associated with severe knee injuries among male GAA players.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"147-155"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894669","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":"Interpretation of acid-base metabolism on arterial blood gas samples via machine learning algorithms.","authors":"Habib Ozdemir, Muhammed Ikbal Sasmaz, Ramazan Guven, Akkan Avci","doi":"10.1007/s11845-024-03767-6","DOIUrl":"10.1007/s11845-024-03767-6","url":null,"abstract":"<p><strong>Background: </strong>Arterial blood gas evaluation is crucial for critically ill patients, as it provides essential information about acid-base metabolism and respiratory balance, but evaluation can be complex and time-consuming. Artificial intelligence can perform tasks that require human intelligence, and it is revolutionizing healthcare through technological advancements.</p><p><strong>Aim: </strong>This study aims to assess arterial blood gas evaluation using artificial intelligence algorithms.</p><p><strong>Methods: </strong>The study included 21.541 retrospective arterial blood gas samples, categorized into 15 different classes by experts for evaluating acid-base metabolism status. Six machine learning algorithms were utilized; accuracy, balanced accuracy, sensitivity, specificity, precision, and F1 values of the models were determined; and ROC curves were drawn to assess areas under the curve for each class. Evaluation of which sample was estimated in which class was conducted using the confusion matrices of the models.</p><p><strong>Results: </strong>The bagging classifier (BC) model achieved the highest balanced accuracy with 99.24%, whereas the XGBoost model reached the highest accuracy with 99.66%. The BC model shows 100% sensitivity for nine classes and 100% specificity for 10 classes, and the model correctly predicted 6438 of 6463 test samples and achieved an accuracy of 99.61%, with an area under the curve > 0.9 in all classes on a class basis.</p><p><strong>Conclusion: </strong>The machine learning models developed exhibited remarkable accuracy, sensitivity, and specificity in predicting the status of acid-base metabolism. However, implementing these models can aid clinicians, freeing up their time for more intricate tasks.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"277-287"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859723","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":"Prognostic role of serum copeptin levels in adults with graded traumatic brain injury.","authors":"Olgun Demir, Adem Az, Sumeyye Cakmak, Ozgur Sogut","doi":"10.1007/s11845-024-03818-y","DOIUrl":"10.1007/s11845-024-03818-y","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of copeptin in patients with severe head injuries remains unclear.</p><p><strong>Aims: </strong>To investigate the role of serum copeptin levels in detecting intracranial injury, assessing trauma severity, and predicting outcomes in adults with graded traumatic brain injury (TBI).</p><p><strong>Methods: </strong>This prospective non-randomized controlled study enrolled 78 adults with isolated head trauma, as well as 59 age- and sex-matched controls. Baseline serum copeptin levels were measured in both groups. Patients were categorized by head trauma severity using Glasgow Coma Scale (GCS) scores (severe GCS 3-8, moderate GCS 9-13, mild GCS 14-15) and by the presence of intracerebral or extracerebral lesions on cranial computed tomography (CCT). Patients were also classified as survivors or non-survivors. Serum copeptin levels were compared among these.</p><p><strong>Results: </strong>Mean serum copeptin levels were significantly higher in patients with graded TBI than in controls. Furthermore, patients with severe and moderate head trauma had significantly higher copeptin levels compared with patients exhibiting mild trauma. An optimal copeptin cutoff value of > 1147 pg/mL was identified, indicating the presence of moderate or severe trauma in TBI patients. Patients with abnormal CCT findings had significantly higher mean serum copeptin levels compared with patients exhibiting normal CCT scans. Non-survivors also showed significantly higher serum copeptin levels compared with survivors.</p><p><strong>Conclusion: </strong>Serum copeptin levels rise after graded TBI and can distinguish between patients with and without intracranial or extracranial lesions evident on CCT. Copeptin levels also aid in identifying moderate or severe TBI and in predicting 28-day mortality.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"353-360"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400272","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":"Patient's barrier to initiate insulin therapy for type 2 D.M.","authors":"Ruqaya Adnan Salih, Anmar B Al-Dewachi, Zaid Muayad Yassen, Saad Abdul-Razzak Ibrahim","doi":"10.1007/s11845-024-03826-y","DOIUrl":"10.1007/s11845-024-03826-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes Mellitus is a health challenging of the century, more than 300 million people lives with diabetes, and it is one of the biggest global health concerns, awing to its complications. Good glycemic control is the cornerstone to decrease risk of type 2 diabetes complications. Even though, many people still have poor glycemic control which can be partly attributed to late insulin initiation, that can be challenging and forced by numbers of barriers. Identification and analysis of these barriers is crucial to find out effective way to overcome them.</p><p><strong>Aim: </strong>To assess patient's barriers to initiate insulin therapy among diabetic patients.</p><p><strong>Method: </strong>A case series study was conducted during the period extending from July 2023 to June 2024, and a total of 360 participants with type two diabetes were included in this study from four Family Medicine Health Centers. Collected data tabulated and analyzed using Excel sheets and applying the Statistical Package for the Social Sciences (SPSS) Version 24.</p><p><strong>Results: </strong>26% of the participants were 45-55 years age group, 40% has been diagnosed with diabetes for 5-10 years, and 66% have developed diabetic complications. Fear from hypoglycemia was the comments barrier to initiate insulin therapy and is seen in 84% of the participants.</p><p><strong>Conclusion: </strong>Many barriers have been identified to influence the initiation of insulin therapy, fear from hypoglycemia was found to be the most influencing barrier. Increasing patient's awareness of symptoms of hypoglycemia, and always take their meal after insulin injection can help to overcome hypoglycemia.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"161-166"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465542","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":"Children's rights and wrongs: respect, equality and dignity.","authors":"Fionn Lynch, Aoife Twohig, John Lyne, Eleanor Molloy, Fiona McNicholas","doi":"10.1007/s11845-024-03830-2","DOIUrl":"10.1007/s11845-024-03830-2","url":null,"abstract":"<p><p>Despite the almost global ratification of the United Nations Convention on the Rights of the Child, Ireland and the international community fall short on the full realisation of these standards. Among the many pervasive and enduring failures are the persistence of child poverty, inadequate access to healthcare services, inequality of access to education, and continued discrimination based on race, ethnicity, gender, and disability. A highly relevant concern in today's world is the increasing exposure of children to armed conflict and our inability to effect change. This paper reviews the progress made in upholding children's rights and areas of ongoing concern.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"247-251"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686967","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 history and development of Irish orthopaedics: a descriptive review.","authors":"Martin S Davey, Paddy Kenny","doi":"10.1007/s11845-024-03859-3","DOIUrl":"10.1007/s11845-024-03859-3","url":null,"abstract":"<p><p>From'grave diggers' to a 'Trauma System for Ireland', the history of Irish orthopaedics is a unique and fascinating story. This story has developed over decades and centuries, with many late and great surgeons and trainers playing major roles in developing our orthopaedic services nationally, as we know them today. The authors acknowledge that it would be wrong to think that a 1500-word review could provide an in-depth, yet comprehensive, discussion of all topics past and present of celebration, deliberation and further debate, related to orthopaedic surgery in Ireland. However, this article sought to provide a brief account of some of the key, landmark moments of orthopaedics over the last 3 centuries in Ireland, many of which are responsible for shaping the landscape of the outpatient rooms, orthopaedic wards and theatre suites, in which we provide high standard orthopaedic care to the people of our island today.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"157-160"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894697","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":"Ultrasound-guided vs. laparoscopic-guided transversus abdominis plane block for postoperative pain following laparoscopic cholecystectomy: a systematic review and meta-analysis.","authors":"Abdullah Yousef Aldalati, Ayham Mohammad Hussein, Dang Nguyen, Cameron John Sabet, Bara M Hammadeh, Wesam I Abo-Elenien, Zaid Kamal, Ramez M Odat","doi":"10.1007/s11845-024-03861-9","DOIUrl":"10.1007/s11845-024-03861-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain following laparoscopic cholecystectomy (LC) is a major concern. The transversus abdominis plane block (TAPB) is one of the anesthetic techniques that has been developed to address this issue. The TAPB can be delivered by the guidance of either ultrasound (UTAPB) or laparoscopic (LTAPB). Our aim is to compare the efficacy of these guidance methods in reducing postoperative pain after LC.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Scopus, Cochrane, and Web of Science databases from inception to June 2024 for randomized studies comparing the delivery of TAPB under ultrasound and laparoscopic guidance. Data analysis was conducted using Review Manager V5.4.</p><p><strong>Results: </strong>Five randomized studies were included in our study. UTAPB was significantly more effective in reducing postoperative pain after 6 h compared to LTAPB (MD =  - 0.38, 95% CI, - 0.67 to 0.09, p = 0.01). However, UTAPB was insignificantly more effective than LTAPB in reducing postoperative pain after 12 h (MD =  - 0.14, 95% CI, - 0.44 to 0.17, p = 0.39), 24 h (MD =  - 0.09, 95% CI, - 0.41 to 0.23, p = 0.60), and 48 h (MD =  - 0.12, 95% CI, - 0.44 to 0.19, p = 0.44). UTAPB insignificantly resulted in decreased opioid consumption (SMD: - 0.09; 95% CI: - 0.42, 0.25; p = 0.62) and less postoperative nausea and vomiting (OR = 0.73, 95% CI, 0.21 to 2.51, p = 0.62) in comparison with LTAPB.</p><p><strong>Conclusion: </strong>Ultrasound guidance of TAPB offers superior pain relief in the setting of LC, especially in the early postoperative period. Further trials are needed to prove and support the results.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"323-331"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931632","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":"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":"205-210"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861390/pdf/","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":"OA","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":"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":"195-204"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861230/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}