Irish medical journal最新文献

GLP-1 Receptor Agonists in Adolescents with Severe Obesity. GLP-1受体激动剂在青少年严重肥胖中的应用

Irish medical journal Pub Date : 2026-10-22

D AlYaqout, S Murphy, A Twohig, O Walsh, E Barrett

引用次数: 0

A Cluster of Anencephaly Cases: The Potential Preventative Role of Folic Acid Fortification. 一组无脑畸形病例：叶酸强化的潜在预防作用。

Irish medical journal Pub Date : 2026-10-22

J Stokes, E Loughman, E Dunn

引用次数: 0

Timely Reperfusion in STEMI: A Closed-Loop Audit of Guideline Compliance and Practice Improvements. STEMI患者及时再灌注：指南依从性和实践改进的闭环审计。

Irish medical journal Pub Date : 2026-10-22

C Murray, J Carey, R Karlsson, I Pearson

{"title":"Timely Reperfusion in STEMI: A Closed-Loop Audit of Guideline Compliance and Practice Improvements.","authors":"C Murray, J Carey, R Karlsson, I Pearson","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Timely reperfusion is vital in STEMI care to reduce mortality. An initial audit showed patients transferred from emergency departments outside Dublin often exceeded the 120-minute reperfusion target. In response, Dublin Mid Leinster protocols were updated to recommend pre-transfer thrombolysis. This study evaluates the impact of these changes on reperfusion times and outcomes.Methods: This observational study included STEMI patients admitted to St. James's Hospital from 2021-2023, compared to a prior cohort (2017-2020). The primary outcome was time from first ECG to reperfusion. Secondary outcomes included thrombolysis rates, success (TIMI 2/3 flow on angiography) and safety.Results: Among 1,301 patients, the median ECG-to-reperfusion time among patients transferred from outside Dublin fell from 124 minutes (IQR 96-166) to 113 minutes (IQR 78-151) (p<0.0001), while the proportion achieving reperfusion within 120 minutes increased from 235/507 (46.4%) to 308/530 (58.1%). Overall thrombolysis use increased from 27/1161 (2.3%) to 131/1301 (10.1%). Among thrombolysed patients, 85/131 (64.9%) achieved successful reperfusion and severe bleeding occurred in 2/131 (1.5%). Mapping demonstrated markedly lower rates of timely reperfusion at the periphery of the DML region.Discussion: A regional protocol promoting thrombolysis substantially increased thrombolysis utilisation and improved overall timely reperfusion among STEMI patients transferred from outside Dublin. Persistent geographical disparities support further optimisation of regional pathways and consideration of prehospital thrombolysis strategies.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"170"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perspectives on current provision of Acute Diabetic Foot Care. 目前提供急性糖尿病足护理的观点。

Irish medical journal Pub Date : 2026-10-22

M P Foley, E Kheirelseid

{"title":"Perspectives on current provision of Acute Diabetic Foot Care.","authors":"M P Foley, E Kheirelseid","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Up to 34% of diabetic patients will develop diabetic foot ulcers (DFUs) over their lifetime, with significant associated morbidity, mortality, and healthcare costs. Timely access to a multidisciplinary foot team (MDFT) can reduce DFU complications and represents the gold standard of management. Despite this, MDFT in Ireland is perceived to be ad hoc. This short report presents feedback from Irish healthcare professionals working on the frontline of diabetic foot disease.Methods: An opportunistic electronic mixed-method surveys was sent to all attendees of the Beaumont Multidisciplinary Diabetic Foot Care Symposium, a cross-speciality meeting of stakeholders in diabetic foot care across hospital and community settings in Ireland. A series of categorial and Likert scale questions were designed to gather current perspectives on service design and delivery. A thematic analysis was performed on free-text responses.Results: The response rate was 84/160 (52%), including 35 podiatrists (42%), 30 doctors (36%), 14 nurses (17%) and 3 orthotists (3.5%). Based on meeting content, 79/84 (94%) of responders reported they found the meeting \"relevant or very relevant\" to their current practice and 60/84 (71%) reported they were \"likely or very likely\" to change their practice. 73/77 (95%) of responders were in favour of a designated \"Diabetic Foot Coordinator\" to bridge community and hospital care. A thematic analysis of free-text \"key take-aways\" identified the importance of a formalised multidisciplinary DFU service with \"buy-in\" from all specialties as the most common response (58 [69%]).Discussion: Regular multidisciplinary meetings can showcase gold-standard care, update on current developments towards MDFT in Ireland and facilitate networking between specialties. However, institutional support, ring-fenced funding and realistic key performance indicators are needed to advance Irish diabetic foot care in line with international best practice.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"172"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Academic Research Careers. 临床学术研究职业。

Irish medical journal Pub Date : 2026-10-22

J F A Murphy

引用次数: 0

De-implementation of Low Value Care and the role of behavioural science in Healthcare Quality Improvement. 低价值护理的去实施和行为科学在医疗保健质量改进中的作用。

Irish medical journal Pub Date : 2026-10-22

J Condren, A Parveen, L Melody

引用次数: 0

Pulmonary embolism mimicking myocardial ischemia in an Emergency Department. 急诊科模拟心肌缺血的肺栓塞

Irish medical journal Pub Date : 2026-10-22

A Nawaz, I Ahmed, A Butt

引用次数: 0

Herpes Simplex Virus Perinatal Management. 单纯疱疹病毒围产期管理。

Irish medical journal Pub Date : 2026-10-22

R Carey, N McCallion, M Eogan, J S Lambert, W Ferguson

{"title":"Herpes Simplex Virus Perinatal Management.","authors":"R Carey, N McCallion, M Eogan, J S Lambert, W Ferguson","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Herpes Simplex Virus (HSV) is a double stranded deoxyribonucleic acid (DNA) virus with 2 serotypes, HSV-1 and HSV-2. Neonatal HSV infection is uncommon due to evidence-based interventions for pregnancy, delivery and the newborn. The study assessed whether pregnant women with a history of genital HSV and their infants were managed according to best practice recommendations.Methods: A retrospective analysis of pregnancies between January 2018 and December 2021. Included were women with documented HSV - either diagnosed, treated, or with positive laboratory testing.Results: 234 women with 261 pregnancies were identified. Mean maternal age was 32 (SD =/- 5.2). 110 (42%) pregnancies had visible lesions. 2 (0.07%) cases of primary HSV occurred within 6 weeks of delivery. 11 (4.2%) had lesions at labour onset - all were recurrences. Prophylaxis was prescribed in 178 (68%) pregnancies. 14 (5%) infants required evaluation, with only one yielding a positive swab requiring full acyclovir treatment.Discussion: Genital HSV prevalence in this population was 0.07% (2 cases), with incidence of 0.003% (1 case) of infant requiring treatment throughout this timeframe. Primary infection within 6 weeks of delivery was rare, with no cases at labour onset. Recurrent lesions were reported in under 50% (110 pregnancies). Requirement for infant evaluation was low (5%, 14 infants).","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"171"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Infectious Needs of Adults Displaced from Ukraine. 乌克兰流离失所成年人的临床感染需求。

Irish medical journal Pub Date : 2026-10-22

S Quirke, L Duffy, N Boyle, M Scarry, M Bohan Keane, K McDonough, H Tuite, D Gallagher, G Moloney, J Lee, C Fleming

{"title":"Clinical Infectious Needs of Adults Displaced from Ukraine.","authors":"S Quirke, L Duffy, N Boyle, M Scarry, M Bohan Keane, K McDonough, H Tuite, D Gallagher, G Moloney, J Lee, C Fleming","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Since February 2022, Ireland has facilitated the resettlement of 119'043 Ukrainians. Our objective was to evaluate case complexity, barriers to access and impact on service.Methods: A retrospective chart review using the electronic patient record, data was compiled and results collated.Results: 123 people displaced from Ukraine newly attended between February 2022-April 2024, 63/123 (51.2%) females. 76 (61.8%) had HIV (PLWH); 68 (89.5%) known diagnoses; 39 (57.3%) were virally suppressed on ART, 27 (40%) were viraemic. Seven (5.7%) newly diagnosed; 4 (57%) with advanced disease (mean CD4 285 IU/mL [28 - 753]). Thirty-two (42%) co-infected with HCV, 4 (5.3%) with HBV. 37 (30%) had HCV mono-infection, 9 (7.3%) had HBV mono-infection. There were 4 (3.25%) cases of active TB; three of MDR pulmonary disease and one extrapulmonary case. Four, 10.5% of women LWH have had pregnancies. Average distance travelled to clinic is 103.9KM; 50.4% (62/123) could access public transport. 115 (93.5%) required an interpreter. 26 (21%) required admission; average length of stay 22.9 days (597 bed days).Discussion: High background rates of infectious diseases Ukraine necessitated specialist healthcare along with intensified surveillance. We identified significant case complexity and high ID service needs.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"174"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Unexpected Conception: Spontaneous Pregnancy Following Bone Marrow Transplantation. 意外受孕：骨髓移植后自然妊娠。

Irish medical journal Pub Date : 2026-10-22

M Mumtaz, G Ryan

引用次数: 0