Irish medical journal最新文献_第2页

Early versus late duodenal atresia repair in preterm and low birth weight neonates. 早期与晚期十二指肠闭锁修复在早产儿和低出生体重新生儿。

Irish medical journal Pub Date : 2026-10-22

M A A Ali, T Boam, S Paran

{"title":"Early versus late duodenal atresia repair in preterm and low birth weight neonates.","authors":"M A A Ali, T Boam, S Paran","doi":"","DOIUrl":"","url":null,"abstract":"Aims: Duodenal atresia (DA) is a common cause of neonatal intestinal obstruction requiring surgical correction. The timing of repair in very low birth weight (VLBW, <1.5 kg) and extremely preterm (<32 weeks gestation) neonates remains debated. Early repair may reduce total parenteral nutrition (TPN)-associated morbidity, whereas delayed repair may mitigate anaesthetic and technical risks in fragile neonates.Methods: A retrospective 20-year review (2004-2024) was conducted at a tertiary paediatric surgical centre. Infants <1.5 kg and/or <32 weeks were classified as early repair (≤14 days) or delayed repair (>14 days). Outcomes included postoperative complications, time to full enteral feeding, hospital stay, and mortality.Results: Sixteen infants met inclusion criteria. Of these, 7 (43.8%) underwent early repair and 9 (56.2%) underwent delayed repair. There were no significant differences in comorbidities or overall complication rates between groups. Time to full feeds was shorter in the early repair group (median 11 vs 40 days, p = 0.013). No surgery-related deaths occurred (0 [0%] in both groups).Discussion: Early repair of DA in stable preterm or VLBW infants is feasible and safe when undertaken by experienced teams. Surgical timing should be guided by physiological stability rather than arbitrary gestational or weight thresholds. Further studies are needed to refine evidence-based guidelines.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"177"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267674","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

Beyond Hereditary Haemorrhagic Telangiectasia (HHT): Capillary Malformation-Arteriovenous Syndrome (CM-AVM). 遗传性出血性毛细血管扩张（HHT）：毛细血管畸形-动静脉综合征（CM-AVM）。

Irish medical journal Pub Date : 2026-10-22

I Haydar, P Leahy, T M O'Connor

引用次数: 0

Acute Traumatic Pubic Ramus Fractures. 急性外伤性耻骨支骨折。

Irish medical journal Pub Date : 2026-10-22

L Flanagan, L Jonah, D Breslin, C Byrne, V Ramiah, E Umana

{"title":"Acute Traumatic Pubic Ramus Fractures.","authors":"L Flanagan, L Jonah, D Breslin, C Byrne, V Ramiah, E Umana","doi":"","DOIUrl":"","url":null,"abstract":"Aims: Pubic rami fractures, common in the older person from low energy trauma, significantly impact morbidity through pain, reduced mobility, and increased injury risk. Effective management in the emergency department (ED) is essential for this population, but the lack of standardised guidelines can lead to inconsistent and potentially suboptimal care. This service evaluation aimed to review current management practices for isolated pubic rami fractures in our ED, identifying areas for improvement and guiding future protocol development.Methods: We retrospectively reviewed electronic patient records. Over a twelve-month period (01/03/2023 - 29/02/2024), pelvic X-rays taken in the ED were screened for isolated pubic rami fractures, excluding duplicates and patients under 60. Cases were analysed for presentation, length of stay, management, discharge, and complications.Results: From 1,135 pelvic X-rays, 42 (3.70%) patients with isolated fractures were included; 35 (83%) were female. Most injuries 37 (88.1%) resulted from falls under 2 metres. Of the patients, 29 (69%) were admitted, 11 (26%) were discharged from the ED (2 of whom were referred to the Silver Trauma outpatient clinic), and 2 (5%) were transferred directly to a rehabilitation unit. Of those admitted, 7 were subsequently transferred to rehabilitation facilities. The median ED length of stay was 12 hours 20 minutes (IQR 10:11-17:44). 4 (13.79%) of the admitted patients died.Conclusion: Management was largely conservative, yet key outcomes including prolonged ED length of stay, high frailty burden and in-hospital mortality were identified. Standardised guidelines based on these findings could enhance care consistency and improve outcomes for older patients with pubic rami fractures.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"175"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267692","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

A Comparative Departmental Census of Intra-Cranial and Spinal Tumours. 颅内和脊柱肿瘤的比较部门普查。

Irish medical journal Pub Date : 2026-10-22

F J O'Higgins, M A Farrell

{"title":"A Comparative Departmental Census of Intra-Cranial and Spinal Tumours.","authors":"F J O'Higgins, M A Farrell","doi":"","DOIUrl":"","url":null,"abstract":"Aims: Concerns have been raised that the incidence of brain and spinal tumours in adults and children is increasing, potentially having implications for support services in immediate and long-term. We compared the incidence of brain and spinal tumours diagnosed in 2019 and 2024, and contrasted these findings with historical data from the same department.Methods: Neuropathology files at Beaumont Hospital for 2019 and 2024 were reviewed. Tumours with pathologically confirmed diagnoses were included and classified using the International Classification of Diseases. Information regarding topography, genetic data, and patient age was harvested. Comparative analyses were performed using Fisher's exact test, and paired t-tests.Results: No significant differences were identified between 2019 and 2024 in tumour frequency, morphology, mean age, or incidence of childhood tumours. However, an increase from an average of 123 patients between 1969 and 1983 to an average of 750 patients across 2019 and 2024 was noted, reflecting a 510% increase.Conclusion: Over the period between 2019 and 2024, no significant increase in brain or spinal tumours was observed, suggesting no immediate rise in demand for support services based on case numbers alone. The marked increase relative to historical likely reflects improved access to neurological care, advanced neuroimaging, and evolving clinical management strategies rather than a true rise in tumour incidence.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"176"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267667","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

Anaesthetic Management of a Child with Chromosome 7q32.1 Microdeletion Undergoing Ligation of Patent Processus Vaginalis. 1例染色体7q32.1微缺失患儿行阴道未闭结扎术的麻醉处理。

Irish medical journal Pub Date : 2026-10-22

S Lal, E Khan, M Rasheed, M O'Shea

{"title":"Anaesthetic Management of a Child with Chromosome 7q32.1 Microdeletion Undergoing Ligation of Patent Processus Vaginalis.","authors":"S Lal, E Khan, M Rasheed, M O'Shea","doi":"","DOIUrl":"","url":null,"abstract":"Presentation: A six-year-old boy with chromosome 7q32.1 microdeletion, autism spectrum disorder, attention deficit hyperactivity disorder, hypotonia and asthma presented for elective ligation of a patent processus vaginalis under general anaesthesia.Diagnosis: Chromosome 7q32.1 microdeletion is a rare genetic disorder with developmental, behavioural and neuromuscular features. Coexisting reactive airway disease and autism spectrum disorder heighten the risk of perioperative respiratory adverse events (PRAEs) and complicate induction and emergence.Treatment: A perioperative strategy minimising airway stimulation and preserving spontaneous ventilation was employed. Anaesthesia was induced with sevoflurane in oxygen; a laryngeal mask airway (LMA) was used instead of endotracheal intubation, and neuromuscular blockade was avoided. The perioperative course was uneventful, with no respiratory complications.Discussion: Use of a supraglottic airway with maintenance of spontaneous ventilation, and a calm behaviourally tailored approach, facilitated safe anaesthesia in this child. This case adds to the limited literature on the anaesthetic implications of chromosome 7q32.1 microdeletion.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"182"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267505","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

Using Visual Aids to Improve Communication in Oncology Consultations. 使用视觉辅助工具改善肿瘤会诊中的沟通。

Irish medical journal Pub Date : 2026-10-22

S Moore-Davis, M Keane, S Blazkova, S Chew

{"title":"Using Visual Aids to Improve Communication in Oncology Consultations.","authors":"S Moore-Davis, M Keane, S Blazkova, S Chew","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To evaluate the impact of visual aids on patient understanding, recall and communication during oncology consultations.Methods: This single-centre prospective observational study was conducted at Portiuncula University Hospital. Visual aids were introduced into oncology consultations from 1/7/2024. Patients receiving systemic anti-cancer therapy (SACT) at the oncology day ward between 1/9/2024 and 1/11/2024 completed anonymous questionnaires using 5-point Likert scales. Descriptive statistical analysis was performed using Microsoft Excel.Results: Of 50 questionnaires distributed, 27 were completed (54%). 8 patients (29.6%) received visual aids and 19 (70.4%) had standard consultations. Median age was 66 years (range 37-80). 18 (66.7%) were female. The most common tumour types were gastrointestinal (16 [59.3%]), breast (6 [22.2%]) and lung (2 [7.4%]). 22 patients (81.5%) attended with a companion. Cancer stage awareness was reported as early, metastatic or unsure as 5 (18.5%), 8 (29.6%), and 14 (51.9%) respectively. Correct identification of cancer stage was higher with visual aids (5 [62.5%] vs 8 [42.1%]). 7 visual aid-users (87.5%) reported improved recall of the conversation and treatment schedule. 6 visual aid-users (75.0%) reported improved communication with those not present, while 17 non-users (89.5%) reported anticipated benefit. 17 non-users (89.5%) anticipated improved recall. Overwhelm was lower with visual aid-users (3 [37.5%] vs 14 [73.7%]).Discussion: Visual aids improved patient-reported understanding, recall and communication while reducing information overload, supporting integration into routine oncology practice.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"178"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267603","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

Lung Cancer Spectrum, Molecular Alterations and PD-L1 Expression. 肺癌谱、分子改变和PD-L1表达。

Irish medical journal Pub Date : 2026-10-22

A Fatima, M Redmond

{"title":"Lung Cancer Spectrum, Molecular Alterations and PD-L1 Expression.","authors":"A Fatima, M Redmond","doi":"","DOIUrl":"","url":null,"abstract":"Aim: This audit evaluated lung cancer cases diagnosed in 2024, focusing on histological subtypes, molecular testing, and PD-L1 expression to assess diagnostic trends and biomarker testing compliance.Methods: All lung malignancy cases on core biopsy or cytology between January 1 and December 31, 2024, were included. Data were extracted from the institutional lab information system (Win-Path and Power-chart).Results: Adenocarcinoma was the most common subtype, accounting for 91 (55%) cases, followed by squamous cell carcinoma 32 (19%) cases, small cell carcinoma, 17 (10%) cases, carcinoma NOS, 24 (14%) cases, and High-grade Neuroendocrine carcinoma, 1 (1%) case. Molecular testing was performed in 83 (50%) cases. Reflex testing by pathologists was done in 76 (92%) cases and testing was done on clinician's request in 7 (8%) cases. Mutations were identified in 38 (46%) cases of them. KRAS mutations were detected in 19 (50%), EGFR in 8 (21%), BRAF in 6 (16%), MET exon 14 skipping in 2 (5%), and PIK3CA in 3 (8%). PD-L1 immunohistochemistry was performed on 110 (66%) of total cases. Among these, the tumour proportion score was <1% in 50 (45.5%) cases, 1-49% in 28 (25.5%) cases, and ≥50% in 32 (29%) cases.Discussion: Adenocarcinoma predominated, KRAS was the most common driver mutation, and PD-L1 expression influenced treatment decisions, aligning with global trends in precision oncology.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 9","pages":"173"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267686","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

Confessions of a failed quality improver. 一个失败的质量改进者的自白

Irish medical journal Pub Date : 2026-10-22

C Tufan, A Curley

引用次数: 0

Simple Site, Serious Sequelae: Septic Emboli from a Peripheral Cannula. 部位简单，严重后遗症：外周插管引起脓毒性栓塞。

Irish medical journal Pub Date : 2026-10-22

A Walker, E Keelan

引用次数: 0

Coping with an Exam Failure. 应付考试失败。

Irish medical journal Pub Date : 2026-09-28

J F A Murphy

引用次数: 0