Irish medical journal最新文献_第4页

When Lupus Hits the Spine: A Case of Extensive Transverse Myelitis. 当狼疮侵袭脊柱：一例广泛的横向脊髓炎。

Irish medical journal Pub Date : 2026-03-19

J Diogo, N Nagle, K Murray, J Devlin

{"title":"When Lupus Hits the Spine: A Case of Extensive Transverse Myelitis.","authors":"J Diogo, N Nagle, K Murray, J Devlin","doi":"","DOIUrl":"","url":null,"abstract":"Presentation: The patient presented with acute urinary retention, fever (39°C), and rapidly progressive bilateral lower limb weakness progressing to flaccid paraplegia (0/5 MRC) with a T6 sensory level.Diagnosis: MRI spine demonstrated longitudinally extensive T2-hyperintense intramedullary lesions from T6 to the conus. CSF analysis showed lymphocytic pleocytosis and elevated protein; autoimmune serology confirmed active systemic lupus erythematosus (SLE). SLE-associated longitudinally extensive transverse myelitis (LETM) was diagnosed following exclusion of other differential diagnoses.Treatment: High-dose intravenous methylprednisolone, intravenous immunoglobulin (IVIg), and rituximab were administered. Corticosteroids precipitated psychosis, managed with antipsychotics. Maintenance therapy with mycophenolate mofetil and hydroxychloroquine was continued. Despite aggressive immunotherapy, there was no neurological recovery, and the patient remained paraplegic with neurogenic bowel and bladder dysfunction.Discussion: This case underscores LETM as a rare, aggressive manifestation of SLE that can occur even in patients of European ancestry. Despite prompt multimodal immunotherapy, neurological recovery was absent, reflecting the poor prognosis of extensive cord involvement. Early recognition, exclusion of mimics, and coordinated multidisciplinary care are vital to optimise outcomes and quality of life.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 3","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498776","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

The Sentinel Flap: A Visible Canvas for Organ Transplant Care. 前哨皮瓣：器官移植护理的可见画布。

Irish medical journal Pub Date : 2026-03-19

O Quidwai, H Giele, O El Sherif, R Dolan

引用次数: 0

Omental band induced bowel ischemia following combination immunotherapy in a patient with renal cell cancer. 肾细胞癌联合免疫治疗后大网膜带性肠缺血1例。

Irish medical journal Pub Date : 2026-03-19

S Khan, U Aleem, N Peters

{"title":"Omental band induced bowel ischemia following combination immunotherapy in a patient with renal cell cancer.","authors":"S Khan, U Aleem, N Peters","doi":"","DOIUrl":"","url":null,"abstract":"Presentation: A 62-year-old female, diagnosed with intermediate IMDC risk metastatic clear cell renal cell cancer, with multifocal metastases to left pleural membrane and primary renal mass in-situ, received combination of 1st line Nivolumab/Ipilimumab therapy. She was admitted to hospital within 2 weeks of administration of 1st cycle of immunotherapy with severe abdominal pain, vomiting, and nausea. On examination, she was noted to have severe abdominal tenderness with positive guarding. Her blood levels showed increased white cell count, C-reactive protein, and high lactate levels.Diagnosis: A CT Abdomen and Pelvis and CT Mesenteric Angiogram was performed which showed evidence of mechanical small bowel obstruction. Secondary mesenteric oedema was also noted, and early ischemic changes of bowel were evident.Treatment: Emergency laparotomy was performed. Omental banding of the small bowel loop was noted. This omental banding had resulted in bowel obstruction and ischemia. She underwent surgical resection of 15cm of gangrenous small bowel with an ileostomy formation. Histological examination revealed inflammatory cells and exudate present in small bowel biopsy sample.Discussion: Small bowel obstruction because of an omental band is an extremely rare occurrence. It is thus postulated that the patients omental band developed as a consequence of immune mediated enteritis secondary to immunotherapy. Although small bowel obstruction secondary to immunotherapy is rare, with under five cases in the literature, it is a potentially life-threatening complication that treating physicians need to be aware of.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 3","pages":"49"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498795","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

Medical Education Must Address Climate Change and Planetary Health. 医学教育必须解决气候变化和地球健康问题。

Irish medical journal Pub Date : 2026-03-19

O L Nordrum, I Waters, S Dunlea, T O'Dowd, D Stanistreet

引用次数: 0

All-cause mortality rates in nonagenarians treated for hip fracture. 接受髋部骨折治疗的90岁老人的全因死亡率。

Irish medical journal Pub Date : 2026-03-19

I Hickey, D Moloney, D Jones, D Collins

{"title":"All-cause mortality rates in nonagenarians treated for hip fracture.","authors":"I Hickey, D Moloney, D Jones, D Collins","doi":"","DOIUrl":"","url":null,"abstract":"Aims: To identify in-hospital, 30-day, and one-year mortality rates in patients aged 90 and above who underwent hip fracture surgery at an Irish tertiary referral hospital.Methods: The authors retrospectively examined two years of theatre lists from 2021 to 2023. Inclusion criteria were an age of 90 and above at the time of fracture and surgical treatment of a proximal femur fracture. Exclusion criteria were periprosthetic fractures and patients who had conservative management. Mortality rates were extracted from hospital records and a national online death notices website.Results: We identified 69 patients aged greater than 90 years old who received surgical management of a hip fracture between November 2021 and November 2023. Among these 69 patients, in-hospital mortality was 6 (8.7%), 30-day mortality was also 6 (8.7%), and one-year mortality was 23 (33%).Conclusion: The one-year mortality rate among a sample of nonagenarians managed surgically for hip fracture at a single Irish hospital is higher than the estimated all-age one-year mortality rate, demonstrating significant long-term mortality in the eldest patients. No \"90 paradox\" was observed in mortality rates.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 3","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499040","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

Trick or Treat: paediatric plastic surgery at Halloween. 不给糖就捣蛋：万圣节的儿科整形手术。

Irish medical journal Pub Date : 2026-03-19

A Feeley, C de Blacam

{"title":"Trick or Treat: paediatric plastic surgery at Halloween.","authors":"A Feeley, C de Blacam","doi":"","DOIUrl":"","url":null,"abstract":"Aims: The aim of this study was to describe a snapshot experience of firework-related injuries during a single Halloween at the national paediatric burns unit.Methods: This was a retrospective review of paediatric patients referred to the plastic surgery service in the week of Halloween 2024. Baseline characteristics in addition to date of injury, mechanism of injury, intervention, and patient outcomes were collected. Data was collected using theatre logbooks, hospital in-patient enquiry, and plastic surgery dressing clinic logbooks.Results: In total, 10 referrals were made to the service for management of firework-related injuries over the 7-day period. All patients referred were male, with an average age of 12.1 years. Three patients required admission; two were taken to theatre for management of hand fractures under general anaesthetic, with one patient also sustaining an injury to his eye, resulting in permanent loss of vision. One patient underwent exploration of his hand under a local anaesthetic. Average length of stay for the 3 patients who required admission was 2.6 days.Discussion: In addition to being prepared to manage a surge in these injuries at Halloween, healthcare professionals have a role in raising public awareness in an effort to mitigate these potentially devastating injuries.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 3","pages":"44"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498825","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

The Impact of Targeted Informal Information Days on Early-Career Doctor's Interest in Surgery. 针对性非正式信息日对早期职业医生对外科兴趣的影响。

Irish medical journal Pub Date : 2026-02-19

B V Bolarinwa, E McCormack, Z Penny, D Lennon, M P Foley

{"title":"The Impact of Targeted Informal Information Days on Early-Career Doctor's Interest in Surgery.","authors":"B V Bolarinwa, E McCormack, Z Penny, D Lennon, M P Foley","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To investigate how much impact targeted informal information days have on early-career doctors and the impact of these information days on their perception of surgical careers.Methods: All attendees of the 2024 Irish Surgical Training Group (ISTG) Careers' Day and Aspiring Surgeons Research Symposium were given a link to an online survey following the event. Their responses were aggregated and analysed using Microsoft Excel.Results: 57% (n=47/82) of attendees submitted feedback forms. All respondents were considering a career in surgery prior to the event. After the event, 93.5% (n=44) attendees rated themselves more likely or much more likely to pursue a career in surgery, while none reported a new negative view on surgery. Additionally, prior to the event, 47% of attendees (n=22) were considering applying to Core Surgical Training, while a further 13% (n=6) were unsure. After the event, 76.5% (n=36) reported themselves to be more likely or much more likely to apply for CST at some point, and only 2 (4.3%) considered themselves somewhat less likely to apply.Discussion: Our study has identified the positive influence that informal sessions can have in promoting interest in surgical specialities as well as providing networking opportunities amongst consultants and NCHDs that otherwise may not have been easily accessible.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 2","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271147","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

Propofol: A Safer Future Forged from a Lethal Past. 异丙酚：从致命的过去锻造出更安全的未来。

Irish medical journal Pub Date : 2026-02-19

E Kaar, T Tan

引用次数: 0

Cutting Costs and Carbon: The Case for Oral Paracetamol in Elective Surgery. 削减成本和碳：在选择性手术中口服扑热息痛的案例。

Irish medical journal Pub Date : 2026-02-19

I Waters, L Geoghegan, I Haupfear, A Cafferkey, A Sherwin

{"title":"Cutting Costs and Carbon: The Case for Oral Paracetamol in Elective Surgery.","authors":"I Waters, L Geoghegan, I Haupfear, A Cafferkey, A Sherwin","doi":"","DOIUrl":"","url":null,"abstract":"Aim: IV paracetamol is approximately 10 times the cost and has 68 times higher carbon emissions compared to oral paracetamol (PO) however, it has been shown to be equally as effective. This paper aims to assess potential environmental and financial savings of an oral paracetamol switch in a large day surgery unit using a simple behaviour change intervention.Methods: Charts were collected at random from the Day Surgery Unit over a four-week period. An education campaign was carried out aimed at Anaesthetic trainees and data was collected over a second four-week period. The proposed financial and carbon cost savings of the intervention were then calculated.Results: The proportion of patients who received preoperative PO paracetamol significantly increased post-intervention, from 5% (2/40) to 24.4% (11/45) (p=0.014). Projected over a one-year period, we estimate that our intervention would save the hospital €188.04 and reduce carbon emissions by 54.53 kgCO₂e from elective day cases alone, without compromising patient safety.Discussion: The education intervention led to a shift towards preoperative prescribing of oral paracetamol. The relatively simple intervention could be adapted and applied to other settings in order to yield further cost and carbon emission savings, such as the main theatre, surgical wards, and the emergency department.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 2","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271148","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

The Escalating Burden of E-Scooter-Related Injuries: A Two-Year Comparative Analysis. 电动滑板车相关伤害的不断升级负担：一项为期两年的比较分析。

Irish medical journal Pub Date : 2026-02-19

M Ni Mhiochain de Grae, B Rigney, R Mahony, L Govender, J F Quinlan, N P McGoldrick

{"title":"The Escalating Burden of E-Scooter-Related Injuries: A Two-Year Comparative Analysis.","authors":"M Ni Mhiochain de Grae, B Rigney, R Mahony, L Govender, J F Quinlan, N P McGoldrick","doi":"","DOIUrl":"","url":null,"abstract":"Aim: Electric scooter (e-scooter) injuries represent an emerging challenge in Emergency Departments due to their rising incidence and associated resource demands. This study is a follow up from our previous study which demonstrated that 50% of e-scooter injuries required specialist orthopaedic referral 1. This study aims to analyse trends in e-scooter-related injuries presenting to a tertiary referral centre and to evaluate the clinical outcomes, management strategies, and compare service impact over a two-year period.Methods: This is a retrospective analysis of all patients presenting to our hospital between 1st August 2023 and 31st July 2024. We compared our data to our previous study which analysed e-scooter presentations between 1st August 2021 and 31st July 2022. Datapoints measured included mechanism of injury, type of injury, use of safety equipment, outcome of emergency presentation, admission length, surgery performed, and follow-up.Results: A total of 306 patients were included, increasing from 105 in Phase 1 (1st August 2021 - 31st July 2022) to 201 in Phase 2 (1st August 2023 - 31st July 2024) (p = 0.157). Fractures were identified in 134 e-scooter presentations (43%), and 27 patients (8.9%) required emergency fixation. Physiotherapy referrals rose from 4.8% to 34.3% (p = 0.001), and wound care needs increased from 6.7% to 14.4% (p = 0.07). Orthopaedic clinic visits rose (mean 1.96 to 3.1), while admission (13.3% vs. 13.4%, p = 1.0) and surgery rates (9.5% vs. 8.5%, p = 0.92) remained stable.Discussion: This study highlights a significant increase in both the frequency and complexity of e-scooter-related trauma over two years, with rising rates of vertebral and hip fractures, wound care needs, and physiotherapy referrals. Despite stable admission and surgical rates, outpatient and allied health burdens have escalated. These findings underscore the need for targeted public health interventions to mitigate injury severity and reduce preventable harm.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 2","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271151","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