Irish medical journal最新文献_第5页

Continuous Spinal Anaesthesia in the Management of Challenging Hip Fracture.

Irish medical journal Pub Date : 2025-01-27

S Moore, M Narayanan

引用次数: 0

Potential impact of pembrolizumab in the adjuvant setting for intermediate-high risk and high risk kidney cancer.

Irish medical journal Pub Date : 2025-01-27

M Muheilan, C Bohonos, K O'Malley, N Hegarty, D Galvin, G Nason, S Connolly

引用次数: 0

Potential of national/regional datasets to support targeted service planning.

Irish medical journal Pub Date : 2025-01-27

C B Hayes, S Sayers, N McCarthy, H Johnson

{"title":"Potential of national/regional datasets to support targeted service planning.","authors":"C B Hayes, S Sayers, N McCarthy, H Johnson","doi":"","DOIUrl":"","url":null,"abstract":"Aim: This survey reviewed the content of national and regional health datasets to assess their potential to support service planning and sub-population targeting.Methods: The Health Information and Quality Authority catalogue (v.4) of health and social care datasets (129) was examined. Datasets relevant to the implementation of Sláintecare (37) were selected by consensus. A variable list was constructed for geographic granularity, and inclusivity measures. An online survey of the presence of parameters was sent to the database managers in Microsoft Forms. Analysis was descriptive.Results: The survey response rate was 33/36 (92%), (one duplicate removed). Age was recorded on all databases and sex on 31/33 (94%). Socio-economic, medical-card and education status were poorly recorded on 11 (33%,) 10 (30%) and 9 (27%) databases respectively). Race, ethnicity or cultural details were recorded on 16 (49% and disability on 12 (36%). County was recorded on 27 (82%) , Health Region (not current) on 13, (38%) electoral division on 11 (33%), and CSO small area on 8 (24%). Concerns around GDPR and lack of resources emerged as key themes from comments.Discussion: Existing datasets have large gaps in variables that could support tailored health service planning. A standardised approach to the inclusion of critical parameters within health datasets is required to support the full implementation of Sláintecare.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"118 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500778","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

IgG 4 -related hypophysitis leading to diabetes insipidus.

Irish medical journal Pub Date : 2025-01-27

A N Khan, M A Khan, A Khan, S Shah

引用次数: 0

Opportunistic Measles Immunisation within the Paediatric Inclusion Health Service.

Irish medical journal Pub Date : 2025-01-27

D J Foley, S Geoghegan, A Walsh

引用次数: 0

A very frightening but not dangerous rash in children.

Irish medical journal Pub Date : 2025-01-27

D Ly-Liu, R Sampedro Ruiz, J P Meza-Budani, E O'Riordan, D Ly-Pen

引用次数: 0

Assessment of increased General Practitioner access to diagnostic imaging.

Irish medical journal Pub Date : 2025-01-27

C O'Doherty, W Cullen, S Morris, G McCombe

{"title":"Assessment of increased General Practitioner access to diagnostic imaging.","authors":"C O'Doherty, W Cullen, S Morris, G McCombe","doi":"","DOIUrl":"","url":null,"abstract":"Aim: This study aims to evaluate the impact of increased radiological access for General Practitioners (GPs) on healthcare workflows and patient care outcomes, with a focus on musculoskeletal (MSK) MRIs.Methods: A mixed methods approach was used for this study. GPs completed online questionnaires and semi-structured interviews were conducted with orthopaedic and radiology consultants. Doctors were asked to evaluate their experience working within the GP 'direct access' to radiology scheme.Results: Increased GP access to radiology had many positive benefits, including improved efficiencies in healthcare workflow. Of the GPs surveyed 44 (84.5%) found an increased patient satisfaction rate and 46 (88.5%) found improved efficiencies in patient outcomes. However, it may be contributing to downstream inefficiencies and affecting prioritization of more urgent imaging in the system. 52 GPs surveyed and 8 semi structured interviews with radiologist and orthopaedic consultants were analysed.Discussion: Increased GP access to radiology has led to many important benefits in the Irish healthcare system. There is potential for more efficient healthcare workflows, and improved patient outcomes, pending more appropriate referral pathways and further investment in infrastructure and training.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"118 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492117","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

Consequences of the Crisis in Social Care for Older Hospital Inpatients with Frailty.

Irish medical journal Pub Date : 2025-01-27

R Ahmed, J Cloonan, E May, H Chambers, R Madden, J Doyle, R Briggs

{"title":"Consequences of the Crisis in Social Care for Older Hospital Inpatients with Frailty.","authors":"R Ahmed, J Cloonan, E May, H Chambers, R Madden, J Doyle, R Briggs","doi":"","DOIUrl":"","url":null,"abstract":"Aim: The social care system is currently under enormous pressure leading to delays in home care provision and unnecessarily prolonged hospital stays for frail, older people. This study examines the rate of hospital-associated complications (HAC) amongst older inpatients who are medically optimised but awaiting home care to facilitate discharge home.Methods: Electronic records of patients =65 years with delayed transfer of care (DTOC) awaiting home care provision were examined for incidence of delirium, falls and infection (n=100). A smaller cohort of current inpatients (n=14) awaiting home care were interviewed with focus on quality-of-life (CASP-19), loneliness (UCLA Scale) and depressive symptoms (CES-D).Results: 59% (57/97) (median 82 years) developed a HAC while medically optimised for discharge. For every additional day awaiting home care, the likelihood of HAC increased by 4% (Adjusted Odds Ratio 1.04 (1.00-1.08; p=0.027). Almost half of interview respondents reported quality-of-life had declined while discharge home was delayed (6/14, 43%), while over one third reported significant depressive symptoms (5/14, 36%).Discussion: Almost 60% of frail, older inpatients have a HAC while awaiting home care provision, with the likelihood increasing significantly for every additional day in hospital awaiting care. Interventions to address this deficit in home care are required urgently.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"118 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492120","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 Insight into the Implications of the NCCP 2024 Guideline on the Staging & Surveillance of Melanoma.

Irish medical journal Pub Date : 2025-01-27

M E McMahon, J Keaney, N Walsh, N Conroy, A O'Shea, J Sorensen, A D K Hill, B O'Sullivan, F Martin, R Dolan

{"title":"An Insight into the Implications of the NCCP 2024 Guideline on the Staging & Surveillance of Melanoma.","authors":"M E McMahon, J Keaney, N Walsh, N Conroy, A O'Shea, J Sorensen, A D K Hill, B O'Sullivan, F Martin, R Dolan","doi":"","DOIUrl":"","url":null,"abstract":"Aim: In 2024, the NCCP introduced changes to the staging and surveillance of cutaneous melanoma. This study aims to evaluate the cost-effectiveness of this proposed change and the impact on future modelling of services.Methods: Patients diagnosed with melanoma (Clinical Stage Ib and above) treated between 2017 and 2023 at Beaumont Hospital were identified from a prospectively maintained database. Data were analysed for their journey on an idealized pathway modelled over a 5-year follow-up period according to new guidelines. The increased number and cost of surveillance imaging required was estimated and compared with previous best practice.Results: According to new guidelines, based on our patient population, an additional 110 surveillance whole-body CT and brain-CT scans could be required annually for stage IIb and IIc melanoma. Regarding PET-CT scans, this could lead to a potential additional annual expense of €176,000. An additional 390 surveillance MRI-Brain scans could potentially be required annually for stage III and IV melanoma patients.Discussion: This study identifies cost and service access implications with the implementation of these guidelines. The clinical utility of increased surveillance imaging is yet to be determined. This provides key information for planning future service delivery in the context of an aging population and increased prevalence of melanoma.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"118 2","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501081","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

RSV Burden on Ireland's Tertiary Children's Hospitals: An In-Depth Winter 2023/2024 review.

Irish medical journal Pub Date : 2024-12-19

A Ali, R O'Neill, B Treston, E Kitt, P J Morris, M A Healy, J Donnelly

引用次数: 0