Irish medical journal最新文献_第9页

An evaluation of a revised analgesia protocol for elective joint arthroplasty. 择期关节置换术镇痛方案的修订评价。

Irish medical journal Pub Date : 2026-06-18

L Di Lucia, R O'Neill, J Fahey, M Duggan

{"title":"An evaluation of a revised analgesia protocol for elective joint arthroplasty.","authors":"L Di Lucia, R O'Neill, J Fahey, M Duggan","doi":"","DOIUrl":"","url":null,"abstract":"Aims: Mayo University Hospital performs approximately 350 joint arthroplasty surgeries per annum. We revised our analgesia protocol in 2024 based on best current practice.Methods: We conducted this evaluation from January to July 2025. All patients presenting for joint arthroplasty surgeries were invited to be included.Results: Our evaluation included 147 patients; 94 patients had a total hip arthroplasty and 53 had a total knee arthroplasty. The average age was 69 years, and 142 (96.5%) of patients were living at home independently before surgery. 53 (36%) were on prescribed analgesics pre-operatively. The average pain score on day 1 (day after surgery) was 4.8 for the hip arthroplasty patients and 5.5 for the knee arthroplasty patients. The total oral morphine equivalent requirements for the first 2 days were 48 mgs for the hip surgery patients and 65 mgs for the knee surgery patients. The median length of stay for all patients was 4 days. On follow up at 6 weeks, 135 (91%) of patients were mobilising independently. Overall satisfaction of the patient's experience (0-10) was 8.7 for the knee arthroplasty patients and 8.8 for the hip arthroplasty patients.Discussion: Overall, we were satisfied with our analgesic protocol, but we want to improve the day 1 and 2 pain scores particularly in the knee arthroplasty patients. We are discussing the introduction of adductor canal blocks pre-operatively.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 6","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317091","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

Bridging the Gap: Implementing the 2024 National Cancer Control Programme (NCCP) Melanoma Imaging Guidelines in Real-World Practice. 弥合差距：在现实世界实践中实施2024年国家癌症控制规划（NCCP）黑色素瘤成像指南。

Irish medical journal Pub Date : 2026-06-18

A Foo, A O'Regan, L Mahon, B L O'Neill, D Goodman

引用次数: 0

Factors affecting prolonged Emergency Department stays in the over 75s. 75岁以上病人在急诊科长时间住院的影响因素。

Irish medical journal Pub Date : 2026-05-21

T MacMahon, N A Yusri, B Murphy

引用次数: 0

Navigating Parenthood during Medical Training. 在医疗培训期间导航父母。

Irish medical journal Pub Date : 2026-05-21

J O'Brien, K McCarthy, R Corcoran, C Roberts, N O'Hanrahan, R McConnell, P Carr

{"title":"Navigating Parenthood during Medical Training.","authors":"J O'Brien, K McCarthy, R Corcoran, C Roberts, N O'Hanrahan, R McConnell, P Carr","doi":"","DOIUrl":"","url":null,"abstract":"Aims: There is limited understanding of the impact of parenthood on doctors in medical training in Ireland. We aimed to identify key challenges faced by trainees focusing on childcare, breast-feeding, the return to work, and the impact of parenthood on medical careers and training.Methods: This study was a multi-centre, cross-sectional survey of parents in medical training in a national medical training body. All 1,849 trainees were invited to participate through email. A survey was created and distributed using the online survey platform Qualtrics. Descriptive statistical analysis was performed using the survey platform.Results: Two hundred five trainees met the inclusion criteria of being a parent whilst in medical training. 131/205 (63%) were required to live away from their families during their training. 178/191 (93%) reported that childcare limitations impact their training and 186/187 (99%) felt that parenthood influences their training, research, and career opportunities. 104/187 (56%) had considered leaving their specialty and 97(52%) considered leaving their career in medicine due to family commitments.Discussion: Being a parent during medical training presents unique challenges that impact both personal and family life. There is a need to explore how we can best support our trainees who are parents and enable them to lead both fulfilling personal and professional lives.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 5","pages":"87"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015525","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

Antacid Abuse - A Case of Milk-Alkali Syndrome. 抗酸剂滥用-乳碱综合征1例。

Irish medical journal Pub Date : 2026-05-21

S Varghese, K Cinnamond, B Malek, E McMonagle, L Casserly

{"title":"Antacid Abuse - A Case of Milk-Alkali Syndrome.","authors":"S Varghese, K Cinnamond, B Malek, E McMonagle, L Casserly","doi":"","DOIUrl":"","url":null,"abstract":"Presentation: A 42-year-old man presented with a four-week history of nausea, vomiting, and abdominal pain, ultimately attributed to chronic overuse of calcium carbonate tablets for gastroesophageal reflux disease (GORD).Diagnosis: Diagnostic evaluation revealed hypercalcaemia, metabolic alkalosis, and acute kidney injury, necessitating intravenous fluid administration and cessation of calcium carbonate tablet consumption. Comprehensive investigations excluded alternative aetiologies, confirming Milk-Alkali Syndrome (MAS).Treatment: Management involved cessation of calcium carbonate intake, aggressive intravenous fluid administration, and a single 4 mg dose of zoledronic acid. The patient was discharged with esomeprazole. His serum calcium normalised within six days, and creatinine showed further improvement at the 18-month follow-up, underscoring the importance of prompt recognition and intervention.Discussion: This case emphasizes the need for awareness among healthcare providers regarding MAS as a potential consequence of over-the-counter antacid use and underscores the importance of vigilant medication history review and patient education to prevent MAS-related complications.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 5","pages":"88"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015476","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

Pathological Response and Toxicity of Neoadjuvant Immunotherapy in Advanced Melanoma. 新辅助免疫治疗晚期黑色素瘤的病理反应和毒性。

Irish medical journal Pub Date : 2026-05-21

H FitzGerald, H Carroll, Y Ahmed

{"title":"Pathological Response and Toxicity of Neoadjuvant Immunotherapy in Advanced Melanoma.","authors":"H FitzGerald, H Carroll, Y Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"Aim: To evaluate pathological response and safety outcomes of neoadjuvant immunotherapy in a real-world cohort of patients with locally advanced resectable melanoma.Methods: A retrospective chart review was conducted on 24 consecutive patients treated between 2023-2025. Most patients had Stage IIIC disease (14/24, 58%). Treatment comprised pembrolizumab monotherapy (19/24, 79%) or ipilimumab/nivolumab (5/24, 21%). Pathological response was assessed using the International Neoadjuvant Melanoma Consortium criteria, and categorised as complete (pCR), partial (pPR) or no pathological response (pNR).Results: Overall, 4/24 (16.7%) achieved pCR and 8/24 (33.3%) achieved pPR. In the pembrolizumab subgroup, 4/19 (21%) achieved pCR. NRAS codon 61 mutations were present in 10/24 (42%); among these, 5/10 (50%) achieved pPR and 2/10 (20%) progressed pre-operatively. Adverse events occurred in 11/24 (46%), including 8/19 (42%) on pembrolizumab and 3/5 (60%) on ipilimumab/nivolumab. Colitis occurred in 2/5 (40%) receiving combination therapy. Four patients (4/24, 16.7%) died due to disease progression.Discussion: Observed pCR rates with pembrolizumab align with controlled trial data, supporting the applicability of neoadjuvant therapy. The high prevalence of NRAS mutations and associated pPR is notable, though progression in a subset underscores the need for improved biomarker-guided treatment selection. Toxicity, particularly colitis with combination therapy, remains a significant clinical challenge.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 5","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015538","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

Cross-Matching in Spinal Surgery - An Audit of Compliance at the National Spinal Injuries Unit (NSIU). 脊柱外科交叉匹配——国家脊柱损伤科（NSIU）依从性审计。

Irish medical journal Pub Date : 2026-05-21

T McCarthy, P Cagney, C Gleeson, M Kelly, M Timlin

{"title":"Cross-Matching in Spinal Surgery - An Audit of Compliance at the National Spinal Injuries Unit (NSIU).","authors":"T McCarthy, P Cagney, C Gleeson, M Kelly, M Timlin","doi":"","DOIUrl":"","url":null,"abstract":"Aims: Excessive preoperative cross-matching can waste resources and shorten blood product shelf-life. The purpose of this study was to evaluate compliance with the Maximum Surgical Blood Order Schedule (MSBOS) in spinal surgery at NSIU and to quantify the impact of deviations on red cell utilisation and cost, before and after implementation of a revised departmental guideline.Methods: A two-cycle, closed-loop audit at NSIU comparing how practice before and after a revised, spine-specific departmental transfusion guideline aligned with Maximum Surgical Blood Order Schedules was performed. Outcomes included MSBOS compliance, Red Cell Concentrate (RCC) utilisation, and estimated cost impact; two-sided tests were used.Results: Comparing October 2024 (63 surgeries) and May 2025 (50 surgeries), MSBOS compliance improved (33/63 [52%] to 36/50 [72%]; p=0.03), over-crossmatching decreased (27/63 [43%] to 6/50 [12%]; p<0.001), and estimated overspend fell (€19,662 to €6,780). Neither cycle required intra-operative ordering beyond preoperative plans.Discussion: Implementation of a revised, spine-focused transfusion guideline improved compliance and reduced unnecessary cross-matching at NSIU without compromising peri-operative safety.","PeriodicalId":14713,"journal":{"name":"Irish medical journal","volume":"119 5","pages":"86"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015477","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

Delayed Diagnosis of Ruptured Cornual Pregnancy following IVF after Bilateral Salpingectomy. 双侧输卵管切除术后IVF后角破裂妊娠的延迟诊断。

Irish medical journal Pub Date : 2026-05-21

S Tahir, S Saeed, U Mahmood, K I Ismail

引用次数: 0

Writing a Good Medical Paper. 写一篇好的医学论文。

Irish medical journal Pub Date : 2026-05-21

J F A Murphy

引用次数: 0

Frenotomy for Ankyloglossia in Early Infancy - Findings from the FLORAL Birth Cohort. 截骨术治疗早期婴儿的强直性咬合——来自花卉出生队列的发现。

Irish medical journal Pub Date : 2026-05-21

A Sokay, J Crupper, A Doolan, S Burke, M Iatan, L Halpenny, S Giva, R Joyce, S Byrne, S Verdon, J Hanoudi, I M Miramontes, M Dimakos, N Bout, M White, A Curley, N McCallion, J Hourihane

引用次数: 0