The Ulster medical journal最新文献

{"title":"Current Practice and Outcomes of Patients Undergoing Surgical Resection for Renal Cell Metastases to the Pancreas in Northern Ireland.","authors":"K Dodds, D Curry, P Kelly, D O'Rourke, J McClements","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metastatic tumours to the pancreas are rare but most commonly arise from primary renal cell carcinoma (RCC). Contrary to other metastatic malignancies, metastatic RCC demonstrates indolent behaviour; with a long latency between primary tumour presentation and the development of metastasis, as well as a predilection to isolated pancreas-only disease. As such, pancreatic metastasectomy has evolved as a treatment option for patients with metastatic RCC; reported to associate with improved outcomes in selected patients. The aim of this study was to describe the clinicopathological characteristics and patient outcomes in a series of patients undergoing pancreatic resection for metastatic RCC in a high volume, regional hepatopancreatobiliary (HPB) centre.</p><p><strong>Design: </strong>Retrospective review of all patients who underwent pancreatic metastasectomy for pathologically-confirmed metastatic RCC over an eighteen-year period. Clinicopathological characteristics and outcomes were collected and analysed.</p><p><strong>Results: </strong>Fifteen patients underwent pancreatic resection for metastatic RCC between October 2004 and October 2022. Two patients underwent synchronous nephrectomy and pancreatectomy. In thirteen patients, the pancreas was the only site of metastatic disease. For those with metachronous metastases, the median disease-free interval (DFI) was 126 months from initial nephrectomy.Five-year disease-free and overall survival were 32.7 % and 63.3 %, respectively. No clinicopathological factor was found to associate with overall survival (OS); however, patients with synchronous metastatic disease had a significantly shorter disease-free survival (p = 0.029). Similarly, patients with a longer DFI (≥ ten years) between RCC primary and the development of pancreatic metastases had a trend towards improved OS (p = 0.074).Post-operative morbidity and mortality rates were comparable to that of pancreatic surgery for primary pancreatic pathology.</p><p><strong>Conclusion: </strong>This case series supports the role of pancreatic resection in patients with metastatic RCC, with acceptable rates of morbidity and mortality and favourable patient outcomes. The long DFI between nephrectomy and pancreatic metastases highlights the importance of long-term follow-up for patients diagnosed with RCC.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"58-66"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deeds not Words.","authors":"David J Armstrong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"45-46"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It takes a village to raise a child- A multidisciplinary approach to promoting paediatric health literacy in cystic fibrosis.","authors":"Beverley C Millar, Lauren Alexander, Jane Bell, Esther Grieve, Christine A McCabe, Esther Wright, Katherine Catney, Dearbhla Toland, Brian Coyle, Alec Parkin, Hannah L Anderson, Christy Benny, Rachel E Moore, Damian O'Neill, Laura Jenkins, Alastair Reid, Jacqueline C Rendall, John E Moore","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In Northern Ireland, approximately 550 people with cystic fibrosis (PwCF) attend the regional paediatric and adult centres within the Belfast Health and Social Care Trust. This autosomal recessive chronic condition necessitates regular clinical monitoring and a high treatment burden, as well as time implications for the maintenance of respiratory devices. Development of health literacy skills at an early age and promoting children with CF (CwCF) to take an active role in their healthcare has many advantages relating to their long-term self-care in preparation for transition from paediatric to adult care, decision-making and partnership engagement with the CF-multidisciplinary team (CF-MDT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study comprised of four individual components, namely (i) an analysis of responses (n=24) to an anonymous questionnaire from the Northern Ireland CF community to determine where PwCF and their carers/families seek healthcare information; (ii) to co-produce paediatric-facing healthcare educational resources, namely colouring/ storybooks and animations, relating to the importance of microbiological sampling, nebuliser hygiene and pancreatic replacement therapy (PERT) in conjunction with the CF-MDT, CwCF, parents, students and animators and (iii) assess the readability of these new materials using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), SMOG Index and Gunning Fog (GF) Index and compare these with paediatric and adult-facing materials available from CF charities, pharmaceutical companies and the scientific literature. The final component (iv) examined parents' and children's knowledge of PERT pre- and post-viewing the bespoke animation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(i) The findings showed that the CF community relied upon the CF-MDT as their primary source of healthcare information, most frequently consulting the Doctor/CF Consultant (61.5%), the physiotherapist (61.6%), the nurse (57.7%), followed by the CF dietitian (34.6%), as well as the Cystic Fibrosis Trust (38.4%). Pharmaceutical websites were least consulted with 69.2% of respondents never consulting such resources.(ii) Reflective learning points from this co-production of resources are provided to assist other healthcare teams preparing engaging and effective healthcare information for the paediatric service user.(iii) The readability of the new paediatric-facing materials prepared by the CF-MDT was appropriate for primary school aged-children and was not statistically different from paediatric-facing information prepared by charities or pharmaceutical companies. A statistical difference was noted in relation to the prepared materials in comparison with adult-facing charity information (p=0.04; 0.02; 0.03; 0.04) and scientific abstracts (p&lt;0.0001), which were more complex in terms of readability parameters, FRE, FKGL, SMOG and GF, respectively.(iv) Following viewing the PERT animation, both parents' and children'","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"67-82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and complications after total hip arthroplasty via the posterior approach for displaced intracapsular hip fracture: Results from a regional trauma centre.","authors":"Grace Em Kennedy, Julie Craig, Samuel E McMahon, Laurence A Cusick","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) for displaced intracapsular hip fracture is increasingly common. The aim of this project was to determine all-cause mortality rates, rates of significant complications and functional outcomes following THA for fractures.</p><p><strong>Methods: </strong>An inpatient database search identified all patients undergoing THA for displaced intracapsular fracture in Northern Ireland's regional trauma centre from 2010-2017. Regional electronic healthcare systems were reviewed for evidence of complications.</p><p><strong>Results: </strong>After exclusions, 345 cases were identified. The median age was 70 years (31 - 91 years).Median follow-up was 4.3 years (1.6 - 9.3 years). The all-cause mortality rate was 0.3% at 30 days, 3.2% at one year, and 5.5% at two years.Seven patients (2.0%) experienced dislocations. Most occurred within 60 days; five patients underwent revision.Radiographic evidence of heterotopic ossification (HO) was seen in 48 patients (13.8%).Re-operation was required for 16 patients (4.6%). This included 5 dislocations, eight cases of periprosthetic fractures (in seven patients), two cases of infection, and one case of symptomatic HO.Pre-injury, 96.2% (332/345) were independently mobile, and after one year 78.9% (262/332) of those patients remained so. Pre-injury, 96.2% obtained the maximum functional score (Barthel Index, maximum score of 20), and after one year 78.9% (262/332) of these continued to report a maximum Barthel Index score.</p><p><strong>Conclusion: </strong>THA for hip fracture holds a 2.0% risk of dislocation and a 4.6% risk of re-operation. HO is common but seldom requires re-operation. All-cause mortality rates and functional levels compared favourably with current literature.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radar to Radiology.","authors":"John Hedley-Whyte, Debra R Milamed","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curiositas - Teenage Kicks.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"93-95"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First use of Bedaquiline, Linezolid, and Pretomanid (BPaL) in a family cluster of multi-drug resistant (MDR) TB infection.","authors":"Marcus Pratt, Mark McNicol, Michael Hunter, Martin Dedicoat","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"55-57"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Northern Ireland Healthcare Crisis.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHAT'S IN A NAME? DECIPHERING THE TAXONOMY OF BACTERIA, FUNGI AND PARASITES CAUSING INFECTION.","authors":"J E Moore, B C Millar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics - A matter of principle?","authors":"Michael Trimble","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Discussion of bioethical issues using the four principles approach proposed by Beauchamp and Childress is now standard practice in the UK. This paper first documents the history of principlism before considering its impact and reviewing some criticisms of the approach. A future paper will examine some of the philosophical difficulties arising from principlism in greater depth.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 2","pages":"83-86"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}