The Ulster medical journal最新文献

{"title":"Northern Ireland Healthcare Crisis.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643780","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":"Cure sometimes, care always.","authors":"David J Armstrong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864214","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":"A GAME-CHANGER IN FREE-TISSUE SURGERY: THE FUTURE'S BRIGHT, THE FUTURE'S FLUORESCENT….","authors":"J D Clements, M J McBride","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868532","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":"Immediate sequential bilateral cataract surgery (ISBCS): A single-site experience of 41 patients during the COVID-19 pandemic.","authors":"Tim Patterson, Gerard Reid, Stephen Stewart, Olivia Earley","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The practice of immediate sequential bilateral cataract surgery (ISBCS) was more widely adopted in the UK during the COVID-19 pandemic, in response to limited surgical capacity and the risk of nosocomial infection. This study reports on a single site experience of ISBCS in Northern Ireland.</p><p><strong>Methods: </strong>Data was collected prospectively between 17^th November 2020 and 30^th November 2021. The ISBCS surgical protocol, recommended by RCOphth and UKISCRS, was followed. Primary outcomes measures were: postoperative visual acuity (VA), refractive prediction accuracy, intraoperative and postoperative complications.</p><p><strong>Results: </strong>Of 41 patients scheduled, 39 patients completed ISBCS and two patients underwent unilateral surgery (n=80 eyes). Mean age at the time of surgery was 71.6 years (standard deviation (SD) ±11.8 years). Median preoperative VA was 0.8 logMAR (range: PL to 0.2 logMAR). Seventeen (20.9%) eyes were highly myopic and 9 (11.1%) eyes were highly hypermetropic. Median cumulative dissipated phacoemulsification energy was 15.7 sec (range: 1.8 sec to 83.4 sec). Median case time was 10.4 min (range: 4.3 min to 37.1 min).One eye (1.3%) developed iritis secondary to a retained tiny cortical fragment. Four eyes (5.0%, n=3 patients) developed cystoid macular oedema, with full resolution. On wide field imaging, an asymptomatic unilateral peripheral suprachoroidal haemorrhage was noted in two highly myopic patients (axial lengths of 27.01mm and 25.05mm respectively). The posterior pole was spared, and both resolved spontaneously without any visual impairment.</p><p><strong>Conclusions: </strong>In our initial experience, ISBCS was found to be a safe approach to cataract surgery. Our patient cohort included eyes with dense cataracts and high ametropia. Further studies are required to assess patient reported outcome measures and the possible economic benefits of ISBCS in our local population.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873371","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":"Does performing manipulation of nasal bones under local anaesthetic beyond two weeks after injury affect outcomes? A prospective study during the SARS-CoV-2 pandemic.","authors":"J Smith, K O'Doherty, B Hanna","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>ENTUK guidelines recommend that manipulation of nasal bones (MNB) should be performed within 14 days of injury. However, evidence suggests treatment under general anaesthetic remains effective up to 5 weeks after injury. With the SARS-CoV-2 pandemic leading to delays in referral and limited access to theatre, local practice changed to offer delayed MNB under local anaesthetic. This prospective study assesses the effectiveness of MNB delayed until 3 weeks or later from time of injury when performed mostly under local anaesthetic.</p><p><strong>Methods: </strong>Data was prospectively collected between April and November 2020. All patients referred to ENT with a new nasal bone deformity presenting more than 21 days after injury were included. Demographic information, injury details and patient satisfaction was recorded for each patient.</p><p><strong>Results: </strong>11 patients were included. Average age was 32.6 years (Range 8-65 years). 10 procedures (91%) were performed under local anaesthetic, with 1 (9%) performed under general anaesthetic. 9 patients (82%) gained complete reduction of the deformity, and 1 patient (9%) gaining partial reduction. 10 patients (91%) patients were satisfied with the cosmetic outcome.</p><p><strong>Conclusion: </strong>This study supports the small volume of recent literature showing that delayed manipulation of nasal bones is effective and additionally demonstrates that efficacy is maintained when performed under local anaesthetic.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"125-128"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643857","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.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"40-41"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874385","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":"Good Things are Difficult.","authors":"David J Armstrong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"117-119"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643779","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":"Perceptions towards Nephrology Specialty: The Good, the Bad and the Ugly.","authors":"Siddhesh Prabhavalkar, Aarushi Puri, Girish Shivashankar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is a decline in the interest in pursuing a career in nephrology globally as well as locally in Northern Ireland. There is also an expansion in the burden of kidney disease worldwide due to a combination of factors like higher detection rates, increase in population size and improved life expectancy. Workforce shortages in nephrology have a direct impact on provision of care for people with kidney disease. Understanding perceptions among doctors towards nephrology is an important factor in acknowledging the barriers in recruitment and advocating evidence based changes to improve current practices.</p><p><strong>Aim: </strong>The aim of this study is to explore both the positive and the negative perceptions among medical students and trainees towards nephrology as a specialty in order to understand the factors that are most influential in either choosing or forgoing a career in nephrology.</p><p><strong>Methods: </strong>Scoping review methodology was used to address the research question through a phenomenological lens. Sixteen articles were included that studied the perceptions towards nephrology mainly through questionnaires and also through direct quotations. Basic numerical analysis and content analysis was completed.</p><p><strong>Findings: </strong>A total of 3745 participants including medical students, trainees and consultants participated in the 16 studies were included in this review at an international level. Most of the studies used survey (questionnaire) as their methodology (n= 10). The seven themes that emerged to describe perceptions towards nephrology were exposure to specialty; complex specialty; mentorship; work-life balance; financial compensation; personal interest; and procedural component. Exposure to specialty was the most influential factor in future career choice decision. The other factors that could improve recruitment in nephrology include innovative and novel teaching methods, good role models, flexible training and working patterns, and adequate financial remuneration.</p><p><strong>Conclusions: </strong>In order to rekindle interest in nephrology we need a multi-pronged approach based on ensuring early exposure to the specialty, good mentorship, holistic clinical experience covering different aspects of the specialty and the opportunity of flexibly moulding one's interests and skills whilst ensuring service provision, and with an emphasis on adequate financial remuneration.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"148-156"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643781","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":"Extrapleural Haematoma following Percutaneous Coronary Intervention.","authors":"Tunde Oyebanji, Peter Mhandu, Rory Beattie, Adesh Ramsewak, Jebrail Merza","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"32-33"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874081","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":"The use of colonic stents as a bridge to surgery in malignant colonic obstruction - A dual trust experience over 10 years.","authors":"J D Canny, D B Johnston, J A McBrearty, K McElvanna, G Caddy, D McKay","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide colonic cancer is the third most common cancer with up to 30% of cases presenting with large bowel obstruction. Self-expanding metal stents (SEMS) have been used as a bridge to surgery (BTS) in the treatment of this malignant obstruction. We review the outcomes of SEMS as a BTS across two high volume colorectal units.</p><p><strong>Methodology: </strong>A retrospective analysis of patients undergoing colonic stenting as a bridge to surgery was performed; outcomes were compared to previously published figures on emergency colonic resections. Inclusion criteria were adults (>18 years of age) undergoing colonic stenting for colonic obstruction with a view to elective resection. Patients undergoing stenting for palliation of symptoms were excluded.</p><p><strong>Results: </strong>39 patients were identified across both trusts over a ten-year period. 90 day mortality following BTS was found to be 3.6% and there was an 82.1% (32/39) technical success rate. 46.4% proceeded to an elective resection which was started laparoscopically. Permanent stoma rate was observed at 14.3% for elective surgery.</p><p><strong>Conclusion: </strong>Stenting for relief of acute malignant obstruction as a bridge to surgery is a viable option in select patients. Further research is required to determine oncological safety and rate of local recurrences.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643785","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}