Irish journal of medical science
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The management of breast cancer has evolved in the last 40 years to now encompass not only treating the cancer in the most effective way, but also to detect and treat cancers before they can pose a risk to patients. This evolution in therapy and diagnostics has moved away from treating patients with the maximum amount of therapy they can tolerate towards a new paradigm where patents receive the minimum treatment to be most efficacious.
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Methods of teaching and assessment in medical schools have transformed over the recent past. Accreditation of medical schools through national licensing bodies and removal of bias at examinations is the norm. This review is intended to inform senior doctors who are peripherally involved in training at speciality or general professional level. ⋯ Examining the performance of examiners as well as that of students is a necessary part of good examination practice. The World Federation for Medical Education with the World Health Organisation has developed nine standards with two categories of basic and quality for the accreditation of medical education.
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This study was performed to test the hypothesis that urinary levels of L-carnitine and its derivatives are enhanced in children and adolescents with hypertension and also check if analyzed parameters may serve as early markers of subclinical renal damage. ⋯ The results of this study do not explain the increased urine levels of L-carnitine. The most likely reason for excessive urinary loss was disturbed renal tubular reabsorption. It is possible to hypothesize that in hypertensive adolescents subclinical kidney dysfunction occurs. It is proposed that studies examining the concurrent plasma and urine concentration of L-carnitine and correlation with acknowledged proximal tubular markers are needed.
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This study aimed at investigating the clinical characteristics of malignancies associated with pregnancy and to provide information for the development of suitable strategies of treating maternal malignancies. ⋯ The management of malignancies associated with pregnancy is a challenge for doctors and patients. It should be based on histological subtype, disease stage, gestational age, obstetrics complications, and patient's preference regarding continuing the pregnancy.
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As all tertiary paediatric hospitals are based in the capital of Dublin, it is therefore necessary for general surgeons in centres outside of Dublin to undertake routine elective and emergency paediatric surgery to provide children with care close to home. The aim of this study is to assess the volume and type of procedures this entails. ⋯ The range of procedures in general paediatric surgery is small with only five procedures representing the majority of all elective and emergency procedures performed. This suggests that a period of specialist paediatric surgery training would enable more general surgeons to provide this vital service.