Irish journal of medical science
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Comparative Study
Experience with different techniques for the management of postpartum hemorrhage due to uterine atony: compression sutures, artery ligation and Bakri balloon.
To report our experience with different management approaches to treat postpartum hemorrhage (PPH) due to uterine atony with reference to need for hysterectomy. ⋯ Our case series suggest that in the condition of PPH due to atony, both compression sutures and Bakri balloon tamponade are effective methods. In combination of uterine artery ligation and B-Lynch suture with Bakri balloon tamponade might be the best surgical approach due to its higher success according to our results. To obtain more information further studies with large case series are important.
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Penetrating trauma--the classical presentation of disorganised crime--can pose a challenge in their management due to their complexity and unpredictability. ⋯ Although many patients with penetrating trauma can be safely managed conservatively, our study shows that over half required surgical intervention. These data highlight the need for a trauma team in each Irish centre receiving trauma with a clear need for general surgeons on emergency on-call rotas to be experienced in trauma management. There is an urgent need to centralise the management of trauma to a limited number of designated trauma centres where expertise is available by surgeons with a special interest in trauma management.
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Randomized Controlled Trial
Efficacy of uvulopalatopharyngoplasty combined with oral appliance in treatment of obstructive sleep apnea-hypopnea syndrome.
This study aimed to investigate the efficacy of UPPP combined with an oral appliance (OA) in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). ⋯ The long-term efficacy of the combined UPPP and OA for the treatment of OSAHS was higher than that of pure UPPP treatment.
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Comparative Study
The accuracy of magnetic resonance imaging in prostate cancer staging: a single-institution experience.
Magnetic resonance imaging (MRI) has a wide reported variation in sensitivity and specificity for staging prostate cancer (PCA). ⋯ MRI may be reliable for excluding ECE and SVI in PCA patients where the lesion is visible on MRI. It has a good diagnostic ability for ECE, but is less accurate for identifying SVI. This article supports the use of MRI in the preoperative evaluation of PCA.
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Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period. ⋯ Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.