Irish journal of medical science
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The Central Statistics Office released new figures on Ireland's health spending in December 2015, based on the System of Health Accounts (SHA2011). These figures differ from previous figures, by virtue of an expanded definition of what constitutes health care. The new figures also provide more detail on health expenditure than the previous figures allowed. ⋯ Suggestions that Ireland is over-spending on health need to be tempered by cognisance that the Irish health system is under-resourced in a number of areas (particularly the number of doctors and the number of hospital beds) and has not fully recovered from cutbacks in the late 1980s and early 1990s.
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Homeless people have excessively high morbidity and mortality rates, yet they face barriers accessing primary care. A mobile health clinic, staffed by GP registrars, was developed to provide services to homeless people, particularly rough sleepers and sex workers. ⋯ A GP Registrar-run Mobile Health Clinic achieved its aims of improving access to primary care for rough sleepers and sex workers, and challenging stereotypes of GP Registrars.
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Review Historical Article
A retrospective review of farm injuries presenting to an Irish hospital emergency department in 2013.
The agricultural and equestrian businesses are an important source of employment in the Midlands. This is a retrospective study examining the demographics, characteristics, and outcomes of agricultural and equestrian related injuries presenting to the Midland Regional Hospital, Tullamore, Co. Offaly. There were a total of 30,700 attendances to the Emergency Department for 2013. ⋯ Our study has identified high-risk mechanisms of injury, which should alert clinicians to the potential for significant injury. In addition, our findings could be used to help policy makers promote safety and awareness through public health policies that target high-risk practices with appropriate training and legislation.
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In the last decades, the studies performed on the field of endothelial dysfunction confirmed the fact that the starting point of this pathology is the inflammation. Several inflammatory biomarkers had been discovered and studied, ones showing systemic inflammation, and others being more specific biomarkers and showing the local inflammation. Pentraxin-3 (PTX3) is a new inflammatory biomarker, from the same family as high-selectivity C-reactive protein (hs-CRP), but it is a more specific biomarker, due to its local production: the endothelial cells and not the liver like in the case of hs-CRP. ⋯ Candesartan decreases PTX3 and hs-CRP plasma levels more powerful than other classes of antihypertensive drugs (beta blockers, calcium channel blockers, and diuretics), so we may assume that candesartan has a more potent action in reversing endothelial dysfunction and that it offers a higher vascular protection than other classes of antihypertensive drugs. We are suggesting that this new biochemical marker, PTX3, might be better and more specific marker for endothelial dysfunction, than hs-CRP.
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The presence of a structural cardiac defect in the setting of dextrocardia is extremely rare. Graspable models allow enhanced appreciation of aberrant structures and vascular relations, particularly in rare and complex cases. This is the first case report of the use of a replica of a patients' anatomy to plan the surgical strategy in the setting of dextrocardia. ⋯ The ongoing advances in medical image procurement and 3D processing software and printing technology will continue to enhance preoperative planning and thereby improve patient care. We demonstrate the pivotal role played by such technologies in advancing spatial comprehension of complex aberrant anatomy.