Irish journal of medical science
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Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. ⋯ The mandatory integration of CAST has been welcomed with widespread enthusiasm among specialist anaesthesia trainees. Intuitively, course participation instils confidence in trainees and better equips them to manage anaesthesia emergencies in the clinical setting. It remains to be seen if translational outcomes result from this increase in confidence. Nevertheless, the findings of this extensive review have cemented the place of mandatory simulation training in specialist anaesthesia training in Ireland.
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Review Meta Analysis
Angiotensin II receptor blockers for the treatment of portal hypertension in patients with liver cirrhosis: a systematic review and meta-analysis of randomized controlled trials.
Randomized controlled trials (RCTs) showed inconsistent results regarding the efficacy of angiotensin II receptor blockers (ARBs) on portal pressure as indicated by hepatic venous pressure gradient (HVPG). ⋯ ARBs did not reduce portal pressure in patients with cirrhosis; moreover, the risk of symptomatic hypotension may increase.
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Antimicrobial resistance is an emerging global threat to health and is associated with increased consumption of antibiotics. Seventy-four per cent of antibiotic prescribing takes place in primary care. Much of this is for inappropriate treatment of acute respiratory tract infections. ⋯ There is an emerging consensus in the literature regarding strategies proven to reduce antibiotic consumption for acute respiratory tract infections. The widespread adoption of these strategies in primary care is imperative.
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Hypertensive urgency is defined as a severely elevated systolic blood pressure (SBP) of ≥ 180 mmHg and/or diastolic blood pressure (DBP) of ≥ 120 mmHg, in the absence of end organ damage. It is known that there are racial differences in prevalence and severity of hypertension but there is a dearth of studies looking at hypertensive urgency in Black populations living in Europe. ⋯ The large proportion of newly diagnosed hypertensive patients presenting with end organ signs of prolonged uncontrolled hypertension suggests that there are significant numbers of undiagnosed Black patients in the community, suggesting that we should more actively conduct test for hypertension and its complications when we encounter these patients, who constitute a growing part of the populations in Europe.