Irish journal of medical science
-
Elective and emergent coronary interventions via transradial access (TRA) are been used increasingly as they carry a reduced risk of complications. Percutaneous coronary intervention via TRA may lead to radial artery spasms (RAS) that may result in prolonged procedure time, cross-over of access site, and other complications. This review article discusses the recent definitions, incidences, pathophysiology, predictive score calculator, efficacy, the safety of the radial cocktails, and treatment of the RAS.
-
Surgical site infection (SSI) is a major cause of morbidity, resulting in significant healthcare and economic implications. The ability to predict patients at high risk of SSI may enable targeted follow-up and management. This study sought to examine the relationship between the CRP/albumin ratio in the prediction of SSI in patients undergoing emergency major abdominal surgery. ⋯ Though CRP and albumin have merit in isolation in preoperative identification of patients at risk of SSI, CRP/albumin ratio is a useful postoperatively adjunct in predicting SSI postoperatively at 24 and 48hrs postoperatively.
-
Asthma is the commonest chronic condition in childhood but mortality from asthma during childhood is a rare occurrence. No national review into asthma deaths in children in Ireland has been performed to date. ⋯ Our data suggests that most patients present in extremis and have little warning signs of severity of the attack. Better education on recognition of symptoms and initiation of action plans is required.
-
Laparoscopic transperitoneal and retroperitoneoscopic adrenalectomy have largely replaced open adrenal surgery, particularly in benign disease. Laparoscopic surgery results in less post-operative pain, fewer surgical site complications and reduced length of hospital stay. The aim of this retrospective study was to analyse the characteristics of patients and evolution of surgical technique in adrenal surgery at Cork University Hospital over a 12-year period. ⋯ Adrenalectomy is a safe procedure and in our setting was primarily performed for pheochromocytoma and non-functioning adenomas. Minimally invasive adrenalectomy has become the standard of care internationally and is associated with fewer complications, shorter hospital stay and a low conversion rate.
-
The incidence of hip fractures is expected to increase over the coming years, placing a greater burden on limited resources. A high volume of patients is brought to hospitals that do not have the resources necessary to provide definitive care. Optimal care involves a coordinated and integrated system of trauma care. The hip fracture care pathway introduced between a referring peripheral hospital and our institution represents a coordinated multidisciplinary approach to patient care. ⋯ The fragmented approach to the management of trauma patients both in a pre-hospital and hospital care setting is a cause for concern. Our integrated hip fracture referral pathway, incorporating bypass of the referring hospital, represents a multidisciplinary care pathway for the management of patients with fractured neck of femur and can have potential benefits including improved patient outcomes, allowing the optimal allocation of resources and providing training opportunities.