Irish journal of medical science
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Collagenase Clostridium histolyticum (CCH) is a recent treatment for Dupuytren disease, which is a fibroproliferative disorder that leads to progressive, persistent digital flexion contracture that interferes with basic daily activities. While CCH has changed the treatment of this hand disorder, numerous concerns have to be analyzed. ⋯ Currently, the administration of this treatment is promising although long-term studies are necessary to see the real role that this drug can play in both Dupuytren's disease and other fibrotic disorders.
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New-onset diabetes after transplant (NODAT) confers risk of diabetes-related complications as well as a threat to graft function and overall patient survival. The reported incidence of NODAT varies from 14 to 37% in renal transplant recipients worldwide; however, NODAT is yet to be studied in the Irish renal transplant population. ⋯ NODAT incidence in the Irish renal transplant population is slightly below international figures. This project has highlighted current deficits in the national transplant guidelines for the detection of NODAT and NODAT-related risk factors.
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For all its abundant rewards, many assert that surgery is a career that requires significant commitment and sacrifice. Many suggest that when left unchecked, this commitment may incite burnout owing principally to the unique time and emotional demands of the profession. Burnout is variably defined as a complex stress reaction that disproportionately affects healthcare workers, including surgeons. ⋯ As a result of this, the phenomenon of burnout is increasing attracting attention in contemporary healthcare. This essay examines the extent to which commitment is required in a surgical career and offsets it against the risks and consequences of burnout. Ultimately, the authors conclude that surgeons must be aware of both when and how overzealous, unchecked commitment may paradoxically impair their care via the incubation of burnout.
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Accidental dural puncture (ADP) during epidural catheter insertion and the possible consequent post-dural puncture headache (PDPH) remain challenging complications in obstetric anaesthesia. ADP/PDPH can represent a considerable degree of morbidity for the parturient and require immediate diagnosis and appropriate management to ensure recovery and avoid complications. ⋯ The incidence of ADP at our hospital (0.78%) is within the range quoted in the literature (0.1-1.5%) and below the UK standard of 1%. The incidence of PDPH after recognized ADP (68%) is also consistent with other published reports.
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Dr Séamus Mac Suibhne (Sweeney) (1978-2019) was a widely admired psychiatrist, writer and scholar whose contributions ranged from psychiatric care to Greek philosophy, and from medical education to the application of new technologies in educational and clinical settings. Séamus wrote extensively on these and many other themes in the professional and popular literature. In his clinical work, Séamus was a compassionate doctor, effective team-worker and skilled manager. ⋯ Philosophy was, perhaps, his greatest intellectual passion and he spoke and wrote extensively on themes linking philosophy with clinical care, the history of psychiatry and reflective practice in medicine. Séamus wrote and co-wrote on a range of other topics including psychiatric liaison with primary care, 'vampirism' as a mental illness, translation and interpretation in psychiatry, synaesthesia, 'new' mental illnesses such as solastalgia and hubris syndrome, bibliotherapy, the work of Nicholas Culpeper (a seventeenth-century English physician) and mental illness among psychiatrists. Séamus Mac Suibhne is deeply missed in Irish psychiatry, but his many contributions bear elegant, lasting testament to a dedicated family man, a gifted doctor and an enquiring, often brilliant mind.