Irish journal of medical science
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Review
Practical experience of secukinumab in the treatment of psoriasis: experience from a single centre.
Secukinumab is a novel anti-interleukin-17A agent that has achieved a 75% decrease from baseline in Psoriasis Area and Severity Index (PASI 75) in 77-81% of patients treated in clinical trials Langley et al. (N Engl J Med 371:326-338, 2014). There is limited data on the use of secukinumab outside of clinical trials. We provide real-world data on the efficacy and safety of secukinumab in patients with severe psoriasis attending an outpatient dermatology service. ⋯ Our efficacy is comparable to that seen in the Signature study who examined similar populations. Response was maintained at follow-up of almost 1 year with acceptable safety data. Patients with psoriatic arthritis were more likely to remain on secukinumab than those without at last clinic follow-up.
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Physical activity (PA) is a modifiable health behaviour in patients with colorectal cancer (CRC). Knowing the possible predictors of PA will contribute to producing physical and psychological benefits for CRC patients. ⋯ This study suggests that quality of life, knee extensor muscle strength, and fatigue have the greatest influence on PA in patients with CRC.
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Dysphagia affects up to 30% of hospitalized patients, and it is associated with numerous complications. ⋯ Despite its limitations, this study demonstrates that dysphagia screening produces a significant impact on patients' lives, as well as healthcare professionals and resources. We hope that our results will encourage others to adopt a patient-centred multidisciplinary approach that includes a dysphagia screening protocol.
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Irish Travellers are a marginalised ethnic minority with poor health outcomes, especially in mental health: the suicide rate in this population is 6-7 times that in the general population. There is a paucity of research into associated clinical risk factors including self-harm and mental illnesses. ⋯ This study shows that there is a significant overrepresentation of Travellers in mental health services, suggesting significant need for accessible and acceptable interventions. Those with a BPD diagnosis have a significantly higher risk of self-harm, representing an ultra-high-risk population. These findings can be used to plan future service development projects to better meet the needs of this population: they may require specially adapted version of the mentalisation-based treatment programme.
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The true incidence of sepsis in surgical cohorts in Ireland remains unclear. According to inpatient audits, patients in surgical diagnostic groups (DRG) who developed sepsis had a longer length of stay and higher mortality rate compared with medical DRG patients who developed sepsis. ⋯ Sepsis was under-documented, and barriers exist with use of the national sepsis screening form. Frailty, which is a sepsis risk factor, should be assessed pre-operatively to maximise prevention.