Irish journal of medical science
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Multiple sclerosis (MS) is a chronic, progressive, and neurodegenerative central nervous system disorder. MS usually causes disability, cognitive deficiency, fatigue, and depression symptoms. ⋯ The level of disability and fatigue adversely affects the cognitive functions of pwMS; depression has no significant effect. BICAMS that is specific for MS can be beneficial to assess the cognitive state of pwMS.
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The reconfiguration of many Irish stand-alone psychiatric units has led to many patients in acute mental health need now being assessed in emergency departments (EDs). This has implications for ED resources and raises questions about appropriate assessment location for this group. ⋯ Removing a direct community access point for this group resulted in a substantial increase in ED presentations, many of which did not have physical needs. This study has implications for future policy to address the needs of this group, especially in light of the pandemic.
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Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL). ⋯ The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.
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Internationally, the number of computerised tomographic pulmonary angiographies (CTPAs) being performed to rule out pulmonary embolism (PE) has caused some concern. ⋯ Application of the PERC rule, as per the ACP guidelines, would have reduced the number of CTPAs performed by 32 (6%) without missing any patient with a proven pulmonary embolus.
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Ireland has the highest rates of overnight hospitalisations for COPD in the OECD, yet lacks estimates of the prevalence of this disease or its pharmacological management. We aimed to estimate the age and sex-specific prevalence of symptomatic COPD and to identify patterns of respiratory medication use to inform interventions to improve pharmacotherapy in this condition. ⋯ The prevalence of medication use consistent with the management of symptomatic COPD mirrors international prevalence estimates. Several patterns raise concern: high ICS use in older adults, under use of LAMA therapy and poor persistence of those newly initiated. We recommend the development of an intervention to assist in the implementation of new national prescribing guidelines for the management of COPD.