Irish journal of medical science
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There is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years. ⋯ In both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes.
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Pachydermodactyly is a rare, benign fibromatosis located around the proximal interphalangeal joints. It is often misdiagnosed as juvenile idiopathic arthritis and may cause unnecessary treatments and anxiety in patients. The goal of this paper is to describe this condition through all the existing information in the scientific literature. ⋯ Diagnosis can be established in asymptomatic young patients through a congruent physical exam, regular analytic results and imaging tests that simply show swelling of soft tissue-a biopsy is generally not required for diagnosis. As pachydermodactyly's course is asymptomatic and benign, knowledge about this condition is limited, which increases the likelihood of its underdiagnosis-it is important that clinicians know of pachydermodactyly in order to avoid misdiagnosis.
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Osteoarthritis is a significant cause of chronic pain in the elderly population with hip osteoarthritis as one of the main causes of functional disability and joint pain in adults older than 55 years. Recently, platelet rich plasma (PRP) injections have been introduced for treatment of osteoarthritis. The aim of this systematic review is to assess its effectiveness in the management of hip osteoarthritis. ⋯ PRP was shown to improve patient outcome scores at follow-up at 6 and 12 months; however, there was no significant difference seen between patients treated with PRP or hyaluronic acid alone. Following this systematic review, we cannot currently recommend the use of intra-articular injections of PRP for the treatment of hip OA. Given that intra-articular steroid injections are the only such injection recommended by international guidelines for the treatment of hip OA, further studies comparing PRP to steroid would be of benefit to determine the value of PRP injections in hip OA.
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The colon has an important role in managing nitrogenous waste products, electrolytes, and mineral balance during kidney diseases. However, colonic microbiota produces uremic toxins, such as indoxyl sulfate and p-cresyl sulfate, in chronic kidney disease (CKD) patients, which due to their proinflammatory properties contribute to CKD progression. Conversely, in acute renal injury patients, intestinal microbiota could reduce inflammation by secreting short-chain fatty acids and inducing a renal protective immune response. However, since the intestines are the most frequently affected organ in advanced sepsis, colonic microbiota can also represent a negative factor for kidney health in this scenario. ⋯ In the present review, the main characteristics of kidney-gut crosstalk are described.
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Reproductive surrogacy can be altruistic or commercial, each with complex ethical considerations that are complicated by heterogeneity in governing laws across jurisdictions. Surrogacy in Ireland is relatively new and largely unregulated, so this review aims to elucidate its current regulatory status and associated ethical issues. AIMS: On reproductive surrogacy from an Irish legal perspective, to: 1. ⋯ However, Ireland is free to draft laws aligned with modern societal views on reproduction, which is especially relevant given the recent legalisation of same-sex marriage. Ethically, carrying mothers and children are vulnerable, particularly in commercial arrangements, with significant financial disparities between commissioning and surrogate parties. Altruistic arrangements can be a boon to Irish society if supported by public education and appropriate legal frameworks.