Irish journal of medical science
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Endometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not. ⋯ Endometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.
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Because of the uncertainty in the appropriate initial loop diuretic dose in acute decompensated heart failure (ADHF), the risk of acute kidney injury (AKI) is believed to be increased with the high dose of initial intravenous (IV) loop diuretic. ⋯ In patients with ADHF, the initial high dose of IV loop diuretics is associated with an increased risk of developing AKI.
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To report the advice consultants wish they had received on their appointment and to see if that advice differs by gender, or length of time since appointment. ⋯ The emergence of 'self-care' and 'work-life balance' as the top pieces of advice suggests that consultants regret that they have not looked after their health. The fact that 'self-care' was significantly less likely to feature among consultants more than twenty years in practice may point to generational differences.
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Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability. Its diagnosis, classification and management are complex. There is a paucity of data on the standard of COPD management in Irish general practice. ⋯ This study provides a comprehensive snapshot of care in Irish general practice for patients with COPD prior to introduction of the Chronic Disease Management programme (CDM).
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With among the lowest urologist per population ratios in Europe, the demand for urology specialist review in Ireland far exceeds supply. Lower urinary tract symptoms (LUTS) account for a significant number of referrals. The traditional paradigm of every patient being reviewed in a consultant-led clinic is unsustainable. New models of care with nurse-led clinics represent an opportunity to optimise limited resources. ⋯ Introduction of a CNS-led LUTS clinic has significantly reduced the number of patients requiring follow-up in general urology clinics, representing a quality improvement in service provision.