Irish journal of medical science
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Longitudinal integrated clerkships (LICs) are a relatively new model of clinical medical education, whereby students participate in patient care over time and develop relationships with those patients', their clinicians, and other health care staff involved in the care of those patients. It has been called 'relationship-based education' but, to date, no review has investigated the development and impact of these central relationships within this curricula model. ⋯ The longitudinal integrated clerkship model of clinical education facilitates the development of meaningful triangular relationships between student, clinical teacher and patient, which are the central drivers of successful learning within the context of an LIC. These relationships are nested in a set of important supporting relationships involving other supervisors, the medical school and university, the practice clinical and administrative team and peers.
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This retrospective study reviews the maxillofacial fractures (MF) over a 5-year period at the National Maxillofacial Unit, St James Hospital Dublin, with an emphasis on female patients. ⋯ This study confirms maxillofacial fractures are less common in females. The female age distribution demonstrates two peaks, one in early adult and a second in old age. This may be explained by females living longer and independently and at risk for falls. The most commonly reported fracture aetiology in females was "falls." This raises concerns as to whether "falls" are used to explain an assault. There is an informal concern amongst maxillofacial surgeons that females presenting with facial trauma may be the victims of domestic violence, which may be denied by the victims.
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Review
There are similarities between rheumatic disease with lung involvement and COVID-19 pneumonia.
There is considerable overlap between the clinical manifestations of covid-19 pneumonia and the acute interstitial lung disease seen in certain rheumatic disorders. In addition, pulmonary fibrosis is increasingly recognised as a potentially serious consequence of both. ⋯ We propose how lessons learned from the insights recently gained into each disorder can improve our insight into immunological mechanisms and application of therapeutic interventions in the other.
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International studies show that dizziness and vertigo are a significant burden on the general population, with 20-30% experiencing symptoms over a lifetime. There are no Irish studies indicating prevalence. The aim of this study was to review primary care referrals for patients with dizziness and vertigo to an otolaryngology tertiary centre. ⋯ This study demonstrates that a significant number of patients referred to an otologist from primary care are referred with dizziness and vertigo and supports the need for the establishment of multi-disciplinary vestibular/balance centres to address and manage these patients.
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Multiple sclerosis (MS) is an immune-mediated, demyelinating disease of the nervous system, which may impact the audiovestibular pathway at different stages of the disease. The auditory and vestibular manifestations of MS as a presenting or early symptom are an area in which more investigation is needed. ⋯ An understanding of the sensitivity of evoked potentials in the detection of demyelinating lesions as well as the most common audiovestibular presentations of the disease allows the practitioner to provide an appropriate onward referral for MRI which may lead to early diagnosis and intervention of MS. We suggest that there is enough evidence to include evoked potentials complementary to MRI in the detection and monitoring of MS. As the review suggests evidence of involvement of the immune-mediated mechanisms of MS on peripheral structures like the inner ear, further clinical research is recommended to explore this mechanism. Key points 1. The most common audiovestibular manifestation as an early symptom of MS was unilateral moderate to profound SSHL across all frequencies (250 Hz-8000 Hz). 2. Findings of the review indicated the involvement of the immune-mediated mechanisms of MS in the peripheral structures of the inner ear. 3. These findings included peripheral results in the vestibular test of the patients involved in the study and secondly, the three studies which reported an absence of full recovery of hearing loss were also three papers which within their ABR results showed abnormality of wave I 4. This is the first paper to support the theory (Di Stadio et al. 2018) [32] that immune-mediated processes of MS can spread to peripheral inner ear structures 5. The review highlighted the sensitivity of evoked potentials in detecting MS lesions in the presenting stage, particularly ABR which demonstrated that in instances in which hearing loss recovered ABR results remained abnormal.