Irish journal of medical science
-
The Assisted Decision Making (Capacity) Act 2015 in Ireland is designed to support and maximise a person's capacity to make decisions, although it has not yet commenced. Amendments to the legislation propose to deal with deprivation of liberty of persons lacking capacity. Health care professionals such as geriatricians will need to focus on enabling patient autonomy in response to legislative changes. ⋯ Results highlight a need for collaborative communication between doctors and legal professionals to achieve a structured and supportive framework to inform practice when working under any proposed legislation relating to deprivation of liberty.
-
Observational Study
A preliminary prospective observational study of the effectiveness of high-concentration capsaicin cutaneous patch in the management of chronic post-surgical neuropathic pain.
Chronic post-surgical neuropathic pain is difficult to treat. Topically applied analgesics provide an alternative to systemic therapy in localised neuropathic pain syndromes. The aim of this study was to prospectively assess whether 8% capsaicin is effective in surgically induced neuropathic pain. ⋯ This prospective study provides preliminary evidence for an improvement in patient outcomes with 8% capsaicin in surgically induced neuropathic pain. Improvements were noted in pain interference, and significant reductions in the painful surface area were noted for those who underwent subsequent treatments. Findings should be replicated in a randomised control trial to establish causation.
-
Determining how many female patients who underwent breast imaging meet the eligibility criteria for genetic testing for familial pancreatic cancer (FPC). ⋯ About 10.4% of the female patients were classified as being at high risk for FPC. This finding emphasizes the importance of applying criteria to the general population, in order to ensure that individuals with high risk are identified early.
-
Observational Study
A physiotherapy triage service for orthopaedic upper limb service: an effective way to reduce clinic visits and identify patients for operative intervention.
Waiting times for orthopaedic outpatient clinics are steadily increasing over the past number of years worldwide. Physiotherapy triage clinics are being utilised to improve access for patients with non-urgent or routine musculoskeletal disorders, to be seen in a timely manner in specialised out-patient clinics. Using these clinics, the aim is to ultimately stratify patients into appropriate management pathways. The aim of our study is to review the effectiveness of a physiotherapy triage clinic run by advanced practitioner physiotherapists (APP), who specialise in the review of upper limb referrals from primary care physicians. ⋯ There is a high initial discharge rate after initial assessment by APP triage clinics for upper limb musculoskeletal pathology. This is beneficial in alleviating waiting list pressures allowing only those patients in need of intervention to be placed on the ever expanding waiting lists to see orthopaedic surgeons. This study shows a high proportion of patients being offered surgical intervention after being referred by the APP. We conclude from this that the agreement between the physiotherapist's initial diagnosis and that of the consultant surgeon being similar in identifying patients who would benefit from operative intervention.