Irish journal of medical science
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Supracondylar humerus fractures (SCHFs) represent the most common pediatric elbow fracture, constituting approximately 12-17% of all pediatric fractures. The vast majority of operative supracondylar humerus fractures are treated with closed reduction and percutaneous pinning (CRPP); however, the estimated rate of SCHFs requiring open reduction is approximately 12.7%. ⋯ In our series, a 1.8% rate of open reduction was indicated in flexion-type SCH fractures. All 52 cases of extension-type SCHFs were successfully managed with closed reduction with or without percutaneous pinning. Successful closed reduction using the concept of intact periosteal hinge to aid and maintain reduction is crucial.
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Parenteral nutrition may lead to inevitable complications. ⋯ Close monitoring of electrolyte levels, especially in the first 3 days, is crucial to prevent complications of parenteral nutrition. When individualized PN preparations are used for metabolically unstable patients, it can be easier to maintain the blood glucose, lipids, and electrolyte levels within the normal range.
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The centralisation of rectal cancer management to high-volume oncology centres has translated to improved oncological and survival outcomes. We hypothesise that individual surgeon caseload, specialisation, and experience may be as significant in determining oncologic and postoperative outcomes in rectal cancer surgery. ⋯ Despite improved outcomes seen with centralisation of rectal cancer services at an institutional level, surgeon caseload, experience, and specialisation is of similar importance in obtaining optimal outcomes within institutions.
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To evaluate the short-term effect of intravitreal bevacizumab (avastin) injection on visual outcomes of patients with diabetic macular oedema. ⋯ Treatment with intravitreal bevacizumab injection produces short-term improvement in vision and reduction in central macular thickness in African patients with diabetic macular oedema.
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Measuring and monitoring safety (MMS) is critical to the success of safety improvement efforts in healthcare. However, a major challenge to improving safety is the lack of high quality information to support performance evaluation. ⋯ There are a wide range of methods of MMS in Irish hospitals. It is suggested that there is a need to identify those methods of MMS that are particularly useful in reducing harm and supporting action and improvement and do not place a large burden on healthcare staff to either use or interpret.