Irish journal of medical science
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Coercive measures to protect public health are controversial, eliciting questions regarding state-patient relationships and conflicts between individual autonomy and public good. This is challenging in a time when respect for patient autonomy has become elevated yet society faces an increasing number of public health challenges, the most recent being the SARS-CoV-2 virus (COVID-19). ⋯ Further, we consider freedom of choice versus mandatory treatment necessitated to avoid contagion during disease outbreaks (such as COVID-19). In doing so, we utilise rhetorical reasoning in the form of casuistry focusing on the core challenges regarding public good versus personal antipathy towards vaccination.
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Review Case Reports
Nitrous oxide-induced myeloneuropathy: an emerging public health issue.
Increasing use of nitrous oxide as a recreational drug has been reported among young adults in western countries over the past decade. We present two cases of young males presenting to the Emergency Department (ED) of a large urban university hospital in Dublin with progressive neurological dysfunction related to nitrous oxide use. We review the pathophysiology, clinical features and treatment of nitrous oxide neurotoxicity. It is important that clinicians are aware of this evolving public health issue and are able to recognize the clinical features of this rare presentation, which may become more common in Irish EDs and GP surgeries as nitrous oxide abuse becomes more prevalent.
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The vast majority of breast cancers are diagnosed via image-guided procedures yet despite significant advances, imaging does not identify all breast malignancies. Clinically suspicious breast lesions with normal breast imaging remain a cause for concern. The aim of this study is to determine the diagnostic value of clinical core and cutaneous punch biopsies in the diagnosis of breast malignancy in clinically suspicious lesions with normal breast imaging. ⋯ Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies.
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Due to elderly residents, nursing homes/assisted living facilities were the most affected places in COVID-19 pandemic. Besides symptomatic patients, asymptomatic patients were detected during routine screening. ⋯ A durable SARS-CoV-2 IgG antibody response was monitored at least 9 months after the participants were diagnosed with COVID-19. SARS-CoV-2 antibody positivity was detected 76.9% in PCR (+) and 10.0% in PCR (-) participants. Knowing the duration of detectable antibodies is an important finding for developing disease prevention and public health strategies.