Irish journal of medical science
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Observational Study
Efficacy and feasibility of awake proning in patients with COVID-19-related acute hypoxemic respiratory failure: an observational, prospective study.
Most of COVID-19 patients present with hypoxemic respiratory failure. Proning is one of the management options proven to improve oxygenation and reduce mortality in non-COVID-19-related acute respiratory distress syndrome. As a response to COVID-19 pandemic surge, a dedicated COVID-19 respiratory ward for the management of mild to moderate ARDS patients who require oxygen therapy, non-invasive ventilation (NIV), or high-flow nasal cannula (HFNC) was established. We adopted a policy of early awake proning in such patients. ⋯ Awake proning was feasible, tolerable, and effective in improving oxygenation in patients with COVID-19-related pneumonia and acute hypoxemic respiratory failure in this prospective study.
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Calreticulin (CALR) mutations are commonly identified in patients with essential thrombocythaemia or myelofibrosis. CALR type 1 mutations are known to have a higher overall incidence in males but little is known about the risks of mutation subtypes on myelofibrotic change across patient age and sex. ⋯ Male patients have a worse myeloproliferative neoplasm phenotype than female patients with it occurring at a younger age and being more myelofibrotic in nature. Further investigation is needed into the reasons for this variability.
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The anti-tumor effect of polo-like kinase 4 (PLK4) inhibitor has been explored in several neoplasms, while its synergy with bortezomib in multiple myeloma (MM) remains elusive. Hence, the present study aimed to investigate the effect of PLK4 inhibitor on the sensitivity of MM to bortezomib treatment and its underlying mechanism. ⋯ PLK4 inhibitor plus bortezomib shows synergy in decreasing cell viability and enhancing cell apoptosis via repressing PI3K/AKT signaling in MM.
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The global healthcare activity including neurosurgical services has been significantly impacted by the COVID-19 pandemic. ⋯ Despite the exceptional stress imposed on our institution by COVID-19, the neurosurgical service managed to maintain comparable activity levels to 2019. The 2021 activity levels were more significantly impacted with 9.4% reduction when compared with pre-pandemic figures in 2019. Institutions need to develop a robust emergency plan to reduce the impact of any subsequent pandemics on healthcare delivery.
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The effect of single or multiple arteries in the donor kidney on renal transplant surgical outcomes.
As the number of end-stage renal disease (ESRD) patients is increasing, but there are not enough living donors, it is necessary to broaden the criteria for candidates who can undergo donor nephrectomy. Thanks to surgeons' increasing experience with laparoscopic donor nephrectomy (LND), multiple renal artery grafts, previously considered a relative contraindication to donor nephrectomy, have become candidates for LDN. We aimed to compare the outcomes of donors and recipients with single artery and with multiple arteries in LDN. ⋯ Increasing the number of donor arteries in renal transplantation (RT) operations prolonged the operation time on both the donor and recipient sides. Still, it had no negative impact on complications or graft function in the postoperative period.