Irish journal of medical science
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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.
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Severe acute kidney injury (AKI) requiring urgent hemodialysis (uHD) is associated with considerable morbidity and mortality in patients with multiple myeloma (MM). ⋯ The need for uHD was associated with poor survival. Recovery of renal function was not associated with improved survival.
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Advanced clinical prioritisation (ACP) pathways could potentially improve the interface between primary and secondary care, instigating appropriate treatment pathways with improved efficiencies. Telemedicine is a key component of ACP pathways. ⋯ Telemedicine as part of ACP represents an opportunity to improve speed of access to care, reducing the number of patients and time spent on waiting lists. Future studies should be directed at assessing efficacy of treatment plans initiated in telemedicine clinics whilst also looking at cost effectiveness and patient satisfaction.
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With blood products being a limited and expensive resource within the healthcare system, there is an ever-increasing emphasis on judicial and appropriate use. ⋯ The implementation of guidelines has resulted in substantial reduction in RCC transfusions between 2015 and 2018. Fewer women received a blood transfusion, and those who did received fewer units. There is a higher proportion of patients being reassessed between units and receiving single unit transfusions. Recording of consent has improved.
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Fatigue following acute viral illnesses is a major issue that complicates the clinical course of several epidemic and non-epidemic viral infections. There is a noticeably higher trend of patients with symptoms that persist after initial recovery from acute COVID-19. This study seeks to obtain more data about the prevalence of post-COVID-19 fatigue and the factors associated with higher fatigue frequency among patients who had COVID-19. ⋯ Post-COVID-19 fatigue is a major issue following the initial acute illness with COVID-19, with a prevalence of 43.3%. We recommend implementing standardized measures to screen for post-COVID-19 fatigue, especially among female patients.