Irish journal of medical science
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MRHT is the regional trauma service for the Midlands, providing 24/7 orthopaedic cover. 'Out of hours' surgery is reserved for those occasions where waiting for the next operating list during normal working hours would result in an unacceptable outcome for the patient. ⋯ Surgery out of hours has been associated with increased complications, and so decisions to perform emergency surgery should not be made lightly. However, sometimes they are unfortunately necessary and are some of the most important operations we can perform as orthopaedic surgeons.
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Qualitative research regarding the experience of diabetes self-care management in schools is underrepresented in published literature. In addition, there are methodologic limitations in some of the existing studies. ⋯ Our findings suggest that experiences regarding self-care management of type 1 diabetes are generally more positive among primary school students. Education and knowledge of school staff should be a particular area of focus in both cohorts.
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Observational Study
Non-diabetic fetal macrosomia: outcomes of elective delivery versus expectant management.
Macrosomia in the absence of diabetes can be associated with increased neonatal and maternal morbidity. Management is usually undertaken on a case-by-case basis. ⋯ Overall, there was no difference in major maternal or neonatal outcomes between management options for fetal macrosomia. However, inducing nulliparas with an unfavorable cervix for non-diabetic macrosomia was associated with obstetric anal sphincter injury and postpartum hemorrhage.
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Vitamin B12 (VB12) deficiency is a well-described complication post-gastrectomy. It is caused by the loss of parietal cell mass leading to megaloblastic anaemia. This closed-loop audit assesses patient understanding of and adherence with VB12 supplementation guidelines post-gastrectomy. ⋯ This study demonstrates good adherence in those undergoing TG. Patient understanding correlates with adherence, suggesting that patient education and knowledge reinforcement may be key to adherence with VB12 supplementation. A simple educational intervention can improve adherence with VB12 supplementation in patients undergoing gastrectomy.
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Palliative care (PC) for children with life-limiting conditions (LLC) is a holistic approach to achieve the best quality of life. ⋯ Our study highlights the growing number of LLCs and current pediatric and PC services require further resources and development.