Irish journal of medical science
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Despite the increased uptake of intravascular lithotripsy (IVL) for treating severely calcified coronary lesions, there is limited patient-level data examining the effect of IVL on quality of life, symptomatology, and outcomes beyond 30 days. We sought to assess demographics, procedural characteristics, outcomes, and impact of IVL on patient-reported angina after a minimum of 6 months follow-up. ⋯ Coronary IVL is a safe and effective adjunctive therapy for treating heavily calcified coronary lesions. This cohort shows high procedural success and a significant reduction in CCS angina at follow-up.
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Obesity and its increasing prevalence are global public health concerns. Following joint replacement, there is evidence to support that obese patients are more likely to suffer complications. We examined 10-year trends in BMI of the primary total hip and total knee replacement cohorts in our institution to discern whether the BMI of these patients has changed over time. ⋯ The average BMI of patients undergoing primary hip and knee arthroplasty in our high-volume tertiary orthopaedic centre has remained relatively unchanged over the past 10 years; however, our local service is caring for a greater number of overweight/obese patients due to the increase in overall volume. This will have significant implications on health care expenditure and infrastructure going forward which further emphasises the importance of ongoing national obesity prevention strategies. The increase in BMI seen in females aged < 45 may mark an impending era of obese younger patients with end-stage osteoarthritis.
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Observational Study
Adherence to secondary prevention recommendations after coronary artery bypass graft surgery.
This study was undertaken to assess and evaluate adherence to secondary prevention recommendations and risk factor modifications among a patient cohort at a single-tertiary centre in Ireland, following coronary artery bypass grafting (CABG). ⋯ In this patient population, adherence to medication and control of risk factors is acceptable. However, there is room for improvement in terms of attendance at cardiac rehab (59%) and maintenance of a healthy lifestyle post-CABG.
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The aim of this study is to investigate the impact of the coronavirus pandemic on teenage psychiatry referrals following crisis presentation to the adult emergency department (ED) of an Irish tertiary hospital. In doing so, this study will specifically examine the effect of COVID-19 on self-injurious behaviour, suicidality and substance use among older adolescents (age 16/17 years). ⋯ To our knowledge, this is the first study to specifically examine the impact of COVID-19 on suicidality, self-harming behaviours, substance misuse and on-call ED presentations of teenagers in Ireland. This study demonstrates that coronavirus-related stress is associated with negative mental health sequelae for vulnerable at-risk older adolescents, as evidenced by a rise in ED presentations and on-call referrals since the onset of the pandemic. Presentation of increased numbers of under-18's for psychiatry assessment at the adult ED/general hospital indicates a deepening chasm between available and aspirational emergency (adolescent-specific) psychiatric care in the community. Mobilising resilience factors and maximising coping skills for at-risk youth will inform tailored intervention and support strategies along with adequate resourcing of services for vulnerable adolescents in the community.
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Altered mental status occurs in one in four older adults, and the risk increases with age. Numerous scoring systems have been improved to predict mortality, but data are limited for these scoring systems to interpret older adult patients. ⋯ NEWS2 score can be used to predict 48-h mortality, 30-day mortality, and intensive care unit hospitalization compared with qSOFA in older adults with altered mental status.