Irish journal of medical science
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In 2018, there were more than 12,000 self-harm presentations to emergency departments (EDs) in Ireland with 50% occurring between 7p.m. and 3a.m. There is evidence that the assessment quality and follow-up is variable across clinicians. To address this, The National Clinical Programme for the Management of Self-Harm in the ED (NCPSH 2016) was developed to set clear standards. ⋯ In contrast to previous findings, our study found higher rates of alcohol-related disorders diagnosed during normal hours vs OOH. Furthermore, voluntary and addiction services were under-utilised OOH and this presents an important teaching opportunity.
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Fibromyalgia patients who are exposed to extreme oxidative stress may face more severe clinical features or oxidative stress may be increased by the severity of the disease. ⋯ These results suggest that FMS patients have an alteration in levels of MDA, NO, and PON-1 activities. We think that impaired oxidant/antioxidant status may affect the symptoms of the disease. Also, they may be of importance in the complex physiopathologic mechanism behind the development of FMS.
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Poor COVID-19 outcomes occur with higher frequency in people with rheumatic and musculoskeletal diseases (RMD). Better understanding of the factors involved is crucial to informing patients and clinicians regarding risk mitigation. ⋯ Hospitalisation or death were more frequently experienced by RMD patients with increasing age, certain comorbidities including potentially modifiable ones, and certain medications and diagnoses amongst other factors. These are important 'indicators' that can help risk-stratify and inform the management of RMD patients.
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The SARS-CoV-2 pandemic has prompted clinicians to develop an early and effective treatment of viral infections. To date, vaccines, monoclonal antibodies, and antivirals are the cornerstone of therapy for SARS-CoV-2. AIFA approved the prescription of molnupiravir on 30/12/2021. Molnupiravir is a prodrug that causes the accumulation of errors in the viral genome. ⋯ Molnupiravir is safe and well-tolerated by patients with high-risk of progression to severe COVID. No patients were hospitalized or showed sequelae, including all patients affected by IPF.
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Cystic hygroma (CH) is a benign congenital lymphatic malformation, occurring predominantly in children, typically as an asymptomatic neck mass. Surgical resection or sclerotherapy is the recommended treatment options. A retrospective review of four cases of adult-onset CH was performed over 2 years by a single surgeon across two institutions. ⋯ As of yet, there are no guidelines on the management of CH. Individualised care tailored to each patient, following careful discussion is the most prudent approach. This study demonstrates that surgical resection is a safe and effective treatment for adults in this rarely encountered clinical entity.