Irish journal of medical science
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Butyrylcholinesterase (BChE), an important biomarker of exposure to anticholinesterases, varies its activity according to the intensity and duration of exposure to these agents. Their normal values may vary in different populations. It is important to determine the reference values for the local population, mostly black/brown. ⋯ Despite the high miscegenation and predominance of the black race in Salvador, contrary to what was expected, the sample did not show statistically significant intra-racial differences in BChE activity, being able to use the same reference values currently used, observing factors such as sex, use of contraceptives, and drinking alcohol.
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Subarachnoid haemorrhage (SAH) clinical decision rules can provide successful results in the differential diagnosis of non-traumatic headache. ⋯ EMERALD SAH rule plus eosinophil, which offers 100% sensitivity and NPV for predicting SAH in adult non-traumatic headaches, may be recommended as a successful and practical decision rule for clinical use according to the Ottawa and EMERALD SAH rule.
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The brief rise in blood glucose level during acute physiological stress in patients with no previous symptoms of diabetes mellitus is called stress hyperglycemia. ⋯ For patients who are admitted to the hospital with STEMI, stress hyperglycemia in the non-DM group and hyperglycemia in the DM group are associated with both mortality and adverse conditions; thereby, glucose levels of those patients must be evaluated.
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Recruitment and retention of doctors is a priority for the Irish healthcare service, with many leaving to work in regions with more favourable conditions. Aligning flexible training options with other jurisdictions may be an effective means of improving working conditions. We sought to assess possible improvements to the existing system and to review barriers to flexible training. ⋯ Suggestions for improving the system included expanding the number of places available, removing eligibility criteria, job sharing options, and the provision of regional training schemes. Access to flexible training should be a priority for the healthcare service, which may enhance recruitment and retention. A majority of our sample of non-consultant doctors identified a preference for access to flexible training options.
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Myocardial infarction with nonobstructive coronary arteries (MINOCA) is now being recognized as an important clinical entity with prognostic implications. There are limited data in relation to MINOCA in our local Australian settings. ⋯ The clinical prevalence rate of MINOCA at Peninsula Health is 10.9% with a MACE of 5.2%. MINOCA is recognized and the low rate of additional testing could be improved given the female predominance and prognostic implications.