Irish journal of medical science
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Confronted by the many barriers and deficiencies which currently face those responsible for the training of doctors, the concept of a logic model applied in real time may seem aspirational. However, several of the necessary of logic-based practices are already in place - these include quantified training effect and performance, learning analytics, and applied reflective practice. A nationally or internationally co-ordinated effort is required to harness these disciplines (which currently exist disparately) to create a sustainable and effective training system which is adaptive to its own performance and to society's changing needs. This will mean making better use of the data currently being generated by and around training, and its presentation in a timely and comprehensible form to the person(s) who is responsible, prepared, and able to use it to best effect.
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Review
Can social adversity alter the epigenome, trigger oral disease, and affect future generations?
The nature versus nurture debate has intrigued scientific circles for decades. Although extensive research has established a clear relationship between genetics and disease development, recent evidence has highlighted the insufficiency of attributing adverse health outcomes to genetic factors alone. In fact, it has been suggested that environmental influences, such as socioeconomic position (SEP), may play a much larger role in the development of disease than previously thought, with extensive research suggesting that low SEP is associated with adverse health conditions. ⋯ Although little is known about the biological mechanisms underlying this relationship, epigenetic modifications resulting from environmental influences have been suggested to play an important role. This review explores the intersection of health inequalities and epigenetics, the role of early-life social adversity and its long-term epigenetic impacts, and how those living within the lower hierarchies of the socioeconomic pyramid are indeed at higher risk of developing diseases, particularly in relation to oral health. A deeper understanding of these mechanisms could lead to the development of targeted interventions for individuals of low SEP to improve oral health or identify those who are at higher risk of developing oral disease.
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Randomized Controlled Trial Comparative Study
Comparing the tolerability of preservative-free tafluprost versus preserved latanoprost in the management of glaucoma and ocular hypertension - an observer blinded active-control trial.
Dry eye is a condition related to long-term topical eye therapy. We wish to evaluate the effectiveness and tolerability of preservative free prostaglandin drops versus benzalkonium chloride containing prostaglandin drops in the treatment of glaucoma. ⋯ Preservative-free and benzalkonium chloride-containing drops were found to be equally effective in lowering IOP with no significant difference in either subjective or objective measurements of dry eye severity.
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The use of therapeutic plasma exchange (TPE) for treatment of hypertriglyceridemia-induced acute pancreatitis (HTGP) remains controversial in the literature. This study compared the clinical outcomes of TPE versus conventional therapy in patients with HTGP. ⋯ The approach of using TPE for treatment of HTGP was not found to be superior to the conventional treatment. Randomized controlled studies with larger number of patients are needed to gain better understanding of this issue.
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Comparative Study
Absorbable vs. non-absorbable suture: which one gives better results?
There is no ideal suture material or ideal sewing technique. The type of suture material affects the quality of the scars. Patient and surgeon satisfaction with the quality and comfort of the scar is one of the main goals of modern surgery. ⋯ Non-resorptive sutures show statistically significantly better results, especially after 2 weeks from the patient's point of view so we consider them more comfortable and convenient to use.