Irish journal of medical science
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The literature emphasizes that a consideration of patients' perspectives is an important part of the assessment process; however, it is ignored by many clinicians because they believe physical impairment measures can reflect patients' perspectives about their symptoms. But the relevance of changes in physical impairments to changes in patient-reported outcome scores in rotator cuff disease is ambiguous. ⋯ This study implies that the changes in glenohumeral ROM and shoulder muscle strength do not represent the changes in patients' perspectives in pain, disability, and health-related quality of life after the physical therapy program in patients with rotator cuff disease.
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The use of continuous subcutaneous insulin infusion (CSII) in the management of paediatric patients with type 1 diabetes mellitus (T1DM) has increased substantially in the last decade. The aim of this study was to evaluate and compare glycaemic control in a population of paediatric patients with T1DM before commencing CSII compared with 2 years after commencing CSII. ⋯ CSII commencement is associated with significantly improved glycaemic control most notably in the first 6 months after CSII commencement. There is association between CSII commencement and increased BMI noted to be statistically significant in the second year.
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Celiac disease (CD) is a chronic intestinal immune-mediated disease occurring in genetically susceptible individuals who are exposed to gluten. Although it primarily affects the small intestine, CD has been associated with a wide spectrum of extraintestinal manifestations, including thromboembolism and cardiovascular events. ⋯ The pathogenetic mechanism of increasing hypercoagulability in CD is multifactorial and involves hyperhomocysteinemia due to malabsorption of vitamins B12, B6, and folic acid; endothelial dysfunction; acceleration of atherosclerosis; chronic inflammation; thrombocytosis; and thrombophilia. Therefore, in cases of thromboembolic complications and cardiovascular disease of obscure etiology, clinicians' awareness of possible celiac disease is warranted.
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To assess for changes in trends of GP chest radiograph reporting over a 10-year period and to assess if there has been a change in recommendations for follow-up. ⋯ Along with the increase in the quantity of GP-referred chest radiographs over the past 10 years, suggestions for follow-up have increased, particularly for nodule surveillance. Reasons for this increase may include lack of availability of CT to GPs for lung cancer screening, insensitivity of plain radiographs to early cancer detection, and possible fear of litigation for missing lesions, making radiologists more cautious.