Irish journal of medical science
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Tobacco is the leading cause of preventable death in Ireland; half of all long-term smokers die prematurely from smoking-related diseases. Achieving 'Tobacco Free Ireland' (a smoking prevalence of less than 5%) will require the prevention of smoking initiation and the promotion of smoking cessation. ⋯ This study highlights the need to strengthen smoking cessation in Ireland to increase the number of smokers that successfully quit and achieve a Tobacco Free Ireland. The development and implementation of National Clinical Guidelines for the Diagnosis and Treatment of Tobacco Addiction will play a key role in this.
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Observational Study
Prediction of postoperative delirium by comprehensive geriatric assessment among elderly patients with hip fracture.
The purpose of this study is to investigate whether the preoperative comprehensive geriatric assessment (CGA) would predict postoperative delirium (POD) in elderly patients with hip fracture. ⋯ The comprehensive geriatric assessment before hip fracture surgery can predict the occurrence of POD in elderly patients.
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Sacubitril-valsartan has been shown by the PARADIGM-HF trial to decrease hospital admissions and improve mortality in patients with heart failure with reduced ejection fraction. The PARADIGM trial had stringent exclusion criteria. It is not known how applicable these trial criteria are to real-life practice. In this study, we sought to determine the percentage of patients eligible for sacubitril-valsartan therapy in a level 3 hospital without a dedicated heart failure service. ⋯ Our study showed that a smaller than expected proportion of our patients in real-world practice are suitable for sacubitril-valsartan therapy at discharge. Most patients were in the HFPEF cohort which does not currently have evidence for treatment with sacubitril-valsartan. Low rates of prescribing of basic heart failure medicatons and the absence of dedicated heart failure services in a non-tertiary centre may explain the poor compliance observed. Improving guideline adherence and increasing awareness of evidence-based medication use at primary and secondary care levels would be of benefit to Irish heart failure patients.
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Mid-adolescence, that twilight era when the human child transitions to adulthood, is an often overlooked developmental age yet harbours a subpopulation of patients with their own myriad of medical problems somewhat unique to their age group. ⋯ The results highlight the most common presentations of this subgroup of patients, with trauma, in keeping with recent international data, being the most common presentation. The noted high frequency in the number of mental health/intoxication/self-harm presentations among the Irish teenagers in our region is consistent with trends reported in world literature and serves to emphasise one of the main challenges facing those working in paediatrics in Ireland over the next 10 years.
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Shoulder instability following traumatic glenohumeral dislocation is a common injury sustained by athletes particularly in contact and collision sports. Overhead contact sports such as gaelic football and hurling pose a unique hazard to the glenohumeral joint, increasing the risk of dislocation. ⋯ Favourable outcomes can be expected for overhead contact sport athletes undergoing anterior arthroscopic stabilisation for recurrent instability. Players from these groups returned to sport sooner than those from other sports and no difference in recurrence was noted. The level at which they can expect to return to is favourable with most athletes reaching their pre-injury level.