Irish journal of medical science
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Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). ⋯ This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.
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The majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function. ⋯ The study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.
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Large loop excision of the transformation zone (LLETZ) is the most common form of treatment for cervical pre-cancer. The majority of procedures should be performed under local anaesthesia (LA) in an outpatient setting. ⋯ The use of GA for LLETZ rarely confers benefits in terms of diagnostic or therapeutic quality indicators. The categorisation we propose is a simple audit tool that could be adopted by all colposcopy units to reduce the rate of GA.
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The location and staging of a colorectal cancer (CRC) determine prognosis and choice of treatment. We examined the sub-site, sex, and stage distribution for CRC in Ireland for patients diagnosed in the period immediately prior to the implementation of a national screening programme. ⋯ There was a distal-to-proximal shift and a trend towards diagnosis at late stage during 1994-2012. Some reversal of this trend is expected following the implementation of a national screening programme.
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Review Case Reports
Novel antibody associations in immune-mediated necrotising myopathy without inflammation.
The patient presenting with proximal muscle weakness, elevated serum creatinine kinase and myopathic electromyography and biopsy findings has a wide differential diagnosis that includes toxic, autoimmune, paraneoplastic and congenital myopathies. Autoimmune myopathies are important to identify because they may respond to immunosuppressive therapies. ⋯ The identification of myositis-specific antibodies is important because they are associated with distinct clinical phenotypes and may guide the physician in terms of treatment strategies.