Irish journal of medical science
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Randomized Controlled Trial Comparative Study
Propofol-ketamine combination: a choice with less complications and better hemodynamic stability compared to propofol? On a prospective study in a group of colonoscopy patients.
In this study, we compared duration for reaching desired Ramsay Sedation Score (RSS) and postoperative recovery according to Modified Aldrete Score (MAS) of propofol and propofol-ketamine combination in a group of colonoscopy patients. Rates of cardiovascular, respiratory, laryngospasm, visual and nausea/vomiting complications were also compared as secondary outcomes. ⋯ Propofol-ketamine combination is an advantageous choice in means of achieving sedation in a shorter period of time, a better hemodynamic stability, less nausea and vomiting and respiratory complication rates. Yet it seems that this choice might be related with longer recovery duration.
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Randomized Controlled Trial
Administration of hydrogen sulfide protects ischemia reperfusion-induced acute kidney injury by reducing the oxidative stress.
Renal ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury. Hydrogen sulfide (H2S) has been known as a novel gaseous signaling molecule. ⋯ Our data demonstrated that H2S can protect against renal IRI and that its therapeutic effects may be mediated by reducing oxidative stress.
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A positive learning environment in which postgraduate doctors are supported, supervised and nurtured, is likely to lead to enhanced professional satisfaction and improved patient care. ⋯ Recommendations stemming from this study should lead to improvements in the quality of the educational environment of junior doctors and may stimulate similar evaluations in other teaching hospitals.
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More than 48,000 people in Ireland are living with dementia, and the number is likely to rise to 130,000 by 2041. Dementia frequently remains undiagnosed, depriving many of early interventions and the opportunity to plan for the future. Neuroimaging is helpful in the diagnosis of dementia, yet it is often insufficiently utilised. General practitioners (GPs) often decide which patients should be referred on for specialist assessment and as such play a crucial role in dementia diagnosis. ⋯ Access to neuroimaging investigations for suspected cases of dementia varies between locations and public and private systems. To improve diagnostic rates and ensure appropriate utilisation of imaging resources, GPs require access to clinical and referral guidelines to ensure appropriate use of neuroimaging and the best possible patient outcomes.
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Stroke leads to high mortality and morbidity but often there is a conflict between need for palliative care and avoidance of 'therapeutic nihilism'. ⋯ Dyspnoea, pain and respiratory secretions were identified as the main palliative care needs.