Irish journal of medical science
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Award incentives encourage higher standards of personal performance, which closely reflects the quality of patient care. We report the development, implementation, and success of our internal medicine department awards program. ⋯ In summary, we feel that this transparent, objective, and peer-nominated awards program could serve as an incentivized model for healthcare providers to elevate the standards of personal performance, which in turn will benefit the advancement of patient care.
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The MAGIC/UK Medical Research Council (MRC) trial set the standard of care for treatment of resectable gastric and junctional adenocarcinoma, demonstrating that perioperative chemotherapy with epirubicin, cisplatin and 5-fluorouracil (ECF) confers a survival benefit over surgery alone. The randomized ECF for advanced and locally advanced esophagogastric cancer (REAL-2) trial showed that, in the metastatic setting, the EOX regimen (epirubicin, oxaliplatin and capecitabine) is as effective as ECF, with a favourable toxicity profile. ⋯ This study in a high-volume centre demonstrates that EOX in resectable gastric and junctional adenocarcinoma is associated with a reasonable safety profile, and efficacy consistent with that reported for ECF.
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The incidence of developmental dysplasia of the hip (DDH) in the Republic of Ireland is unknown. It has been shown by previous Irish studies that effective screening methods for DDH are not widely practiced. The effect of this on treatment outcomes is unknown. ⋯ Our overall incidence rate of 6.73 per 1,000 live births in 2009 is similar to other international studies. Worryingly our incidence of 2.77 per 1,000 having late diagnosis and 1.08 per 1,000 live births requiring open surgery was higher. Despite screening with clinical examination, the percentage of late diagnosis remains high. There is a need for the development of a national screening policy with greater use of ultrasound screening to improve current practices.
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A meta-analysis of 25 international studies suggests that 4.2-6.0% of medical admissions are the result of an adverse drug reaction (ADR). One Irish study has found that 8.8% of admissions to a university teaching hospital were attributable to ADRs. ⋯ This study outlines the feasibility of screening for ADR-related admission in the hospital setting. ADRs constitute an important and avoidable cause of hospital admission.
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In addition to its direct cytotoxic effects, radiation therapy renders tumor cells more susceptible to T cell-mediated cytotoxicity by modulating cell surface molecules involved in antigen presentation. The purpose of the present study was to determine the benefit of combined 89Sr radiation and dendritic cell (DC) vaccine therapy in bone metastasis patients. ⋯ The study has important implications for that combined 89Sr radiation, and DC vaccine therapy can benefit cancer patients with bone metastasis.