Irish journal of medical science
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The traditional model for emergency surgical care consists of an on-call team providing service to the emergency department, while simultaneously balancing the demands of elective work. Various newer models, such as the "surgeon of the week" aim to reduce the conflict between elective and emergency duties. Despite the recent focus on newer models, there remains no data on the effectiveness of the traditional model. We aim to assess the efficacy of the traditional model in a large regional hospital. ⋯ Newer models of acute surgical care have desirable outcomes in consultation times. However, regional and economical implications have a substantial impact on which model is feasible at local levels. We demonstrated that the traditional model still remains effective in a large sized tertiary referral unit.
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As the Irish population ages, the management of chronic conditions in primary care is emerging as a challenge. The presence of co-morbid depression is common among such patients and may affect their response to treatment. ⋯ Patients with type 2 DM are more likely to suffer from severe depression than those without. Depression itself is not an independent predictor of diabetes control. However, it may be that the increased rates of depression observed in patients with type 2 DM are at least partially attributable to the burden of additional illnesses seen in these patients.
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The aim of this study was to assess the relationship between the maternal superior mesenteric artery Doppler, pancreatic size and gestational diabetes mellitus (GDM). ⋯ Superior mesenteric artery Doppler and pancreatic size evaluation may be utilized to detect abnormal glucose metabolism during pregnancy care.
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Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period. ⋯ Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.
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Comparative Study
Open versus laparoscopic abdominal rectopexy: an examination of early postoperative outcomes.
Abdominal rectopexy is used to treat full thickness rectal prolapse and obstructed defecation syndrome, with good outcomes. Use of a laparoscopic approach may reduce morbidity. The current study assessed short-term operative outcomes for patients undergoing laparoscopic or open rectopexy. ⋯ Laparoscopic rectopexy has similar short-term outcomes to open rectopexy.