Irish journal of medical science
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Randomized Controlled Trial Comparative Study
Ventilator-associated pneumonia in patients using HME filters and heated humidifiers.
Ventilator-associated pneumonia (VAP) is a clinical form of hospital-associated pneumonia, which may develop within 48 h in patients on mechanical ventilation who had no pre-existing pneumonia at the time of intubation. ⋯ There were no significant differences between the groups on HME filters and heated humidifiers in terms of infection development; although pulmonary radiography showed delayed average days to infiltration development for subjects using HME filters.
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Stress and burnout are common among doctors. Excess levels of stress have been shown to have detrimental personal and professional effects as well as a negative influence on patient care. ⋯ Burnout is reported among interns in our pilot study. Measures need to be taken to heighten awareness of burnout among doctors and to educate physicians regarding self-awareness and personal health.
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A variety of free flaps have been successfully used for mandible reconstruction. The iliac crest has similar dimensions and form to the lateral mandible. The success rate and complication rate of deep circumflex iliac artery flap transplants had no significant difference to those of other microvascular bone transplants. ⋯ Our results show that deep circumflex iliac artery is a reliable method for reconstructing hemimandibular body defects with an acceptably low rate of morbidity. The iliac crest is a safe foundation for the placement of osseointegrated implants, which enable good reconstruction and further improve life quality of patients.
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Material deprivation in cold weather may increase the risk of hypothermia and contribute to excess winter mortality. To date, there were no local data to support the potential contribution of material deprivation to the incidence of hypothermia in Irish older people. ⋯ The NDI could be an adequate tool to target fuel poverty in older people.
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Comparative Study Clinical Trial
Tubular stomach or whole stomach for esophagectomy through cervico-thoraco-abdominal approach: a comparative clinical study on anastomotic leakage.
Esophagectomy through cervico-thoraco-abdominal approach is a useful surgical technique in treating patients with esophageal cancer. However, the cervical reconstruction is also known to have a high rate of anastomotic leakage, as well as anastomotic stricture, intrathoracic stomach syndrome, reflux esophagitis and other complications, thereby influencing postoperative recovery and quality of life. ⋯ This observation study suggests that for esophageal cancer patients undergoing the 3-field esophagectomy tubular stomach is better than whole stomach for esophageal reconstruction as reflected by a reduced postoperative anastomotic leakage, intrathoracic syndrome and reflux esophagitis.