Irish journal of medical science
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A combination of improvements in patient survival, increasing treatment duration, and the development of more expensive agents has led to a doubling of per-capita spending on cancer medicines in Ireland (2008-2018). Despite this, access to new drugs is poor in comparison to other EU countries. We examine methods to optimise oncology drug spending to facilitate access to newer anticancer agents. ⋯ A variety of techniques are being employed by oncologists to optimise costs and increase access to innovation for patients. Use of biosimilars, drug wastage, and prescribing at end of life should be audited as key performance indicators, which may lead to reflective practice on treatment planning. Such measures could further optimise oncology drug expenditure nationally facilitating approval of new agents.
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Randomized Controlled Trial Comparative Study
Validity of galactin-3 in acromegaly: comparison with traditional markers.
Acromegaly occurs due to overproduction of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Galectin-3 (Gal-3) has recently emerged as a novel biomarker, related to IGF-1. This study aimed to assess Gal-3 in patients with acromegaly and compare its effectiveness with traditional biomarker tests. ⋯ In a summary, this study recommended clinicians measure serum Gal-3 as biomarkers for patients with acromegaly. In addition, the result above shed light on role of Gal-3 on acromegaly pathogenesis and might provide a therapeutic target of acromegaly patients.
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Randomized Controlled Trial
Effect of oral naloxone on opioid-induced constipation in methadone maintenance treatment patients, a double-blind, placebo-control, clinical trial.
Opioid-induced constipation (OIC) is the most prevalent side effect of methadone maintenance therapy (MMT). Naloxone could reduce the OIC. ⋯ Oral naloxone at doses of 0.5 and 2 mg/day was significantly more effective than placebo on OIC in MMT. However, the dose of 4 mg induced intolerable OWS.
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Observational Study
Examining the approach to medical remediation programmes-an observational study.
Remediation of underperforming students is recognised as an important tool in medical education; however, there is no universally agreed approach. ⋯ This study demonstrates the need to focus on overall academic performance to identify struggling students rather than one high stakes exam. Most of the students in the remediation programme ultimately passed LCA2.
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Randomized Controlled Trial
The effectiveness of aerobic exercise and neck exercises in pediatric migraine treatment: a randomized controlled single-blind study.
Migraine is a prevalent condition with debilitating effects. In the context of pediatric migraine, there exists a notable scarcity of data regarding the effectiveness of exercise interventions. Furthermore, despite the prevalent occurrence of neck pain in these patients, the role of cervical musculoskeletal disorders in the etiology continues to be a debated topic. ⋯ Aerobic and neck exercises are effective in reducing the symptoms of pediatric migraine. Aerobic exercise may be particularly beneficial for reducing the attack frequency. These findings contribute to the limited data on exercise interventions for pediatric migraineurs and highlight the importance of tailored exercise programs for managing this condition. Future studies should consider more extensive exercise modalities and include diverse patient cohorts.