Irish journal of medical science
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Immigration has been shown to have an increasingly important effect on the epidemiology of tuberculosis (TB) in developed countries. ⋯ Our study highlights the problem of TB in children, the majority of whom are native to this country.
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To analyse the efficacy of short-course (SCRT) versus long-course radiotherapy/chemoradiation (LCRT) as a neoadjuvant modality for the management of lower rectal cancer (LRC). ⋯ SCRT and LCRT may be as effective as traditional LCRT in terms of overall survival, recurrence, perioperative complications, sphincter preservation and toxicity. Traditional neoadjuvant chemoradiation may continue to be used.
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Review Case Reports
Transient isolated lingual nerve neuropraxia associated with general anaesthesia and laryngeal mask use: two case reports and a review of the literature.
Transient, isolated lingual nerve neuropraxia is a rare complication following general anaesthesia. Reports implicate airway manipulation and we describe two new cases associated with laryngeal mask airway (LMA) and review the related English language literature. ⋯ Lingual neuropraxias reported have been transient and patients can be advised, despite disturbing symptoms, that recovery is anticipated in about 1 month. Lingual neuropraxia reports are becoming more frequent, perhaps associated with increasing LMA use. Research is recommended as modification to LMA cuff volume, pressure and/or position within the oral cavity might ameliorate the entity.
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Gun-related crime offences have increased in the Republic of Ireland steadily over the past number of years. Regional trauma units are witnessing unprecedented numbers of injuries in the Republic of Ireland with limited prior experience. ⋯ Ireland has comparable survival outcomes to other international centres with similar patient demographics due to timely and appropriate operative intervention. These results serve to provide a template for further patient management.
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Case Reports
Fractured closed suction catheter: an unusual cause of endobronchial obstruction in a ventilated patient.
A 32-year-old HIV-positive man required ventilation for seizures secondary to viral encephalitis. He had a prolonged care unit stay and had percutaneous tracheostomy performed on day 14 of his admission. He subsequently developed persistent right basal infiltrates and atelectasis on chest radiographs that were slow to respond to antibiotic treatment. Fiberoptic bronchoscopy revealed the cause of his infiltrates to be a 14-cm tip section of closed suction catheter tubing that had presumably fractured during suctioning and became lodged in his trachea and right main bronchus. ⋯ This case describes a rare cause of endobronchial obstruction in a ventilated patient. Medical staff requires education about the importance of ensuring that suction catheters and other airway adjuncts are intact following use to prevent possible airway foreign bodies.