Irish journal of medical science
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Biography Historical Article
Douglas Argyll Robertson (1837-1909) and his pupil.
Douglas Argyll Robertson's (1837-1909) experimental work with physostigmine in 1863 sharpened his knowledge of the innervation of the internal muscles of the eye. So he was ideally prepared in 1869 to analyse the conundrum when he saw patients with spinal cord disease who had lost the response to light even though accommodation to near objects was normal. By translating his knowledge of basic science to a clinical problem he drew attention to this phenomenon, known subsequently as the Argyll Robertson pupil that came to be considered pathognomonic of tabes dorsalis, general paresis and neurovascular syphilis.
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This study evaluated outcomes for the first 100 bariatric surgical procedures in a single, publicly funded Irish centre. ⋯ This series audits the introduction of a publicly funded bariatric service in Ireland and reports a high percentage of procedures completed laparoscopically with an acceptable morbidity and mortality.
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Comparative Study
An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006.
Evidence-based practice supports the provision of integrated geriatric multidisciplinary care for older people with hip fractures. ⋯ Following introduction of an orthogeriatric service, improvements in mortality and discharge destination occurred. This may have been influenced by higher proportions of disability among the 2001 cohort.
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A 76-year-old previously well farmer presented having caught his left index finger in a gate. He gave no history of prior tetanus vaccination. ⋯ Eleven days later he represented unable to open his mouth. On examination he was noted to have trismus, generalised muscle spasms, diaphoresis and emotional lability and he was diagnosed with generalised tetanus.
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Cholelithiasis typically presents with right upper quadrant pain, as can pain from other right upper quadrant organs. Pain of cholelithiasis is often referred to tip of scapula. Professor Paddy Collins drew attention to fact that patients with gallstone pain would attempt to demonstrate this by placing their hand behind the back and thumb pointing upwards. This became known amongst his students as Collins' sign. ⋯ Collins' sign was positive in over half of all patients with cholelithiasis and was useful discriminator in diagnosis of gallstones.