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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Patients' awareness of the increased cardiovascular risk associated with their diabetes is poorly documented. ⋯ Awareness of cardiovascular risk and knowledge of effective measures to reduce this were low in our study and an alternative means of education may need to be considered.
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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.
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Renal transplantation remains the preferred method of renal replacement therapy in terms of patient survival, quality of life and cost. However, patients have a high risk of complications ranging from rejection episodes, infection and cancer, amongst others. ⋯ This study highlights the work needed by the transplantation community to improve patient education, adjust immunosuppression where necessary and aggressively manage patient risk factors.
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To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy. ⋯ The SAQ was successfully applied to an AMAU setting giving a valuable insight into staff issues of concern across the safety spectrum: employee and environmental safety, clinical risk management and medication safety.