Irish journal of medical science
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Intravenous drug misuse, principally heroin, occurs primarily in the Greater Dublin area. Methadone maintenance treatment has been an important part of the response to opiate misuse in Dublin since 1992. ⋯ Opiate-related deaths occur primarily in males in the 25-34 year age group and are associated with a high level of polydrug use. Diverted methadone accounted for the majority of deaths involving
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The mortality and morbidity of patients with breast cancer can vary even between individuals with similar histological stage at diagnosis. Identification of those individuals with prognostically poorer tumours is an essential prerequisite in planning adjuvant therapies. Some prognostic indices of tumour size, grade, oestrogen receptor status and nodal status are well established. ⋯ The profiling of individual tumour genetic expression of proto-oncogenes may allow for more specific identification of patients at higher risk of recurrence in breast cancer.
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Most patients with cancer prefer to die at home but the majority die in institutions. ⋯ The majority of people fail to achieve a home death. Resources need to be targeted to those most at risk of an institutional death; females, the elderly, the unmarried, those with haematological malignancies and residents of South Belfast.
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Hip fracture causes significant morbidity and mortality in older women. ⋯ Factors related to falls and fracture may be more discriminatory predictors of hip fracture risk than osteoporosis in older females. Medications for sleep should be prescribed with caution. Hip fracture may have an independent effect on one year mortality, this effect is not seen in the second year.
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Volatile anaesthetic agents influence neutrophil function, and potentially, the inflammatory response to surgery. ⋯ Human neutrophil apoptosis is inhibited in a concentration-dependent manner in vitro by isoflurane in clinical concentrations.