Irish journal of medical science
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Reconfiguration of the Irish acute hospital sector resulted in the establishment of a Medical Assessment Unit (MAU) in Mallow General Hospital (MGH). We developed a protocol whereby certain patients deemed to be low risk for clinical deterioration could be brought by the National Ambulance Service (NAS) to the MAU following a 999 or 112 call. ⋯ Our results have demonstrated the safety, feasibility and effectiveness of this pathway. With increased resourcing, upscaling of this initiative is possible and should be considered.
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Cases of intoxication are increasing day by day and these patients are presenting to emergency departments. These patients are usually individuals with poor self-care, inadequate oral intake, and unable to meet their own needs, and may have significant dehydration due to the agents they have taken. The caval index (CI) is a recently used index to determine fluid requirement and response. ⋯ In our study, we found that CI can be used as an index to assist emergency clinicians in determining and monitoring fluid requirement in cases of intoxication presenting to the emergency department.
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Type 1 diabetes is an autoimmune disorder which is caused due to T-cell mediated destruction of β cells of pancreas leading to insulin deficiency and hyperglycemia. The prevalence has been increasing in many countries especially Europe and America. ⋯ The US. FDA approved the first cell therapy drug, Donislecel for brittle T1D which may be a crucial achievement in treatment of the autoimmune disorder.
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Proprotein convertase subtilisin/kexin type 9 (PCSK9) modulates CD4+ T cell differentiation and inflammatory response, the latter ones mediate ulcerative colitis (UC) initiation. This study intended to explore the correlation of serum PCSK9 with disease activity, T helper (h)1/Th2/Th17 cells, and clinical response of tumor necrosis factor inhibitor (TNFi) in UC patients. ⋯ Serum PCSK9 is positively related to disease activity, Th1, and Th17 cells in UC patients; further, its decline correlates with TNFi response achievement in these patients.
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Axial spondyloarthritis (axSpA) comprises patients with both radiographic and non-radiographic features. Previous studies have shown similar burden of disease between these two groups. ⋯ This study provides evidence to suggest that the burden of disease is less in patients with non-radiographic axial spondyloarthritis than radiographic axial spondyloarthritis.