Irish medical journal
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Irish medical journal · Nov 2011
Pyroglutamic aciduria: a cause of high anion-gap metabolic acidosis associated with common drugs.
Pyroglutamic aciduria is a rare and probably under-recognised cause of metabolic acidosis which may be precipitated by certain common drugs.
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Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. ⋯ Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.
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The objective was to study presentation patterns of scald injuries in children and suggest potential countermeasures to reduce these injuries. We retrospectively studied scald injuries in children attending an urban paediatric emergency department between January 1st and December 31st 2008. Data was extracted from our emergency department database using search terms 'burn', 'scald', 'other burn'. ⋯ Overall 45 (28%) were discharged home requiring no further treatment, 9 (6%) were admitted to hospital and 101 (63%) attended dressing clinic or plastic surgery OPD. Our results are consistent with other studies and illustrate that the incidence and pattern of scald injuries have not changed over the past decade. Scalds will continue to be a significant cause of unintentional injury and morbidity among young children unless preventative strategies are devised and employed.
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Irish medical journal · Sep 2011
Antimicrobial usage in an intensive care unit: a prospective analysis.
Antimicrobial therapies in the Intensive Care Unit (ICU) need to be appropriate in both their antimicrobial cover and duration. We performed a prospective observational study of admissions to our semi-closed ICU over a three-month period and recorded the indications for antimicrobial therapy, agents used, duration of use, changes in therapy and reasons for changes in therapy. A change in therapy was defined as the initiation or discontinuation of an antimicrobial agent. ⋯ Changes were made due to a deterioration or lack of clinical response in 41 (30%) cases, due to the completion of prescribed course in 36 (27%) cases, and in response to a sensitivity result in 25 (19%) cases. Prophylactic antibiotic courses (n=24) were of a duration greater than 24 hours in 15 (63%) instances. In conclusion, the majority of changes in antimicrobial therapy were not culture-based and the duration of surgical prophylaxis was in excess of current recommended guidelines.